Notice of Funding Opportunity: DP18-1815PPHF18

Centers for Disease Control
National Center for Chronic Disease Prevention and Health Promotion
Improving the Health of Americans Through Prevention and Management of Diabetes and
Heart Disease and Stroke-Financed in part by 2018 Prevention and Public Health Funds (PPHF)
CDC-RFA-DP18-1815PPHF18
Application Due Date: 06/11/2018

Improving the Health of Americans Through Prevention and Management of Diabetes and
Heart Disease and Stroke-Financed in part by 2018 Prevention and Public Health Funds (PPHF)
CDC-RFA-DP18-1815PPHF18
TABLE OF CONTENTS
Part I. Overview Information
A. Federal Agency Name
B. Funding Opportunity Title
C. Announcement Type
D. Agency Funding Opportunity Number
E. Catalog of Federal Domestic Assistance (CFDA) Number
F. Dates
G. Executive Summary
Part II. Full Text
A. Funding Opportunity Description
B. Award Information
C. Eligibility Information
D. Required Registrations
E. Review and Selection Process
F. Award Administration Information
G. Agency Contacts
H. Other Information
I. Glossary

Part I. Overview Information
Applicants must go to the synopsis page of this announcement at www.grants.gov and click on
the "Send Me Change Notifications Emails" link to ensure they receive notifications of any
changes to CDC-RFA-DP18-1815PPHF18. Applicants also must provide an e-mail address to
www.grants.gov to receive notifications of changes.
A. Federal Agency Name:
Centers for Disease Control and Prevention (CDC)
B. Notice of Funding Opportunity (NOFO) Title:
Improving the Health of Americans Through Prevention and Management of Diabetes and
Heart Disease and Stroke-Financed in part by 2018 Prevention and Public Health Funds (PPHF)
C. Announcement Type: New - Type 1
This announcement is only for non-research activities supported by CDC. If research is
proposed, the application will not be considered. For this purpose, research is defined at https
://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.
Guidance on how CDC interprets the definition of research in the context of public health can
be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html
(See section 45 CFR 46.102(d)).
Cooperative Agreement
D. Agency Notice of Funding Opportunity Number:
CDC-RFA-DP18-1815PPHF18
E. Catalog of Federal Domestic Assistance (CFDA) Number:
93.426
F. Dates:
1. Due Date for Letter of Intent (LOI):
N/A
Is a LOI:
Not Applicable
N/A
2. Due Date for Applications:

06/11/2018, 11:59 p.m. U.S. Eastern
Standard Time, at www.grants.gov.
3. Date for Informational Conference Call:
04/23/2018
Scheduled for 3:00 - 4:00 pm, Eastern Standard Time.
URL:

https://adobeconnect.cdc.gov/r798tz97pl0/

Conference
Number(s):

Conference I.D.:

3461523#

Conference Number:

18885667703

Questions may be submitted to 1815COMMS@cdc.gov as soon as the NOFO is released.
G. Executive Summary:
1. Summary Paragraph:
This NOFO is non-competitive, and will support state investments in implementing and
evaluating evidence-based strategies to prevent and manage cardiovascular disease (CVD) and
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diabetes in high-burden populations/communities within each state and the District of
Columbia, contributing to improved health outcomes. High burden populations are those
affected disproportionately by high blood pressure, high blood cholesterol, diabetes, or
prediabetes due to socioeconomic or other characteristics, including inadequate access to care,
poor quality of care, or low income. Category A strategies focus on diabetes management and
type 2 diabetes prevention. Category B strategies focus on CVD prevention and management. In
both categories, applicants will select from a menu of strategies, and should focus in areas
where they have capacity, subject matter expertise, and potential to achieve greatest reach and
impact. Where appropriate, applicants will apply their selected Category A and B strategies in
the same targeted communities/settings, so that work on these strategies may be mutually
reinforcing. Complementary strategies should be addressed in a way that benefits both people
with prediabetes or diabetes and people with high blood pressure and with or at risk for high
blood cholesterol. Funding, resources, and level of effort should be divided equally between
Category A and B strategies.
a. Eligible Applicants:
b. NOFO Type:
c. Approximate Number of Awards:

Limited
Cooperative Agreement
51

d. Total Period of Performance Funding:
$530,000,000
e. Average One Year Award Amount:
$1,765,000
Refer to the Funding Table for specific funding amounts for each recipient.
f. Number of Years of Award:
4.75
g. Estimated Award Date:
09/30/2018
h. Cost Sharing and / or Matching Requirements: N
Cost sharing or matching funds are not required for this program. Although no statutory
matching requirement for the NOFO exists, applicants are encouraged to leverage other
resources and related ongoing efforts to promote sustainability.

Part II. Full Text
Executive Summary
This NOFO is non-competitive, and will support state investments in implementing and
evaluating evidence-based strategies to prevent and manage cardiovascular disease (CVD) and
diabetes in high-burden populations/communities within each state and the District of
Columbia, contributing to improved health outcomes. High burden populations are those
affected disproportionately by high blood pressure, high blood cholesterol, diabetes, or
prediabetes due to socioeconomic or other characteristics, including inadequate access to care,
poor quality of care, or low income. Category A strategies focus on diabetes management and
type 2 diabetes prevention. Category B strategies focus on CVD prevention and management. In
both categories, applicants will select from a menu of strategies, and should focus in areas
where they have capacity, subject matter expertise, and potential to achieve greatest reach and
impact. Where appropriate, applicants will apply their selected Category A and B strategies in
the same targeted communities/settings, so that work on these strategies may be mutually

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reinforcing. Complementary strategies should be addressed in a way that benefits both people
with prediabetes or diabetes and people with high blood pressure and with or at risk for high
blood cholesterol. Funding, resources, and level of effort should be divided equally between
Category A and B strategies.
A. Funding Opportunity Description
1. Background
a. Overview
Diabetes is the 7th leading cause of death in the U.S.; the number one cause of kidney failure,
lower-limb amputations, and adult-onset blindness; and a leading cause of heart disease and
stroke. A large body of evidence supports the effectiveness of diabetes self-management
education and support (DSMES) in improving health outcomes (A1c, systolic blood pressure),
lowering medication use, and decreasing hospitalizations and other health care costs for people
with diabetes. However, DSMES utilization rates are low.
Approximately 84 million Americans, or 1 in 3 adults, have prediabetes, a health condition
characterized by blood glucose levels that are higher than normal but not high enough to be
diagnosed as diabetes. People with prediabetes have an increased risk of developing type 2
diabetes, heart disease, and stroke. Prediabetes is treatable, but only about 10 percent of people
who have it are aware that they do. The CDC-led National Diabetes Prevention Program
(National DPP) is a partnership of public and private organizations working collectively to build
the infrastructure for nationwide delivery of an evidence-based lifestyle change program for
adults with prediabetes to prevent or delay onset of type 2 diabetes. The lifestyle change
program is founded on the science of the Diabetes Prevention Program research study, and
several translation studies that followed, which showed that making modest behavior changes
helped participants with prediabetes lose 5% to 7% of their body weight and reduce their risk of
developing type 2 diabetes by 58%. The program has been shown to be cost effective and can
be cost saving.
Heart disease is the leading cause of death, and stroke is the 5th leading cause of death, in the
U.S. Cardiovascular Disease (CVD) , including heart disease, stroke, and other vascular
diseases, accounts for >800 000, or about 1 in 3, deaths/year, and around 1 in 5 who die from
CVD are younger than 65 years. CVD is costly, with an estimated 1 in 7 health care dollars
spent on CVD (about 15%). Hypertension is a primary risk factor for CVD. While control of
hypertension, reflective of individual and system-level improvements, has been increasing, less
than half of those with hypertension are controlled. Interventions to support patient engagement,
prevention, and health system improvements need to be maximized to improve hypertension
management. High blood cholesterol is another primary risk factor for CVD. Several modifiable
health behaviors can lower cholesterol, including eating a healthy diet, losing weight, and being
physically active. Behavior modification improvements and health systems advances are needed
to reduce the need for treatment and close the gap in treatment across the population. Health
system interventions may include use of team-based care and community health workers,
electronic health record alignment with national guidelines, improved medication adherence,
and interventions supporting better continuity of care across health care settings.
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This NOFO represents a collaboration between CDC's Division of Diabetes Translation and
Division for Heart Disease and Stroke Prevention. It will build on the accomplishments and
outcomes achieved in the healthcare systems and community-clinical linkage domains of CDCRFA-DP13-1305 (1305) and CDC-RFA-DP14-1422 (1422). The purpose of this NOFO is to
implement and evaluate evidence-based strategies contributing to the prevention and
management of CVD and diabetes in high-burden populations.
b. Statutory Authorities
Section 30l(a) of the Public Health Service Act [42] U.S.C. Section 241(a) 93.426
Title IV Section 4002 of the Affordable Care Act, Prevention and Public Health Fund
c. Healthy People 2020
CVD:






HDS-2: Reduce coronary heart disease deaths.
HDS-3: Reduce stroke deaths.
HDS-7: Reduce the proportion of adults with high total blood cholesterol levels.
HDS-8: Reduce the mean total blood cholesterol levels among adults.
HDS-12: Increase the proportion of adults with hypertension whose blood pressure is
under control.

https://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Diabetes:
 D-14: Increase the proportion of persons with diagnosed diabetes who receive formal
diabetes education.
 Increase the proportion of persons at high risk for diabetes with prediabetes who report
increasing their levels of physical activity (D-16.1), trying to lose weight (D-16.2), and
reducing the amount of fat or calories in their diet (D-16.2).
https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes
d. Other National Public Health Priorities and Strategies
Hypertension prevention, detection, and control
Million Hearts® 2022
https://millionhearts.hhs.gov/
National Diabetes Prevention Program (type 2 diabetes prevention): https://www.cdc.gov/diabe
tes/prevention/index.html
Diabetes care and self-management
Diabetes and cardiovascular disease management: https://www.thecommunityguide.org/
e. Relevant Work

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This NOFO builds on the accomplishments and outcomes achieved in the healthcare systems
and community-clinical linkage domains of CDC-RFA-DP13-1305 (https://www.cdc.gov/chron
icdisease/about/state-public-health-actions.htm) and CDC-RFA-DP14-1422 (https://www.cdc
.gov/chronicdisease/about/foa/2014foa/public-health-action.htm).
2. CDC Project Description
a. Approach
Bold indicates period of performance outcome.

i. Purpose
This NOFO will support the implementation and evaluation of a set of evidence-based strategies
to prevent and control diabetes and cardiovascular disease (CVD) in high-burden populations.
Category A includes diabetes management and type 2 diabetes prevention strategies. Category
B includes CVD prevention and management strategies. Applicants are encouraged to

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implement Category A and B strategies in the same high burden areas/communities, so that
work on these strategies is mutually reinforcing and implemented in a coordinated fashion to
accelerate progress toward goals.
ii. Outcomes
Applicants will focus only on those outcomes that align with the strategies they select.
Applicants are required to select a minimum of 5 strategies from Category A (minimum of 2
diabetes management strategies and 3 type 2 diabetes prevention strategies) and a minimum of 5
strategies from Category B. Refer to the Strategy Table in Section 2.b.i. CDC Evaluation and
Performance Measurement Strategy for more information.
CATEGORY A: Diabetes Management and Type 2 Diabetes Prevention
Diabetes Management
Short-term outcomes:
--Increased access to and coverage for ADA-recognized/AADE-accredited diabetes selfmanagement education and support (DSMES) programs for people with diabetes (Note: These
programs meet national quality standards and are more likely to be sustained long-term due to
reimbursement by Medicare, many private insurance plans, and some State Medicaid
Agencies.)
--Increased use of pharmacist patient care processes that promote medication management for
people with diabetes
Intermediate outcomes:
--Increased participation in ADA-recognized/AADE-accredited DSMES programs by people
with diabetes
Long-term outcomes:
--Decreased proportion of people with diabetes with an A1C > 9
Type 2 Diabetes Prevention
Short-term outcomes:
--Increased access to and coverage for the National DPP lifestyle change program for people
with prediabetes
--Increased community clinical links that facilitate referrals and provide support to enroll and
retain participants in the National DPP lifestyle change program
Intermediate outcomes:
--Increased enrollment and retention in CDC-recognized organizations delivering the National
DPP lifestyle change program
Long-term outcomes:
--Increased number of people with prediabetes enrolled in a CDC-recognized lifestyle change
program who have achieved 5-7% weight loss

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CATEGORY B: Cardiovascular Disease Prevention and Management
Short-term outcomes:
--Increased reporting, monitoring, and tracking of clinical data for improved identification,
management, and treatment of patients with high blood pressure and high blood cholesterol
--Increased use of and adherence to evidence-based guidelines and policies related to teambased care for patients with high blood pressure and high blood cholesterol
--Increased community clinical links that support systematic referrals, self-management, and
lifestyle change for patients with high blood pressure and high blood cholesterol
Intermediate outcomes:
--Increased medication adherence among patients with high blood pressure and high blood
cholesterol
--Increased engagement in self-management among patients with high blood pressure and high
blood cholesterol
--Increased participation in evidence-based lifestyle interventions among patients with high
blood pressure and high blood cholesterol
Long-term outcomes:
--Increased control among adults with known high blood pressure and high blood cholesterol
iii. Strategies and Activities
Category A (Diabetes Management and Type 2 Diabetes Prevention) and Category B
(Cardiovascular Disease Prevention and Management) strategies are listed below. Applicants
are encouraged to implement Category A and B strategies in the same high burden
areas/communities, so that work on these strategies is mutually reinforcing. Complementary
strategies should be addressed in a way that benefits both people with prediabetes or diabetes
and people with high blood pressure and with or at risk for high blood cholesterol. Applicants
will select a minimum of 5 strategies from Category A (minimum of 2 diabetes management
strategies and 3 type 2 diabetes prevention strategies) and a minimum of 5 strategies from
Category B.
Category A: Diabetes Management and Type 2 Diabetes Prevention Strategies
(Applicants will select a minimum of 5 strategies from the list below. Selected strategies must
include a minimum of 2 diabetes management and 3 type 2 diabetes prevention strategies)
Diabetes Management: Improve care and management of people with diabetes.
A.1. Improve access to and participation in ADA-recognized/ AADE-accredited DSMES
programs in underserved areas (Note: These programs meet national quality standards and are
more likely to be sustained long-term due to reimbursement by Medicare, many private
insurance plans, and some State Medicaid Agencies.)
OPTIONAL: Applicants selecting strategy #1 may also choose to engage in efforts to increase
participation in other DSMES programs that are not recognized/accredited or in chronic disease

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self-management programs (CDSMP). These programs/curricula must have evidence
documenting their impact on people with diabetes. If selected, this work should be secondary to
improving access to and participation in ADA-recognized/AADE-accredited DSMES programs
that meet national quality standards.
A.2. Expand or strengthen DSMES coverage policy among public or private insurers or
employers, with emphasis on one or more of the following: Medicaid and employers
A.3. Increase engagement of pharmacists in the provision of medication management or
DSMES for people with diabetes
Type 2 Diabetes Prevention: Improve access to, participation in, and coverage for the
National Diabetes Prevention Program (National DPP) lifestyle change program for
people with prediabetes, particularly in underserved areas
A.4. Assist health care organizations in implementing systems to identify people with
prediabetes and refer them to CDC-recognized lifestyle change programs for type 2 diabetes
prevention
A.5. Collaborate with payers and relevant public and private sector organizations within the
state to expand availability of the National DPP as a covered benefit for one or more of the
following groups: Medicaid beneficiaries; state/public employees; employees of private sector
organizations
A.6. Implement strategies to increase enrollment in CDC-recognized lifestyle change programs
Diabetes Management and/or Type 2 Diabetes Prevention
A.7. Develop a statewide infrastructure to promote long-term sustainability/reimbursement for
Community Health Workers (CHWs) as a means to establish or expand their use in a) CDCrecognized lifestyle change programs for type 2 diabetes prevention and/or b) ADArecognized/AADE-accredited DSMES programs for diabetes management
Category B: Cardiovascular Disease Prevention and Management Strategies
Recipients will select a minimum of 5 strategies.
Track and Monitor Clinical Measures shown to improve healthcare quality and identify
patients with hypertension
B.1. Promote the adoption and use of electronic health records (EHR) and health information
technology (HIT) to improve provider outcomes and patient health outcomes related to
identification of individuals with undiagnosed hypertension and management of adults with
hypertension.
B.2. Promote the adoption of evidence-based quality measurement at the provider level (e.g.,
use dashboard measures to monitor healthcare disparities and implement activities to eliminate
healthcare disparities)
Implement Team-Based Care for patients with high blood pressure and high blood
cholesterol
B.3. Support engagement of non-physician team members (e.g., nurses, nurse practitioners,

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pharmacists, nutritionists, physical therapists, social workers) in hypertension and cholesterol
management in clinical settings
B.4. Promote the adoption of MTM between pharmacists and physicians for the purpose of
managing high blood pressure, high blood cholesterol, and lifestyle modification
Link Community Resources and Clinical Services that support systematic referrals, selfmanagement, and lifestyle change for patients with high blood pressure and high blood
cholesterol
B.5. Develop a statewide infrastructure to promote sustainability for CHWs to promote
management of hypertension and high blood cholesterol
B.6. Facilitate use of self-measured blood pressure monitoring (SMBP) with clinical support
among adults with hypertension
B.7 Implement systems to facilitate systematic referral of adults with hypertension and/or high
blood cholesterol to community programs/resources

1. Collaborations
a. With other CDC programs and CDC-funded organizations:
Applicants are encouraged to collaborate with other related CDC-funded programs that have a
role in achieving the NOFO outcomes for the strategies selected. Collaborations may center on
shared data; partner organizations; coalitions; intervention settings/locations; marketing
approaches/messages; EHRs or other electronic clinical decision support systems; and/or
targeted high burden populations. Related CDC-funded programs include but are not limited to
WISEWOMAN; national organizations funded under CDC-DP17-1705 (Scaling the National
Diabetes Prevention Program in Underserved Areas); tribes or tribal organizations funded under
CDC-DP14-1421 (Good Health and Wellness in Indian Country); and other CDC-funded
chronic disease prevention and management programs (for example, State Disability and Health
Programs, see https://www.cdc.gov/ncbddd/disabilityandhealth/index.html). Applicants should
also link to strategies and collaborations described in the State Chronic Disease Plan, as
appropriate. Letters of support and MOAs/MOUs are not required but should be considered
where appropriate and helpful in supporting collaborative efforts.
b. With organizations not funded by CDC:
Collaborations with a variety of public and private organizations are encouraged to leverage
resources and maximize reach and impact for the strategies selected. These organizations
include employers; commercial health plans; hospitals; FQHCs/RHCs/community health
centers; non-profit agencies; other federal, state, or local government agencies (e.g., State
Medicaid Agency, State Employee Benefit Agency, etc.); tribes or tribal organizations;
professional associations (state medical society, other medical specialty associations, etc.);
quality improvement organizations; ADA-recognized and AADE-accredited diabetes selfmanagement education and support programs; local/regional ADA or AADE chapters; CDC9 of 64

recognized organizations delivering the National DPP lifestyle change program; and others that
have a stake in supporting the evidence-based strategies described in this NOFO. Letters of
support and MOAs/MOUs are not required but should be considered where appropriate and
helpful in supporting collaborative efforts.
2. Target Populations
Applicants must identify criteria for selecting their priority populations based on disease and
risk factor burden data and combined potential to impact large numbers of adults across the
state. Priority populations should include those affected disproportionately by high blood
pressure, high blood cholesterol, diabetes, or prediabetes due to socioeconomic or other
characteristics, including inadequate access to care, poor quality of care, or low
income. Emphasis should be placed on achieving maximum reach and impact across these
populations.
a. Health Disparities
Eliminating health disparities is one of the four Healthy People 2020 Foundational Health
Measures. This NOFO will address the challenges and health inequities in chronic disease risk
factors and conditions that high-burden populations experience. These efforts will help
determine the public health impact of programs intended to improve specific risks, conditions,
and/or barriers experienced by populations living with high levels of disease burden for high
blood pressure, high blood cholesterol, diabetes, or prediabetes. Additionally, the program will
include populations who can benefit from the strategies included in this NOFO (e.g., people
with disabilities; non-English speaking populations; lesbian, gay, bisexual, and transgender
(LGBT) populations; people with limited health literacy); or other targeted populations.
iv. Funding Strategy (for multi-component NOFOs only)
Summary of Anticipated Funding
The table below provides guidance related to the maximum amount of funding available by
state for this non-competitive program. This funding is based on a funding formula that includes
factors for base funding, population, and poverty. The funding amounts listed below are for the
"Year 1" budget period, which is only 9 months. As such, the ceiling for each recipient is lower
than the anticipated amount for subsequent 12-month budget periods.
State

Dollar Amount State

Dollar Amount

Alabama

$ 1,864,604

Montana

$ 1,610,090

Alaska

$ 1,465,310

Nebraska

$ 1,552,328

Arizona

$ 1,891,018

Nevada

$ 1,690,222

Arkansas

$ 1,812,378

New Hampshire

$ 1,392,190

California

$ 2,713,246

New Jersey

$ 1,713,264

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Colorado

$ 1,641,838

New Mexico

$ 1,861,156

Connecticut

$ 1,544,264

New York

$ 2,185,574

Delaware

$ 1,545,214

North Carolina

$ 1,941,614

District of Columbia

$ 1,798,784

North Dakota

$ 1,489,144

Florida

$ 2,209,728

Ohio

$ 1,947,414

Georgia

$ 1,973,450

Oklahoma

$ 1,795,560

Hawaii

$ 1,468,850

Oregon

$ 1,695,066

Idaho

$ 1,643,522

Pennsylvania

$ 1,917,642

Illinois

$ 1,922,022

Rhode Island

$ 1,606,580

Indiana

$ 1,789,184

South Carolina

$ 1,793,280

Iowa

$ 1,602,110

South Dakota

$ 1,585,672

Kansas

$ 1,615,262

Tennessee

$ 1,859,840

Kentucky

$ 1,891,702

Texas

$ 2,442,842

Louisiana

$ 1,972,564

Utah

$ 1,541,326

Maine

$ 1,575,268

Vermont

$ 1,516,606

Maryland

$ 1,604,430

Virginia

$ 1,721,810

Massachusetts

$ 1,657,760

Washington

$ 1,702,200

Michigan

$ 1,916,042

West Virginia

$ 1,807,428

Minnesota

$ 1,598,396

Wisconsin

$ 1,679,650

Mississippi

$ 1,960,486

Wyoming

$ 1,499,930

Missouri

$ 1,774,142

Total:

$ 90,000,000

b. Evaluation and Performance Measurement
i. CDC Evaluation and Performance Measurement Strategy
Evaluation and performance measurement help demonstrate program accomplishments and
strengthen the evidence for strategy implementation. They can also assist in determining
whether the identified strategies and associated activities can be implemented at various levels

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(i.e., state, sub-population, etc.) within a state.
Throughout the five-year period, CDC will work individually and collectively with recipients to
track the implementation of recipient strategies and activities and assess progress on achieving
the 5-year NOFO outcomes. Both the process and outcome evaluation will seek to answer the
following overarching evaluation questions in five areas:
1. Approach: To what extent has the recipient's implementation approach resulted in
achieving the desired outcomes?
2. Effectiveness:
1. To what extent has the recipient increased the reach of Category A and B
strategies to prevent and control diabetes and cardiovascular disease?
2. To what extent has implementation of Category A and B strategies led to
improved health outcomes among the identified priority population(s)?
3. What factors were associated with effective implementation of Category A and B
strategies?
3. Efficiency: To what extent has the NOFO affected efficiencies with regard to
infrastructure, management, partners, and financial resources?
4. Sustainability: To what extent can the strategies implemented be sustained after the
NOFO ends?
5. Impact: To what extent have the strategies implemented contributed to a measurable
change in health, behavior, or environment in a defined community, population,
organization, or system?
CDC will use an evaluation approach that consists of (1) ongoing monitoring and evaluation
through the collection and reporting of performance measures, (2) a CDC-led national
evaluation, and (3) state-led evaluations.
Performance measures developed for this program correspond to the strategies and outcomes
described in the logic model. Performance measures recipients will be responsible for collecting
and reporting on are noted in the table in this section in the table below. Tier 1 measures are
measures that will be reported by all recipients regardless of the strategies selected, and will
focus on long term outcomes. Tier 2 measures are measures that will be reported by recipients
based on the specific strategies selected, and will focus on short term outcomes. CDC will work
with recipients on operationalizing and further defining each performance measure, and
guidance will be provided prior to the first year of reporting. Performance measures will be
reported annually to CDC, and CDC will manage and analyze the data to assess recipient
program improvements, respond to broader technical assistance needs, and report to
stakeholders. CDC will analyze performance measure data annually and develop aggregate
performance measure reports to be disseminated to recipients and other key stakeholders,
including federal partners, other funded and non-funded partners, and policy makers, as
appropriate. These aggregate findings may also be presented during site visits and recipient
meetings. In addition to performance measures reported by recipients, CDC will track specific
intermediate outcome measures and other short and long-term measures (as indicated in the
table below) that are relevant to the program through national datasets or national evaluation
activities.
For the national evaluation activities, CDC will lead the design, data collection, analysis, and

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reporting. Recipients will be asked to participate in national evaluation activities such as
surveys, interviews, case studies, and other data collection efforts. An appropriate level of
guidance and support will be provided to the recipients to ensure their effective participation in
the national evaluation. CDC will use findings from these evaluation efforts to refine its
technical assistance and, in turn, maximize and sustain program outcomes.
For state-led evaluations, CDC will assist recipients in developing and implementing evaluation
plans that are useful for state-level program improvement and for the overall evaluation of the
program. For all components of the evaluation, CDC and recipients will only collect data that
will be analyzed and used.
CDC will provide recipients with performance measure reporting templates, and potentially,
with evaluation plan reporting templates. CDC will provide evaluation technical assistance and
ongoing evaluation guidance on recipient-level evaluation and performance measures.
Evaluation technical assistance will be provided using a tiered approach to ensure that the tools
and services provided best meet the needs of the recipients. All information will be stored using
a secure system. All evaluation findings produced by CDC and recipients, where appropriate,
will contribute to: (1) continuous improvement of quality and effectiveness of program
strategies; (2) the evidence base; (3) documentation and sharing of lessons learned to support
replication and scaling of these program strategies; and/or (4) future funding opportunities
supported by CDC.
The data collected by CDC for performance measurement and evaluation are directly related to
the implementation of the strategies and/or the desired outcomes indicated in the logic model.
The data collected for this NOFO for performance measurement and national evaluation do not
include any personally identifiable information. Data being collected are strictly related to the
implementation of the NOFO strategies, and shall be used for assessing and reporting progress
and for other pertinent program improvement actions. All performance measure data will be
stored using a secure data system. Recipients will report their performance measure data
annually and will only have access to their data. Over the 5-year performance period, data will
be secured with limited access to authorized CDC program and evaluation staff to the extent
allowed under applicable Federal law. CDC will aggregate data across all recipients to publish
annual and summative reports.
Short-term measures for each strategy (reported based on the strategies selected) and long-term
measures reported by all recipients are described in the table below. The table aligns with the
logic model and shows the alignment between the overarching focus areas, specific strategies,
outcomes, and performance measures.
Category A (Diabetes Management and Type 2 Diabetes Prevention) and Category B
(Cardiovascular Disease Prevention and Management) strategies are listed below. Applicants
are encouraged to implement Category A and B strategies in the same high burden
areas/communities, so that work on these strategies is mutually reinforcing. Complementary
strategies should be addressed in a way that benefits both people with prediabetes or diabetes
and people with high blood pressure and with or at risk for high blood cholesterol. Applicants
will select a minimum of 5 strategies from Category A (minimum of 2 diabetes management
strategies and 3 type 2 diabetes prevention strategies) and a minimum of 5 strategies from
Category B.

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Category A: Diabetes Management and Type 2 Diabetes Prevention Strategies
Strategies
(Applicants will select a minimum
of 5 strategies from the list below.
Selected strategies must include a
minimum of 2 diabetes
management and 3 type 2
diabetes prevention strategies)

Short term
Intermediate
outcomes and
outcomes and
measures (Recipients measures
will report the short
All measures are
term measure for
Tier 1 measures
each strategy
selected)

Long term
outcomes and
measures
All measures
are Tier 1
measures

All measures are
Tier 2 measures
Diabetes Management: Improve
care and management of people
with diabetes.

Outcomes:

Outcome:
Increased
Increased access to
participation in
and coverage for
ADAADArecognized/AADE- recognized/AADE
accredited diabetes - accredited
DSMES programs
self-management
education and support by people with
diabetes
(DSMES) programs
for people with
diabetes

Outcome:
Decreased
proportion of
people with
diabetes with an
A1C > 9

Increased use of
pharmacist patient
care processes that
promote medication
management for
people with diabetes
A.1. Improve access to and
participation in ADA-recognized/
AADE-accredited DSMES
programs in underserved areas
(Note: These programs meet
national quality standards and are
more likely to be sustained longterm due to reimbursement by
Medicare, many private insurance
plans, and some State Medicaid

Measure: A.1. # and
proportion of new
recognized/accredited
DSMES programs

Measure: A.8. #
of people with
diabetes with at
least one
encounter at an
ADArecognized/AADE
-accredited
DSMES program

Measure: A.10.
Proportion of
people with
diabetes with an
A1C > 9

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Agencies.)
OPTIONAL: Applicants selecting
strategy #1 may also choose to
engage in efforts to increase
participation in other DSMES
programs that are not
recognized/accredited or in chronic
disease self-management programs
(CDSMP). These
programs/curricula must have
evidence documenting their impact
on people with diabetes. If selected,
this work should be secondary to
improving access to and
participation in ADArecognized/AADE-accredited
DSMES programs that meet
national quality standards.
A.2. Expand or strengthen DSMES
coverage policy among public or
private insurers or employers, with
emphasis on one or more of the
following: Medicaid and employers

Measure: A.2. # of
employees/Medicaid
beneficiaries who
have DSMES as a
covered benefit

A.3. Increase engagement of
pharmacists in the provision of
medication management or DSMES
for people with diabetes

Measure: A.3. # of Measure: A.3. No
pharmacy locations/ Intermediate term
pharmacists using
measures
patient care processes
that promote
medication
management or
DSMES for people
with diabetes

Type 2 Diabetes Prevention:
Improve access to, participation in,
and coverage for the National
Diabetes Prevention Program
(National DPP) lifestyle change
program for people with
prediabetes, particularly in
underserved areas

Outcomes:

Outcome:
Increased
Increased access to
enrollment and
and coverage for the
retention in CDCNational DPP
recognized
lifestyle change
program for people organizations
delivering the
with prediabetes
National DPP
Increased community lifestyle change
clinical links that
program

Outcome:
Increased
number of
people with
prediabetes
enrolled in a
CDC-recognized
lifestyle change
program who
have achieved 5-

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facilitate referrals and
provide support to
enroll and retain
participants in the
National DPP
lifestyle change
program
A.4. Assist health care
organizations in implementing
systems to identify people with
prediabetes and refer them to CDCrecognized lifestyle change
programs for type 2 diabetes
prevention

Measure: A.4. # of
patients served within
healthcare
organizations with
systems to identify
people with
prediabetes and refer
them to CDCrecognized lifestyle
change programs

A.5. Collaborate with payers and
relevant public and private sector
organizations within the state to
expand availability of the National
DPP as a covered benefit for one or
more of the following groups:
Medicaid beneficiaries; state/public
employees; employees of private
sector organizations

Measure: A.5. # of
employees; Medicaid
beneficiaries;
state/public
employees; and/or
employees of private
sector organizations
who have the
National DPP
lifestyle change
program as a covered
benefit

A.6. Implement strategies to
increase enrollment in CDCrecognized lifestyle change
programs

Measure: A.6. No
Short term measures

7% weight loss

Measure: A.9. #
of participants
enrolled in CDCrecognized
lifestyle change
programs

Measure: A.11.
# of people with
prediabetes
participating in
CDC-recognized
lifestyle change
programs who
have achieved 57% weight loss

Diabetes Management and/or
Type 2 Diabetes Prevention
A.7. Develop a statewide
infrastructure to promote long-term
sustainability/reimbursement for
Community Health Workers
(CHWs) as a means to establish or
expand their use in a) CDCrecognized lifestyle change

Measure: A.7. # of Measure: A.7. No
CHWs covered under intermediate
state efforts to expand performance
CHW curricula and measure
training delivery
vehicles, CHW
certification systems,

Measure: A.10.
a) Proportion of
people with
diabetes with an
A1C > 9
A.11. b) # of
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programs for type 2 diabetes
prevention and/or b) ADArecognized/AADE-accredited
DSMES programs for diabetes
management

and/or CHW payment
mechanisms

people with
prediabetes
participating in
CDC-recognized
lifestyle change
programs who
have achieved 57% weight loss

Category B: Cardiovascular Disease Prevention and Management Strategies
Strategies (recipients will
select a minimum of 5
strategies)

Short term
outcomes and
measures
(recipients will
report the short
term measure
for each strategy
selected) All
measures are
Tier 2 measures

Intermediate outcomes and
measures (all intermediate
measures will be
tracked/evaluated by CDC)

Long term
outcomes
and
measures (all
recipients
will report
long term
measures as
Tier 1
measures)

Track and Monitor
Clinical Measures shown
to improve healthcare
quality and identify
patients with
hypertension

Outcome:
Increased
reporting,
monitoring, and
tracking of
clinical data for
improved
identification,
management, and
treatment of
patients with high
blood pressure
and high blood
cholesterol

Outcome: Increased medication
adherence among patients with
high blood pressure and high
blood cholesterol

Outcome:
Increased
control
among adults
with known
high blood
pressure and
high blood
cholesterol

B.1. Promote the adoption
and use of electronic health
records (EHR) and health
information technology
(HIT) to improve provider
outcomes and patient health
outcomes related to
identification of individuals
with undiagnosed

Measure: B.1. #
and % of patients
within health care
systems with
systems to report
standardized
clinical quality
measures for the
management and

Measure:
B.7.
Proportion
of adults
with known
high blood
pressure who

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have
achieved
blood
pressure
control

hypertension and
treatment of
management of adults with patients with high
hypertension.
blood pressure
(e.g., NQF0018)
B.2. Promote the adoption of Measure: B.2. #
evidence-based quality
and % of clinics
measurement at the provider or providers that
level (e.g., use dashboard
use standardized
measures to monitor
quality measures
healthcare disparities and
to track
implement activities to
differences in BP
eliminate healthcare
control and
disparities)
cholesterol
management in
priority
populations
compared to
overall
populations
Implement Team-Based
Outcome:
Care for patients with high Increased use of
blood pressure and high
and adherence to
blood cholesterol
evidence-based
guidelines and
policies related to
team-based care
for patients with
high blood
pressure and high
blood cholesterol
B.3. Support engagement of
non-physician team
members (e.g., nurses, nurse
practitioners, pharmacists,
nutritionists, physical
therapists, social workers) in
hypertension and cholesterol
management in clinical
settings

Measure:
B.8.
Proportion
of patients
with total
cholesterol at
goal (LDL
and HDL).

Outcome: Increased medication
adherence among patients with
high blood pressure and high
blood cholesterol
Increased engagement in selfmanagement among patients
with high blood pressure and
high blood cholesterol

Measure: B.3. #
and % of patients
that are in health
care systems that
have policies or
systems to
encourage a
multi-disciplinary
team approach to
blood pressure
control and

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cholesterol
management
B.4. Promote the adoption of Measure: B.4. #
MTM between pharmacists and % of
and physicians for the
pharmacists
purpose of managing high engaged in the
blood pressure, high blood practice of MTM
cholesterol, and lifestyle
to promote
modification
medication self management and
lifestyle
modification for
high blood
pressure and high
blood cholesterol
Link Community
Resources and Clinical
Services that support
systematic referrals, selfmanagement, and lifestyle
change for patients with
high blood pressure and
high blood cholesterol

Outcome:
Increased
community
clinical links that
support
systematic
referrals, selfmanagement, and
lifestyle change
for patients with
high blood
pressure and high
blood cholesterol

Outcomes:
Increased medication adherence
among patients with high blood
pressure and high blood
cholesterol
Increased engagement in selfmanagement among patients
with high blood pressure and
high blood cholesterol
Increased participation in
evidence-based lifestyle
interventions among patients
with high blood pressure and
high blood cholesterol

B.5. Develop a statewide
infrastructure to promote
sustainability for CHWs to
promote management of
hypertension and high blood
cholesterol

Measure B.5. #
of CHWs covered
under state efforts
to expand CHW
curricula and
training delivery
vehicles, CHW
certification
systems, and/or
CHW payment
mechanisms

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B.6. Facilitate use of selfmeasured blood pressure
monitoring (SMBP) with
clinical support among
adults with hypertension

Measure B.6. #
and % of patients
within health care
systems with
policies or
systems to
encourage selfmonitoring of
high blood
pressure tied to
clinical support

B.7 Implement systems to
facilitate systematic referral
of adults with hypertension
and/or high blood
cholesterol to community
programs/resources

Measure B.7. #
and % of patients
in health care
systems with high
blood pressure
and high blood
cholesterol
referred to an
evidence-based
lifestyle program

In Category A (Diabetes Management and Type 2 Diabetes Prevention), the following
performance measures are not required for recipients to report but will be tracked and/or
evaluated by CDC (through national datasets, data from the American Diabetes Association's
Education Recognition Program and the American Association of Diabetes Educators' Diabetes
Education Accreditation Program, and the CDC Diabetes Prevention Recognition Program):
·
# of people with diabetes with at least one encounter at an ADA-recognized/AADEaccredited DSMES program
·

# of participants enrolled in CDC-recognized lifestyle change programs

·

Proportion of people with diabetes with an A1C > 9

·
# of people with prediabetes participating in CDC-recognized lifestyle change programs
who have achieved 5-7% weight loss
In Category B (Cardiovascular Disease Prevention and Management), the following
performance measures are not required for recipients to report but will be tracked and/or
evaluated by CDC (through national datasets, Million Hearts® data, national evaluation of the
program, evaluations conducted by innovation states, case studies, etc.):
·
# and % of providers with a protocol for identifying patients with undiagnosed
hypertension
·

% of patients with high blood pressure in adherence to medication regimens

·

# and % of patients considered at high risk of cardiovascular events who were prescribed

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or were on statin therapy
·

# and % of patients with high blood pressure that have a self-management plan

·
# and % of health care systems with an implemented community referral system (tracking
bi-directional referrals) for evidence-based lifestyle change programs for people with high
blood pressure and high blood cholesterol
·
# and % of patients referred to an evidence based lifestyle intervention who attend at least
one session
ii. Applicant Evaluation and Performance Measurement Plan
Applicants must provide an evaluation and performance measurement plan that demonstrates
how the recipient will fulfill the requirements described in the CDC Evaluation and
Performance Measurement and Project Description sections of this NOFO. At a minimum, the
plan must describe:
 How applicant will collect the performance measures, respond to the evaluation
questions, and use evaluation findings for continuous program quality improvement.
 How key program partners will participate in the evaluation and performance
measurement planning processes.
 Available data sources, feasibility of collecting appropriate evaluation and performance
data, and other relevant data information (e.g., performance measures proposed by the
applicant)
 Plans for updating the Data Management Plan (DMP), if applicable, for accuracy
throughout the lifecycle of the project. The DMP should provide a description of the
data that will be produced using these NOFO funds; access to data; data standards
ensuring released data have documentation describing methods of collection, what the
data represent, and data limitations; and archival and long-term data preservation plans.
For more information about CDC’s policy on the DMP, see
https://www.cdc.gov/grants/additionalrequirements/ar-25.html.
Where the applicant chooses to, or is expected to, take on specific evaluation studies, they
should be directed to:
 Describe the type of evaluations (i.e., process, outcome, or both).
 Describe key evaluation questions to be addressed by these evaluations.
 Describe other information (e.g., measures, data sources).
Recipients will be required to submit a more detailed Evaluation and Performance Measurement
plan, including a DMP, within the first 6 months of award, as described in the Reporting
Section of this NOFO.
In addition, evaluation plans should:
 Describe data collection approaches, measures, and data sources.
 Align each evaluation question with the approach, instruments/data sources, and

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timeline.
 Propose analyses for at least two time points (baseline and follow-up), and assess
program impact on any intended health disparate populations.
 Describe the amount of the award allocated to evaluation.
 Describe how applicants will work with professional evaluators (either internal or
external) to meet the evaluation and performance measurement requirements.
Applicants are encouraged to work with professional evaluators (either internal or external) to
meet the evaluation and performance reporting requirements of this NOFO. Therefore, CDC
encourages allocating at least 10% of the total funding award to evaluation and performance
monitoring and to consider both development and implementation costs. For information on
developing an evaluation plan, please refer to the CDC Framework for Program Evaluation in
Public Health (Centers for Disease Control and Prevention. Framework for Program Evaluation
in Public Health. MMWR 1999; 48, No. RR-11) https://www.cdc.gov/mmwr/preview/mmwrh
tml/rr4811a1.htm.
With support from CDC, recipients will be required to submit a more detailed Evaluation and
Performance Measurement Plan, including a Data Management Plan (DMP), within the first 6
months of receiving the award, as described in the Reporting Section of this NOFO. CDC will
review and approve the recipient's monitoring and evaluation plan to ensure that it is appropriate
for the activities to be undertaken as part of the agreement and for compliance with the
monitoring and evaluation guidance established by CDC or other guidance otherwise applicable
to this cooperative agreement.
Applicants are required to submit a plan for Performance Measurement Data Collection and
Use. A detailed plan for Performance Measurement Data Collection and Use will be due within
6 months of receiving the award. CDC will provide additional templates and guidance for
developing the Performance Measurement Data Collection and Use plan. Applicants should
review the published Performance Measure Dictionary in-depth before finalizing this plan to
gain an understanding of the purpose of each measure, the values to be reported, as well as the
supporting qualitative information to be reported and attachments to be submitted with the
report. Any anticipated issue with data collection should be highlighted in the plan, along with
options to remedy it. Additionally, the plan should address how the information generated by
the performance measures will be used for program improvement by the recipient.
c. Organizational Capacity of Recipients to Implement the Approach
Applicants must describe their organizational capacity to carry out the strategies included in
Categories A and B. CDC anticipates that all applicants will be able to demonstrate capacity to
carry out the activities outlined over the 5-year project period.
When applicants are describing organizational capacity, consideration should be given to prior
experience:
 Addressing health equity within the state/jurisdiction.
 Minimizing duplication of effort.
 Coordinating efforts with other federally and privately funded programs within the state
in an effort to leverage resources and maximize reach and impact.

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Demonstrated readiness to implement the evidence-based strategies includes the ability of
applicants to describe the following:





Established partnerships with groups/organizations relevant to the strategies selected.
Prior experience working on the strategies selected.
Proven ability to collect data at a population level and use data to demonstrate impact.
Experience with planning and implementing programs at a state level and/or statewide
or at a systems level.
 Sufficient leadership within the state health department for program planning and
development including the identification, hiring, or reassignment and supervision of
staff, contractors, and/or consultants sufficient in number and subject matter expertise to
plan and implement strategies across Categories A and B.
 Category specific readiness:
Category A
 Access to subject matter expertise (staff and/or contractual) relevant to the diabetes
management and type 2 diabetes prevention strategies selected.
Category B
 Access to health systems data, including, for example, payer data (e.g., Medicaid),
hospital discharge data, and health plan performance data.
 Demonstrated experience in health systems quality improvement processes.
d. Work Plan
Category A (Diabetes Management and Type 2 Diabetes Prevention Strategies) and
Category B (Cardiovascular Disease Prevention and Management strategies)
Applicants must submit a detailed work plan for "Year 1" (which is only 9 months, September
30, 2018 - June 29, 2019) of the award and provide a general summary of work plan activities
for Years 2-5 in narrative form. Applicants must include strategies and activities in two
categories, Category A (Diabetes Management and Type 2 Diabetes Prevention strategies) and
Category B (Cardiovascular Disease Prevention and Management strategies). In both
categories, applicants will select from a menu of strategies.
The work plan should demonstrate how activities addressing the selected Category A and B
strategies will be implemented in the same high burden areas/communities, so that work on
these strategies may be mutually reinforcing. Where appropriate, strategies specific to
advancing diabetes management and type 2 diabetes prevention and heart disease and stroke
prevention should be addressed in a mutually beneficial way. (Example: Efforts to increase
adoption of medication therapy management should be implemented in a way that will benefit
both people with diabetes and people with hypertension or high blood cholesterol.) (See Project
Goals and Objectives for a list of Category A and B strategies.)
The work plan should describe how the applicant plans to implement all of the required
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strategies and activities to achieve NOFO outcomes for Categories A and B. A sample work
plan template is available for use at www.cdc.gov/RFA-DP18-1815. Applicants are not required
to use the work plan template but are required to include all of the elements listed within the
template. Applicants must name this file Project Narrative_name of state and upload it as a PDF
file. CDC will provide feedback and technical assistance to award recipients to finalize the
work plan activities post-award.
Recipients will be held accountable for work on the selected Category A and B strategies and
corresponding performance measures described in the "Strategies and Activities" table. CDC
will work with recipients to operationalize the performance measures and to identify available
and feasible data sources.
Category A: Applicants must select a minimum of 5 strategies (2 diabetes management and
3 type 2 diabetes prevention), and report on the status of relevant and applicable performance
measures listed in the table of Category A strategies.
Category B: Applicants must select a minimum of 5 strategies listed in the table of Category
B strategies, and report on the performance measures for those interventions.
Within the state department of health, cost sharing of positions to support these activities is
encouraged (i.e., using Category A and B funds to pay for staff who support activities in both
categories).
Work Plan
Complete a work plan template for each of the five strategies selected in Category A.
CATEGORY A: DIABETES MANAGEMENT AND TYPE 2 DIABETES PREVENTION
DIABETES MANAGEMENT (Select a minimum of 2 management strategies from the
table of Category A strategies.)
Strategy Description A.1
Activity Description Lead
Personnel
Assigned

CONTRIBUTING KEY
Start
End
PARTNERS
CONTRACTS & Quarter Quarter
CONSULTANTS

Activity 1
Activity 2
Activity 3
Activity 4
Activity 5

Short Term Outcome(s)

Short Term Measures

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(Outcome description)

(For each measure, include the Measure
Description, Baseline Value, Year 1 Target Value,
and Data source)
Measure:
·

Baseline:

·

Year 1 Target:

·

Data Source:

Measure:

Setting
Please provide all that apply
POPULATION OF
FOCUS

·

Baseline:

·

Year 1 Target:

·

Data Source:

(State Government, Community, Faith-Based, Healthcare, Other
{Please Describe})
General

(General if this strategy does not have a specific population of
Only show the populations of focus)
focus that apply. Others
should be deleted.
Age
(Adults {20-24}, Adults {25-39}, Adults {40-49}, Adults {50-64},
Adults {65 & Older})

Ethnicity
(Hispanic or Latino, Not Hispanic or Latino)
Gender
(Male, Female)
Geography
(Rural, Urban, Frontier)

25 of 64

Race
(African American or Black, American Indian or Alaska Native,
Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese,
Other Asian {Specify}, Native Hawaiian or Other Pacific
Islander, Guamanian or Chamorro, Samoan, White, Other
{Specify})
Sexual Identity
(Bisexual, Gay, Heterosexual, Lesbian, Questioning)
Other Populations
(Low Socioeconomic Status, Disability, Other {Specify})

Work Plan
CATEGORY A: DIABETES MANAGEMENT AND TYPE 2 DIABETES
PREVENTION
DIABETES PREVENTION (Select a minimum of 3 prevention strategies from the table
of Category A strategies.)
Strategy Description
Activity Description Lead
Personnel
Assigned

CONTRIBUTING KEY
Start
End
PARTNERS
CONTRACTS & Quarter Quarter
CONSULTANTS

Activity 1
Activity 2
Activity 3
Activity 4
Activity 5

26 of 64

Short Term Outcome(s)

Short Term Measures

(Outcome description)

(For each measure, include the Measure
Description, Baseline Value, Year 1 Target Value,
and Data source)
Measure:
·

Baseline:

·

Year 1 Target:

·

Data Source:

Measure:

Setting
Please provide all that
apply
POPULATION OF
FOCUS
Only show the
populations of focus
that apply.
Others
should be deleted.

·

Baseline:

·

Year 1 Target:

·

Data Source:

(State Government, Community, Faith-Based, Healthcare, Other
{Please Describe})
General
(General if this strategy does not have a specific population of focus)

Age
(Adults {20-24}, Adults {25-39}, Adults {40-49}, Adults {50-64},
Adults {65 & Older})

Ethnicity
(Hispanic or Latino, Not Hispanic or Latino)
Gender
(Male, Female)

27 of 64

Geography
(Rural, Urban, Frontier)
Race
(African American or Black, American Indian or Alaska Native,
Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese,
Other Asian {Specify}, Native Hawaiian or Other Pacific Islander,
Guamanian or Chamorro, Samoan, White, Other {Specify})
Sexual Identity
(Bisexual, Gay, Heterosexual, Lesbian, Questioning)
Other Populations
(Low Socioeconomic Status, Disability, Other {Specify})
Category A Work Plan: Years 2-5
Provide a general summary of work plan activities proposed in Category A for Years 2-5
(maximum of one page narrative).

Work Plan
Complete a work plan template for each of the five strategies selected in Category B.
CATEGORY B: CARDIOVASCULAR DISEASE PREVENTION AND
MANAGEMENT
Strategy Description B.1
Activity Description Lead
Personnel
Assigned

CONTRIBUTING KEY
Start
End
PARTNERS
CONTRACTS & Quarter Quarter
CONSULTANTS

Activity 1
Activity 2
Activity 3
Activity 4

28 of 64

Activity 5

Short Term Outcome(s)

Short Term Measures

(Outcome description)

(For each measure, include the Measure Description, Baseline
Value, Year 1 Target Value, and Data source)
Measure:
·

Baseline:

·

Year 1 Target:

·

Data Source:

Measure:

Setting
Please provide all that apply
POPULATION OF
FOCUS

·

Baseline:

·

Year 1 Target:

·

Data Source:

(State Government, Community, Faith-Based, Healthcare, Other
{Please Describe})
General

(General if this strategy does not have a specific population of
Only show the populations of focus)
focus that apply.
Others
should be deleted.
Age
(Adults {20-24}, Adults {25-39}, Adults {40-49}, Adults {50-64},
Adults {65 & Older})

Ethnicity
(Hispanic or Latino, Not Hispanic or Latino)
Gender

29 of 64

(Male, Female)
Geography
(Rural, Urban, Frontier)
Race
(African American or Black, American Indian or Alaska Native,
Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese,
Other Asian {Specify}, Native Hawaiian or Other Pacific
Islander, Guamanian or Chamorro, Samoan, White, Other
{Specify})
Sexual Identity
(Bisexual, Gay, Heterosexual, Lesbian, Questioning)
Other Populations
(Low Socioeconomic Status, Disability, Other {Specify})
Category B Work Plan: Years 2-5
Provide a general summary of work plan activities proposed in Category B for Years 2-5
(maximum of one page narrative).

e. CDC Monitoring and Accountability Approach
Monitoring activities include routine and ongoing communication between CDC and recipients,
site visits, and recipient reporting (including work plans, performance, and financial reporting).
Consistent with applicable grants regulations and policies, CDC expects the following to be
included in post-award monitoring for grants and cooperative agreements:
 Tracking recipient progress in achieving the desired outcomes.
 Ensuring the adequacy of recipient systems that underlie and generate data reports.
 Creating an environment that fosters integrity in program performance and results.
Monitoring may also include the following activities deemed necessary to monitor the award:
 Ensuring that work plans are feasible based on the budget and consistent with the intent
of the award.
 Ensuring that recipients are performing at a sufficient level to achieve outcomes
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within stated timeframes.
 Working with recipients on adjusting the work plan based on achievement of
outcomes, evaluation results and changing budgets.
 Monitoring performance measures (both programmatic and financial) to assure
satisfactory performance levels.
Monitoring and reporting activities that assist grants management staff (e.g., grants management
officers and specialists, and project officers) in the identification, notification, and management
of high-risk recipients.
The proposed work plan and performance measures will be reviewed annually by the project
officer and evaluation staff, and may need to be altered to better reflect program activities as
outlined in the NOFO. Monitoring will occur routinely through ongoing communication
between CDC and recipients via monthly calls, reporting mechanisms (i.e., work plans,
performance measures, and financial reporting), and site visits. Post-award cooperative
agreement monitoring and provision of technical assistance and training will include:
 Ensuring that work plans are feasible, fiscally responsible, consistent with the intent of
the award, and have acceptable milestones and timelines.
 Ensuring that the activities outlined in the NOFO are being completed.
 Assisting recipients in adjusting work plan activities based on achievement of objectives
and/or budget changes.
 Communicating as needed, or at minimum monthly, with the project coordinator and
other program staff on conference calls/webinars.
 Sponsoring webinars and other meetings/trainings associated with the NOFO.
 Providing tools/resources aligned with program activities and NOFO outcomes,
assessment, and implementation support.
CDC will analyze performance measurement data to review progress and identify technical
assistance needs for all NOFO strategies at the national-level on an annual basis. The
performance measure data will be triangulated with other internal and external sources of
appropriate data to arrive at a rational assessment of progress. Findings from the annual analysis
of performance measure data will be used to identify areas of program improvement, broader
technical assistance needs, and to report to stakeholders. CDC will develop annual, aggregate
performance measure reports to be disseminated to recipients and other key stakeholders,
including federal partners, other funded and non-funded partners, and policy makers as
appropriate. These aggregate findings may also be presented during site visits and recipient
meetings. In addition to performance measures reported by recipients, CDC will track specific
intermediate outcome measures and other short and long-term measures (as indicated in the
table notes on page 20-21) that are relevant to the program through national datasets or national
evaluation activities.
The national evaluation will be used to answer questions regarding the approach, efficiency,
effectiveness, sustainability, and impact of the strategies being implemented by recipients. The
specific questions in each area will be updated annually based on findings from the performance
measure data as well as other lessons learned throughout the year. Recipients will be asked to
participate in data collection activities for the CDC-led national evaluation of Component A and
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Component B strategies. CDC guidance will be provided to the recipients to ensure effective
participation in the CDC-led national evaluation. All evaluation findings produced by CDC and
recipients, where appropriate, will contribute to: (1) continuous improvement of quality and
effectiveness of program strategies; (2) the evidence base; (3) documentation and sharing of
lessons learned to support replication and scaling of these program strategies; and/or (4) future
funding opportunities supported by CDC.
f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO
COOPERATIVE AGREEMENTS)
The CDC programs supporting this NOFO will be substantially involved beyond site visits and
regular performance and financial monitoring during the project period. Substantial
involvement means that the recipient can expect federal programmatic partnership in carrying
out efforts under the award. CDC will work in partnership with the recipient to ensure the
success of the cooperative agreement by:
 Supporting recipients in implementing cooperative agreement requirements and meeting
program outcomes;
 Providing technical assistance to revise annual work plans;
 Assisting recipients in advancing program activities to achieve project outcomes;
 Providing scientific subject matter expertise (e.g., engaging non-physician team
members, implementing and sustaining the National Diabetes Prevention Program) and
resources in support of the selected strategies;
 Collaborating with recipients to develop and implement evaluation plans that align with
CDC evaluation activities;
 Providing technical assistance on recipients' evaluation and performance measurement
plans;
 Providing technical assistance to define and operationalize performance measures;
 Using webinars and other social media for recipients and CDC to communicate and
share tools and resources;
 Establishing learning communities to facilitate the sharing of information among
recipients;
 Providing professional development and training opportunities, either in person or
through virtual, web-based training formats, for the purpose of sharing the latest science,
best practices, success stories, and program models;
 Participating in relevant meetings, committees, conference calls, and working groups
related to the cooperative agreement requirements to achieve outcomes;
 Coordinating communication and program linkages with other CDC programs and
Federal agencies, such as the Health Resources and Services Administration (HRSA),
Centers for Medicare & Medicaid Services (CMS), Indian Health Service (IHS), and the
National Institutes of Health (NIH);
 Providing surveillance technical assistance and state-specific data collected by CDC;
 Providing technical expertise to other CDC programs and Federal agencies on how to
interface with recipients;
 Translating and disseminating lessons learned through publications, meetings, and other
means on promising and best practices to expand the evidence base; and

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 Hosting a meeting/training during the first year of the project period and later in the
project period (for a total of 2 meetings/trainings for recipients).
CDC will:
1. Ensure that grantees have access to expertise found throughout NCCDPHP. For
example, a team of subject matter experts could include, but is not limited to, the project
officer, health scientists, epidemiologists, statisticians, policy analysts, communication
specialists, health economists, and evaluators to provide technical assistance to
grantees. Technical assistance teams will also work in collaboration with other
programs and divisions across NCCDPHP to identify specific actions that improve
efficiency and greater public health impact.
2. Collaborate with grantees to explore appropriate flexibilities needed to meet public
health outcomes and goals. Flexibility in cooperative agreements includes grantee’s
ability to propose alternative methods to achieve the outcomes and goals of the
cooperative agreement that align with grantee’s opportunities for success, infrastructure,
partner and stakeholder buy-in, demographics, and burden. This includes bringing
together resources from multiple cooperative agreements to jointly advance the goals of
each, and expanding the dialogue to bring in other CDC and grantee staff to reach a
win/win solution.
3. Create greater efficiencies and consistency across NCCDPHP programs for grantees.
Examples of how NCCDPHP divisions and programs work together to achieve this
include but are not limited to:
o Joint site visits that maximize the ability to do collaborative problem solving,
offer insights and ideas to strengthen or augment grantee approaches, and
increase understanding of grantee’s context to accomplish chronic disease
prevention and health promotion.
o Jointly developed resources and tools that focus on cross-cutting functions,
settings, domains, risk factors, conditions and diseases to ensure consistent
messages and to meet grantee technical assistance needs.
o Joint training and technical assistance opportunities that help grantees produce
policies and programs that are more holistic and fully supportive of work in
tobacco, nutrition, physical activity, chronic disease management and other
strategies and topics, as appropriate.
4. Continue and expand support for grantees to leverage NCCDPHP resources to address
cross-cutting functions, domains, settings, risk factors and diseases.
Defining terms
Cross-cutting functions: Are functions that are necessary to all programs and include
communication, epidemiology, evaluation, health equity, leadership, partnerships, planning,
policy, and training among others; as well as functions specific to the cooperative agreement.
Domains:
1. Epidemiology and surveillance—to monitor trends and track progress.
2. Environmental approaches—to promote health and support healthy behaviors.
3. Health care system interventions—to improve the effective delivery and use of clinical
33 of 64

and other high-value preventive services.
4. Community programs linked to clinical services—to improve and sustain management
of chronic conditions.
Settings: Early care and education, schools, worksites, community, health care system, etc.
Risk factors, conditions and diseases: Nutrition, physical activity, tobacco, sleep, excessive
alcohol use, maternal and infant health, Alzheimer’s, arthritis, diabetes, cancer, chronic
obstructive pulmonary disease, heart disease and stroke, and oral health.

B. Award Information
1. Funding Instrument Type:

2. Award Mechanism:

Cooperative Agreement
CDC's substantial involvement in this
program appears in the CDC Program
Support to Recipients Section.
U58

3. Fiscal Year:
2018
Estimated Total Funding:
$90,000,000
4. Approximate Total Fiscal Year Funding:
$90,000,000
For the initial budget period, which is only 9 months, the ceiling for each recipient is lower than
the anticipated amount for subsequent 12-month budget periods. CDC anticipates subsequent
budget periods will be 12 months, starting June 30, 2019.
This amount is subject to the availability of funds.
5. Approximate Period of Performance Funding:

$530,000,000

6. Total Period of Performance Length:

4.75

7. Expected Number of Awards:

51

8. Approximate Average Award:
$1,765,000 Per Budget Period
Refer to the Funding Table for specific funding amounts for each recipient.
This amount is subject to the availability of funds.
9. Award Ceiling:
$3,000,000 Per Budget Period
Refer to the Funding Table for the specific ceiling amount for each recipient.
10. Award Floor:
$800,000 Per Budget Period
Refer to the Funding Table for the specific amounts for each recipient.
11. Estimated Award Date:

09/30/2018

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Throughout the period of performance, CDC will continue the award based on the
availability of funds, the evidence of satisfactory progress by the recipient (as documented in
required reports), and the determination that continued funding is in the best interest of the
federal government. The total number of years for which federal support has been approved
(period of performance) will be shown in the “Notice of Award.” This information does not
constitute a commitment by the federal government to fund the entire period. The total period of
performance comprises the initial competitive segment and any subsequent non-competitive
continuation award(s).
12. Budget Period Length:
9 month(s)
The initial budget period will be 9 months. CDC anticipates that subsequent budget periods will
be 12 months, starting June 30.
13. Direct Assistance
Direct Assistance (DA) is not available through this FOA.

C. Eligibility Information
1. Eligible Applicants
Eligibility Category:

State governments
Others (see text field entitled "Additional
Information on Eligibility" for
clarification)

Additional Eligibility Category:
Government Organizations:
State (includes the District of Columbia)
2. Additional Information on Eligibility
State governments and the District of Columbia, or their bona fide agents.
Applicants should refer to the funding table for specific funding ceiling amounts for each
recipient; for the initial budget period, which is only 9 months, the ceiling for each recipient is
lower than the anticipated amount for subsequent 12-month budget periods.
The award ceiling for each component under Section B. Award Information is $3,000,000.
CDC will not consider any application requesting an award higher than the specified amount. If
a pre-application is required, then specify here and include it in the special eligibility
requirements section. (https://www.hhs.gov/sites/default/files/grants/grants/policiesregulations/gpd2-04.pdf)

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3. Justification for Less than Maximum Competition
2018 Congressional appropriations language, summarized below, directs CDC to fund state,
local, and tribal public health departments. Local health departments will be eligible to
compete under a separate NOFO, and tribes and tribal-serving organizations are currently
funded under separate NOFOs. Therefore, this NOFO is limited to state governments and the
District of Columbia or their bona fide agents.
Heart Disease and Stroke Prevention:
 House committee language states, “The Committee increases support for CDC’s heart
disease and stroke prevention activities within state, local, and tribal public health
departments, and for enhanced surveillance and research to target high-burden
populations and guide public health strategies.“
 Senate committee language states, “The Committee continues funding to support,
strengthen, and expand heart disease and stroke prevention and control activities within
state, local, and tribal public health departments and to enhance surveillance and
research to target high burden populations and guide public health strategies. The
Committee encourages CDC to prioritize these funds to communities with the highest
disease burden of heart disease and stroke to identify and disseminate novel and
innovative evidence-based strategies, including scientifically valid risk factor reduction
measures, through competitive awards.”
Diabetes:
 Senate committee language states, “...The Committee believes these activities must
include clear outcomes and ensure transparency and accountability that demonstrate
how funding was used to support diabetes prevention and specifically how diabetes
funding reached state and local communities. Additionally, the Committee encourages
CDC to support the translation of research into better prevention, care, and
surveillance.”

4. Cost Sharing or Matching
Cost Sharing / Matching Requirement:
No
Cost sharing or matching funds are not required for this program. Although no statutory
matching requirement for the NOFO exists, applicants are encouraged to leverage other
resources and related ongoing efforts to promote sustainability.
5. Maintenance of Effort
Maintenance of effort is not required for this program.
D. Required Registrations
Additional materials that may be helpful to applicants: http://www.cdc.gov/ od/ pgo/ funding/

36 of 64

docs/ Financial ReferenceGuide.pdf.
1. Required Registrations
An organization must be registered at the three following locations before it can submit an
application for funding at www.grants.gov.
a. Data Universal Numbering System: All applicant organizations must obtain a Data
Universal Numbering System (DUNS) number. A DUNS number is a unique nine-digit
identification number provided by Dun & Bradstreet (D&B). It will be used as the Universal
Identifier when applying for federal awards or cooperative agreements.
The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll
free) or internet at http:// fedgov.dnb. com/ webform/ displayHomePage.do. The DUNS
number will be provided at no charge.
If funds are awarded to an applicant organization that includes sub-recipients, those subrecipients must provide their DUNS numbers before accepting any funds.
b. System for Award Management (SAM): The SAM is the primary registrant database for
the federal government and the repository into which an entity must submit information
required to conduct business as a recipient. All applicant organizations must register with SAM,
and will be assigned a SAM number. All information relevant to the SAM number must be
current at all times during which the applicant has an application under consideration for
funding by CDC. If an award is made, the SAM information must be maintained until a final
financial report is submitted or the final payment is received, whichever is later. The SAM
registration process can require 10 or more business days, and registration must be renewed
annually. Additional information about registration procedures may be found at www.SAM.gov.
c. Grants.gov: The first step in submitting an application online is registering your
organization at www.grants.gov, the official HHS E-grant Web site. Registration information is
located at the “Get Registered” option at www.grants.gov.
All applicant organizations must register at www.grants.gov. The one-time registration process
usually takes not more than five days to complete. Applicants should start the registration
process as early as possible.
Step System
1
Data
Universal
Number
System
(DUNS)

Requirements
Duration
1. Click
1-2 Business Days
on http:// fedgov.dnb.com/
webform
2. Select Begin DUNS
search/request process
3. Select your country or
territory and follow
instructions to obtain your
DUNS 9-digit #
4. Request appropriate staff
member(s) to obtain DUNS
number, verify & update
information under DUNS
number

Follow Up
To confirm that you
have been issues a
new DUNS number
check online at
(http:// fedgov.dnb.
com/ webform) or
call 1-866-7055711

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2

System for
Award
Management
(SAM)
formerly
Central
Contractor
Registration
(CCR)

1. Retrieve organizations
3-5 Business Days but up
DUNS number
to 2 weeks and must be
2. Go to www.sam.gov and renewed once a year
designate an E-Biz
POC (note
CCR username will not
work in SAM and you will
need to have an active SAM
account before you can
register on grants.gov)

For SAM Customer
Service Contact
https://fsd.gov/fsdgov/home.do
Calls: 866-6068220

3

Grants.gov

1. Set up an individual
Same day but can take 8
account in Grants.gov using weeks to be fully
organization new DUNS
registered and approved in
number to become an
the system (note,
authorized organization
applicants MUST obtain a
representative (AOR)
DUNS number and SAM
2. Once the Account is set account before applying to
up the E_BIZ POC will be grants.gov)
notified via email
3. Log into grants.gov using
the password the EBIZ POC received and
create new password
4. This authorizes
the AOR to submit the
applications on behalf of
the organization

Register early! Log
into Grants.gov and
check AOR status
until it shows you
have been approved

2. Request Application Package
Applicants may access the application package at www.grants.gov.
3. Application Package
Applicants must download the SF-424, Application for Federal Assistance, package associated
with this funding opportunity at www.grants.gov. If Internet access is not available, or if the
online forms cannot be accessed, applicants may call the CDC OGS staff at 770-488-2700 or email OGS ogstims@cdc.gov for assistance. Persons with hearing loss may access CDC
telecommunications at TTY 1-888-232-6348.
4. Submission Dates and Times
If the application is not submitted by the deadline published in the NOFO, it will not be
processed. Office of Grants Services (OGS) personnel will notify the applicant that their
application did not meet the deadline. The applicant must receive pre-approval to submit a paper
application (see Other Submission Requirements section for additional details). If the applicant
is authorized to submit a paper application, it must be received by the deadline provided by

38 of 64

OGS.
a. Letter of Intent Deadline (must be emailed or postmarked by)
Due Date for Letter of Intent: N/A
N/A
b. Application Deadline
Due Date for Applications: 06/11/2018 , 11:59 p.m. U.S. Eastern Standard Time, at
www.grants.gov. If Grants.gov is inoperable and cannot receive applications, and circumstances
preclude advance notification of an extension, then applications must be submitted by the first
business day on which grants.gov operations resume.
Date for Informational Conference Call:
04/23/2018
Scheduled for 3:00 - 4:00 pm, Eastern Standard Time.
URL:

https://adobeconnect.cdc.gov/r798tz97pl0/

Conference
Number(s):

Conference I.D.:

3461523#

Conference Number:

18885667703

Questions may be submitted to 1815COMMS@cdc.gov as soon as the NOFO is released.

5. CDC Assurances and Certifications
All applicants are required to sign and submit “Assurances and Certifications” documents
indicated at http:// wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa)) /
Homepage.aspx.
Applicants may follow either of the following processes:
 Complete the applicable assurances and certifications with each application submission,
name the file “Assurances and Certifications” and upload it as a PDF file with
at www.grants.gov
 Complete the applicable assurances and certifications and submit them directly to CDC
on an annual basis at http:// wwwn.cdc.gov/ grantassurances/
(S(mj444mxct51lnrv1hljjjmaa)) / Homepage.aspx
Assurances and certifications submitted directly to CDC will be kept on file for one year and
will apply to all applications submitted to CDC by the applicant within one year of the
submission date.
Duplication of Efforts
Applicants are responsible for reporting if this application will result in programmatic,
budgetary, or commitment overlap with another application or award (i.e. grant, cooperative
agreement, or contract) submitted to another funding source in the same fiscal year.

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Programmatic overlap occurs when (1) substantially the same project is proposed in more than
one application or is submitted to two or more funding sources for review and funding
consideration or (2) a specific objective and the project design for accomplishing the objective
are the same or closely related in two or more applications or awards, regardless of the funding
source. Budgetary overlap occurs when duplicate or equivalent budgetary items (e.g.,
equipment, salaries) are requested in an application but already are provided by another source.
Commitment overlap occurs when an individual’s time commitment exceeds 100 percent,
whether or not salary support is requested in the application. Overlap, whether programmatic,
budgetary, or commitment of an individual’s effort greater than 100 percent, is not permitted.
Any overlap will be resolved by the CDC with the applicant and the PD/PI prior to award.
Report Submission: The applicant must upload the report in Grants.gov under “Other
Attachment Forms.” The document should be labeled: "Report on Programmatic, Budgetary,
and Commitment Overlap.”

6. Content and Form of Application Submission
Applicants are required to include all of the following documents with their application package
at www.grants.gov.
7. Letter of Intent
Is a LOI:
Not Applicable
A letter of intent is not requested or required as part of the application for this NOFO.
8. Table of Contents
(There is no page limit. The table of contents is not included in the project narrative page
limit.): The applicant must provide, as a separate attachment, the “Table of Contents” for the
entire submission package.
Provide a detailed table of contents for the entire submission package that includes all of the
documents in the application and headings in the "Project Narrative" section. Name the file
"Table of Contents" and upload it as a PDF file under "Other Attachment Forms"
at www.grants.gov.
9. Project Abstract Summary
A project abstract is included on the mandatory documents list and must be submitted
at www.grants.gov. The project abstract must be a self-contained, brief summary of the
proposed project including the purpose and outcomes. This summary must not include any
proprietary or confidential information. Applicants must enter the summary in the "Project
Abstract Summary" text box at www.grants.gov.

10. Project Narrative
Multi-component NOFOs may have a maximum of 15 pages for the “base” (subsections of the
Project Description that the components share with each other, which may include target

40 of 64

population, inclusion, collaboration, etc.); and up to 4 additional pages per component for
Project Narrative subsections that are specific to each component.
Text should be single spaced, 12 point font, 1-inch margins, and number all pages.
Page limits include work plan; content beyond specified limits may not be reviewed.
Applicants should use the federal plain language guidelines and Clear Communication Index to
respond to this Notice of Funding Opportunity Announcement. Note that recipients should also
use these tools when creating public communication materials supported by this NOFO. Failure
to follow the guidance and format may negatively impact scoring of the application.
For the purposes of this NOFO, there is a 40-page limit for the Project Narrative, inclusive of
the Work Plan.
a. Background
Applicants must provide a description of relevant background information that includes the
context of the problem (See CDC Background).
b. Approach
i. Purpose
Applicants must describe in 2-3 sentences specifically how their application will address the
problem as described in the CDC Background section.
ii. Outcomes
Applicants must clearly identify the outcomes they expect to achieve by the end of the period of
performance. Outcomes are the results that the program intends to achieve. All outcomes must
indicate the intended direction of change (e.g., increase, decrease, maintain). (See the logic
model in the Approach section of the CDC Project Description.)
iii. Strategies and Activities
Applicants must provide a clear and concise description of the strategies and activities they will
use to achieve the period of performance outcomes. Applicants must select existing evidencebased strategies that meet their needs, or describe in the Applicant Evaluation and Performance
Measurement Plan how these strategies will be evaluated over the course of the period of
performance. (See CDC Project Description: Strategies and Activities section.)
1. Collaborations
Applicants must describe how they will collaborate with programs and organizations either
internal or external to CDC. Applicants must address the Collaboration requirements as
described in the CDC Project Description.
2. Target Populations and Health Disparities
Applicants must describe the specific target population(s) in their jurisdiction and explain how
such a target will achieve the goals of the award and/or alleviate health disparities. The
applicants must also address how they will include specific populations that can benefit from
41 of 64

the program that is described in the Approach section. Applicants must address the Target
Populations and Health Disparities requirements as described in the CDC Project Description.

c. Applicant Evaluation and Performance Measurement Plan
Applicants must provide an evaluation and performance measurement plan that demonstrates
how the recipient will fulfill the requirements described in the CDC Evaluation and
Performance Measurement and Project Description sections of this NOFO. At a minimum, the
plan must describe:
 How applicant will collect the performance measures, respond to the evaluation
questions, and use evaluation findings for continuous program quality improvement. The
Paperwork Reduction Act of 1995 (PRA): Applicants are advised that any activities
involving information collections (e.g., surveys, questionnaires, applications, audits,
data requests, reporting, recordkeeping and disclosure requirements) from 10 or more
individuals or non-Federal entities, including State and local governmental agencies, and
funded or sponsored by the Federal Government are subject to review and approval by
the Office of Management and Budget. For further information about CDC’s
requirements under PRA see http://www.hhs.gov/ ocio/policy/collection/.
 How key program partners will participate in the evaluation and performance
measurement planning processes.
 Available data sources, feasibility of collecting appropriate evaluation and performance
data, data management plan (DMP), and other relevant data information (e.g.,
performance measures proposed by the applicant).
Where the applicant chooses to, or is expected to, take on specific evaluation studies, they
should be directed to:
 Describe the type of evaluations (i.e., process, outcome, or both).
 Describe key evaluation questions to be addressed by these evaluations.
 Describe other information (e.g., measures, data sources).
Recipients will be required to submit a more detailed Evaluation and Performance Measurement
plan (including the DMP elements) within the first 6 months of award, as described in the
Reporting Section of this NOFO.

d. Organizational Capacity of Applicants to Implement the Approach
Applicants must address the organizational capacity requirements as described in the CDC
Project Description.

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11. Work Plan
(Included in the Project Narrative’s page limit)
Applicants must prepare a work plan consistent with the CDC Project Description Work Plan
section. The work plan integrates and delineates more specifically how the recipient plans to
carry out achieving the period of performance outcomes, strategies and activities, evaluation
and performance measurement.

12. Budget Narrative
Applicants must submit an itemized budget narrative. When developing the budget narrative,
applicants must consider whether the proposed budget is reasonable and consistent with the
purpose, outcomes, and program strategy outlined in the project narrative. The budget must
include:











Salaries and wages
Fringe benefits
Consultant costs
Equipment
Supplies
Travel
Other categories
Contractual costs
Total Direct costs
Total Indirect costs

Indirect costs could include the cost of collecting, managing, sharing and preserving data.
Indirect costs on grants awarded to foreign organizations and foreign public entities and
performed fully outside of the territorial limits of the U.S. may be paid to support the costs of
compliance with federal requirements at a fixed rate of eight percent of MTDC exclusive of
tuition and related fees, direct expenditures for equipment, and subawards in excess of $25,000.
Negotiated indirect costs may be paid to the American University, Beirut, and the World Health
Organization.
If applicable and consistent with the cited statutory authority for this announcement, applicant
entities may use funds for activities as they relate to the intent of this NOFO to meet national
standards or seek health department accreditation through the Public Health Accreditation
Board (see: http://www.phaboard.org). Applicant entities to whom this provision applies
include state, local, territorial governments (including the District of Columbia, the
Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern
Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of
the Marshall Islands, and the Republic of Palau), or their bona fide agents, political subdivisions
of states (in consultation with states), federally recognized or state-recognized American Indian
or Alaska Native tribal governments, and American Indian or Alaska Native tribally designated
organizations. Activities include those that enable a public health organization to deliver public
health services such as activities that ensure a capable and qualified workforce, up-to-date
information systems, and the capability to assess and respond to public health needs. Use of
43 of 64

these funds must focus on achieving a minimum of one national standard that supports the
intent of the NOFO. Proposed activities must be included in the budget narrative and must
indicate which standards will be addressed.
Applicants must name this file “Budget Narrative” and upload it as a PDF file
at www.grants.gov. If requesting indirect costs in the budget, a copy of the indirect cost-rate
agreement is required. If the indirect costs are requested, include a copy of the current
negotiated federal indirect cost rate agreement or a cost allocation plan approval letter for
those Recipients under such a plan. Applicants must name this file “Indirect Cost Rate” and
upload it at www.grants.gov.
Applicants should prepare a budget narrative and justification for the strategies they are
proposing to implement in each category. Costs should be divided equally between work on
Category A (Diabetes Management and Type 2 Diabetes Prevention) and Category B
(Cardiovascular Disease Prevention and Management) strategies. For example, if an applicant is
eligible to apply for a total of $2,000,000, the proposed budget should be divided equally
between staff, contractors, and other costs needed to support work on Category A strategies
($1,000,000) and Category B strategies ($1,000,000). The total amount of funding requested
should not exceed the total dollar amount for which the applicant is eligible to apply. (Refer to
the Funding Table for specific funding amounts for each recipient.)
Recipients will be required to attend a 3-day meeting/training to be held in Atlanta in the first
year of the funding cycle, and should budget for key program staff and evaluators to attend.
This includes staff working on both the Category A and Category B strategies.
A sample budget template is available for use at www.cdc.gov/RFA-DP18-1815. Applicants are
not required to use the budget template, but are required to include all of the elements listed
within the template and to show how funding is divided equally to support work on the
Category A and B strategies.

13. Intergovernmental Review
The application is subject to Intergovernmental Review of Federal Programs, as governed by
Executive Order 12372, which established a system for state and local intergovernmental
review of proposed federal assistance applications. Applicants should inform their state single
point of contact (SPOC) as early as possible that they are applying prospectively for federal
assistance and request instructions on the state's process. The current SPOC list is available at:
http://www.whitehouse.gov/omb/grants_spoc/.
14. Pilot Program for Enhancement of Employee Whistleblower Protections
Pilot Program for Enhancement of Employee Whistleblower Protections: All applicants will be
subject to a term and condition that applies the terms of 48 Code of Federal Regulations
(CFR) section 3.908 to the award and requires that recipients inform their employees in writing
(in the predominant native language of the workforce) of employee whistleblower rights and
protections under 41 U.S.C. 4712.
14a. Funds Tracking
Proper fiscal oversight is critical to maintaining public trust in the stewardship of federal funds.

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Effective October 1, 2013, a new HHS policy on subaccounts requires the CDC to set up
payment subaccounts within the Payment Management System (PMS) for all new grant
awards. Funds awarded in support of approved activities and drawdown instructions will be
identified on the Notice of Award in a newly established PMS subaccount (P
subaccount). Recipients will be required to draw down funds from award-specific accounts in
the PMS. Ultimately, the subaccounts will provide recipients and CDC a more detailed and
precise understanding of financial transactions. The successful applicant will be required to
track funds by P-accounts/sub accounts for each project/cooperative agreement awarded.
Applicants are encouraged to demonstrate a record of fiscal responsibility and the ability to
provide sufficient and effective oversight. Financial management systems must meet the
requirements as described 2 CFR 200 which include, but are not limited to, the following:
 Records that identify adequately the source and application of funds for federally-funded
activities.
 Effective control over, and accountability for, all funds, property, and other assets.
 Comparison of expenditures with budget amounts for each Federal award.
 Written procedures to implement payment requirements.
 Written procedures for determining cost allowability.
 Written procedures for financial reporting and monitoring.
14b. Copyright Interests Provisions
This provision is intended to ensure that the public has access to the results and
accomplishments of public health activities funded by CDC. Pursuant to applicable grant
regulations and CDC’s Public Access Policy, Recipient agrees to submit into the National
Institutes of Health (NIH) Manuscript Submission (NIHMS) system an electronic version of the
final, peer-reviewed manuscript of any such work developed under this award upon acceptance
for publication, to be made publicly available no later than 12 months after the official date of
publication. Also at the time of submission, Recipient and/or the Recipient’s submitting author
must specify the date the final manuscript will be publicly accessible through PubMed Central
(PMC). Recipient and/or Recipient’s submitting author must also post the manuscript through
PMC within twelve (12) months of the publisher's official date of final publication; however the
author is strongly encouraged to make the subject manuscript available as soon as possible. The
recipient must obtain prior approval from the CDC for any exception to this provision.
The author's final, peer-reviewed manuscript is defined as the final version accepted for journal
publication, and includes all modifications from the publishing peer review process, and all
graphics and supplemental material associated with the article. Recipient and its submitting
authors working under this award are responsible for ensuring that any publishing or copyright
agreements concerning submitted articles reserve adequate right to fully comply with this
provision and the license reserved by CDC. The manuscript will be hosted in both PMC and the
CDC Stacks institutional repository system. In progress reports for this award, recipient must
identify publications subject to the CDC Public Access Policy by using the applicable NIHMS
identification number for up to three (3) months after the publication date and the PubMed
Central identification number (PMCID) thereafter.
14c. Reporting of Foreign Taxes (International/Foreign projects only)

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A. Valued Added Tax (VAT) and Customs Duties – Customs and import duties, consular fees,
customs surtax, valued added taxes, and other related charges are hereby authorized as an
allowable cost for costs incurred for non-host governmental entities operating where no
applicable tax exemption exists. This waiver does not apply to countries where a bilateral
agreement (or similar legal document) is already in place providing applicable tax exemptions
and it is not applicable to Ministries of Health. Successful applicants will receive information
on VAT requirements via their Notice of Award.
B. The U.S. Department of State requires that agencies collect and report information on the
amount of taxes assessed, reimbursed and not reimbursed by a foreign government against
commodities financed with funds appropriated by the U.S. Department of State, Foreign
Operations and Related Programs Appropriations Act (SFOAA) (“United States foreign
assistance funds”). Outlined below are the specifics of this requirement:
1)
Annual Report: The recipient must submit a report on or before November 16 for each
foreign country on the amount of foreign taxes charged, as of September 30 of the same year,
by a foreign government on commodity purchase transactions valued at 500 USD or more
financed with United States foreign assistance funds under this grant during the prior United
States fiscal year (October 1 – September 30), and the amount reimbursed and unreimbursed by
the foreign government. [Reports are required even if the recipient did not pay any taxes during
the reporting period.]
2)
Quarterly Report: The recipient must quarterly submit a report on the amount of foreign
taxes charged by a foreign government on commodity purchase transactions valued at 500 USD
or more financed with United States foreign assistance funds under this grant. This report shall
be submitted no later than two weeks following the end of each quarter: April 15, July 15,
October 15 and January 15.
3)
Terms: For purposes of this clause: “Commodity” means any material, article, supplies,
goods, or equipment; “Foreign government” includes any foreign government entity; “Foreign
taxes” means value-added taxes and custom duties assessed by a foreign government on a
commodity. It does not include foreign sales taxes.
4)
Where: Submit the reports to the Director and Deputy Director of the CDC office in the
country(ies) in which you are carrying out the activities associated with this cooperative
agreement. In countries where there is no CDC office, send reports to VATreporting@cdc.gov.
5)
Contents of Reports: The reports must contain: a.
recipient name; b.
contact
name with phone, fax, and e-mail; c.
agreement number(s) if reporting by agreement(s);
d.
reporting period; e.
amount of foreign taxes assessed by each foreign government;
f.
amount of any foreign taxes reimbursed by each foreign government; g.
amount of
foreign taxes unreimbursed by each foreign government.
6)
Subagreements. The recipient must include this reporting requirement in all applicable
subgrants and other subagreements.
14d. Data Management Plan
As identified in the Evaluation and Performance Measurement section, applications involving
data collection must include a Data Management Plan (DMP) as part of their evaluation and
performance measurement plan. The DMP is the applicant’s assurance of the quality of the
public health data through the data’s lifecycle and plans to deposit data in a repository to
preserve and to make the data accessible in a timely manner. See web link for additional
information: https://www.cdc.gov/grants/additionalrequirements/ar-25.html
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15. Funding Restrictions
Restrictions that must be considered while planning the programs and writing the budget are:
 Recipients may not use funds for research.
 Recipients may not use funds for clinical care except as allowed by law.
 Recipients may use funds only for reasonable program purposes, including personnel,
travel, supplies, and services.
 Generally, recipients may not use funds to purchase furniture or equipment. Any such
proposed spending must be clearly identified in the budget.
 Reimbursement of pre-award costs generally is not allowed, unless the CDC provides
written approval to the recipient.
 Other than for normal and recognized executive-legislative relationships, no funds may
be used for:
o publicity or propaganda purposes, for the preparation, distribution, or use of any
material designed to support or defeat the enactment of legislation before any
legislative body
o the salary or expenses of any grant or contract recipient, or agent acting for such
recipient, related to any activity designed to influence the enactment of
legislation, appropriations, regulation, administrative action, or Executive order
proposed or pending before any legislative body
 See Additional Requirement (AR) 12 for detailed guidance on this prohibition
and additional guidance on lobbying for CDC recipients.
 The direct and primary recipient in a cooperative agreement program must perform a
substantial role in carrying out project outcomes and not merely serve as a conduit for an
award to another party or provider who is ineligible.
 In accordance with the United States Protecting Life in Global Health Assistance policy,
all non-governmental organization (NGO) applicants acknowledge that foreign NGOs
that receive funds provided through this award, either as a prime recipient or
subrecipient, are strictly prohibited, regardless of the source of funds, from performing
abortions as a method of family planning or engaging in any activity that promotes
abortion as a method of family planning, or to provide financial support to any other
foreign non-governmental organization that conducts such activities. See Additional
Requirement (AR) 35 for applicability
(https://www.cdc.gov/grants/additionalrequirements/ar-35.html).
No additional restrictions.

16. Other Submission Requirements
a. Electronic Submission: Applications must be submitted electronically at www.grants.gov.
The application package can be downloaded at www.grants.gov. Applicants can complete the
application package off-line and submit the application by uploading it at www.grants.gov. All
application attachments must be submitted using a PDF file format. Directions for creating PDF

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files can be found at www.grants.gov. File formats other than PDF may not be readable by OGS
Technical Information Management Section (TIMS) staff.
Applications must be submitted electronically by using the forms and instructions posted for
this funding opportunity at www.grants.gov.
If Internet access is not available or if the forms cannot be accessed online, applicants may
contact the OGS TIMS staff at 770- 488-2700 or by e-mail at ogstims@cdc.gov, Monday
through Friday, 7:30 a.m.–4:30 p.m., except federal holidays. Electronic applications will be
considered successful if they are available to OGS TIMS staff for processing
from www.grants.gov on the deadline date.
b. Tracking Number: Applications submitted through www.grants.gov are time/date stamped
electronically and assigned a tracking number. The applicant’s Authorized Organization
Representative (AOR) will be sent an e-mail notice of receipt when www.grants.gov receives
the application. The tracking number documents that the application has been submitted and
initiates the required electronic validation process before the application is made available to
CDC.
c. Validation Process: Application submission is not concluded until the validation process is
completed successfully. After the application package is submitted, the applicant will receive a
“submission receipt” e-mail generated by www.grants.gov. A second e-mail message to
applicants will then be generated by www.grants.gov that will either validate or reject the
submitted application package. This validation process may take as long as two business days.
Applicants are strongly encouraged to check the status of their application to ensure that
submission of their package has been completed and no submission errors have occurred.
Applicants also are strongly encouraged to allocate ample time for filing to guarantee that their
application can be submitted and validated by the deadline published in the NOFO. Nonvalidated applications will not be accepted after the published application deadline date.
If you do not receive a “validation” e-mail within two business days of application submission,
please contact www.grants.gov. For instructions on how to track your application, refer to the email message generated at the time of application submission or the Grants.gov Online User
Guide.
https://www.grants.gov/ help/html/help/ index.htm? callingApp=custom#t=
Get_Started%2FGet_Started. htm
d. Technical Difficulties: If technical difficulties are encountered at www.grants.gov,
applicants should contact Customer Service at www.grants.gov. The www.grants.gov Contact
Center is available 24 hours a day, 7 days a week, except federal holidays. The Contact Center
is available by phone at 1-800-518-4726 or by e-mail at support@grants.gov. Application
submissions sent by e-mail or fax, or on CDs or thumb drives will not be accepted. Please note
that www.grants.gov is managed by HHS.
e. Paper Submission: If technical difficulties are encountered at www.grants.gov, applicants
should call the www.grants.gov Contact Center at 1-800-518-4726 or e-mail them
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at support@grants.gov for assistance. After consulting with the Contact Center, if the technical
difficulties remain unresolved and electronic submission is not possible, applicants may e-mail
CDC GMO/GMS, before the deadline, and request permission to submit a paper application.
Such requests are handled on a case-by-case basis.
An applicant’s request for permission to submit a paper application must:
1. Include the www.grants.gov case number assigned to the inquiry
2. Describe the difficulties that prevent electronic submission and the efforts taken with
the www.grants.gov Contact Center to submit electronically; and
3. Be received via e-mail to the GMS/GMO listed below at least three calendar days before
the application deadline. Paper applications submitted without prior approval will not be
considered.
If a paper application is authorized, OGS will advise the applicant of specific
instructions for submitting the application (e.g., original and two hard copies of the
application by U.S. mail or express delivery service).

E. Review and Selection Process
1. Review and Selection Process: Applications will be reviewed in three phases.
a. Phase I Review
All applications will be initially reviewed for eligibility and completeness by the Office of
Grants Services. Complete applications will be reviewed for responsiveness by Grants
Management Officials and Program Officials. Non-responsive applications will not advance to
Phase II review. Applicants will be notified that their applications did not meet eligibility and/or
published submission requirements.
b. Phase II Review
A review panel will evaluate complete, eligible applications in accordance with the criteria
below.
i. Approach ii. Evaluation and Performance Measurement iii. Applicant’s Organizational
Capacity to Implement the Approach
Not more than thirty days after the Phase II review is completed, applicants will be notified
electronically if their application does not meet eligibility or published submission
requirements.
iii. Applicant's Organizational Capacity to Implement the
Approach
iii. Applicant's Organizational Capacity to Implement the Approach

Maximum Points: 0

Organizational Capacity – The extent to which the applicant:
 Describes its organizational capacity to carry out the Category A and B strategies,
including coordination with other federally and privately funded programs within the
state in order to leverage resources and maximize reach and impact.
 Describes its ability to address health equity.
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 Describes how it will minimize duplication of effort.
 Describes how it will access subject matter expertise (staff and/or contractual) relevant
to the strategies selected.
Project Management – The extent to which the applicant:
 Describes core project management plans and capability to execute Categories A and B,
including roles and responsibilities of project staff.
 Describes who will have day-to-day responsibility for key tasks such as: leadership of
the project; monitoring of the project’s on-going progress; preparation of reports;
program evaluation; and communication with partners and CDC.
 Describes any contractual organization(s) that will have a significant role(s) in
implementing program strategies and achieving project outcomes.
 Describes how any consultants and/or partner organizations will contribute to achieving
project outcomes.
Budget
Budget

Maximum Points: 0

Evaluate the extent to which the applicant proposes a budget which:
 Aligns with the proposed work plan.
 Is supportive of the intent of and budgetary guidance in the NOFO, including a 50/50
split in budgetary support for work on Category A and B strategies.
 Supports CDC fiscal policy (e.g., provides all six required elements for proposed
contractors). (Refer to CDC’s Budget Preparation Guidelines at: http://www.cdc.gov
/grants/interestedinapplying/applicationresources.html for more information.)
i. Approach
Maximum Points: 0
Because this NOFO is non-competitive, a Technical Review will be conducted by CDC
staff. The review criteria below will be used. Applications will not be scored.
i. Approach
Purpose and Outcomes - The extent to which the applicant:
 Describes how it will address the problem statement, required project period outcomes,
and its approach to addressing the required program strategies by category to achieve
the outcomes, including identification of target populations and inclusion of populations
who may otherwise be missed by the program.
Collaboration – The extent to which the applicant:
 Describes how it will collaborate with CDC-funded programs as well as programs
external to CDC in implementing the Category A and B program strategies.
Work Plan - The extent to which the applicant describes a detailed 9-month work plan for
"Year 1" as outlined in the sample work plan template located at www.cdc.gov/RFA-DP1850 of 64

1815 that:
 Aligns with the program logic model in the "CDC Project Description, Approach"
section.
 Specifies the strategies and performance measures (from the table in the "Evaluation
and Performance Measurement, CDC Evaluation and Performance Measurement
Strategy" section) the applicant will be working on, and provides a proposed data
source, baseline, and target for each measure.
 Specifies the scope, setting(s), and population(s) of focus for work under each strategy.
 Lists appropriate activities that will be done to accomplish the work and achieve the
performance measures for each strategy, including sufficient detail to determine key
milestones and deliverables planned.
 Describes how it will apply Category A and B strategies in the same
communities/settings, where appropriate, so that work may be mutually reinforcing, and
address complementary Category A and B strategies in a way that will benefit both
people with prediabetes or diabetes and people with high blood pressure and with or at
risk for high blood cholesterol.
 Provides a general summary of activities for Years 2-5. Includes plans for identifying
and accessing data for any short-term performance measures where data are currently
unavailable (i.e., those measures on the work plan template that are missing information
on data source, baseline, and target).
ii. Evaluation and Performance Measurement
ii. Evaluation and Performance Measurement

Maximum Points: 0

The extent to which the applicant:
 Describes how key program partners will be engaged in the evaluation and performance
measurement planning processes.
 Describes the type of evaluations to be conducted (i.e. process and/or outcome).
 Describes how key evaluation questions will be answered.
 Describes potentially available data sources for evaluation and performance
measurement.
 Describes how evaluation findings will be used for continuous program and quality
improvement.
 Describes appropriate data collection approaches, measures, and data sources.
 Describes the amount of the award allocated to evaluation.
 Describes how applicants will work with professional evaluators (either internal or
external) to meet the evaluation and performance reporting requirements.
Because this NOFO is non-competitive, a Technical Review will be conducted by CDC staff.
The above review criteria will be used. Applications will not be scored.
c. Phase III Review
All applicants submitting a technically acceptable application will be funded for this NOFO.
Applications will be reviewed using a Technical Review process involving CDC program staff
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and will not be scored.
Review of risk posed by applicants.
Prior to making a Federal award, CDC is required by 31 U.S.C. 3321 and 41 U.S.C. 2313 to
review information available through any OMB-designated repositories of government-wide
eligibility qualification or financial integrity information as appropriate. See also suspension
and debarment requirements at 2 CFR parts 180 and 376.
In accordance 41 U.S.C. 2313, CDC is required to review the non-public segment of the OMBdesignated integrity and performance system accessible through SAM (currently the
Federal Recipient Performance and Integrity Information System (FAPIIS)) prior to making a
Federal award where the Federal share is expected to exceed the simplified acquisition
threshold, defined in 41 U.S.C. 134, over the period of performance. At a minimum, the
information in the system for a prior Federal award recipient must demonstrate a satisfactory
record of executing programs or activities under Federal grants, cooperative agreements, or
procurement awards; and integrity and business ethics. CDC may make a Federal award to a
recipient who does not fully meet these standards, if it is determined that the information is not
relevant to the current Federal award under consideration or there are specific conditions that
can appropriately mitigate the effects of the non-Federal entity's risk in accordance with 45 CFR
§75.207.
CDC’s framework for evaluating the risks posed by an applicant may incorporate results of the
evaluation of the applicant's eligibility or the quality of its application. If it is determined that a
Federal award will be made, special conditions that correspond to the degree of risk assessed
may be applied to the Federal award. The evaluation criteria is described in this Notice of
Funding Opportunity.
In evaluating risks posed by applicants, CDC will use a risk-based approach and may consider
any items such as the following:
(1) Financial stability;
(2) Quality of management systems and ability to meet the management standards prescribed in
this part;
(3) History of performance. The applicant's record in managing Federal awards, if it is a prior
recipient of Federal awards, including timeliness of compliance with applicable reporting
requirements, conformance to the terms and conditions of previous Federal awards, and if
applicable, the extent to which any previously awarded amounts will be expended prior to
future awards;
(4) Reports and findings from audits performed under subpart F 45 CFR 75 or the reports and
findings of any other available audits; and
(5) The applicant's ability to effectively implement statutory, regulatory, or other requirements
imposed on non-Federal entities.
CDC must comply with the guidelines on government-wide suspension and debarment in 2
CFR part 180, and require non-Federal entities to comply with these provisions. These
provisions restrict Federal awards, subawards and contracts with certain parties that are
debarred, suspended or otherwise excluded from or ineligible for participation in Federal
programs or activities.

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2. Announcement and Anticipated Award Dates
Successful applicants can anticipate notice of funding by September 30, 2018 with a start date
of September 30, 2018.
F. Award Administration Information
1. Award Notices
Recipients will receive an electronic copy of the Notice of Award (NOA) from CDC OGS. The
NOA shall be the only binding, authorizing document between the recipient and CDC. The
NOA will be signed by an authorized GMO and emailed to the Recipient Business Officer listed
in application and the Program Director.
Any applicant awarded funds in response to this NOFO will be subject to the DUNS, SAM
Registration, and Federal Funding Accountability And Transparency Act Of 2006 (FFATA)
requirements.
Unsuccessful applicants will receive notification of these results by e-mail with delivery receipt
or by U.S. mail.
2. Administrative and National Policy Requirements
Recipients must comply with the administrative and public policy requirements outlined in 45
CFR Part 75 and the HHS Grants Policy Statement, as appropriate.
Brief descriptions of relevant provisions are available
at http://www.cdc.gov/grants/additionalrequirements/index.html#ui-id-17.
The HHS Grants Policy Statement is available
at http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.












AR-7: Executive Order 12372 Review
AR-9: Paperwork Reduction Act Requirements
AR-10: Smoke-Free Workplace Requirements
AR-11: Healthy People 2020
AR-12: Lobbying Restrictions (June 2012)
AR-13: Prohibition on Use of CDC Funds for Certain Gun Control Activities
AR-14: Accounting System Requirements
AR-24: Health Insurance Portability and Accountability Act Requirements
AR-25: Data Management and Access
AR-26: National Historic Preservation Act of 1966
AR-29: Compliance with EO13513, “Federal Leadership on Reducing Text Messaging
while Driving”, October 1, 2009
 AR-30: Compliance with Section 508 of the Rehabilitation Act of 1973
 AR-34: Language Access for Persons with Limited English Proficiency
For more information on the CFR visit http://www. access.gpo.gov/ nara/cfr/cfr-tablesearch.html.

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3. Reporting
Reporting provides continuous program monitoring and identifies successes and challenges
that recipients encounter throughout the period of performance. Also, reporting is a requirement
for recipients who want to apply for yearly continuation of funding. Reporting helps CDC
and recipients because it:
 Helps target support to recipients;
 Provides CDC with periodic data to monitor recipient progress toward meeting the
NOFO outcomes and overall performance;
 Allows CDC to track performance measures and evaluation findings for continuous
quality and program improvement throughout the period of performance and to
determine applicability of evidence-based approaches to different populations, settings,
and contexts; and
 Enables CDC to assess the overall effectiveness and influence of the NOFO.
The table below summarizes required and optional reports. All required reports must be sent
electronically to GMS listed in the “Agency Contacts” section of the NOFO copying the CDC
Project Officer.
Report

When?

Required?

Recipient Evaluation and
Performance Measurement
Plan, including Data
Management Plan (DMP)

6 months into award

Yes

Annual Performance Report
(APR)

No later than 120 days before
Yes
end of budget period. Serves as
yearly continuation application.

Federal Financial Reporting
Forms

90 days after the end of the
budget period.

Yes

Final Performance and
Financial Report

90 days after end of period of
performance.

Yes

Payment Management System Quarterly reports due January 30; Yes
(PMS) Reporting
April 30; July 30; and October
30.
a. Recipient Evaluation and Performance Measurement Plan (required)
With support from CDC, recipients must elaborate on their initial applicant evaluation and
performance measurement plan. This plan must be no more than 20 pages; recipients must
submit the plan 6 months into the award. HHS/CDC will review and approve the recipient’s
monitoring and evaluation plan to ensure that it is appropriate for the activities to be undertaken
as part of the agreement, for compliance with the monitoring and evaluation guidance

54 of 64

established by HHS/CDC, or other guidance otherwise applicable to this Agreement.
Recipient Evaluation and Performance Measurement Plan (required): This plan should provide
additional detail on the following:
Performance Measurement
• Performance measures and targets
• The frequency that performance data are to be collected.
• How performance data will be reported.
• How quality of performance data will be assured.
• How performance measurement will yield findings to demonstrate progress towards
achieving NOFO goals (e.g., reaching target populations or achieving expected outcomes).
• Dissemination channels and audiences.
• Other information requested as determined by the CDC program.
Evaluation
• The types of evaluations to be conducted (e.g. process or outcome evaluations).
• The frequency that evaluations will be conducted.
• How evaluation reports will be published on a publically available website.
• How evaluation findings will be used to ensure continuous quality and program improvement.
• How evaluation will yield findings to demonstrate the value of the NOFO (e.g., effect on
improving public health outcomes, effectiveness of NOFO, cost-effectiveness or cost-benefit).
• Dissemination channels and audiences.
HHS/CDC or its designee will also undertake monitoring and evaluation of the defined
activities within the agreement. The recipient must ensure reasonable access by HHS/CDC or
its designee to all necessary sites, documentation, individuals and information to monitor,
evaluate and verify the appropriate implementation the activities and use of HHS/CDC funding
under this Agreement.
b. Annual Performance Report (APR) (required)
The recipient must submit the APR via www.Grantsolutions.gov 120 days prior to the end of
the budget period. This report must not exceed 45 pages excluding administrative reporting.
Attachments are not allowed, but weblinks are allowed.
This report must include the following:
 Performance Measures: Recipients must report on performance measures for each
budget period and update measures, if needed.
 Evaluation Results: Recipients must report evaluation results for the work completed to
date (including findings from process or outcome evaluations).
 Work Plan: Recipients must update work plan each budget period to reflect any
changes in period of performance outcomes, activities, timeline, etc.
 Successes
o Recipients must report progress on completing activities and progress towards
achieving the period of performance outcomes described in the logic model and
work plan.

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o Recipients must describe any additional successes (e.g. identified through
evaluation results or lessons learned) achieved in the past year.
o Recipients must describe success stories.
 Challenges
o Recipients must describe any challenges that hindered or might hinder their
ability to complete the work plan activities and achieve the period of
performance outcomes.
o Recipients must describe any additional challenges (e.g., identified through
evaluation results or lessons learned) encountered in the past year.
 CDC Program Support to Recipients
o Recipients must describe how CDC could help them overcome challenges to
complete activities in the work plan and achieving period of performance
outcomes.
 Administrative Reporting (No page limit)
o SF-424A Budget Information-Non-Construction Programs.
o Budget Narrative – Must use the format outlined in "Content and Form of
Application Submission, Budget Narrative" section.
o Indirect Cost Rate Agreement.
The recipient must submit the Annual Performance Report via www.Grantsolutions.gov 120
days prior to the end of the budget period.
Carryover requests must:
 Express a bona fide need for permission to use an unobligated balance;
 Include a signed, dated, and accurate Federal Financial Report (FFR) for the budget
period from which funds will be transferred (as much as 75% of unobligated balances);
and
 Include a list of proposed activities, an itemized budget, and a narrative justification for
those activities.
c. Performance Measure Reporting (optional)
CDC programs may require more frequent reporting of performance measures than annually in
the APR. If this is the case, CDC programs must specify reporting frequency, data fields, and
format for recipients at the beginning of the award period.
d. Federal Financial Reporting (FFR) (required)
The annual FFR form (SF-425) is required and must be submitted 90 days after the end of the
budget period. The report must include only those funds authorized and disbursed during the
timeframe covered by the report. The final FFR must indicate the exact balance of unobligated
funds, and may not reflect any unliquidated obligations. There must be no discrepancies
between the final FFR expenditure data and the Payment Management System’s (PMS) cash
transaction data. Failure to submit the required information by the due date may adversely affect
the future funding of the project. If the information cannot be provided by the due date,
awardees are required to submit a letter of explanation to OGS and include the date by which
56 of 64

the Grants Officer will receive information.
e. Final Performance and Financial Report (required)
This report is due 90 days after the end of the period of performance. CDC programs must
indicate that this report should not exceed 40 pages. This report covers the entire period of
performance and can include information previously reported in APRs. At a minimum, this
report must include the following:
 Performance Measures – Recipients must report final performance data for all process
and outcome performance measures.
 Evaluation Results – Recipients must report final evaluation results for the period of
performance for any evaluations conducted.
 Impact/Results/Success Stories – Recipients must use their performance measure results
and their evaluation findings to describe the effects or results of the work completed
over the period of performance, and can include some success stories.
 A final Data Management Plan that includes the location of the data collected during the
funded period, for example, repository name and link data set(s)
 Additional forms as described in the Notice of Award (e.g., Equipment Inventory
Report, Final Invention Statement).
No additional information.
4. Federal Funding Accountability and Transparency Act of 2006 (FFATA)
Federal Funding Accountability and Transparency Act of 2006 (FFATA), P.L. 109–282, as
amended by section 6202 of P.L. 110–252 requires full disclosure of all entities and
organizations receiving Federal funds including awards, contracts, loans, other assistance, and
payments through a single publicly accessible Web site, http://www.USASpending.gov.
Compliance with this law is primarily the responsibility of the Federal agency. However, two
elements of the law require information to be collected and reported by applicants: 1)
information on executive compensation when not already reported through the SAM, and 2)
similar information on all sub-awards/subcontracts/consortiums over $25,000.
For the full text of the requirements under the FFATA and HHS guidelines, go to:
 https://www.gpo.gov/fdsys/pkg/PLAW-109publ282/pdf/PLAW-109publ282.pdf,
 https://www. fsrs.gov/documents /ffata_legislation_ 110_252.pdf
 http://www.hhs.gov/grants/grants/grants-policies-regulations/index.html#FFATA.

G. Agency Contacts
CDC encourages inquiries concerning this NOFO.
Program Office Contact

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For programmatic technical assistance, contact:
Lazette Lawton, Project Officer
Department of Health and Human Services
Centers for Disease Control and Prevention
Email: 1815COMMS@cdc.gov
Grants Management Office Information
For financial, awards management, or budget assistance, contact:
Stephanie Latham, Grants Management Specialist
Department of Health and Human Services
Office of Grants Services
Email: fzv6@cdc.gov
For assistance with submission difficulties related to www.grants.gov, contact the Contact
Center by phone at 1-800-518-4726.
Hours of Operation: 24 hours a day, 7 days a week, except on federal holidays.
For all other submission questions, contact:
Technical Information Management Section
Department of Health and Human Services
CDC Office of Financial Resources
Office of Grants Services
2920 Brandywine Road, MS E-14
Atlanta, GA 30341
Telephone: 770-488-2700
E-mail: ogstims@cdc.gov
CDC Telecommunications for persons with hearing loss is available at: TTY 1-888-232-6348.
H. Other Information
Following is a list of acceptable attachments applicants can upload as PDF files as part of their
application at www.grants.gov. Applicants may not attach documents other than those listed; if
other documents are attached, applications will not be reviewed.
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Project Abstract
Project Narrative
Budget Narrative
CDC Assurances and Certifications
Report on Programmatic, Budgetary and Commitment Overlap
Table of Contents for Entire Submission

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For international NOFOs:
 SF424
 SF424A
 Funding Preference Deliverables
Optional attachments, as determined by CDC programs:
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Resumes / CVs
Position descriptions
Letters of Support
Organization Charts
Indirect Cost Rate, if applicable
Bona Fide Agent status documentation, if applicable

For this NOFO, there is a 40-page limit for the Project Narrative, inclusive of the Work Plan.
I. Glossary
Activities: The actual events or actions that take place as a part of the program.
Administrative and National Policy Requirements, Additional Requirements
(ARs): Administrative requirements found in 45 CFR Part 75 and other requirements mandated
by statute or CDC policy. All ARs are listed in the Template for CDC programs. CDC programs
must indicate which ARs are relevant to the NOFO; recipients must comply with the ARs listed
in the NOFO. To view brief descriptions of relevant provisions, see http:// www.cdc.gov/
grants/ additional requirements/ index.html. Note that 2 CFR 200 supersedes the administrative
requirements (A-110 & A-102), cost principles (A-21, A-87 & A-122) and audit requirements
(A-50, A-89 & A-133).
Approved but Unfunded: Approved but unfunded refers to applications recommended for
approval during the objective review process; however, they were not recommended for funding
by the program office and/or the grants management office.
Award: Financial assistance that provides support or stimulation to accomplish a public
purpose. Awards include grants and other agreements (e.g., cooperative agreements) in the form
of money, or property in lieu of money, by the federal government to an eligible applicant.
Budget Period or Budget Year: The duration of each individual funding period within the
period of performance. Traditionally, budget periods are 12 months or 1 year.
Carryover: Unobligated federal funds remaining at the end of any budget period that, with the
approval of the GMO or under an automatic authority, may be carried over to another budget
period to cover allowable costs of that budget period either as an offset or additional
authorization. Obligated but liquidated funds are not considered carryover.
Catalog of Federal Domestic Assistance (CFDA): A government-wide compendium

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published by the General Services Administration (available on-line in searchable format as
well as in printable format as a .pdf file) that describes domestic assistance programs
administered by the Federal Government.
CFDA Number: A unique number assigned to each program and NOFO throughout its
lifecycle that enables data and funding tracking and transparency.
CDC Assurances and Certifications: Standard government-wide grant application forms.
Competing Continuation Award: A financial assistance mechanism that adds funds to a grant
and adds one or more budget periods to the previously established period of performance (i.e.,
extends the “life” of the award).
Continuous Quality Improvement: A system that seeks to improve the provision of services
with an emphasis on future results.
Contracts: An award instrument used to acquire (by purchase, lease, or barter) property or
services for the direct benefit or use of the Federal Government.
Cooperative Agreement: A financial assistance award with the same kind of interagency
relationship as a grant except that it provides for substantial involvement by the federal agency
funding the award. Substantial involvement means that the recipient can expect federal
programmatic collaboration or participation in carrying out the effort under the award.
Cost Sharing or Matching: Refers to program costs not borne by the Federal Government but
by the recipients. It may include the value of allowable third-party, in-kind contributions, as
well as expenditures by the recipient.
Direct Assistance: A financial assistance mechanism, which must be specifically authorized by
statute, whereby goods or services are provided to recipients in lieu of cash. DA generally
involves the assignment of federal personnel or the provision of equipment or supplies, such as
vaccines. DA is primarily used to support payroll and travel expenses of CDC employees
assigned to state, tribal, local, and territorial (STLT) health agencies that are recipients of grants
and cooperative agreements. Most legislative authorities that provide financial assistance to
STLT health agencies allow for the use of DA. http:// www.cdc.gov /grants
/additionalrequirements /index.html.
DUNS: The Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number is
a nine-digit number assigned by Dun and Bradstreet Information Services. When applying for
Federal awards or cooperative agreements, all applicant organizations must obtain a DUNS
number as the Universal Identifier. DUNS number assignment is free. If requested by telephone,
a DUNS number will be provided immediately at no charge. If requested via the Internet,
obtaining a DUNS number may take one to two days at no charge. If an organization does not
know its DUNS number or needs to register for one, visit Dun & Bradstreet at
http://fedgov.dnb.com/ webform/displayHomePage.do.
Evaluation (program evaluation): The systematic collection of information about the
activities, characteristics, and outcomes of programs (which may include interventions, policies,
and specific projects) to make judgments about that program, improve program effectiveness,
and/or inform decisions about future program development.
Evaluation Plan: A written document describing the overall approach that will be used to guide
an evaluation, including why the evaluation is being conducted, how the findings will likely be
used, and the design and data collection sources and methods. The plan specifies what will be
done, how it will be done, who will do it, and when it will be done. The NOFO evaluation plan
is used to describe how the recipient and/or CDC will determine whether activities are
implemented appropriately and outcomes are achieved.
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Federal Funding Accountability and Transparency Act of 2006 (FFATA): Requires that
information about federal awards, including awards, contracts, loans, and other assistance and
payments, be available to the public on a single website at www.USAspending.gov.
Fiscal Year: The year for which budget dollars are allocated annually. The federal fiscal year
starts October 1 and ends September 30.
Grant: A legal instrument used by the federal government to transfer anything of value to a
recipient for public support or stimulation authorized by statute. Financial assistance may be
money or property. The definition does not include a federal procurement subject to the Federal
Acquisition Regulation; technical assistance (which provides services instead of money); or
assistance in the form of revenue sharing, loans, loan guarantees, interest subsidies, insurance,
or direct payments of any kind to a person or persons. The main difference between a grant and
a cooperative agreement is that in a grant there is no anticipated substantial programmatic
involvement by the federal government under the award.
Grants.gov: A "storefront" web portal for electronic data collection (forms and reports) for
federal grant-making agencies at www.grants.gov.
Grants Management Officer (GMO): The individual designated to serve as the HHS official
responsible for the business management aspects of a particular grant(s) or cooperative
agreement(s). The GMO serves as the counterpart to the business officer of the recipient
organization. In this capacity, the GMO is responsible for all business management matters
associated with the review, negotiation, award, and administration of grants and interprets
grants administration policies and provisions. The GMO works closely with the program or
project officer who is responsible for the scientific, technical, and programmatic aspects of the
grant.
Grants Management Specialist (GMS): A federal staff member who oversees the business
and other non-programmatic aspects of one or more grants and/or cooperative agreements.
These activities include, but are not limited to, evaluating grant applications for administrative
content and compliance with regulations and guidelines, negotiating grants, providing
consultation and technical assistance to recipients, post-award administration and closing out
grants.
Health Disparities: Differences in health outcomes and their determinants among segments of
the population as defined by social, demographic, environmental, or geographic category.
Health Equity: Striving for the highest possible standard of health for all people and giving
special attention to the needs of those at greatest risk of poor health, based on social conditions.
Health Inequities: Systematic, unfair, and avoidable differences in health outcomes and their
determinants between segments of the population, such as by socioeconomic status (SES),
demographics, or geography.
Healthy People 2020: National health objectives aimed at improving the health of all
Americans by encouraging collaboration across sectors, guiding people toward making
informed health decisions, and measuring the effects of prevention activities.
Inclusion: Both the meaningful involvement of a community’s members in all stages of the
program process and the maximum involvement of the target population that the intervention
will benefit. Inclusion ensures that the views, perspectives, and needs of affected communities,
care providers, and key partners are considered.
Indirect Costs: Costs that are incurred for common or joint objectives and not readily and
specifically identifiable with a particular sponsored project, program, or activity; nevertheless,
these costs are necessary to the operations of the organization. For example, the costs of
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operating and maintaining facilities, depreciation, and administrative salaries generally are
considered indirect costs.
Intergovernmental Review: Executive Order 12372 governs applications subject to
Intergovernmental Review of Federal Programs. This order sets up a system for state and local
governmental review of proposed federal assistance applications. Contact the state single point
of contact (SPOC) to alert the SPOC to prospective applications and to receive instructions on
the State’s process. Visit the following web address to get the current SPOC
list: http://www.whitehouse.gov/omb/ grants_spoc/.
Letter of Intent (LOI): A preliminary, non-binding indication of an organization’s intent to
submit an application.
Lobbying: Direct lobbying includes any attempt to influence legislation, appropriations,
regulations, administrative actions, executive orders (legislation or other orders), or other
similar deliberations at any level of government through communication that directly expresses
a view on proposed or pending legislation or other orders, and which is directed to staff
members or other employees of a legislative body, government officials, or employees who
participate in formulating legislation or other orders. Grass roots lobbying includes efforts
directed at inducing or encouraging members of the public to contact their elected
representatives at the federal, state, or local levels to urge support of, or opposition to, proposed
or pending legislative proposals.
Logic Model: A visual representation showing the sequence of related events connecting the
activities of a program with the programs’ desired outcomes and results.
Maintenance of Effort: A requirement contained in authorizing legislation, or applicable
regulations that a recipient must agree to contribute and maintain a specified level of financial
effort from its own resources or other non-government sources to be eligible to receive federal
grant funds. This requirement is typically given in terms of meeting a previous base-year dollar
amount.
Memorandum of Understanding (MOU) or Memorandum of Agreement
(MOA): Document that describes a bilateral or multilateral agreement between parties
expressing a convergence of will between the parties, indicating an intended common line of
action. It is often used in cases where the parties either do not imply a legal commitment or
cannot create a legally enforceable agreement.
Nonprofit Organization: Any corporation, trust, association, cooperative, or other organization
that is operated primarily for scientific, educational, service, charitable, or similar purposes in
the public interest; is not organized for profit; and uses net proceeds to maintain, improve, or
expand the operations of the organization. Nonprofit organizations include institutions of higher
educations, hospitals, and tribal organizations (that is, Indian entities other than federally
recognized Indian tribal governments).
Notice of Award (NoA): The official document, signed (or the electronic equivalent of
signature) by a Grants Management Officer that: (1) notifies the recipient of the award of a
grant; (2) contains or references all the terms and conditions of the grant and Federal funding
limits and obligations; and (3) provides the documentary basis for recording the obligation of
Federal funds in the HHS accounting system.
Objective Review: A process that involves the thorough and consistent examination of
applications based on an unbiased evaluation of scientific or technical merit or other relevant
aspects of the proposal. The review is intended to provide advice to the persons responsible for
making award decisions.
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Outcome: The results of program operations or activities; the effects triggered by the program.
For example, increased knowledge, changed attitudes or beliefs, reduced tobacco use, reduced
morbidity and mortality.
Performance Measurement: The ongoing monitoring and reporting of program
accomplishments, particularly progress toward pre-established goals, typically conducted by
program or agency management. Performance measurement may address the type or level of
program activities conducted (process), the direct products and services delivered by a program
(outputs), or the results of those products and services (outcomes). A “program” may be any
activity, project, function, or policy that has an identifiable purpose or set of objectives.
Period of performance –formerly known as the project period - : The time during which the
recipient may incur obligations to carry out the work authorized under the Federal award. The
start and end dates of the period of performance must be included in the Federal award.
Period of Performance Outcome: An outcome that will occur by the end of the NOFO’s
funding period
Plain Writing Act of 2010: The Plain Writing Act of 2010 requires that federal agencies use
clear communication that the public can understand and use. NOFOs must be written in clear,
consistent language so that any reader can understand expectations and intended outcomes of
the funded program. CDC programs should use NOFO plain writing tips when writing NOFOs.
Program Strategies: Strategies are groupings of related activities, usually expressed as general
headers (e.g., Partnerships, Assessment, Policy) or as brief statements (e.g., Form partnerships,
Conduct assessments, Formulate policies).
Program Official: Person responsible for developing the NOFO; can be either a project officer,
program manager, branch chief, division leader, policy official, center leader, or similar staff
member.
Public Health Accreditation Board (PHAB): A nonprofit organization that works to promote
and protect the health of the public by advancing the quality and performance of public health
departments in the U.S. through national public health department
accreditation http://www.phaboard.org.
Social Determinants of Health: Conditions in the environments in which people are born, live,
learn, work, play, worship, and age that affect a wide range of health, functioning, and qualityof-life outcomes and risks.
Statute: An act of the legislature; a particular law enacted and established by the will of the
legislative department of government, expressed with the requisite formalities. In foreign or
civil law any particular municipal law or usage, though resting for its authority on judicial
decisions, or the practice of nations.
Statutory Authority: Authority provided by legal statute that establishes a federal financial
assistance program or award.
System for Award Management (SAM): The primary vendor database for the U.S. federal
government. SAM validates applicant information and electronically shares secure and
encrypted data with federal agencies' finance offices to facilitate paperless payments through
Electronic Funds Transfer (EFT). SAM stores organizational information,
allowing www.grants.gov to verify identity and pre-fill organizational information on grant
applications.
Technical Assistance: Advice, assistance, or training pertaining to program development,
implementation, maintenance, or evaluation that is provided by the funding agency.
Work Plan: The summary of period of performance outcomes, strategies and activities,
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personnel and/or partners who will complete the activities, and the timeline for completion. The
work plan will outline the details of all necessary activities that will be supported through the
approved budget.

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