U.S. Department of Health and Human Services s19

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention (CDC)

Addressing Immunization Disparities in Minority Populations

I. AUTHORIZATION AND INTENT

Announcement Type: New – Type 1

Funding Opportunity Number: CDC-RFA-IP11-1101

Catalog of Federal Domestic Assistance Number: 93.185

Key Dates:

Application Deadline Date: July 5, 2011, 5:00pm Eastern Standard Time.

Authority:

This program is authorized under section 317 (k) (1) of the Public Health Service Act [42

U.S.C. 247b (k) (1)], as amended.

Background:

Immunization is one of the greatest of public health achievements, and is counted as a great public health success. When it comes to eliminating disparities among minority groups, the record is mixed. On one hand, some of the new data point to gains in eliminating disparities, such as the overall “up-to-date” rate for US children, ages 19 to

35 months. On the other hand, pockets of under-immunization persist among certain minority groups and remain difficult to change. So, despite many overall gains in reducing disparities, there still remain groups for whom immunization rates are lower than they should be: For example, in the 19 to 35 month cohort, black children have significantly lower immunization rates than white children. Evidence points to other existing disparities in various cohorts, such as lower varicella and Tdap vaccination coverage for African-American teens, and lower influenza and pneumococcal vaccination rates for older Hispanic and African-American adults. These and other under-immunized minority groups are the target groups of this FOA.

Purpose:

The purpose of the program will be to implement effective approaches for improving immunization rates among one or more minority groups for whom studies show evidence of under-immunization or other disparities in vaccine coverage. For the purpose of this project, minority groups are defined as in the 2000 census: American Indian or Alaskan

Native, Asian American, Black or African American, Hispanic or Latino, and Native

Hawaiian or other Pacific Islander.

This program addresses the "Healthy People 2020" focus area of immunization. Healthy

People 2020 identifies target goals for the immunization focus area, and these in turn are based on the current vaccine recommendations coming from the Advisory Committee on

Immunization Practice (ACIP). In addition, Healthy People 2020 outlines four overreaching goals, one of which one aims “to achieve health equity, eliminate disparities and improve the health for all groups.” In addition to congruence with Healthy People

2020, this program also is in alignment with the HHS Action Plan to Reduce Racial and

Ethnic Disparities. Released April 8, 2011, this action plan outlines goals and actions

HHS will take to reduce health disparities among racial and ethnic minorities.

2 Thus, this project’s goals are in line with Healthy People 2020, the recommendations of the ACIP and the HHS Action Plan to Reduce Racial and Ethnic Health Disparities.

Executive Summary:

The purpose of these projects will be to implement effective approaches for increasing immunization rates among minority groups (American Indian or Alaska Native, Asian

American, Black or African American, Hispanic or Latino, and Native Hawaiian or other

Pacific Islander) experiencing low immunization rates or disparities in vaccine coverage.

Applicants must justify targeting a particular minority group by providing data documenting under-immunization or other immunization disparities within the target group (for example, the target group may have less access to vaccine services, lower enrollment in vaccine registries or the Vaccines for Children (VFC) program, or a higher prevalence of vaccine myths and/or misconceptions when compared to the general population.)

This project will support up to three organizations to develop and implement a set of immunization-related activities for their respective target audiences. Activities should build on one or more successful strategies identified in the Community Guide.”Strategies for Universally Recommended Vaccines” can be found at http://www.thecommunityguide.org/vaccines/universally/index.html and “Strategies for targeted coverage” can be found at http://www.thecommunityguide.org/vaccines/targeted/index.html).

3 Applicants must demonstrate their history of representation of this target group and documented success in collaborating with this group on a public health issue.

Measurable outcomes of the program are in alignment with performance goals for the

National Center for Immunization and Respiratory Diseases, as delineated in Healthy

People 2020 and in the HHS Action Plan to Reduce Racial and Ethnic Disparities:

Healthy People 2020 outlines comprehensive public health goals for the nation and delineates several measurable outcomes related to vaccine-preventable diseases. The overarching goals of Healthy People 2020 are:

 Attain high-quality, longer lives free of preventable disease, disability, injury, and

premature death.

 Achieve health equity, eliminate disparities, and improve the health of all groups.

 Create social and physical environments that promote good health for all.

 Promote quality of life, healthy development, and healthy behaviors across all life

stages.

The overriding mission of NCIRD is aligned with the specific goals of Healthy People

2020 as they relate to immunization and infectious diseases. These are found here: http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=23

More specifically, NCIRD’s mission is aligned with Goal Number IID-1: Reduce, eliminate, or maintain elimination of cases of vaccine-preventable diseases .

Measurable outcomes of the program are also in alignment with the HHS Action Plan to

Reduce Racial and Ethnic Disparities. Released April 8, 2011, this action plan outlines

4 goals and actions HHS will take to reduce health disparities among racial and ethnic minorities. It is found here: http://www.minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=285

A specific goal of this action plan is Goal Number III.A.6: Implement targeted activities to reduce disparities in flu vaccination.

Finally, NCIRD bases its work on the technical guidance of the Advisory Committee on

Immunization Practice, which is the official body charged with making immunization recommendations for the United States.

Further detail on ACIP recommendations are found here: http://www.cdc.gov/vaccines/recs/acip/default.htm and here http://www.cdc.gov/vaccines/pubs/ACIP-list.htm

Projects funded will be able to show improvements in the immunization rates, knowledge or attitudes of the specified target population through direct or proxy measures.

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be reviewed. For the definition of research, please see the CDC Web site at the following Internet address: http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health- research-nonresearch.pdf

5 II. PROGRAM IMPLEMENTATION

Recipient Activities:

Activities should utilize successful strategies identified in the Community Guide to improve immunization rates. Applicants must identify a specific target group for whom they have solid science-based evidence of under-immunization or disparities in access to vaccine services or vaccine coverage.

Activities should include but are not limited to:

 Develop and implement a set of activities to increase immunization rates among

the targeted under-immunized minority group using proven strategies from the

Community Guide.

 Demonstrate how the project activities proposed in your application will

contribute to organizational capacity and will be sustained beyond the life of the

three-year project period.

 Evaluate all major program objectives and activities to determine programmatic

effectiveness. Make recommendations for replicating project strategies, when

appropriate. Report on lessons learned.

 Work in conjunction with CDC NCIRD and partners to avoid duplication of

efforts and to ensure compatibility with the most current science and public health

programming.

In a cooperative agreement, CDC staff is substantially involved in the program activities, above and beyond routine grant monitoring.

CDC Activities:

6  Provide technical assistance in implementing activities, identifying major

immunization issues, setting program priorities and developing effective

programs, as related to the cooperative agreement.

 Provide scientific collaboration for appropriate aspects, including information on

disease impact, vaccination coverage levels, and prevention strategies.

 Review of immunization messages and materials.

 Provide technical assistance in interpreting risk factors for contracting vaccine-

preventable diseases.

 Provide assistance in the evaluation of each plan component (process and

outcome) through the analysis and interpretation of coverage and other relevant

 Facilitate the transfer of successful prevention interventions and program models

to other areas through meetings of grantees, workshops, conferences, newsletters,

and communications with project officers.

 Facilitate partnering to enhance the exchange of program information and

technical assistance between community organizations, state and local health

departments, coalitions, and national and regional organizations.

III. AWARD INFORMATION AND REQUIREMENTS

Type of Award: Cooperative Agreement.

CDC’s substantial involvement in this program appears in the Activities Section above.

Award Mechanism: U21 - Immunization Services for Racial and Ethnic Minorities--

Cooperative Agreements

7 Fiscal Year Funds: 2011

Approximate Current Fiscal Year Funding: $600,000

Approximate Total Project Period Funding: $ 1,800,000 (This is an estimate, and is subject to availability of funds.) This figure includes both direct and indirect costs.

Approximate Number of Awards: Up to three awards

Approximate Average Award: $ 200,000 (This amount is for the first 12-month budget period, and includes both direct and indirect costs)

Floor of Individual Award Range: None

Ceiling of Individual Award Range: $200,000 (This ceiling is for the first 12-month budget period, and includes both direct and indirect costs.)

Anticipated Award Date: September 29, 2011

Budget Period Length: 12 months

Project Period Length: Three Years

Throughout the project period, CDC’s commitment to continuation of awards will be conditioned on the availability of funds, 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.

IV. ELIGIBILITY

Eligible applicants that can apply for this funding opportunity are listed below:

 Nonprofit with 501(c)(3) IRS status (other than institution of higher education)  Nonprofit without 501(c)(3) IRS status (other than institution of higher education)  Faith-based organizations  Federally recognized or state-recognized American Indian/Alaska Native tribal governments

8  American Indian/Alaska native tribally designated organizations  Alaska Native health corporations  Urban Indian health organizations

Justification for Limited Eligibility:

While CDC is viewed as a trusted and credible source for immunization information, recent studies have shown that many people are influenced by immunization information from web-based communications or other electronic media resources, some of which is not scientific, accurate, or credible (see Vaccine Criticism on the World Wide Web,

Zimmerman et al, J Med Internet Res., 2005 Jun3 29; 7(2):e17) and Antivaccination

Activists on the World Wide Web, Davies P, Chapman S, Leask J, Arch Dis Child, 2002

Jul;87(1):22-5). This cooperative agreement is designed to provide an alternate source of scientific, accurate and credible immunization information in reaching minority populations through various venues including electronic and/or digital formats to complement CDC’s own web-based resources, and to provide information for persons who would prefer to receive immunization information from non-government sources.

Interested applicants are eligible to apply for this announcement under the program authority to the extent that they are non-profit private entities. Also, since the intent of this announcement is to support national activities, state and local governments are not eligible, as there is a need for a uniform approach across the country that is national in scope. While state and local governments receive funds to support immunization programs through the Vaccines for Children and 317 Immunization Grants Program, there are few resources for national programs such as those supported under the proposed

9 cooperative agreement. Educational institutions would not possess the infrastructure or the national presence in the healthcare community necessary to conduct the activities of this program announcement. For the purpose of this announcement, National is defined as having an active membership of at least 500 members with representation in the majority of U.S. states.

For the purpose of this announcement:

 National is defined as having an active membership of at least 500 members with

representation in the majority of U.S. states.

SPECIAL ELIGIBILITY CRITERIA: Licensing/Credential/Permits

Cost Sharing or Matching

Cost sharing or matching funds are not required for this program.

Maintenance of Effort

Maintenance of Effort is not required for this program.

If a funding amount greater than the ceiling of the award range is requested, the application will be considered non-responsive and will not be entered into the review process. The applicant will be notified that the application did not meet the eligibility requirements.

Special Requirements:

10 If the application is incomplete or non-responsive to the special requirements listed in this section, it will not be entered into the review process. The applicant will be notified that the application did not meet submission requirements.

 Late applications will be considered non-responsive. See section “V, submission

for more information on deadlines.

 The applicant must be an established, tax-exempt organization (a

nongovernmental, tax-exempt corporation or association whose net earnings in no

way lawfully accrue to the benefit of private shareholders or individuals). Tax-

exempt status may be confirmed by providing a copy of the pages from the

Internal Revenue Service’s (IRS) most recent list of 501 (c) (3) of tax-exempt

organizations or a copy of the current IRS Determination Letter with the

application. This should be labeled as Appendix A.

 The applicant must be national in scope. For the purpose of this cooperative

agreement, “national” is defined as having an active membership of at least 500

members and representation in the majority of U.S. states. Persons who may

benefit from the organization’s mission do not automatically qualify as “active”

members. To qualify as “active”, individuals must meet all criteria the

organization sets for membership, including, but not limited to, being current in

payment of dues, if this is required by the organization. Please include a statement

signed by the organization’s president or Board of Directors describing

specifically how the applicant meets this criteria and label it as “Appendix B.”

 The applicant must have experience in administering one or more national public

health programs specifically serving the minority group targeted with this

11 application. It may be highly beneficial if the applicant’s primary constituency is

from the target population, but it is not a requirement of this cooperative

agreement. List this experience along with dates, describing both programmatic

and fiscal management of the program(s). (Please include as Appendix C)

Note: Title 2 of the United States Code Section 1611 states that an organization described in Section 501(c)(4) of the Internal Revenue Code that engages in lobbying activities is not eligible to receive Federal funds constituting a grant, loan, or an award.

Intergovernmental Review of Applications

Executive Order 12372 does not apply to this program.

V. APPLICATION CONTENT

Unless specifically indicated, this announcement requires submission of the following information:

Project Abstract

Statement of Need

Organization Profile and Capacity

Program Plan

Evaluation Plan

Budget

A Project Abstract must be completed in the Grants.gov application forms. The Project

Abstract must contain a summary of the proposed activity suitable for dissemination to

12 the public. It should be a self-contained description of the project and should contain a statement of objectives and methods to be employed. It should be informative to other persons working in the same or related fields and insofar as possible understandable to a technically literate lay reader. This abstract must not include any proprietary/confidential information.

A Project Narrative must be submitted with the application forms. The project narrative must be uploaded in a PDF file format when submitting via Grants.gov. The narrative must be submitted in the following format:

 Include abstract before Table of Contents (TOC)

 Include TOC

 Maximum number of pages: 25 (excluding the face page, abstract, TOC, budget,

budget justification, and appendices). If your narrative exceeds the page limit,

only the first pages which are within the page limit will be reviewed.

 Font size: 12 point unreduced, Times New Roman

 Double spaced

 Paper size: 8.5 by 11 inches

 Page margin size: One inch

 Printed only on one side of page.

 Number all narrative pages of the application sequentially from page 1, excluding

face page, abstract, TOC, budget, budget justification and appendices; not to

exceed the maximum number of pages. Letter all appendices from A-Z. The

appendices will not be counted toward the narrative page limit; however,

13 applicants should be careful to include only relevant materials in the appendices;

all materials will be evaluated and the inclusion of irrelevant materials could

weaken or negatively impact applications.

 Held together only by rubber bands or metal clips; not bound in any other way.

Potential applicants are encouraged to participate in a conference call to address any questions about this FOA. The call will be held on June 3, 2011 from 2:30 p.m. to 3:30 p.m. Eastern Time. To access the conference line, call 888-323-4515 and enter the participant passcode of 7231697.

The narrative should address activities to be conducted over the entire project period and must include the following items in the order listed:

Statement of Need

This section should include:

 A description of the target group including relevant information such as

population size, geographic location, density, racial and ethnic characteristics,

income levels.

 Justification for the selection of this group as your target audience i.e. science-

based evidence of under-immunization or other immunization-related disparities

that contribute to under-immunization.

 A brief review of the literature concerning barriers and successful interventions

for improving immunization rates in your target audience.

14 Organizational Profile and Capacity

 A brief description of the organization (description of membership, goals, and

history).

 Evidence of the organization’s reach, entrée, and/or affiliation with the intended

target group. It may be highly beneficial if the applicant’s primary constituency is

from the target population, but it is not a requirement of this cooperative

agreement.

 Evidence that the organization is a trusted source of health information in the

target community.

 History of the organization’s successful management of a public health program

with the target group.

 Qualifications and experience of project staff.

 An organizational chart of the applicant organization, specifying the location and

staffing plan for the proposed project (may be alluded to in this section and

included in appendices).

 If applicable, letters of support from potential program partners. Any letters of

support should include a description of the specific role partner organization(s)

will have in supporting this project. Include these as Appendix D

Program Plan

15 A plan for a set of activities that draw on the recommended approaches from the

Community Guide to Preventive Services

(http://www.thecommunityguide.org/vaccines/universally/index.html.) to improve immunization rates or other relevant proxy measures. Applicants may choose to conduct pilot interventions in a specified geographic area if the ultimate goal is to replicate the program on a national scale.

 For universally recommended vaccines, these approaches are:

 Home visits to increase vaccination coverage  Multi-component interventions for expanding access in healthcare settings  Reducing client out-of-pocket costs (Note: Organizations cannot use project funds to purchase vaccine)  Vaccination programs in schools and organized child care centers  Vaccination programs in WIC settings  Multi-component interventions that include education  Vaccination requirements for child care, school and college attendance  Provider assessment and feedback when used alone  Provider reminder systems when used alone  Standing orders when used alone

If the evidence supports the need, an applicant may aim to focus on a specific vaccine or vaccines within the target population. To increase vaccination coverage for influenza, pneumococcal disease, and hepatitis B among adults at high-risk for infection or complications of infection because of occupational, behavioral, or health factors, use these targeted approaches from the community guide

(http://www.thecommunityguide.org/vaccines/targeted/index.html.):

 Multiple interventions implemented in combination  Provider reminder systems when used alone  Vaccination programs in schools and organized childcare settings.

16  Description of intended means for obtaining additional resources from non-

federal sources to supplement program activities and ensure continuation of

project activities after the end of the project period.

Evaluation Plan

 A comprehensive plan for evaluating and monitoring the success of your project.

Tie all objectives to program goals, and for each objective, detail specific process

and impact measures. Process measures determine the extent to which the

program was implemented according to plan. Impact measures assess changes in

immunization rates or other proxy measures. Examples of proxy measures would

be quantifiable decreases in the target group’s adherence to vaccine myths or

misconceptions; comparisons of enrollment rates in Vaccines for Children (VFC)

program; closing of gaps in fully immunized groups, as seen in the Medicare

program; reduction in number of school exemption.

 All objectives should be SMART: (Specific, Measurable, Achievable, Relevant,

and Time-Bound.) For example, by the end of Year 3 of the project, participating

childcare programs will show a 25% increase in the number of children in the

target group who are vaccinated for seasonal influenza. Provide baseline, one-year

interim and three-year overall target performance measures.

 Describe plans for using evaluation data to improve your program.

 Provide a plan for disseminating project results indicating when, to whom, and in

what format the material will be presented.

17 Budget Information (not counted against the 25 page maximum)

Provide an itemized (line-item) budget. Provide a detailed budget with

justification categorized by objective and consistent with the purpose and program

plan of the proposed project. Provide a travel allotment within the budget for

travel to the annual National Immunization Conference (location varies) and also

to an annual CDC reverse site visit in Atlanta, GA.

Additional information may be included in the application appendices. The appendices will not be counted toward the narrative page limit. This additional information includes, but is not limited to:

. Memoranda of agreement from collaborating organizations indicating a

willingness to participate in the project, the nature of their participation period of

performance, names and titles of individuals who will be involved in the project,

and the process of collaboration. Each memorandum should also show how these

organizations will be involved. Include these as Appendix D

. Resumes or CV for individuals that will play a major role in implementing the

proposed program. Include these as Appendix E.

The applicant must submit all application attachments using a PDF file format when submitting via Grants.gov. Directions for creating PDF files can be found on the

Grants.gov Web site. Use of file formats other than PDF may result in the file being unreadable by staff. Additional information submitted via Grants.gov should be uploaded in a PDF file format, and appendices should be labeled. Appendices may include but need not be limited by these label headings:

18 Appendix A: Proof of tax-exempt status

Appendix B: Statement signed by organization’s president or Board of Directors

as evidence of the organization’s national scope

Appendix C: Description of the organization’s experience in administering one or

more national public health programs specifically serving the minority group

targeted with this application

Appendix D: Letters of support and/or memoranda of understanding from

organizations.

Appendix E: Resumes or CV for staff

Appendix F: Indirect Cost Rate Agreement

No more than 10 appendices should be uploaded per application

Additional requirements for additional documentation with the application are listed in

Section VII. Award Administration Information; subsection entitled “Administrative and

National Policy Requirements.”

APPLICATION SUBMISSION

Registering your organization through www.Grants.gov, the official agency-wide E-grant website, is the first step in submitting an application online. Registration information is located on the “Get Registered” screen of www.Grants.gov. Please visit www.Grants.gov at least 30 days prior to submitting your application to familiarize yourself with the registration and submission processes. The “one-time” registration process will take three to five days to complete. However, the Grants.gov registration

19 process also requires that you register your organization with the Central Contractor

Registry (CCR) annually. The CCR registration can require an additional one to two days to complete.

Submit the application electronically by using the forms and instructions posted for this funding opportunity on www.Grants.gov. If access to the Internet is not available or if the applicant encounters difficulty in accessing the forms on-line, contact the HHS/CDC

Procurement and Grant Office Technical Information Management Section (PGO-TIMS) staff at (770) 488-2700 for further instruction.

Note: Application submission is not concluded until successful completion of the validation process.

After submission of your application package, applicants will receive a “submission receipt” email generated by Grants.gov. Grants.gov will then generate a second e-mail message to applicants which will either validate or reject their submitted application package. This validation process may take as long as two (2) business days. Applicants are strongly encouraged check the status of their application to ensure submission of their application package is complete and no submission errors exists. To guarantee that you comply with the application deadline published in the Funding Opportunity Announcement, applicants are also strongly encouraged to allocate additional days prior to the published deadline to file their application. Non-validated applications will not be accepted after the published application deadline date.

In the event that you do not receive a “validation” email within two (2) business days of application submission, please contact Grants.gov. Refer to the email message generated at the time of application submission for instructions on how to track your application or the Application User Guide, Version 3.0 page 57.

Other Submission Requirements

Dun and Bradstreet Universal Number (DUNS)

The applicant is required to have a Dun and Bradstreet Data Universal Numbering

System (DUNS) identifier to apply for grants or cooperative agreements from the Federal government. The DUNS is a nine-digit number which uniquely identifies business

20 entities. There is no charge associated with obtaining a DUNS number. Applicants may obtain a DUNS number by accessing the Dun and Bradstreet website or by calling 1-866-

705-5711.

Electronic Submission of Application:

Applications must be submitted electronically at www.Grants.gov. Electronic applications will be considered as having met the deadline if the application has been successfully submitted electronically by the applicant organization’s Authorized

Organizational representative (AOR) to Grants.gov on or before the deadline date and time.

The application package can be downloaded from www.Grants.gov. Applicants can complete the application package off-line, and then upload and submit the application via the Grants.gov Web site. The applicant must submit all application attachments using a

PDF file format when submitting via Grants.gov. Directions for creating PDF files can be found on the Grants.gov Web site. Use of file formats other than PDF may result in the file being unreadable by staff.

Applications submitted through Grants.gov (http://www.grants.gov), are electronically time/date stamped and assigned a tracking number. The AOR will receive an e-mail notice of receipt when HHS/CDC receives the application. The tracking number serves as a receipt of submission.

If the applicant encounters technical difficulties with Grants.gov, the applicant should contact Grants.gov Customer Service. The Grants.gov Contact Center is available 24 hours a day, 7 days a week. The Contact Center provides customer service to the applicant community. The extended hours will provide applicants support around the

21 clock, ensuring the best possible customer service is received any time it’s needed. You can reach the Grants.gov Support Center at 1-800-518-4726 or by email at [email protected]. Submissions sent by e-mail, fax, CDs or thumb drives of applications will not be accepted.

Organizations that encounter technical difficulties in using www.Grants.gov to submit their application must attempt to covercome those difficulties by contacting the Grants.gov Support Center (1-800-518-4726, [email protected]). After consulting with the Grants.gov Support Center, if the technical difficulties remain unresolved and electronic submission is not possible to meet the established deadline, organizations may submit a request prior to the application deadline by email to PGO TIMS for permission to submit a paper application. An organization’s request for permission must: (a) include the Grants.gov case number assigned to the inquiry, (b) describe the difficulties that prevent electronic submission and the efforts taken with the Grants.gov Support Center, (c) be submitted to PGO TIMS at least 3 calendar days prior to the application deadline. Paper applications submitted without prior approval will not be considered.

If a paper application is authorized, the applicant will receive instructions from PGO TIMS to submit the original and two hard copies of the application by mail or express delivery service.

Submission Dates and Times

This announcement is the definitive guide on LOI and application content, submission, and deadline. It supersedes information provided in the application instructions. If the application submission does not meet the deadline published herein, it will not be eligible for review and the applicant will be notified the application did not meet the submission requirements. The application face page will be returned by HHS/CDC with a written explanation of the reason for non-acceptance.

Application Deadline Date: July 5, 2011, 5:00pm Eastern Standard Time

22 (See full explanation in note found in Section V. Application Submission)

Explanation of Deadlines: Applications must be received in the CDC Procurement and

Grants Office by 5:00 p.m. Eastern Standard Time on the deadline date.

VI. APPLICATION REVIEW INFORMATION

Eligible applicants are required to provide measures of effectiveness that will demonstrate the accomplishment of the various identified objectives of the FOA Number

CDC-RFA-IP11-1101. Measures of effectiveness must relate to the performance goals stated in the “Purpose” section of this announcement. Measures of effectiveness must be objective, quantitative and measure the intended outcome of the proposed program. The measures of effectiveness must be included in the application and will be an element of the evaluation of the submitted application.

Evaluation Criteria

Eligible applications will be evaluated against the following criteria:

Statement of Need (20 Points)

 How well does the applicant describe the target group including population size,

geographic location, density, racial and ethnic characteristics and income levels?

 How well does the applicant justify the selection of this group as target?

 In reviewing the literature of immunization interventions for this target group,

how well does the applicant highlight barriers and successful strategies for

increasing immunization rates (or other proxy measures)?

23  How well does the applicant reference all data sources (published and

unpublished)? Are data sources reputable and verifiable?

Organizational Profile and Capacity (20 Points)

 Based on the applicant’s description of the organization’s membership, goals,

infrastructure and history, would this organization have the capacity to

successfully carry out this project?

 How well does the applicant provide evidence of the organization’s reach, entrée,

and or affiliation with the intended target group?

 Are the applicant’s past and current experiences, knowledge, and expertise

documented and relevant? Does the applicant include details of past experiences

working with this target group on a major public health issue?

 How qualified and experienced are the proposed personnel for the project?

(Curricula vitae for the principal investigator and other project staff may be

referred to in the narrative and included in the appendices.)

 Are staff roles and responsibilities defined and appropriate? (An organizational

chart of the applicant organization illustrating the location for the proposed

project and project staff may be referred to in the narrative and included in the

appendices.)

 Does the applicant include relevant letters of support from collaborating

organizations? If so, do they include a description of the specific role partner

organization(s) will have in supporting this project?

24 Program Plan (40 points)

 How well are the applicants plans tied to the statement of need?

 To what extent do program activities utilize successful approaches from the

community guide? If applicable (some of the community guide strategies require

a multi-component approach), is the applicant using multi-component

interventions?

 To what extent is this program likely to have a measurable impact on the minority

group targeted?

 How thorough and realistic is the applicant’s plan for obtaining additional

resources from non-federal sources to supplement program activities and to

ensure continuation of the activities after the end of the project period?

Evaluation Plan (20 points)

 How comprehensive and realistic is the applicant’s plan to evaluate the significant

aspects of its program?

 If the evaluation plan will report on “proxy measures”, does the applicant make

the case that these proxy measures are the next best thing to tracking actual

immunization rates? Or, alternately, does the applicant make the case that the use

of proxy measures will provide a true indication of project success?

 Does the plan provide baseline measures or include a plan as to how baseline

measures will be obtained? Is this approach realistic? Will it yield reliable results?

 Does the plan include one-year and three-year overall target performance

measures? Do these include process measures (the extent to which the program

25 was implemented according to the program plan)? Do these include

impact/outcome measures (the extent to which the program increased

immunization rates or other proxy measures.)

 Are measurable objectives SMART: (Specific, Measurable, Achievable, Relevant,

and Time-Bound?)

 Does the applicant have a plan in place for using process and outcome data to

improve the program and ensure long-term project success?

Budget (SF 424A) and Budget Narrative (Reviewed, but not scored)

 Is the proposed budget adequately justified, reasonable, and consistent with

proposed project activities and this program announcement?

 Is the budget presented in a table format as shown on

http://www.cdc.gov/od/pgo/funding/budgetguide/htm? Is a written narrative

provided describing and justifying each line item in the table?

 Is funding set aside for travel to the annual National Immunization Conference

and an annual reverse site visit to the CDC in Atlanta, GA during the project

period?

 Is at least 15-20% of the budget set aside for evaluation?

 If the indirect cost rate is a provisional rate, the agreement should be less than 12

months of age. The indirect cost rate agreement should be uploaded as a PDF file

with “Other Attachment Forms” when submitting via Grants.gov. This should be

labeled as Appendix F.

26 Funding Restrictions

Restrictions, which must be taken into account while writing the budget, are as follows:

 Recipients may not use funds for research.

 Recipients may not use funds for clinical care.

 Recipients may only expend funds for reasonable program purposes, including

personnel, travel, supplies, and services, such as contractual.

 Awardees may not generally use HHS/CDC/ATSDR funding for the purchase of

furniture or equipment. Any such proposed spending must be identified in the

budget.

 The direct and primary recipient in a cooperative agreement program must

perform a substantial role in carrying out project objectives and not merely serve

as a conduit for an award to another party or provider who is ineligible.

 Reimbursement of pre-award costs is not allowed.

The applicant can obtain guidance for completing a detailed justified budget on the CDC website, at the following Internet address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm

Application Review Process

All eligible applications will be initially reviewed for completeness by the Procurement and Grants Office (PGO) staff. In addition, eligible applications will be jointly reviewed for responsiveness by NCIRD and PGO. Incomplete applications and applications that are non-responsive to the eligibility criteria will not advance through the review process.

27 Applicants will be notified the application did not meet eligibility and/or published submission requirements.

An objective review panel will evaluate complete and responsive applications according to the criteria listed in Section VI. Application Review Information, subsection entitled

“Evaluation Criteria”. Note: The Objective Review Panel can consist of CDC employees from outside the National Center. Once this requirement is satisfied, the remaining panel personnel may come from the divisions within the granting CIO.

Applications Selection Process

Applications will be funded in order by score and rank determined by the review panel.

CDC will provide justification for any decision to fund out of rank order.

VII. AWARD ADMINISTRATION INFORMATION

Award Notices

Successful applicants will receive a Notice of Award (NoA) from the CDC Procurement and Grants Office. The NoA shall be the only binding, authorizing document between the recipient and CDC. The NoA will be signed by an authorized Grants Management

Officer and e-mailed to the program director. A copy of the NoA will be e-mailed to the recipient fiscal officer identified in the application.

Unsuccessful applicants will receive notification of the results of the application review by mail.

28 Administrative and National Policy Requirements

Successful applicants must comply with the administrative requirements outlined in 45

Code of Federal Regulations (CFR) Part 74 or Part 92, as appropriate. The following additional requirements apply to this project:

 AR-7 Executive Order 12372

 AR-8 Public Health System Reporting Requirements

 AR-10 Smoke-Free Workplace Requirements

 AR-11 Healthy People 2020

 AR-12 Lobbying Restrictions

 AR-14 Accounting System Requirements

 AFR-15 Proof of Non-profit Status

 AR-20 Conference Support

 AR-29 Compliance with E013513 Federal Leadership on Reducing Text

Messaging While Driving

Additional information on the requirements can be found on the CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/Addtl_Reqmnts.htm.

For more information on the Code of Federal Regulations, see the National Archives and

Records Administration at the following Internet address: http://www.access.gpo.gov/nara/cfr/cfr-table-search.html

29 CDC Assurances and Certifications can be found on the CDC Web site at the following

Internet address: http://www.cdc.gov/od/pgo/funding/grants/foamain.shtm

TERMS AND CONDITIONS

Reporting Requirements

Each funded applicant must provide CDC with an annual Interim Progress Report submitted via www.grants.gov:

1. The interim progress report is due no less than 90 days before the end of the

budget period. The Interim Progress Report will serve as the non-competing

continuation application, and must contain the following elements:

a. Standard Form (“SF”) 424S Form

b. SF-424A Budget Information-Non-Construction Programs.

c. Budget Narrative

d. Indirect Cost Rate Agreement.

e. Summary: For this section, consider any activities/information from the

date of your last report to today’s date. Are you on schedule and getting

the expected results from your recent activities? Have there been any

recent programmatic shifts? What barriers or problems have you

encountered since the date of your last report? (For each barrier, indicate

steps towards resolution.) Describe recent personnel changes or

anticipated changes. Describe recent media coverage, presentations,

consultation. Describe evaluation activities and results.

f. Future Plans: Detail plans for new activities and describe how they fit into

30 your overall project goals. Describe where your project will go in the

future.

g. Progress: Using a table format, describe progress in meeting objectives.

Please make sure goals are time-based and measurable, and be sure to

include goals for the next project period. The same tables can be updated

throughout the project period. Please include each of the following

headings: Objective, Activities, Timeframe, and Status (when the activity

was completed or expected completion date).

h. Partners: Using a table format, indicate new and continuing partnerships

developed as a result of direct or indirect association with project

including state and local health departments, provider groups or

individuals, and non-traditional partnerships e.g. faith-based. Please

include each of the following headings: Name of Partnering Organization

or Individual, Description of Collaboration, and Timeframe.

i. Products: Using a table format, indicate any new documents e.g. surveys,

press releases, manuals, policies, etc. developed as a result of direct or

indirect association with project. Please include each of the following

headings: Name of Products, Target audience(s), Distribution method(s),

and Estimated Number of Recipients.

j. Appendices. Attach any materials you developed and other relevant

documents.

Additionally, funded applicants must provide CDC with an original, plus two hard copies

31 of the following reports:

2. Annual progress report, 90 days after the end of the budget period. The progress

report should include:

a. Summary: For this section, consider any activities/information from the

date of your last report to today’s date. Are you on schedule and getting

the expected results from your recent activities? Have there been any

recent programmatic shifts? What barriers or problems have you

encountered since the date of your last report? (For each barrier, indicate

steps towards resolution.) Describe recent personnel changes or

anticipated changes. Describe recent media coverage, presentations,

consultation. Describe evaluation activities and results.

b. Future Plans: Detail plans for new activities and describe how they fit into

your overall project goals. Describe where your project will go in the

future.

c. Progress: Using a table format, describe progress in meeting objectives.

Please make sure goals are time-based and measurable, and be sure to

include goals for the next project period. The same tables can be updated

throughout the project period. Please include each of the following

headings: Objective, Activities, Timeframe, and Status (when the activity

was completed or expected completion date).

d. Partners: Using a table format, indicate new and continuing partnerships

developed as a result of direct or indirect association with project

including state and local health departments, provider groups or

32 individuals, and non-traditional partnerships e.g. faith-based. Please

include each of the following headings: Name of Partnering Organization

or Individual, Description of Collaboration, and Timeframe.

e. Products: Using a table format, indicate any new documents e.g. surveys,

press releases, manuals, policies, etc. developed as a result of direct or

indirect association with project. Please include each of the following

headings: Name of Products, Target audience(s), Distribution method(s),

and Estimated Number of Recipients.

f. Appendices. Attach any materials you developed and other relevant

documents

3. Financial status report (SF 269), due no more than 90 days after the end of the

budget period.

4. Final performance and Financial Status reports, no more than 90 days after the

end of the project period.

These reports must be submitted to the attention of the Grants Management Specialist listed in the Section VIII below entitled “Agency Contacts”.

VIII. AGENCY CONTACTS

CDC encourages inquiries concerning this announcement.

For programmatic technical assistance, contact:

Susan Farrall

Centers for Disease Control and Prevention

33 National Center for Immunization and Respiratory Diseases

1600 Clifton Road, MS E-52

Atlanta, GA 30333

Telephone: 404-639-8852

E-mail: [email protected]

For financial, grants management, or budget assistance, contact:

Peaches Brown, Grants Management Specialist

Department of Health and Human Services

CDC Procurement and Grants Office

2920 Brandywine Road, MS K-14

Atlanta, GA 30341

Telephone: 770-488-2738

E-mail: [email protected]

For general questions, contact:

Technical Information Management Section

Department of Health and Human Services

CDC Procurement and Grants Office

2920 Brandywine Road, MS E-14

Atlanta, GA 30341

Telephone: 770-488-2700

Email: [email protected]

34 CDC Telecommunications for the hearing impaired or disabled is available at: TTY 770-

488-2783.

Other Information

The Immunization Action Coalition (IAC) has compiled a bibliography of current journal articles concerning racial disparities in immunizations. It can be found at http://www.immunize.org/journalarticles/toi_race.asp.