[Federal Register: April 20, 2005 (Volume 70, Number 75)]
[Notices]
[Page 20555-20563]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr20ap05-64]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Addressing Asthma From a Public Health Perspective: Part A;
Enhanced; Notice of Availability of Funds
Announcement Type: New.
Funding Opportunity Number: RFA 05044.
Catalog of Federal Domestic Assistance Number: 93.283.
Key Dates: Application Deadline: June 6, 2005.
I. Funding Opportunity Description
Authority: This program is authorized under Sections 301 and 317
of the Public Health Service Act, (42 U.S.C. 241 and 247b), as
amended.
Purpose: The purpose of the program is to provide the impetus to
further develop program capacity to address asthma from a public health
perspective to bring about: (1) A focus of asthma-related activity
within the state; (2) an increased understanding of asthma-related data
and its application to program planning through development of an
ongoing surveillance system; (3) an increased recognition, within the
public health structure of a state, of the potential to use a public
health approach to reduce the burden of asthma; (4) linkages of the
state to many agencies and organizations addressing asthma in the
population; and (5) participation in intervention program activities.
This program addresses the ``Healthy People 2010'' focus areas of
Environmental Health, Occupational Safety and Health, and Respiratory
Diseases.
Epidemiological surveillance is: ``the ongoing systematic
collection, analysis, and interpretation of health data essential to
the planning, implementation, and evaluation of public health practice,
closely integrated with the timely dissemination of these data to those
who need to know. The final link in the surveillance chain is the
application of these data to prevention and control. A surveillance
system includes a functional capacity for data collection, analysis,
and dissemination linked to public health programs.'' Refer to citation
in Attachment I, ``The Public Health Surveillance of Asthma,'' for more
information. (All attachments will be posted with this program
announcement on the CDC Web site.)
Measurable outcomes of the program will be in alignment with the
following performance goal for the National Center for Environmental
Health (NCEH): Reduce the number of deaths, hospitalizations, emergency
department visits, school or work days missed, and limitations on
activity due to asthma.
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/ads/opspoll1.htm.
Activities: Awardee Activities for this program are as follows:
Enhance the existing asthma surveillance system to include
(at a minimum) asthma hospitalizations, morbidity (measures from the
Behavioral Risk Factor Surveillance System (BRFSS) or equivalent),
mortality, and work-related asthma. Conduct analysis of and interpret
surveillance data; and disseminate these data through reports to local,
state, and federal partners and agencies.
Implement a defined subset of interventions described in
the State Asthma Plan.
--Improve provider compliance with the National Asthma Education and
Prevention Program's (NAEPP) ``Guidelines for the Diagnosis and
Management of Asthma'' (refer to citation in Attachment I for more
information).
--Improve the skills of patients and families affected by asthma to
manage the disease.
--Review legislation and policies impacting people with asthma.
--Identify environmental factors that contribute to asthma prevalence
and morbidity, and reduce or eliminate exposure to these factors.
--Facilitate communication between those implementing and those
affected by planned activities.
Develop and implement an evaluation plan that measures the
effectiveness of your program as a whole, as well as each intervention.
Systematically document lessons learned.
Maintain existing, and expand, as appropriate, statewide
coalition and partnership activities; include a workgroup to address
work-related asthma, if one does not exist; and evaluate effectiveness
of collaboration.
Maintain a strong commitment within the state to support
continued efforts of the asthma program.
Participate in CDC convened meetings and periodic
conference calls for grantees to share experiences, data, and
materials.
In a cooperative agreement, CDC staff is substantially involved in
the program activities, above and beyond routine grant monitoring. CDC
Activities for this program are as follows:
Provide consultation and guidance to awardees to enhance
and expand existing asthma surveillance activities, including data
collection methods and data analysis.
Collaborate with awardees on analysis of asthma data,
interpretation
[[Page 20556]]
of individual state surveillance data, and release of surveillance
reports.
Provide technical and scientific assistance and
consultation on program development, implementation of the State Asthma
Plan, intervention activities, and operational issues.
Serve as a facilitator for communication between states to
share expertise regarding various topics, such as the expansion and
development of partnerships, implementation of the State Asthma Plan,
and surveillance activities.
Collaborate on the development of an appropriate
evaluation plan that measures the effectiveness of the program as a
whole and each intervention. Review and provide feedback on evaluation
plans, and link awardees to additional expertise from CDC or its
contractors.
Plan and implement conferences and meetings to provide a
forum through which awardees can increase their knowledge and skills,
learn from each other, share resources, and work collaboratively to
address issues related to reducing the burden of asthma.
II. Award Information
Type of Award: Cooperative Agreement. CDC involvement in this
program is listed in the Activities Section above.
Fiscal Year Funds: 2005.
Approximate Total Funding: $1,750,000. (This amount is an estimate,
and is subject to availability of funds.)
Approximate Number of Awards: 2-5.
Approximate Average Award: $350,000. (This amount is for the first
12-month budget period, and includes both direct and indirect costs.)
Floor of Award Range: None.
Ceiling of Award Range: $350,000. (This ceiling is for the first
12-month budget period.)
Anticipated Award Date: August 31, 2005.
Budget Period Length: 12 months.
Project Period Length: 3 years.
Throughout the project period, CDC's commitment to continuation of
awards will be conditioned on the availability of funds, and evidence
of satisfactory progress by the recipient (as documented in required
reports), and the determination that federal funding is in the best
interest of the Federal Government.
III. Eligibility Information
III.1. Eligible Applicants
Entities eligible to receive this funding are those states
currently or previously funded under CDC Program Announcement (PA)
01106, ``Addressing Asthma from a Public Health Perspective, Part A
Planning''. Those states currently funded under Part A Enhanced or Part
B Implementation are excluded.
Eligible applicants are the states of Hawaii, Indiana, Nebraska,
Oklahoma, and Washington.
These states may designate their Bona Fide Agents to submit
applications. A Bona Fide Agent is an agency/organization identified by
the state as eligible to submit an application under the state
eligibility in lieu of a state application. If you are applying as a
bona fide agent of a state government, you must provide a letter from
the state government as documentation of your status. Place this
documentation behind the first page of your application form. Only one
application from each state may be submitted.
During the initial phase of Addressing Asthma from a Public Health
Perspective (PA 01106 Part A Planning), states were required to
complete a planning process that entailed developing an asthma
surveillance system, establishing partnerships, and collaboratively
writing a State Asthma Plan. Successfully completing this process is a
prerequisite for states to move into the next phase, Part A Enhanced,
where they will begin implementing a limited number of interventions
from their state asthma plan. Only those states originally selected via
a competitive award process for Part A Planning, and showing evidence
of satisfactory progress in achieving Part A objectives, will be
eligible.
III.2. Cost Sharing or Matching
Matching funds are not required for this program.
III.3. Other
If you request a funding amount greater than the ceiling of the
award range, your application will be considered non-responsive, and
will not be entered into the review process. You will be notified that
your application did not meet the submission requirements.
Special Requirements: If your application is incomplete or non-
responsive to the special requirements listed in this section, it will
not be entered into the review process. You will be notified that your
application did not meet submission requirements. Late applications
will be considered non-responsive. See section ``IV.3. Submission Dates
and Times'' for more information on deadlines.
As previously stated, eligible applicants are those entities
currently or previously funded by CDC Program Announcement 01106
``Addressing Asthma from a Public Health Perspective, Part A
Planning.'' States currently funded for Part A Enhanced or Part B
Implementation are excluded. Eligible states are Hawaii, Indiana,
Nebraska, Oklahoma, and Washington.
Applicants must document eligibility with the following:
1. Submit a copy of the final, approved, comprehensive State Asthma
Plan. Approval can be documented with a letter from the State's Health
or Medical Director and a letter from key partners indicating their
commitment to and approval of the asthma plan. These letters may be
contained within the plan itself. If so, this should be indicated by
the applicant. Plans that are pending final approval may be accepted if
the entire draft plan is submitted and accompanied by letters from the
State Health or Medical Director and key partners stating their
commitment to and approval of the plan, a time frame for final
approval, and a description of the plan's approval process status. The
letters should assure that the State Asthma Plan will be completed
within the first month of the year one budget period.
2. Have an operational surveillance system for asthma. This may be
documented through submission of the most recent, comprehensive
published surveillance report that describes asthma within the state,
including, if available, a report on asthma in the Medicaid population
and for enrollees of the State Children's Health Insurance Program
(SCHIP).
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 an award, grant, or loan.
IV. Application and Submission Information
IV.1. Address To Request Application Package
To apply for this funding opportunity, use application form PHS
5161-1.
CDC strongly encourages you to submit your application
electronically by utilizing the forms and instructions posted for this
announcement at http://www.grants.gov.
Application forms and instructions are available on the CDC Web
site, at the following Internet address: http://www.cdc.gov/od/pgo/forminfo.htm
.
If you do not have access to the Internet, or if you have
difficulty accessing the forms on-line, you may contact the CDC
Procurement and
[[Page 20557]]
Grants Office, Technical Information Management Section (PGO-TIM) staff
at: 770-488-2700. Application forms can be mailed to you.
IV.2. Content and Form of Submission
Application: You must submit a project narrative with your
application forms. The narrative must be submitted in the following
format:
Maximum number of pages: 45. If your narrative exceeds the
page limit, only the first pages, which are within the page limit, will
be reviewed. Budget Justification, State Asthma Plan, and asthma burden
reports will not count against the narrative page limit.
Font size: 12 point unreduced
Spacing: Double-spaced; single-spaced tables in the
narrative are acceptable.
Paper size: 8.5 by 11 inches
Page margin size: One inch
Printed only on one side of page
Held together only by rubber bands or metal clips; not
bound in any other way.
Written in plain language, avoid jargon.
Your narrative should address activities to be conducted over the
entire project period, and must include the following items in the
order listed:
1. Description of the Problem
Describe what is known about the asthma burden in the state and
efforts to systematically address the problem. Include a description of
populations at increased risk of poorly controlled asthma (e.g.,
gender, age groups, racial/ethnic groups, socio-economic groups, and
those located in particular geographic areas).
Identify existing initiatives, capacity, and infrastructure of the
agency within which the asthma programs will occur.
Describe how barriers, identified when developing the State Asthma
Plan, were addressed.
2. Surveillance Plan
Describe the current operational asthma surveillance system within
the state. Include a description of each data set that contains asthma
specific items, and that is currently available to, and used by, the
asthma program. Discuss the limitations of each data set, and specify
the most recent year of data available for analysis. At a minimum, the
surveillance system should include measures to track asthma morbidity
(asthma prevalence measures from the BRFSS or equivalent), asthma
mortality, work-related asthma, and asthma hospitalizations. Medicaid
and SCHIP data should be discussed, if available.
Provide a surveillance plan containing the following information:
Future plans for the data that are currently available to
the asthma program (e.g., frequency of analysis and distribution,
frequency of publication of comprehensive reports, methods of
distribution).
Additional data the program will obtain and methods for
obtaining it.
Plans for identifying specific populations at risk for
poorly controlled asthma (e.g., gender, age groups, racial/ethnic
groups, socio-economic groups, or by geographic area).
How the state will use existing and new data to develop or
enhance an ongoing surveillance system.
How the surveillance data will be used to support policy,
program development, implementation, and evaluation activities.
Describe the methods that will be used to analyze, interpret, and
disseminate surveillance data through published reports to local,
state, and federal partners and agencies.
In addition to cross-sectional analysis, include in the
surveillance plan a discussion of how the asthma surveillance system
will be used to monitor trends over time.
Applicants funded by this announcement will be expected to use the
BRFSS optional ten question adult asthma history module, the BRFSS
optional six-question child selection module and the BRFSS optional two
question child prevalence module within the first year of the project
period, as well as in subsequent years. Applicants should plan to fund
their state BRFSS for the ten adult questions and the two child
prevalence questions. Since the six questions in the child selection
module will be used by other programs, use of this module should be
coordinated with those programs, and costs for this module should be
shared with those other programs, if possible.
A letter of support from the BRFSS coordinator, which acknowledges
the intent to use these modules, must be included in the application. A
letter of support from other programs using the child selection module
must be included in the application, and should specify intent to share
costs.
In place of the ten-question adult asthma history module, the
applicant can choose to use the BRFSS Asthma Call-Back Survey. This
asthma-only call-back survey will provide extensive additional
information on asthma. It will be available to all states for data
collection year 2006, with funding provided through the BRFSS funding
mechanism. The state asthma program will still need to fund the use of
the six question child selection module and the two question child
prevalence module to identify children with asthma for the call-back
survey. Adults with asthma are identified by the BRFSS core questions.
If this call-back survey is used in place of the adult history module,
a letter of support from the BRFSS coordinator, which acknowledges
agreement with the intent to use the asthma call-back survey, must be
included in the application.
If the state asthma program has another method (such as the State
and Local Area Integrated Telephone Survey--National Survey of
Children's Health) to acquire the same or similar information as that
acquired from BRFSS, applicant should provide a detailed justification
and description of alternate information and methodology.
Submit copies of the most recent, comprehensive, published
surveillance report that describes asthma within the state, including
data of all available types (mortality, prevalence, hospitalization,
emergency department visits, Medicaid and SCHIP enrollee data, and
BRFSS adult history and child prevalence data). The report should
include an analysis of the most recent year of data available from each
data source mentioned above.
For more information, refer to the following citations in
Attachment 1:
``Updated Guidelines for Evaluating Surveillance Systems,
Recommendations from the Guidelines Working Group''
``Surveillance of Work-Related Asthma in Selected U.S.
States Using Surveillance Guidelines for State Health Departments--
California, Massachusetts, Michigan and New Jersey, 1993-1995''
``The Role of States in a Nationwide Comprehensive
Surveillance System for Work-related Diseases, Injuries and Hazards''
``Minimum and Comprehensive State-Based Activities in
Occupational Safety and Health''
``American Thoracic Society Statement: Occupational
Contribution to the Burden of Airway Disease''
For more information on the BRFSS Asthma Call-Back Survey, see
Attachment II.
3. State Asthma Plan
Submit a copy of the final, approved, comprehensive State Asthma
Plan. Approval can be documented with a letter from the State's Health
or Medical Director and a letter from key partners indicating their
commitment to and approval of the asthma plan. These letters may be
contained within the plan itself. If so, this should be indicated by
applicant. Plans that are pending final approval may be accepted if the
entire
[[Page 20558]]
draft plan is submitted and accompanied by letters from the State
Health or Medical Director and key partners stating their commitment to
and approval of the plan, a time frame for final approval, and a
description of the plan's approval process status. The letters should
assure that the State Asthma Plan will be completed within the first
month of the year one budget period.
Describe the collaborative process by which the comprehensive State
Asthma Plan was developed. Describe how the plan addresses all persons
with asthma regardless of age, race/ethnicity (including Native
Americans), gender, or geographic locale, and includes key environments
in which persons with asthma spend significant time (e.g., home,
school, or workplace). If a specific population is not affected by
asthma, clearly identify and describe this population.
Include information about the agencies and organizations that have
participated in the planning process and describe their roles and
responsibilities, and how they will be involved in implementing
interventions.
Describe how data collected in the asthma surveillance system is
used to identify priority areas and guide the development of program
goals and objectives.
Describe a subset of interventions from the State Asthma Plan to be
implemented with these grant funds. Also, briefly explain the remaining
interventions in the State Asthma Plan that will not be conducted under
this announcement due to limited funding.
Note that a statewide approach is encouraged. If focusing on one
segment of the population, explain and justify the rationale for this
approach.
Proposed activities to meet the plan's objectives may include, but
are not limited to, efforts to:
Expand surveillance for asthma.
Improve provider compliance with the National Asthma
Education and Prevention Program's (NAEPP) ``Guidelines for the
Diagnosis and Management of Asthma'' (refer to citation in Attachment I
for more information).
Improve the skills of patients and families affected by
asthma to manage the disease.
Review legislation and policies impacting people with
asthma.
Identify environmental factors that contribute to asthma
prevalence and morbidity, and reduce or eliminate exposure to these
factors.
Facilitate communication between those implementing and
those affected by planned activities.
Explain how the State Asthma Plan will evolve and change based on
analysis of surveillance data, evaluation of interventions, and other
outside factors that affect the state support for asthma.
4. Collaboration Plan
Describe experiences with partnerships requiring extensive
collaboration to address asthma, both within and outside the agency.
Specifically, define the approach to be used to establish or further
develop these relationships.
Document partnerships with the clinical community; local health
agencies; physician organizations; community health centers; local,
state, or regional asthma or respiratory health organizations (e.g.,
American Lung Association); state or local education authorities; and
groups or organizations that serve minority or other populations
experiencing a disproportionate burden of asthma. Also, include
representatives from state governmental agencies (e.g., Department of
Labor); federal agencies; public health agencies; and professional care
organizations conducting or interested in work-related asthma
activities. If one or more of these partners is not listed, the
applicant should explain why.
Describe how the collaboration:
Established leadership.
Developed consensus regarding goals.
Identified roles and responsibilities.
Developed procedures and patterns for communication.
Sustained the participation of members over time.
Provide letters of commitment from each specific organization,
including a statement of how they do, or intend to, collaborate, as
well as their expertise and capacity to carry out assigned
responsibilities.
Describe how the partners who developed the State Asthma Plan will
continue to work together to implement and monitor the intervention
strategies and modify the plan over time. Expand partnership activities
as appropriate.
5. Implementation Plan
Provide specific, realistic, measurable, and time-phased objectives
for each of the interventions to be implemented over the three-year
project period using resources of this announcement. If objectives and
interventions from the plan are addressed using other resources,
explain how they are related. While the overall State Asthma Plan must
address all populations, interventions should be prioritized based on
surveillance data, focusing on high priority and disparate populations
first. Disparate populations include those communities that are
experiencing worse than average health, or are medically underserved.
Interventions that change systems and individuals to provide
improved disease management or education are preferred. This discussion
might include the guidelines that the applicant will use for work-
related asthma, such as ``Minimum and Comprehensive State-Based
Activities in Occupational Safety Health,'' and/or ``The Role of States
in a Nationwide Comprehensive Surveillance System for Work-related
Diseases, Injuries and Hazards.'' Refer to citations in Attachment I
for more information.
Include an assessment of existing and needed resources to implement
these strategies.
Describe how implementation activities from the State Asthma Plan
were selected by members of the statewide partnership group, and how
they determined that these particular objectives and strategies would
be addressed first. Demonstrate the extent to which the intervention
plan is supported in the community by the inclusion of letters of
support from key members of the community. Letters should describe
their willingness to work together to implement and monitor the
intervention strategies, and modify the plan over time.
Demonstrate the scientific basis for proposed interventions. If
proposed interventions include case management programs, assure that
patients enrolled are those with moderate to severe persistent asthma,
and are receiving care consistent with the NAEPP ``Guidelines for the
Diagnosis and Management of Asthma.'' Refer to citation in Attachment I
for more information.
Provide the methodology and specific measures for monitoring
progress in meeting all objectives related to implementation of
activities in the asthma plan.
Provide measures for evaluating process, impact, and outcomes for
each goal and objective. For more information, refer to the citation in
Attachment I, ``Framework for Program Evaluation in Public Health,'' or
other evaluation resources on the CDC Web site at http://www.cdc.gov/eval/framework.htm
.
6. Workplan
Provide specific goals, objectives, and activities that describe
what the state intends to accomplish by the end of the three-year
project period. These goals, objectives and activities should be
measurable, realistic, related to
[[Page 20559]]
Awardee Activities described in Section I of this funding opportunity
announcement, and reflect activities in years one, two, and three of
the project. Include a project time-line that indicates when the
proposed goals, objectives, and activities will be completed. A single-
spaced table format may be used for this.
Document how progress made toward meeting the objectives will be
evaluated. Provide measures for evaluating process, impact, and outcome
for each goal and objective. For more information, refer to the
citation in Attachment I, ``Framework for Program Evaluation in Public
Health,'' or other evaluation resources on the CDC Web site at http://www.cdc.gov/eval/framework.htm
.
In addition, describe how lessons learned will be systematically
gathered, documented, and included as an integral part of the
evaluation process.
7. Management and Staffing
Demonstrate the applicant's organizational commitment to the asthma
program by describing how the state as a whole will focus its efforts
on asthma. Provide a plan to maintain a strong commitment within the
state to support continued efforts of the asthma program.
Describe the organizational location of the proposed staff, their
relation to the state asthma contact (the position currently
responsible for contact with CDC on asthma issues), and the support
within the organizational structure for the activities defined for the
project staff. Attach an organizational chart for the unit where asthma
activities will be located and, at a minimum, the next two levels above
it.
Describe the qualifications and roles of trained public health
professionals to serve as: at least the equivalent of one full-time
asthma coordinator to manage the planning process and conduct other
programmatic activities; at least the equivalent of one full-time
epidemiologist to develop and implement surveillance activities for the
asthma project; and a supervisor (paid with grant funds or in-kind
contributions) who will assure support for the project staff. Other
program positions may also be proposed. Attach an official position
description, qualifications and curricula vitae for all proposed staff
positions.
For each position, describe the primary roles and responsibilities
for the project staff over the three-year project period. Also, include
specific staff activities that will contribute to meeting each
objective. Describe the level of involvement of the principal
investigator.
Provide a plan to expedite filling of the staff position(s) within
the first budget year and assure that they have been, or will be,
approved by the applicant's personnel system. Include a letter of
support from the state guaranteeing hiring of personnel and support for
the asthma program. Also, describe positions in the asthma program that
are currently filled, but will not be funded by resources under this
cooperative agreement.
Assure that at least two key project staff will attend and
participate in the conferences or grantee meetings convened by CDC, and
their willingness to share innovations, information, data, and
materials. This should be reflected in the budget.
8. Budget and Justification
Include a detailed first-year budget with narrative justifications,
as well as annual budget projections for years two and three (budget
and justification will not be counted toward the narrative page limit).
The applicant should describe the program purpose for each budget item.
For each contract contained within the budget, provide: (a) The name(s)
of the contractor(s); (b) method of selection; (c) period of
performance; (d) description of activities; (e) method of
accountability; and (f) an itemized budget with narrative
justifications.
The budget should include travel funds for at least two project
staff to attend a yearly conference or grantee meeting convened by CDC.
If applicable, list other funds outside this cooperative agreement
(i.e., in-kind contributions) that will be used to support this
program.
Additional information may be included in the application
appendices. The appendices will not be counted toward the narrative
page limit. This additional information includes: Curriculum Vitaes,
Resumes, Organizational Charts, Position Descriptions, Letters of
Support, the State Asthma Plan and supporting documentation,
Surveillance Reports, etc.
You are required to have a Dun and Bradstreet Data Universal
Numbering System (DUNS) number to apply for a grant or cooperative
agreement from the Federal government. The DUNS number is a nine-digit
identification number, which uniquely identifies business entities.
Obtaining a DUNS number is easy and there is no charge. To obtain a
DUNS number, access http://www.dunandbradstreet.com or call 1-866-705-5711.
For more information, see the CDC Web site at: http://www.cdc.gov/od/pgo/funding/pubcommt.htm.
If your application form does not have a
DUNS number field, please write your DUNS number at the top of the
first page of your application, and/or include your DUNS number in your
application cover letter.
Additional requirements that may require you to submit additional
documentation with your application are listed in section ``VI.2.
Administrative and National Policy Requirements.''
IV.3. Submission Dates and Times
Application Deadline Date: June 6, 2005.
Explanation of Deadlines: Applications must be received in the CDC
Procurement and Grants Office by 4 p.m. Eastern Time on the deadline
date.
You may submit your application electronically at http://www.grants.gov.
Applications completed online through Grants.gov are
considered formally submitted when the applicant organization's
Authorizing Official electronically submits the application to http://www.grants.gov.
Electronic applications will be considered as having
met the deadline if the application has been submitted electronically
by the applicant organization's Authorizing Official to Grants.gov on
or before the deadline date and time.
If you submit your application electronically with Grants.gov, your
application will be electronically time/date stamped, which will serve
as receipt of submission. You will receive an e-mail notice of receipt
when CDC receives the application.
If you submit your application by the United States Postal Service
or commercial delivery service, you must ensure that the carrier will
be able to guarantee delivery of the application by the closing date
and time. If CDC receives your application after closing due to: (1)
Carrier error, when the carrier accepted the package with a guarantee
for delivery by the closing date and time, or (2) significant weather
delays or natural disasters, you will be given the opportunity to
submit documentation of the carrier's guarantee. If the documentation
verifies a carrier problem, CDC will consider the application as having
been received by the deadline.
If you submit a hard copy application, CDC will not notify you upon
receipt of your submission. If you have a question about the receipt of
your LOI or application, first contact your courier. If
[[Page 20560]]
you still have a question, contact the PGO-TIM staff at 770-488-2700.
Before calling, please wait two to three days after the application
deadline. This will allow time for applications to be processed and
logged.
This announcement is the definitive guide on application content,
submission address, and deadline. It supersedes information provided in
the application instructions. If your submission does not meet the
deadline above, it will not be eligible for review, and will be
discarded. You will be notified that you did not meet the submission
requirements.
IV.4. Intergovernmental Review of Applications
Your application is subject to Intergovernmental Review of Federal
Programs, as governed by Executive Order (EO) 12372. This order sets up
a system for state and local governmental review of proposed federal
assistance applications. You should contact your state single point of
contact (SPOC) as early as possible to alert the SPOC to prospective
applications, and to receive instructions on your state's process.
Click on the following link to get the current SPOC list: http://www.whitehouse.gov/omb/grants/spoc.html
.
IV.5. Funding Restrictions
Restrictions, which must be taken into account while writing your
budget, are as follows:
Funds may not be used to conduct research. Surveillance
and evaluation activities that are for the purposes of monitoring
program performance are not considered research. However, any
identifiable information collected must be kept confidential.
Cooperative agreement funds may be used to support costs
that are directly related to the program activities, and are consistent
with the scope of the cooperative agreement.
Awards will allow reimbursement of pre-award costs.
Funds awarded under this program announcement may not be
used for screening or registry activities.
Federal funds awarded under this program announcement may
not be used to supplant state or local funds.
Grant funds may be used to leverage asthma program
development in the state, along with resources from other collaborative
agencies and organizations.
If you are requesting indirect costs in your budget, you must
include a copy of your indirect cost rate agreement.
If your indirect cost rate is a provisional rate, the agreement
must be less than 12 months old.
Guidance for completing your budget can be found on the CDC Web
site, at the following Internet address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm
.
IV.6. Other Submission Requirements
Application Submission Address: CDC strongly encourages applicants
to submit electronically at: http://www.grants.gov You will be able to download a copy of the application package from http://www.grants.gov.,
complete it offline, and then upload and submit the application via the
Grants.gov site. E-mail submissions will not be accepted. If you are
having technical difficulties in Grants.gov, they can be reached by e-
mail at http:http://www.support@grants.gov">//www.support@grants.gov or by phone at 1-800-518-4726 (1-
800-GRANTS). The Customer Support Center is open from 7 a.m. to 9 p.m.,
Monday through Friday.
CDC recommends that you submit your application to Grants.gov early
enough to resolve any unanticipated difficulties prior to deadline. You
may also submit a back-up paper submission of your application. Any
such paper submission must be received in accordance with the
requirements for timely submission detailed in Section IV.3. of the
grant announcement. The paper submission must be clearly marked:
``BACK-UP FOR ELECTRONIC SUBMISSION.''
The paper submission must conform to all requirements for
electronic submissions. If both electronic and back-up paper
submissions are received by the deadline, the electronic version will
be considered the official submission.
It is strongly recommended that you submit your grant application
using Microsoft Office products (i.e., Microsoft Word, Microsoft Excel,
etc.). If you do not have access to Microsoft Office products, you may
submit a PDF file. Directions for creating PDF files can be found on
the Grants.gov web site. Use of file formats other than Microsoft
Office or PDF may result in your file being unreadable by our staff. Or
Submit the original and two hard copies of your application by mail
or delivery service to: Technical Information Management-PA
05044, CDC Procurement and Grants Office, 2920 Brandywine Road,
Atlanta, GA 30341.
V. Application Review Information
V.1. Criteria
Applicants are required to provide measures of effectiveness that
will demonstrate the accomplishment of the various identified
objectives of the cooperative agreement. Measures of effectiveness must
relate to the performance goals stated in the ``Purpose'' section of
this program announcement. Measures must be objective and quantitative,
and must measure the intended outcome. These measures of effectiveness
must be submitted with the application and will be an element of
evaluation.
Your application will be evaluated by the extent to which you
demonstrate evidence for the following criteria. Criteria are listed
according to their point value; you do not have to address them in this
order. Points in parentheses reflect the number of possible points for
that section. The total number of points for the entire application is
100.
1. Workplan (20 Points)
Does applicant identify goals, objectives, and activities that:
Are consistent with surveillance findings and the Awardee
Activities described in Section I of this Program Announcement?
Are specific, measurable, and realistic?
Reflect activities in years one, two, and three of the
project period?
Are the activities likely to achieve objectives, and are the
objectives likely to contribute to accomplishment of identified goals?
Is the time-line for accomplishing proposed goals, objectives, and
activities reasonable?
Are measures for monitoring and evaluating the process, impact, and
outcome of each goal and objective specific and appropriate?
Is the plan to systematically gather and document lessons learned
incorporated into the program evaluation process?
2. Surveillance Plan (20 Points)
Does the applicant demonstrate an operational surveillance system
for asthma as evidenced by a description of existing data sources, the
timeliness of the data available and any limitations? Does the plan use
appropriate measures to track the following over time:
Asthma hospitalizations?
Asthma morbidity (measures from the BRFSS or equivalent)?
Asthma mortality?
Work-related asthma?
Are Medicaid and SCHIP data included, if available?
[[Page 20561]]
Does the applicant explain how the state will enhance an on-going
surveillance system by describing:
Future plans for analyzing the data currently available?
Additional data the state will obtain and the methods for
obtaining it?
Plans for the identification of demographic groups at high
risk for poor asthma health outcomes?
How the existing surveillance system will be enhanced by
additional data sets and/or additional analyses of existing data?
How the data will be used to support policy and program
development, implementation and evaluation?
Are surveillance data analyses, interpretation and dissemination
methods described and are they appropriate? Is the utility of existing
data for time trends analysis discussed and is it reasonable?
Does the plan clearly state applicant's intent, within the first
year of the project period and in subsequent years, to implement:
The BRFSS optional six-question child selection module?
The BRFSS optional two-question child asthma module?
The BRFSS optional ten question adult module; or
The BRFSS Asthma call-back survey?
Are letters of support from the BRFSS coordinator and other
programs using the child selection module (if any) included? If another
method (other than BRFSS) will be used, or if the applicant is unable
to implement the recommended BRFSS modules, is a detailed and
reasonable justification provided?
Are the attached surveillance reports comprehensive and timely
(data from the most recently available year are used)? Is the burden of
asthma within the state fully described, including: mortality; BRFSS
prevalence; BRFSS adult history and child prevalence data; and, if
available, hospitalization, emergency department, Medicaid and SCHIP
enrollee data?
Does the surveillance report clearly identify segments of the
population, such as specific age groups, ethnic/racial groups, socio-
economic groups, or those residing in particular geographic regions, at
disparate risk for asthma and asthma outcomes in each data source?
3. State Asthma Plan (15 Points)
Is the State Asthma Plan comprehensive? Has it been approved by the
state and key partners? If not already approved, has the applicant
provided assurance that the State Asthma Plan will be completed within
one month of the first budget year?
Does the plan address all persons with asthma, regardless of
gender, age, race/ethnicity, or geographic location? Are key
environments in which persons with asthma spend significant time (e.g.,
home, school, or workplace) addressed?
Are the number and type of agencies and organizations that
participated in developing the State Asthma Plan appropriate? Are
partner's roles and responsibilities fully described and reasonable?
Does the applicant describe the collaboration's progress towards:
Establishing leadership?
Developing a consensus regarding goals?
Identifying roles and responsibilities through a
negotiated process?
Developing routine and consistent patterns of
communications?
Sustaining the participation of members over time?
Will collaborative relationships be used after the plan is in place
and the state begins to implement selected interventions?
Are a subset of the interventions to be implemented from the State
Asthma Plan with grant funds described? Do proposed activities to meet
the plan's objectives include, at a minimum, efforts to:
Expand surveillance for asthma?
Improve provider compliance with the NAEPP ``Guidelines
for the Diagnosis and Management of Asthma?
Improve the skills of patients and families affected by
asthma to manage the disease?
Review legislation and policies impacting people with
asthma?
Identify environmental factors that contribute to asthma
prevalence and morbidity, and reduce or eliminate exposure to these
factors?
Facilitate communication between those implementing and
those affected by planned activities?
Was asthma data collected by the surveillance system used to
identify priority areas and guide the development of program goals and
objectives? Are future plans to do this described?
Does applicant describe how the State Asthma Plan will evolve over
time, and the process by which changes will be made?
4. Collaboration Plan (15 Points)
Does applicant demonstrate previous successful experiences
collaborating with internal and external partners to address asthma?
Do collaborating organizations and agencies represent a wide
variety of appropriate partners in the clinical community; local health
agencies; physician organizations; community health centers; local,
state or regional asthma or respiratory health organizations (such as
the American Lung Association); local or state education authorities;
and groups or organizations that serve populations experiencing a
disproportionate burden of asthma? Are representatives from state
governmental agencies (e.g., Department of Labor), federal agencies,
public health agencies, and professional care organizations conducting
or interested in work-related asthma activities included? If one or
more of these partners is not included, does the applicant explain why?
Does the applicant describe satisfactory progress by the
collaboration around:
Establishing leadership?
Developing a consensus regarding goals?
Identifying roles and responsibilities through a
negotiated process?
Developing routine and consistent procedures and patterns
of communications?
Sustaining the participation of members over time?
Does applicant describe how progress is monitored?
Do letters of commitment from key organizations demonstrate their
willingness, expertise, and specific capacity to carry out assigned
responsibilities?
Does applicant realistically describe how partners who developed
the State Asthma Plan will continue to work together to monitor the
intervention strategies over time?
How likely is it that the plan for evaluating the effectiveness of
collaborations will be implemented, and that measures to assess
effectiveness will be reasonable and identify areas for improvement?
5. Management and Staffing Plan (15 Points)
Does the state demonstrate a high level of commitment and
organizational support for the asthma program? Are organizational
charts included, showing where the asthma program is located?
Are roles of proposed staff members adequately defined and
appropriate for carrying out stated responsibilities? Is the proposed
level of involvement of the principal investigator adequate?
Does the staffing plan include at least the equivalent of one full-
time asthma coordinator, at least the equivalent of one full-time
epidemiologist, and a supervisor?
[[Page 20562]]
Do job descriptions, qualifications, and curricula vitae indicate
that each proposed staff member has the credentials, knowledge,
training, and experience to perform assigned duties?
Is the plan to expedite filling of the staff position(s) and assure
that they will be approved by the applicant's personnel system,
realistic?
Does the applicant commit to having at least two key project staff
attend CDC conferences and meetings, to share innovations, information,
data, and materials?
6. Implementation Plan (10 Points)
Does the applicant present specific, realistic, measurable and
time-phased objectives for each intervention proposed, along with
appropriate measures to evaluate process, impact and outcomes?
Do proposed interventions focus on high priority and disparate
populations, with priorities based on surveillance data?
Are interventions focused on bringing about change at both the
systems level and the individual level to provide improved disease
management and education?
Is the intervention plan supported in the community, as
demonstrated by the inclusion of letters of support from key members of
the community?
Does the applicant demonstrate a scientific basis for each proposed
intervention?
Does the applicant demonstrate the availability of sufficient
resources to implement the proposed subset of interventions?
Are the methods and measures for monitoring progress towards
meeting intervention goals and objectives appropriate?
7. Description of the Problem (5 Points)
Does the applicant provide a comprehensive description of what is
known about the asthma burden in the state, including all ages, race/
ethnic groups, and geographic areas?
Does the applicant fully identify existing initiatives, capacity,
and infrastructure of the state within which the asthma programs will
occur?
Were barriers identified when developing the State Asthma Plan
appropriately addressed?
Is the state's commitment to addressing asthma demonstrated by
accomplishments to date and understanding of the problem?
8. Budget (Reviewed, But Not Scored)
The budget is comprehensive and includes details for year one, and
projections for years two and three, of the project period.
The budget contains justifications that are consistent with stated
goals, objectives, activities, and the intended use of cooperative
agreement funds.
The budget is reasonable and includes funds for at least two
project staff to attend a yearly conference or grantee meeting convened
by CDC.
9. Performance Goals (Reviewed, But Not Scored)
The extent to which the applicant will reduce the number of deaths,
hospitalizations, emergency department visits, school or work days
missed, and limitations on activity due to asthma in the state.
V.2. Review and Selection Process
Applications will be reviewed for completeness by the Procurement
and Grants Office (PGO) staff, and for responsiveness by National
Center of Environmental Health (NCEH). Incomplete applications and
applications that are non-responsive to the eligibility criteria will
not advance through the review process. Applicants will be notified
that their application did not meet submission requirements.
An objective review panel will evaluate your application according
to the criteria listed in the ``V.1. Criteria'' section above. All
members of the panel will be CDC employees from outside of the funding
center (NCEH).
In addition, the following factors may affect the funding decision:
(1) Geographic distribution; and (2) racial and ethnic populations with
a disproportionate asthma burden. CDC will provide justification for
any decision to fund out of rank order.
V.3. Anticipated Announcement Award Dates
August 31, 2005.
VI. Award Administration Information
VI.1. 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 mailed to the
recipient fiscal officer identified in the application.
Unsuccessful applicants will receive notification of the results of
the application review by mail.
VI.2. Administrative and National Policy Requirements
45 CFR Part 74 or Part 92
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.
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 2010
AR-12 Lobbying Restrictions
AR-21 Small, Minority, and Women-Owned Business
Additional information on these requirements can be found on the
CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/ARs.htm
.
An additional Certifications form from the PHS5161-1 applications
needs to be included in your Grants.gov electronic submission only.
Refer to http://www.cdc.gov/od/pgo/funding/PHS5161-1Certificates.pdf.
Once the form is filled out, attach it to your Grants.gov submission as
Other Attachment Forms.
VI.3. Reporting Requirements
You must provide CDC with an original, plus two hard copies of the
following reports:
1. Interim progress report, no less than 90 days before the end of
the budget period. The progress report will serve as your non-competing
continuation application, and must contain the following elements:
a. Current Budget Period Activities Objectives.
b. Current Budget Period Financial Progress.
c. New Budget Period Program Proposed Activity Objectives.
d. Detailed Line-Item Budget and Justification.
e. Additional Requested Information.
f. Measures of Effectiveness.
2. Financial status report and annual progress report, no more than
90 days after the end of the budget period.
3. Final financial and performance reports, no more than 90 days
after the end of the project period.
These reports must be sent to the Grants Management Officer listed
in the ``Agency Contacts'' section of this announcement.
VII. Agency Contacts
For general questions about this announcement, contact: Technical
Information Management Section, CDC Procurement and Grants Office, 2920
Brandywine Road, Atlanta, GA 30341, Telephone: 770-488-2700.
For program technical assistance, contact: Michele Mercier, Project
[[Page 20563]]
Officer, Air Pollution and Respiratory Health Branch, Division of
Environmental Hazards and Health Effects, National Center for
Environmental Health, Centers for Disease Control and Prevention, 1600
Clifton Road, NE, Mailstop E-17, Atlanta, GA 30333, Telephone: 404-498-
1033, E-mail: mmercier@cdc.gov.
For financial, grants management, or budget assistance, contact:
Gary Teague, Grants Management Specialist, CDC Procurement and Grants
Office, 2920 Brandywine Road, Atlanta, GA 30341, Telephone: 770-488-
1981, E-mail: GTeague@cdc.gov.
VIII. Other Information
This and other CDC funding opportunity announcements can be found
on the CDC Web site, Internet address: http://www.cdc.gov. Click on
``Funding'' then ``Grants and Cooperative Agreements.''
For additional reference materials, please see Attachments I and
II.
Dated: April 14, 2005.
William P. Nichols,
Director, Procurement and Grants Office, Centers for Disease Control
and Prevention.
Attachment I--References
``National Asthma Training Curriculum'' CD-ROM educational resource,
CDC National Center for Environmental Health and the Academy of
Allergy, Asthma and Immunology, August 2004.
``Potentially Effective Interventions for Asthma'' http://www.cdc.gov/asthma/interventions.htm
.
Boss, L.; Kreutzer, R.; Luttinger, D.; Leighton, J.; Wilcox, K.; and
Redd, S. ``The Public Health Surveillance of Asthma,'' Journal of
Asthma, 38(1), 83-89, 2001.
``Framework for Program Evaluation in Public Health,'' Morbidity and
Mortality Weekly Report, September 17, 1999/48(RR-11); 1-40 at
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm or http://www.cdc.gov/eval/framework.htm.`
`Surveillance of Work-Related Asthma in Selected U.S. States Using
Surveillance Guidelines for State Health Departments--California,
Massachusetts, Michigan and New Jersey, 1993-1995,'' Morbidity and
Mortality Weekly Report, June 25, 1999/48 (SS03); 1-20 at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4803a1.htm
.
``The Role of States in a Nationwide Comprehensive Surveillance
System for Work-related Diseases, Injuries and Hazards'' at http://www.cste.org/occupationalhealth.htm
.
``Minimum and Comprehensive State-Based Activities in Occupational
Safety and Health,'' June 1995--DHHS (NIOSH) Publication No. 95-107
at http://www.cdc.gov/niosh/95-107.html.
``American Thoracic Society: Occupational Contribution to the Burden
of Airway Disease,'' American Journal of Respiratory and Critical
Care Medicine, 167:787-797, 2003.
``Updated Guidelines for Evaluating Surveillance Systems,
Recommendations from the Guidelines Working Group,'' Morbidity and
Mortality Weekly Report, July 27, 2001/(50)RR-13; 1-35 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm
.
Madden, J; Boss, L; Kownaski, M; Lambright, L; Lee, C; Luttinger, D;
Recer, G; Wedemeyer, C. ``Guide for State Health Agencies in the
Development of Asthma Programs.'' Atlanta, Georgia: U.S. Centers for
Disease Control and Prevention, 2003.
``Guidelines for the Diagnosis and Management of Asthma,'' (Clinical
Practice Guidelines, Guidelines for the Diagnosis and Management of
Asthma. National Institutes of Health (NIH), National Heart, Lung
and Blood Institute. NIH publication No. 97-4051, April 1997) at
http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.
``Key Clinical Activities for Quality Asthma Care: Recommendations
of the National Asthma Education and Prevention Program.'' MMWR
March 28, 2003; 52(RR06):1-84.
Strategies for addressing asthma in school settings: http://www.cdc.gov/HealthyYouth/asthma/
.
Attachment II--BRFSS Asthma Call-Back Survey
The National Asthma Survey (NAS) is a comprehensive state/city
level detailed asthma survey. It is administered by phone and
includes respondents of all ages. Previously the NAS was linked to
the National Immunization Survey (NIS) through the State and Local
Area Integrated Telephone Survey (SLAITS) mechanism. SLAITS is a
function of the National Center for Health Statistics. A full
questionnaire for that survey can be viewed on the SLAITS Web site.
http://www.cdc.gov/nchs/about/major/slaits/nsa.htm.
The initial NAS field test occurred in 2002 in Alabama,
California, Illinois and Texas. This first field test did not
achieve an adequate response rate level. Consequently additional
field tests were implemented to determine whether procedural changes
could improve the response rate. In 2003, the NAS was conducted as a
field test in the same four states and also in a national sample.
There were four arms in the 2003 field test. The national sample
and the state sample were the two main arms. The national sample
obtains demographic information about respondents who do not have
asthma in order to estimate prevalence rates. The four-state sample
only solicited information from households that had a member with
asthma and, consequently, prevalence rates cannot be determined.
Results from comparing the four state results with the first field
test will determine if obtaining prevalence rates resulted in a
significantly lower response rate. Comparing the national sample
with the first field test in the four states will determine if the
four selected states were particularly difficult with respect to
response rates as was suggested from the results from other surveys.
Each of the two main arms was also divided into a NIS-connected
sample and a sample independent of the NIS procedures. Comparisons
between these two secondary arms within each primary arm will
determine if restrictions related to the NIS survey procedures were
detrimental to the NAS response rate. In addition, several other
modifications were made to simplify the selection of a single
respondent from the household members.
During 2004 the data obtained were weighted and scrutinized to
determine the best combination of methodological changes to ensure
that quality data result from further implementation of the National
Asthma Survey.
In 2005 the NAS will be implemented as a call-back survey in
conjunction with the Behavioral Risk Factor Surveillance System
(BRFSS) in three test states (Michigan, Minnesota and Oregon). The
child selection module and the child prevalence module must be
conducted at the time of the BRFSS interview. Adults and children
who are identified with lifetime asthma will be called back
approximately 2 weeks after the initial BRFSS telephone interview.
At the time of the call-back the NAS interview will be conducted.
Draft questionnaires can be obtained by contacting the Air Pollution
and Respiratory Health Branch (404-498-1000). Prevalence figures for
adults in all BRFSS areas (50 states, DC and 3 territories) can be
obtained from the core BRFSS survey. However, the child selection
module and child prevalence modules are needed for state level child
prevalence estimates from BRFSS.
In 2006 funding to implement the BRFSS asthma call-back survey
will be provided to BRFSS states, DC, or territories who
successfully apply for that funding in conjunction with their BRFSS
funding. Asthma program staff must work jointly with their state's
BRFSS program coordinator when submitting request for asthma call-
back funding to the National Center for Chronic Disease Prevention
and Health Promotion (NCCDPHP).
[FR Doc. 05-7889 Filed 4-19-05; 8:45 am]
BILLING CODE 4163-18-P