STD Applicant Workplan Template - 5 year plan

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Overview

Home Page
PCHD 5 Year Plan

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Sheet 1: Home Page

			Form Approved OMB No. 0920-0879 Expiration Date 01/31/2021
	Strengthening STD Prevention and Control for Health Departments (STD PCHD)
	5 Year Plan
	PCHD Years 1 - 5
	Project Area:	[Choose your Project Area…]
	Period of Performance:	01/01/2019 - 12/31/2023
	Submission Date: Write the date you are submitting your application in the MM/DD/YYYY format (e.g., 07/16/2018) Submission Date:
		Go to PCHD 5 Year Plan >>
	Instructions:
	You may use this template to prepare a PCHD 5 Year Plan for DSTDP. Please refer to the supplemental guidance document for more information.
	Complete the tab titled "PCHD 5 Year Plan". You will be asked a series of questions that will allow you to reflect on how your STD program's context, goals, and objectives are related to the key strategies and activities put forth in this award.
	Applicants will only need to complete and submit the PCHD 5 Year Plan once during the five year period of performance of the award.
	If you need technical support at any time, please send an email with a detailed description of your need to the following address:
	[email protected]
	Notes on Data Entry:
	All light yellow cells are available for user input. You can type your responses directly into the yellow cells, or copy and paste your responses from another document into the cells. Press ALT+Enter to write on a new line in the same Excel cell.
	Boxes with a red corner have additional tips for data entry. Hover your cursor over them to view the tips. For optimal viewing, keep resolution to 100%.
	Drop-down menus are included in the PCHD 5 Year Plan, in the Program Priorities Section. Click on the small arrow that appears in the cell to select drop-down values.
	Copying Information from Microsoft Word, PDF or Excel? Step 1: Copy (Ctrl+C) the text you want to transfer and click in the yellow cell where you want to paste Step 2: Click into the formula bar (fx) at the top of the screen, and paste (Ctrl+V) -OR- hit F2/double-click within the yellow cell to generate a flashing cursor, and then paste **If the light yellow cell is no longer yellow after you paste, or anything else goes wrong, hit Ctrl+Z to undo your action**
	Saving and Submitting Your Work:
	Click "File" from the ribbon above and then "Save" from the menu. If this is your first time saving this document, you will be prompted to choose a location for where this file will be saved. Please save this file as "[ProjectAreaName]_5YearPlan_yy-mm-dd" and as an .xlsm version. (Note: you will see a warning message reminding you that if you change the format of the document, you may lose some of the functionality. Click "Ok" and save the file in your preferred location.)
	When you are finished with this document, there are two ways to package it for submission. Option 1 - click the button below, select a folder for where you would like the final file saved, and the file will be saved with an automatically-generated filename. You will no longer be able to edit any text, but you will be able to print out the work plan template.
	Option 2 - click "File" from the ribbon above and then "Save As" from the menu or use the button below. Choose the .xls or .xlsx file type from the "Save as type" drop-down menu. You will see a warning sign that says "The following features cannot be saved in macro-free workbooks: VB project". Click "Yes" to save the file as a .xls or .xlsx file type. You will still be able to edit light yellow cells, but a few features from this workbook will no longer be available.
	To submit this document, attach the file ending in .xls or .xlsx to your application for this NOFO in Grants.gov.
	Relevant Links:
	[insert link to NOFO award posting]
	[insert link to NOFO technical notes]
	[insert link to NOFO TA resources (PETT)]
	[insert link to S.M.A.R.T. Objectives Builder]
	[insert link to other guidance documents]
	Microsoft Excel Basics
	CDC estimates the average public reporting burden for this collection of information as 20 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879).

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Sheet 2: PCHD 5 Year Plan

	<< Home Page
	PCHD 5 Year Plan
	This five year planning page is an opportunity for you to step back and reflect on how your STD program's context, goals, and objectives are related to the key strategies and activities put forth in this award. Applicants will only need to complete and submit the PCHD 5 Year Plan once during the five year period of performance of the award.
	Surveillance
	Current Capability: Highlight the essential infrastructure that the STD program has in this Area. Highlight the key functions that the STD program can do in this Area. Consider, for example: • Number and skill set of existing staff • Data and data systems • Epidemiologic priorities • Past programmatic priorities or emphases Current Capability
	What is the current capacity of your STD program, in this Strategy Area?
	Strengths: What does your program do particularly well in this Area? (No need to repeat points made in other responses) Strengths
	What are the key strengths of your program in the STD Surveillance Strategy Area?
	Limitations: What does your program need to improve or strengthen in this Area? (No need to repeat points made in other responses) Limitations
	What are the key limitations of program in the STD Surveillance Strategy Area?
	Progress and Change: What major changes do you foresee making over the next 5 years, to improve or maintain the work in this Area? Consider your current capacity, strengths, and weaknesses. It is recognized these plans may change over the 5 year period. Progress and Change
	What major changes do you plan to make over the next 5 years in the STD Surveillance Strategy Area?
	Program Priorities
	Use the space below to rate the importance of the primary strategies to your STD Surveillance program, and your program's level of strength in implementing them.
	Surveillance Primary Strategy	Importance: This refers to the relative importance among the different strategies in this particular strategy area, not across all strategies or Strategy Areas. Importance: Among Surveillance strategies, how would you rate the relative importance of this strategy to your STD program, based on your resources, morbidity, and local priorities?	Implementation: How strong or weak would you say your STD program is in implementing the following strategies?	Comments (Optional): If needed, use the space below to provide additional information on the strategy importance or implementation.
	Conduct Chlamydia (CT) surveillance
	Conduct Gonorrhea (GC) surveillance
	Conduct syphilis surveillance
	Conduct congenital syphilis (CS) surveillance
	Conduct surveillance of adverse outcomes of STDs
	Disease Investigation and Intervention			Back to Top ^
	Current Capability: Highlight the essential infrastructure that the STD program has in this Area. Highlight the key functions that the STD program can do in this Area. Consider, for example: • Number and skill set of existing staff • Data and data systems • Epidemiologic priorities • Past programmatic priorities or emphases Current Capability
	What is the current capacity of your STD program, in this Strategy Area?
	Strengths: What does your program do particularly well in this Area? (No need to repeat points made in other responses) Strengths
	What are the key strengths of your program in the STD Disease Investigation and Intervention Strategy Area?
	Limitations: What does your program need to improve or strengthen in this Area? (No need to repeat points made in other responses) Limitations
	What are the key limitations of your program in the STD Disease Investigation and Intervention Strategy Area?
	Progress and Change: What major changes do you foresee making over the next 5 years, to improve or maintain the work in this Area? Consider your current capacity, strengths, and weaknesses. It is recognized these plans may change over the 5 year period. Progress and Change
	What major changes do you plan to make over the next 5 years in the STD Disease Investigation and Intervention Strategy Area?
	Program Priorities
	Use the space below to rate the importance of the primary strategies to your STD Disease Investigation and Intervention program, and your program's level of strength in implementing them.
	Disease Investigation and Intervention Primary Strategy	Importance: This refers to the relative importance among the different strategies in this particular strategy area, not across all strategies or Strategy Areas. Importance: Among Disease Investigation and Intervention strategies, how would you rate the relative importance of this strategy to your STD program, based on your resources, morbidity, and local priorities?	Implementation: How strong or weak would you say your STD program is in implementing the following strategies?	Comments (Optional): If needed, use the space below to provide additional information on the strategy importance or implementation.
	Respond to STD-related outbreaks
	Conduct health department disease investigation for pregnant women and other reproductive-age women with syphilis
	Promote Expedited Partner Therapy (EPT) (where permissible) to partners of chlamydia and/or gonorrhea cases
	Conduct health department syphilis disease investigation and intervention for men with syphilis
	Screening, Diagnosis, and Treatment			Back to Top ^
	Current Capability: Highlight the essential infrastructure that the STD program has in this Area. Highlight the key functions that the STD program can do in this Area. Consider, for example: • Number and skill set of existing staff • Data and data systems • Epidemiologic priorities • Past programmatic priorities or emphases Current Capability
	What is the current capacity of your STD program, in this Strategy Area?
	Strengths: What does your program do particularly well in this Area? (No need to repeat points made in other responses) Strengths
	What are the key strengths of your program in the STD Screening, Diagnosis, and Treatment Strategy Area?
	Limitations: What does your program need to improve or strengthen in this Area? (No need to repeat points made in other responses) Limitations
	What are the key limitations of your program in the STD Screening, Diagnosis, and Treatment Strategy Area?
	Progress and Change: What major changes do you foresee making over the next 5 years, to improve or maintain the work in this Area? Consider your current capacity, strengths, and weaknesses. It is recognized these plans may change over the 5 year period. Progress and Change
	What major changes do you plan to make over the next 5 years in the STD Screening, Diagnosis, and Treatment Strategy Area?
	Program Priorities
	Use the space below to rate the importance of the primary strategies to your STD Screening, Diagnosis, and Treatment program, and your program's level of strength in implementing them.
	Screening, Diagnosis, and Treatment Primary Strategy	Importance: This refers to the relative importance among the different strategies in this particular strategy area, not across all strategies or Strategy Areas. Importance: Among Screening, Diagnosis, and Treatment strategies, how would you rate the relative importance of this strategy to your STD program, based on your resources, morbidity, and local priorities?	Implementation: How strong or weak would you say your STD program is in implementing the following strategies?	Comments (Optional): If needed, use the space below to provide additional information on the strategy importance or implementation.
	Promote quality STD specialty care services
	Promote CDC-recommended treatment for gonorrhea and syphilis
	Promote CDC-recommended screening for, and treatment of, STDs among priority populations
	Prevention and Policy			Back to Top ^
	Current Capability: Highlight the essential infrastructure that the STD program has in this Area. Highlight the key functions that the STD program can do in this Area. Consider, for example: • Number and skill set of existing staff • Data and data systems • Epidemiologic priorities • Past programmatic priorities or emphases Current Capability
	What is the current capacity of your STD program, in this Strategy Area?
	Strengths: What does your program do particularly well in this Area? (No need to repeat points made in other responses) Strengths
	What are the key strengths of your program in the STD Prevention and Policy Strategy Area?
	Limitations: What does your program need to improve or strengthen in this Area? (No need to repeat points made in other responses) Limitations
	What are the key limitations of your program in the STD Prevention and Policy Strategy Area?
	Progress and Change: What major changes do you foresee making over the next 5 years, to improve or maintain the work in this Area? Consider your current capacity, strengths, and weaknesses. It is recognized these plans may change over the 5 year period. Progress and Change
	What major changes do you plan to make over the next 5 years in the STD Prevention and Policy Strategy Area?
	Program Priorities
	Use the space below to rate the importance of the primary strategies to your STD Prevention and Policy program, and your program's level of strength in implementing them.
	Prevention and Policy Primary Strategy	Importance: This refers to the relative importance among the different strategies in this particular strategy area, not across all strategies or Strategy Areas. Importance: Among Prevention and Policy strategies, how would you rate the relative importance of this strategy to your STD program, based on your resources, morbidity, and local priorities?	Implementation: How strong or weak would you say your STD program is in implementing the following strategies?	Comments (Optional): If needed, use the space below to provide additional information on the strategy importance or implementation.
	Promote STD prevention to the public
	Promote STD prevention and reporting to provider community
	Monitor STD-related policies and policy development
	Data Use and Utilization			Back to Top ^
	Current Capability: Highlight the essential infrastructure that the STD program has in this Area. Highlight the key functions that the STD program can do in this Area. Consider, for example: • Number and skill set of existing staff • Data and data systems • Epidemiologic priorities • Past programmatic priorities or emphases Current Capability
	What is the current capacity of your STD program, in this Strategy Area?
	Strengths: What does your program do particularly well in this Area? (No need to repeat points made in other responses) Strengths
	What are the key strengths of your program in the STD Data Use and Utilization Strategy Area?
	Limitations: What does your program need to improve or strengthen in this Area? (No need to repeat points made in other responses) Limitations
	What are the key limitations of your program in the STD Data Use and Utilization Strategy Area?
	Progress and Change: What major changes do you foresee making over the next 5 years, to improve or maintain the work in this Area? Consider your current capacity, strengths, and weaknesses. It is recognized these plans may change over the 5 year period. Progress and Change
	What major changes do you plan to make over the next 5 years in the STD Data Use and Utilization Strategy Area?
	Program Priorities
	Use the space below to rate the importance of the primary strategies to your STD Data Use and Utilization program, and your program's level of strength in implementing them.
	Data Use and Utilization Primary Strategy	Importance: This refers to the relative importance among the different strategies in this particular strategy area, not across all strategies or Strategy Areas. Importance: Among Data Use and Utilization strategies, how would you rate the relative importance of this strategy to your STD program, based on your resources, morbidity, and local priorities?	Implementation: How strong or weak would you say your STD program is in implementing the following strategies?	Comments (Optional): If needed, use the space below to provide additional information on the strategy importance or implementation.
	Conduct epidemiologic analysis, translation and dissemination
	Conduct data-driven planning, analysis, monitoring and evaluation for program improvement