APPLETREE Notice of Funding Opportunity

Centers for Disease Control and Prevention
AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY
ATSDR’s Partnership to Promote Local Efforts To Reduce Environmental Exposure
CDC-RFA-TS-23-0001
12/09/2022

Table of Contents
A. Funding Opportunity Description ...............................................................................................3
B. Award Information ....................................................................................................................29
C. Eligibility Information ..............................................................................................................30
D. Required Registrations ..............................................................................................................31
E. Review and Selection Process ...................................................................................................42
F. Award Administration Information ...........................................................................................47
G. Agency Contacts .......................................................................................................................55
H. Other Information .....................................................................................................................56
I. Glossary ......................................................................................................................................56

Part I. Overview
Applicants must go to the synopsis page of this announcement at www.grants.gov and click on
the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA-TS23-0001. Applicants also must provide an e-mail address to www.grants.gov to receive
notifications of changes.
A. Federal Agency Name:
Agency for Toxic Substances and Disease Registry (ATSDR)
B. Notice of Funding Opportunity (NOFO) Title:
ATSDR’s Partnership to Promote Local Efforts To Reduce Environmental Exposure
C. Announcement Type: New - Type 1:
This announcement is only for non-research activities supported by CDC. If research is
proposed, the application will not be considered. For this purpose, research is defined
at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec522.pdf. Guidance on how CDC interprets the definition of research in the context of public health
can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr46/index.html (See section 45 CFR 46.102(d)).
D. Agency Notice of Funding Opportunity Number:
CDC-RFA-TS-23-0001
E. Assistance Listings Number:
93.240
F. Dates:
1. Due Date for Letter of Intent (LOI):
The LOI date will generate once the Synopsis is published if Days or a Date are entered.
Recommended but not Required
Letter of Intent due date: 10/28/2022 (recommended but not required).
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2. Due Date for Applications:
12/09/2022
11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.
3. Due Date for Informational Conference Call:
Call-in details for the Informational Conference Call will be posted to
https://www.atsdr.cdc.gov/states/ no later than October 7, 2022. This web site may be updated
periodically with additional information and/or materials.
F. Executive Summary:
Summary Paragraph
The Agency for Toxic Substances and Disease Registry’s (ATSDR’s) Partnership to Promote
Local Efforts to Reduce Environmental Exposure (APPLETREE) Program is critical to
ATSDR’s success in accomplishing its mission in communities nationwide. ATSDR’s recipients
will use APPLETREE funding to advance ATSDR’s primary goal of keeping communities safe
from harmful environmental exposures and related diseases. APPLETREE gives recipients the
resources to build their capacity to assess and respond to site-specific issues involving human
exposure to hazardous substances in the environment. APPLETREE helps recipients identify
exposure pathways at specific sites; educate affected communities about site contamination and
potential health effects; make recommendations to prevent exposure; and review health outcome
data to evaluate potential links between site contaminants and community health outcomes.
APPLETREE facilitates the implementation of state-level Choose Safe Places for Early Care and
Education (CSPECE) programs to ensure that potential early care and education facilities are
located in areas free from harmful environmental exposures. APPLETREE recipients will
improve the health assessment process through strengthening local connections and partnerships,
engagement of communities, and implementation of public health recommendations.
a. Eligible Applicants:
Open Competition
b. NOFO Type:
CA (Cooperative Agreement)
c. Approximate Number of Awards
34
Component 1: 34
Component 2: Up to 10 (as funding is available)
d. Total Period of Performance Funding:
$73,250,000
e. Average One Year Award Amount:
$420,000
Component 1: $420,000
Component 2: $185,000, subject to the availability of funds
f. Total Period of Performance Length:
5
g. Estimated Award Date:
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March 01, 2023
h. Cost Sharing and / or Matching Requirements:
No
Cost sharing or matching funds are not required for this program. Although no statutory
matching requirement for this NOFO exists, leveraging other resources and related ongoing
efforts to promote sustainability is strongly encouraged.
Part II. Full Text
A. Funding Opportunity Description
1. Background
a. Overview
In 1980, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR) to
implement the health-related sections of laws that protect the public from hazardous wastes and
environmental spills of hazardous substances. The Comprehensive Environmental Response,
Compensation, and Liability Act of 1980 (CERCLA), commonly known as the "Superfund" Act,
provided the Congressional mandate to remove or clean up abandoned and inactive hazardous
waste sites and to provide federal assistance in toxic emergencies. As the lead Agency within the
Public Health Service for implementing the health-related activities of CERCLA, ATSDR is
charged to assess the presence and nature of health hazards at specific Superfund sites, to help
prevent or reduce further exposure and the illnesses that result from such exposures, and to
expand the knowledge base about health effects from exposure to hazardous substances.
In 1984, amendments to the Resource Conservation and Recovery Act of 1976 (RCRA)
authorized ATSDR to conduct public health assessments (PHAs) at these sites. ATSDR was also
authorized to assist the United States (U.S.) Environmental Protection Agency (EPA) in
determining which substances should be regulated and the levels at which substances may pose a
threat to human health. With the passage of the Superfund Amendments and Reauthorization Act
(SARA), ATSDR received additional responsibilities in environmental public health. This Act
broadened ATSDR's responsibilities in the areas of PHAs, establishment and maintenance of
toxicological databases, information dissemination, and medical education.
In 2017, ATSDR launched the Choose Safe Places for Early Care and Education (CSPECE)
initiative under Notice of Funding Opportunity (NOFO) number CDC-RFA-TS17-1701 to
prevent harmful exposures among children before they occur. Newly licensed ECE programs
might inadvertently open in places where children and staff could be exposed to environmental
contamination. CSPECE helps prevent new ECE locations from being sited in potentially
harmful locations through improvements in data use, education, partnership building, and other
activities. Several state programs demonstrated CSPECE is effective at preventing ECEs from
being located at sites that risk harmful environmental exposures. This NOFO builds on previous
efforts of developing CSPECE programs where there were none and expanding existing
programs.
ATSDR’s goals are to expand capabilities by translating science into tools and actions that
individuals, communities, and organizations apply to identify, reduce, or prevent health effects
from exposures to hazardous substances. This NOFO also seeks to support innovative, non-sitespecific activities to contribute to ATSDR’s capacity and prevention mission. Such efforts can
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increase the efficiency of activities and expand reach to more communities, thereby increasing
public health impact.
The primary purpose of this NOFO is to prevent harmful environmental exposures and related
health effects through site health assessments, community engagement activities, and prevention
activities.




Component 1 Strategy A includes site assessment and community engagement, and all
applicants are required to apply for this strategy.
Component 1 Strategy B is optional and includes Choose Safe Places for Early Care and
Education.
Component 2 is optional and focused on capacity development and applied prevention
science.

b. Statutory Authorities
This program is authorized under Section 104(i)(15) of the Comprehensive Environmental
Response, Compensation and Liability Act (CERCLA) of 1980, as amended by the
Superfund Amendments and Reauthorization Act (SARA) of 1986 [42 U.S.C. §9604(i)(15)].
c. Healthy People 2030
This program addresses the Environmental Health topic area of the Healthy People 2030
objective.
d. Other National Public Health Priorities and Strategies
The purpose and goals of the funding are consistent with the mission of ATSDR to serve the
public by using the best available science, take responsive public health actions, and provide
trusted health information to prevent harmful exposures and health effects related to toxic
substances (http://www.atsdr.cdc.gov/).
e. Relevant Work
In 2017, APPLETREE included a new prevention strategy, Choose Safe Places for Early Care
and Education (CSPECE), where recipients developed pilot programs in their state to encourage
the safe siting of childcare facilities. By 2022, most APPLETREE recipients fully implemented
CSPECE programs and developed plans for long-term sustainability. This new funding cycle
builds on ATSDR’s past program activities, successes, and innovations to support additional
activities that contribute to preventing harmful environmental exposures and related health
effects.
2. CDC Project Description
a. Approach
Bold indicates period of performance outcome.
CDC-RFA-TS23-2301 Logic Model: APPLETREE
Bold indicates a period of performance outcome.
Strategies and
Activities

Short-term Outcomes

Intermediate
Outcomes

Long-term
Outcomes
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Component 1: Core
Activities
Required Strategy
A) Site Assessment
and Community
Engagement
Conduct site-specific
assessments
Educate community,
stakeholders, and
health professionals
on site-related risks
and
recommendations

Timely dissemination
of site-specific findings
to partners,
stakeholders, and
community members
Increased partner buyin and acceptance of
recommendations
Increased community,
stakeholder, and health
professional knowledge
of site-related risks and
recommendations

Increased buy in and
support from broad
array of partners

Optional Strategy
B) Choose Safe
Places for Early
Care and Education Increased
(CSPECE)
stakeholder/partner
knowledge of ECE
For new
siting issues and
recipients funded
recommendations to
under TS23-2301
prevent exposure
Define childcare
landscape
Form partnerships to
support program
development and
implementation
Create strategic

Increased actions by
community members
to protect themselves
from site-related
hazards

Increased
understanding of
barriers and
facilitators for safe
siting
Enhanced and/or

Decreased,
eliminated, or
prevented
exposures to
hazardous
chemicals
Decreased,
eliminated, or
prevented
exposure-related
health effects
Increased
collection of
evidence on
effective
practices,
policies, and
processes for
preventing
exposure

Decreased or
eliminated siterelated exposures

Identify, develop,
and maintain partner
and stakeholder
relationships to
support activities

Component 1:

Increased
implementation of
recipient
recommendations to
reduce, eliminate, or
prevent exposures by
regulatory agencies,
and/or individuals

Increased
stakeholder practices
to reduce hazardous
exposure among
children
Increased process,
systems, and policy
changes to support
exposure prevention
Increased
understanding of
actions to enhance
and/or expand program

Increased
capacity of
individuals,
communities,
and
organization to
identify, reduce,
and eliminate
exposure
Improved
infrastructure
and capacity for
sustainability of
programs

Improved efficiency
and quality of
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program plan

expanded CSPECE
programs

Pilot and apply
lessons learned
Educate target
populations
Screen ECE
locations and
respond to screening
results

Increased partner
commitment to CSPECE
program

programs
Increased practices of
partners to manage
CSPECE program
independently

Enhanced
infrastructure among
partners to sustain
CSPECE program

Implement process,
systems, or policy
changes
For previously
funded recipients
under
TS20-2001
Enhance program
capabilities to
maintain multi-sector
partnerships, sustain
program, and
promote the safe
siting of ECE
locations
Component 2:
Optional Capacity
Development and
Applied Prevention
Science

Increased knowledge
among target audience
to identify, reduce, or
prevent health effects
from exposure to
hazardous substances

Increased actions
among target
audience to identify,
reduce, or prevent
health effects from
exposure to
hazardous substances

Build local, state,
and tribal nation
capabilities to
identify, reduce, or
prevent health effects
from exposures to
hazardous substances

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i. Purpose
The purpose of APPLETREE is to protect public health by increasing recipient capacity to 1)
respond to threats of human exposure to hazardous substances in the environment, 2) engage
communities about site contamination and potential health effects, and 3) implement activities to
address local environmental health issues of concern.
ii. Outcomes
Programs are expected to demonstrate measurable progress in short-, intermediate-, and longterm outcomes listed in bold in the logic model. Expected program outcomes listed below
are required for both components.
Short-Term Outcomes:









1.1 Timely dissemination of site-specific findings to partners, stakeholders, and
community members (Component 1: Strategy A)
1.2 Increased partner buy-in and acceptance of recommendations (Component 1: Strategy
A)
1.3 Increased buy in and support from broad array of partners (Component 1: Strategy B)
1.4 Increased stakeholder/partners knowledge of ECE siting issues and recommendations
to prevent exposure (Component 1: Strategy B)
1.5 Increased understanding of barriers and facilitators for safe siting (Component
1: Strategy B)
1.6 Enhanced and/or expanded CSPECE programs (Component 1: Strategy B)
1.7 Enhanced infrastructure among partners to sustain CSPECE program (Component 1:
Strategy B)
1.8 Increased knowledge among target audience to identify, reduce, or prevent health
effects from exposure to hazardous substances (Component 2)

Intermediate Outcomes:







2.1 Increased implementation of recipient recommendations to reduce, eliminate, or
prevent exposures by regulatory agencies, and/or individuals (Component 1: Strategy A)
2.2 Decreased or eliminated site-related exposures (Component 1: Strategy A)
2.3 Increased stakeholder practices to reduce hazardous exposure among
children Component 1: Strategy B)
2.4 Increased process, systems, and policy changes to support exposure prevention
(Component 1: Strategy B)
2.5 Increased practices of partners to manage CSPECE program independently
(Component 1: Strategy B)
2.6 Increased actions among target audience to identify, reduce, or prevent health effects
from exposure to hazardous substances (Component 2)

Long-Term Outcomes:


3.1 Decreased, eliminated, or prevented exposures to hazardous chemicals (all Strategies
for Component 1 and Component 2)

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

3.2 Increased collection of evidence on effective practices, policies, and processes for
preventing exposure (all Strategies for Component 1 and Component 2)

iii. Strategies and Activities
COMPONENT 1: Core Activities (required)
The Core Activities component of the program supports two strategies: Strategy A (Site
Assessment and Community Engagement) and Strategy B (CSPECE). Applicants are required to
propose activities under Strategy A, and Strategy B is optional.
Strategy A (required): Site Assessment and Community Engagement
Strategy A1. Conduct site-specific health assessments and provide recommendations to prevent,
reduce, or eliminate harmful exposures. In order to achieve the outcomes listed above, recipients
must conduct environmental health assessment activities at hazardous waste sites. Hazardous
waste sites may include, but are not limited to,:








National Priorities List (NPL),
Petition,
Comprehensive Environmental Response, Compensation, and Liability Information
System (CERCLIS),
State-identified,
RCRA,
Brownfields, and
Other sites or releases within the recipient’s jurisdiction.

Environmental health assessments (public health assessments and health consultations or HCs)
are focused responses to a specific question or request for information about health risks posed
by a specific site, chemical release, hazardous material, or emergency response actions.
Recipients lead site assessments for all requests that ATSDR or the recipient receives in their
jurisdiction. In the assessment of hazardous exposures, recipients are required to follow
ATSDR’s policy and guidance including, but not limited to, procedures and tools in ATSDR’s:


Public Health Assessment Guidance Manual (PHAGM) and exposure dose guidance
documents. Environmental health assessments will include information described in the
PHAGM such as available environmental sampling data, demographic characterizations,
community health concerns, health equity, and health outcome data reviews where
appropriate. Recipients must conduct environmental health assessments in a public health
assessment or health consultation (standard or letter) format. As part of the environmental
health assessment process, recipients should use data, indices, and geospatial tools (e.g.,
CDC’s Social Vulnerability Index or Environmental Justice Dashboard; ATSDR’s
Environmental Justice Index; and EPA’s MyEnvironment and EJScreen) to better
understand community characteristics and environmental health burden.



Public Health Assessment Site Tool (PHAST) that contains ATSDR’s health-based
comparison values and health guidelines, such as minimal risk levels. All documents in
which specific exposures are evaluated are required to use PHAST guidelines and
procedures. State (or other agency/organization) derived screening values may be used if
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the values are more conservative or more protective of public health or if an ATSDRderived comparison value is not available. Technical Project Officers (TPOs) will assist
recipients with obtaining PHAST access.
Recipients are required to follow APPLETREE certified and non-certified procedures for
products. Certified PHAs and HCs (standard and letter) will be cleared through ATSDR's
internal review and clearance process, released with an ATSDR cover page, and posted to
ATSDR’s web site. ATSDR certifies PHAs and HCs for the following sites:



NPL (proposed and/or listed)
ATSDR-accepted petition

The decision to certify documents are subject to change throughout the period of performance.
The APPLETREE Program Officer will communicate in writing any changes to the
aforementioned certification criteria or site scoping requirements. Site scoping meetings are also
required for certified PHAs and HCs. Recipients are required to request and address all
comments from external stakeholders (e.g., recipient’s leadership staff and other agencies) before
submitting the certified document to the TPO for preclearance review. Certified PHAs and HCs
will be posted to ATSDR’s web site no later than 60 days after final ATSDR clearance.
Recipients will work with their TPO and ATSDR staff to ensure that certified documents are
508-compliant before public release and posting on ATSDR’s web site. Recipients are required
to send non-certified PHAs and HCs to the TPO for approval before the recipients release the
document to the public.
Exposure Investigations (EIs) may be conducted as part of the public health assessment process
to fill data gaps and better define site-specific human exposures. EIs may include the collection
of environmental and biological data. EIs using APPLETREE funds require approval from
ATSDR’s Technical Project Team and EI Program staff as well as written approval from the
APPLETREE Program Officer. Protocols for EIs using APPLETREE funds must complete
ATSDR’s clearance process. For the purposes of this program, the state, recipient agency, or the
ATSDR Office of Science must also designate EIs “nonresearch”. Recipients are encouraged to
work with state environmental labs when conducting exposure investigations. Recipients are
required to use a PHA or HC format to summarize EI procedures and findings.
ATSDR periodically receives petitions from community members requesting ATSDR to
investigate a particular site. Recipients will provide any available data to assist ATSDR in
deciding how to respond to petitions. Recipients will review existing information including
environmental data pertaining to a site or release identified in a petition. Recipients will conduct
health consultations or appropriate public health assessment activities for ATSDR-accepted
petition sites.
Conducting exposure assessments, health studies, cancer incidence analyses, cancer cluster
investigations, epidemiological studies, risk assessments, and alternative health assessment
products are not authorized under this NOFO. Recipients will also respond promptly to
ATSDR’s requests for information about the program, including information needed for
congressional inquiries/testimony, program evaluation, and other reporting.
Strategy A2. Educate community, stakeholders, and health professionals on site-specific
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environmental exposures and risks to human health. Recipients are required to lead effective
community engagement activities for all site assessment activities. Effective community
engagement activities will incorporate the nine principles outlined in the CDC/ATSDR
Principles of Community Engagement manual. For more information, see the CDC/ATSDR
Committee on Community Engagement (Principles of Community Engagement (Second Edition)
2011, Public Health Practice Program Office, Centers for Disease Control and Prevention,
Atlanta, GA). Recipients are expected to follow the Public Health Assessment Guidance Manual
to evaluate sites and involve communities in the public health assessment process. The use of
additional resources including the ATSDR’s Community Engagement Playbook,
Communication Toolkit, and Community Stress Resource Center are encouraged. When
appropriate, recipients may consider using additional strategies for engaging communities,
including the ATSDR Action Model and the National Association of County and City Health
Officials/CDC Protocol for Assessing Community Excellence in Environmental Health (PACE
EH). Recipients are required to:




Prepare health education and community involvement materials that are accessible and
inclusive of underserved populations and people with disabilities.
Participate in local, state, federal, and tribal health and environmental workshops and
community meetings to discuss and respond to questions concerning a particular site’s
impact on public health.
Conduct soil Screening, Health, Outreach and Partnership (soilSHOP) events, as
appropriate, as part of their health education efforts in communities where lead in soil is a
potential health concern.

Health education activities should focus on ensuring that community members understand the
findings of health assessments and where applicable, adopt behavioral changes that will reduce
harmful environmental exposures and improve health. Applicants should describe strategies for
effectively engaging communities and other stakeholders and ensuring communication materials
are effective. Health education materials to healthcare providers should focus on ensuring that
patients seeking care related to environmental exposures are appropriately evaluated and treated.
Health education should also support the consideration of environmental exposure-related
etiologies in patient care.
Strategy A3. Identify, develop, and maintain partner and stakeholder relationships to support
these activities. Details of expected collaborative efforts are outlined in the Collaborations
section.

Major Activities
Activities specified within the
logic model to support overall
strategy

Recommended Sub-Activities
ATSDR provided recommended sub-activities that
recipients can engage in to advance strategies below. Some
sub-activities are standard practices for an activity, but
many are not required and only suggestions. Applicants
may propose actions that are not listed below if they
advance the strategy and make progress toward achieving
logic model outcomes. Evidence should be provided to
justify how actions support the overall strategy.
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Major Activities
Conduct site-specific health
assessments

Recommended Sub-Activities
Develop work plan based on requests for involvement and
state landscape of the following: NPL, ATSDR-accepted
petition, Comprehensive Environmental Response,
Compensation, and Liability Information System
(CERCLIS), state-identified, RCRA, Brownfields, and
other redevelopment sites and facilities or releases within
the recipient’s jurisdiction
Work with Technical Project Officers to prioritize sites.
Recipients should prioritize work at NPL (proposed and/or
listed) sites, ATSDR-accepted petition sites, sites of
greatest public health significance as identified by ATSDR,
and sites deemed an ATSDR priority
Identify/assess site needs and match needs to a plan of
activities
Evaluate exposure pathways
Evaluate exposures and human health effects
Identify appropriate interventions or recommendations, and
follow-up on all recommendations provided to policy
makers, regulatory agencies, and individuals, within one
year of recommending public health actions
Engage in capacity building opportunities to improve
quality and efficiency, such as participating in relevant
training and skill building opportunities

Educate community,
stakeholders, and health
professionals on site-related
risks and recommendations

Use tools, data, and public health assessment guidance to
identify communities underserved or disproportionately
impacted by site exposures
Assess community site-specific health education needs and
applicable educational strategies to meet needs
Participate in local, state, federal, and tribal health and
environmental workshops and community meetings to
discuss and respond to questions concerning a particular
site’s impact on public health
Provide other direct education concerning a particular
site’s impact on public health (e.g., one-on-one or group
education such as phone calls, emails, Community
Advisory Group meetings, web-based or conference call
education, site visits, or other education involving direct
instruction)
Create and provide indirect educational materials through
outlets such as paper material distribution (e.g., flyers,
brochures, fact sheets), web-based material distribution

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Major Activities

Identify, develop, and
maintain partner and
stakeholder relationships to
support activities

Recommended Sub-Activities
(e.g., blog posts, social media, webpage posts), or
television, radio, or newspaper
Use resources such as ATSDR’s Community Engagement
Playbook, Community Engagement Planning Tool, and
Communication Toolkit to promote best practices in
communication strategies
Host soilSHOP events when lead in soil is a potential
health concern
Respond to written or verbal requests for environmental
public health technical and/or educational information and
document response in a written form. Technical assistance
should not draw a public health conclusion or comment on
another entity’s health conclusion.
Identify relevant environmental, regulatory, policy, and
other partners to support and advance activities
Foster commitment with partners to support activities
Engage in consistent communication to maintain and
strengthen partnerships
Engage in collaborative activities with partners that meet
common goals

Strategy B (optional): Choose Safe Places for Early Care and Education (CSPECE)
The primary goal of CSPECE is to prevent exposures to hazardous substances at prospective
childcare locations before an ECE is licensed. Applicants that choose to participate in CSPECE
for the 5-year period of performance must select and clearly indicate either option 1 or 2 below
in their application. Applicants should also include one combined budget for Component 1
Strategies A and B in their application that has line items for Component 1 Strategy B
expenses. Applicants must receive an award for Component 1 Strategy A to receive funding for
Component 1 Strategy B. Applicants should list activities in a work plan table and provide a
narrative overview of their Choose Safe Places for Early Care and Education program plans.
1. For new recipients funded under TS23-2301:
Recipients will develop a CSPECE program in their jurisdiction using ATSDR guidance. The
following activities are recommended milestones for the 5-year period of performance:



April 2023 - December 2023: Define the landscape for safe siting of childcare
centers within the recipient’s boundaries and form partnerships, including non-federal
advisory committees.
January 2024 - December 2024: Develop a program plan for safe siting of childcare
centers that include operation, training, data, and evaluation needs, as well as roles and
responsibilities.
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


January 2025 - December 2025: Implement a pilot program that tests the feasibility and
scalability of the program plan. Identify lessons learned to improve CSPECE program.
January 2026 - March 2028: Fully implement, maintain, and enhance CSPECE program.

Major Activities
Activities specified
within the logic model
to support overall
strategy

Define childcare
landscape

Form partnerships to
support program
development and
implementation

Create strategic
program plan

Recommended Sub-Activities
ATSDR provided recommended sub-activities that recipients may
engage in to advance strategies below. Some sub-activities are
standard practices for an activity or suggestions. Applicants may
propose actions that are not listed below if they advance the
strategy and make progress toward achieving logic model
outcomes. Evidence should be provided to justify how actions
support the overall strategy.
Quantify Early Care and Education (ECE) programs and
populations in the state
Identify state ECE licensing process and policies
Identify state intersection of ECE licensing and environmental
health
Identify governmental and non-governmental stakeholders of ECE
licensing programs and how they could be involved in ECE
licensing
Identify data sources that could be used to foster a CSPECE
program
Identify relevant childcare, licensing, environmental, health,
academic, zoning, planning, non-governmental, and other partners
to support and advance activities
Foster commitment with partners to support activities
Proactively engage in consistent communication to maintain and
strengthen partnerships
Engage in collaborative activities with partners that meet common
goals
Engage in activities that foster sustainability such as building
partner capacity
Establish overall goals and SMART (Specific, Measurable,
Achievable, Relevant, Time-framed) goals for your program
Describe how the state program will operate
Describe education and training the program will conduct
Describe the data and processes the program will use to identify
proposed ECEs that have potential harmful environmental
exposure
Describe partnerships the program will support
Describe data the program will collect
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Major Activities
Pilot and apply lessons
learned
Educate target
populations
Screen ECE locations
and respond to
screening results

Implement process,
systems, or policy
changes

Recommended Sub-Activities
Implement pilot plan
Use lessons learned to inform program improvements
Conduct training on the importance of safe siting of ECE
programs and environmental risks
Disseminate outreach materials to raise awareness about CSPECE
Develop approaches (e.g., mapping) to identify proposed ECE
locations and potential environmental health issues
Gather relevant property and environmental data
Communicate results to appropriate parties
Make recommendations to prevent or reduce environmental
exposures
Create procedure for evaluating and referring potentially
problematic sites
Explore opportunities to change policies and procedures at the
local, state, and federal level

2. For recipients previously funded under TS20-2001:
Building upon CSPECE programs developed under the previous APPLETREE NOFO,
applicants will provide and implement a 5-year plan for maintaining, enhancing, and sustaining
their CSPECE program. In this plan, applicants are expected to describe what activities they
intend to implement, including activities such as screening, education, response actions, process
or policy change, and any other innovative activities that support the goals of CSPECE.
Applicants should include a sustainability section in their plan that describes how they will
maintain their program long-term, including key partnerships with roles and commitments,
infrastructure and resources, capacity building activities, and potential adaptations or changes.
The plan should include measurable milestones for each year in the period of performance to
achieve CSPECE program goals.
Applicants should:




Provide a description of relevant background information, including the state-specific
context of the problem and target audience. Applicants should provide a 2-3 sentence
purpose/goal for their program.
Provide a concise description of the strategies and activities, outcomes expected to be
achieved, and year to year benchmarks.
Describe activities focused on preventing exposures to hazardous substances at
prospective childcare locations before an ECE is licensed.

COMPONENT 2 (optional): Capacity Development and Applied Prevention Science
ATSDR builds capabilities by translating science into tools and actions that individuals,
communities, and organizations apply to identify, reduce, or prevent health effects from
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exposures to hazardous substances. Proposals made under this Component should promote the
ATSDR’s mission. Applicants can address up to three of the following Focus Areas advanced by
their proposal:






Partner with internal and external stakeholders to incorporate health equity perspectives
into new or existing environmental health programs, policies, and practices
Promote partnerships, strategies, and tools to support environmental exposure and health
equity education to health care providers
Develop new and accessible strategies to support underserved, tribal, and/or indigenous
communities disproportionately impacted by adverse environmental outcomes
Develop model(s) and/or protocol(s) for successful coordination between APPLETREE,
cancer registry, environmental, and other internal health agency partners to address
community cancer concerns
Build capacity in impacted communities to respond to harmful environmental exposures
resulting from locally driven hazards such as contaminated site flooding, drought-related
dust, wildfire smoke, or other weather-related impacts

Applicants should:






Describe, in 2-3 sentences, specifically how their application will address the Focus
Area(s) for which activities are being proposed.
Describe relevant background information that includes the context of the issue being
addressed, nationally and in the applicant’s jurisdiction.
Identify the outcomes they expect to achieve by the end of the period of performance.
Outcomes are the results that the program intends to achieve. All outcomes must indicate
the intended direction of change (e.g., increase, decrease, maintain).
Provide a clear and concise description of the strategies and activities they will use to
achieve the period-of-performance outcomes.
Describe how the interventions to be improved or evaluated target high-risk groups to
achieve the greatest health impact, as described in the "Target Populations" section of this
NOFO.

1. Collaborations
a. With other CDC programs and CDC-funded organizations:
Recipients are required to collaborate with other CDC and ATSDR cooperative agreement and/or
grant programs to identify common needs, promote resource and information sharing to assure
review of documents in order to advance ATSDR goals and facilitate public health actions to
improve the health of communities. For Components 1 and 2, applicants are required to describe
how existing or potential collaborations with other CDC-funded programs and organizations
could assist the recipient in implementing activities and achieving the NOFO outcomes. These
programs include, but are not limited to,: Pediatric Environmental Health Specialty Units
(PEHSU), Safe Water for Community Health (Safe WATCH), National Environmental Public
Health Tracking Program, and Childhood Lead Poisoning Prevention Program. Applicants must
Page 15 of 61

file the letters of support, memorandums of understanding, and/or memorandums of agreement
(MOUs/MOAs), name the file “Letters of Support” or “MOUs/MOAs”, and upload it as a PDF
file at www.grants.gov.
b. With organizations not funded by CDC:
Component 1 and 2 recipients are required to collaborate with the appropriate federal (e.g., U.S.
Environmental Protection Agency), state agencies, local health departments, environmental
laboratories, and community groups to identify common needs, promote resource and
information sharing to advance ATSDR goals, and facilitate public health actions to improve the
health of communities. Collaborative relationships may include entities supporting various areas
such as public health, geographic information systems, childcare licensing, health equity, and
children’s environmental health. Applicants should:






Describe specific examples of successful partnerships and collaborations between the
applicant and environmental regulatory agencies and communities in achieving the
desired outcome of reducing exposure to hazardous chemicals in the environment. Strong
applicants will demonstrate effective communications in getting the environmental
regulatory agencies and communities to accept public health recommendations from the
applicant. Specific outcomes achieved should be included.
Include two letters of support (dated between July 1, 2022, and December 9, 2022) from
environmental regulatory agencies, community groups, state environmental labs, or
federal/state/local/tribal agencies that detail the applicant’s role and success with
reducing exposure to hazardous chemicals in the environment and engaging
communities. Applicants should explain collaborations with other groups that could assist
them in implementing activities.
Include one letter of support (dated between July 1, 2022, and December 9, 2022) from
their program or leadership staff (e.g., Director, Principal Investigator) stating their intent
to follow ATSDR’s guidance (e.g., the use of comparison values, public health
assessment guidance document certification), policies, and procedures (e.g., ATSDR
clearance and release of HCs/PHAs) in carrying out the cooperative agreement goals and
objectives.

Applicants must file the letters of support, MOUs, or MOAs, name the file “Letters of Support”
or “MOUs/MOAs”, and upload it as a PDF file at www.grants.gov. For Component 1 Strategy B
(CSPECE), recipients should seek to build both internal and external partnerships to ensure the
sustainability of CSPECE in their jurisdiction beyond this period of performance.
2. Target Populations
ATSDR’s mission is to protect communities from harmful health effects from exposure to
hazardous waste and hazardous materials spills. Therefore, the target population for this NOFO
is anyone previously, currently, or potentially exposed to existing or emerging environmental
health threats, particularly sensitive subpopulations including children, the elderly, and people
with disabilities. Children attending early care and education (ECE) facilities and stakeholders
involved in the licensing, siting, and operation of ECE facilities are specifically targeted in
Component 1 Strategy B. Additionally, as part of the Component 2 activities described herein,
any public health entity, national organization, academic institution, medical system, or nonprofit organization that potentially plays a part in increasing the capacity of state, local, tribal or
Page 16 of 61

territorial health agencies to respond to, investigate, or prevent harmful exposures are potential
targeted populations.
a. Health Disparities
This NOFO supports efforts to improve the lives of populations disproportionately affected by
harmful environmental exposures. Recipients must consider under-served populations such as
tribal nations, people with disabilities, rural populations, and populations where English is a
second language when conducting activities. Recipients will use ATSDR’s public health
assessment and community engagement guidance to evaluate a community’s environmental and
health burden when evaluating exposures from hazardous wastes sites and engaging
communities. Recipients will also use data, indices, and geospatial tools (e.g., CDC’s Social
Vulnerability Index or Environmental Justice Dashboard; ATSDR’s Environmental Justice
Index; and EPA’s MyEnvironment and EJScreen) to better understand community
characteristics. Examples of criteria to consider for a community include income level,
accessibility to health care and healthy food choices, and the presence of major environmental
pollution sources. This information can help plan effective community engagement strategies,
build or strengthen collaborations, and develop solution-based interventions.
iv. Funding Strategy
This announcement contains two components. All applicants must apply for Component 1
Strategy A (site assessment and community engagement). Component 1 Strategy B (CSPECE)
and Component 2 (capacity development and applied prevention sciences) are optional.
Applicants applying for Component 1 Strategies A and B should submit one combined budget
that includes line items for Strategy B expenses. Applicants that apply for Component 2 should
submit a separate budget.
Component 1 Strategy B applicants should list activities in a work plan table and provide a
narrative overview of their Choose Safe Places for Early Care and Education program plans.
Component 1 Strategy B activities will not be ranked or scored. All Component 1 Strategy B
applicants that include expenses in their Component 1 budget will receive funding for
Component 1 Strategy B. ATSDR anticipates providing funding of up to $100,000 for
Component 1 Strategy B. Component 1 Strategy B funding is included in the Component 1
annual average award amount stated in this NOFO. Component 1 Strategy B funding will be
based on the applicant’s proposed budget and the availability of funds. Applicants must be
approved and receive an award for Component 1 Strategy A to receive funding for Component 1
Strategy B. ATSDR may award more or less than the expected average award amount for all
components and strategies.
Component 2 applicants must be approved with a minimum score of 60 points for Component 1
(Strategy A) to be eligible for review and funding under Component 2. Component 2 funding is
also based on the Component 2 score and rank. The number of recipients for Component 2 is
dependent on the availability of funds. Eligible applicants may receive one of the following
awards:




Component 1 (Strategy A)
Component 1 (Strategies A and B)
Component 1 (Strategies A and B) and Component 2
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


Component 1 (Strategy A) and Component 2
Component 2

b. Evaluation and Performance Measurement
i. CDC Evaluation and Performance Strategy
ATSDR requires ongoing evaluation and performance measurement under this NOFO and
expects recipients to maintain sufficient staffing and analytic capacity to meet these
requirements. Program evaluation and performance measurement help demonstrate the
effectiveness of programs, drive continuous program improvement, and contribute to the
evidence-base for each intervention.
ATSDR will assess the degree to which strategies in the logic model have been implemented and
outcomes have been achieved through submitted quantitative and qualitative reporting,
conference calls, site visits, and other communications with recipients. This section provides
example measures that ATSDR will use to track the implementation of strategies and progress on
achieving outcomes. The assessment will occur on an ongoing basis through the evaluation of
submitted products, training, and technical assistance delivered. Recipients are expected to
develop an evaluation plan, submit an annual progress report, and an additional final project
report at the conclusion of the period of performance summarizing achievements, challenges,
lessons learned, and next steps. Optional templates may be provided to guide the Evaluation and
Performance Measurement Plan development and the final project reporting.
Targets for performance measures may vary by program and can be established in the 6-month
period following the award. However, all recipients are expected to meet or exceed the target
of completing at least 80% of the activities specified in their work plan each year.
Modifications to the work plan should be discussed with the Technical Project Officer, and all
changes should be finalized at least three months prior to submission of Annual Performance
Reports.
This section presents example measures that ATSDR will use to track the implementation of
strategies and activities (process evaluation) and progress on achieving period-of-performance
outcomes (outcome evaluation). The measures below are not comprehensive or final, and
ATSDR will finalize evaluation and performance measures in collaboration with recipients
within six months of the project start date.
Process Performance Measures
To better understand outcome results, it is important to collect process measures. Evaluating the
implementation of a program in addition to its outcomes helps to show what aspects of a
program are working well and what may require change to achieve the intended impact.
COMPONENT 1:
Strategy

Process Performance Measures

Page 18 of 61



A: Site Assessment and
Community Engagement




B: Choose Safe Places for Early
Care and Education, new recipients
under TS23- 2301




B: Choose Safe Places for Early
Care and Education, previously
funded under TS20-2001

Assessment that defines the childcare landscape
and identifies needs
Number of partnerships identified to help
prevent exposures
Choose Safe Places for Early Care and
Education pilot plan

Recipients must specify performance measures based
on proposal activities. Performance measures may vary
significantly based on proposal, but may generally
include:


COMPONENT 2:
C: Build local, state, and tribal
nation capabilities to identify,
reduce, or prevent health effects
from
exposures to hazardous
substances

Proportion of site-specific health assessments
completed from work plan
Proportion of requests for technical assists
provided a written response

Number of MOUs and/or letters of intent
from partners demonstrating long-term
commitment to program

May vary significantly based on proposal, but may
generally include:




Identification of key implementation barriers
Facilitators
Lessons learned from pilot process

Outcome Performance Measures
Short-term Outcomes
1.1 Timely dissemination of sitespecific findings to partners,
stakeholders, and community members.
(Strategy A)
1.2 Increased partner buy-in and
acceptance of public health
recommendations made by recipients.
(Strategy A)
1.3 Increased buy in and support from
broad array of partners. (Strategy B,

· Proportion of site-specific health assessments
disseminated from work plan within one year
from the date adequate data was received.

· Percentage of recipient’s public health
recommendations accepted by regulatory agencies
or policy makers within one year
· Number of partners indicating commitment to
help prevent exposures

Page 19 of 61

new recipients funded under TS232301)
1.4 Increased stakeholder/partners
knowledge of ECE siting issues and
public health recommendations made by
recipients to prevent exposure. (Strategy
B, new recipients funded under TS232301)
1.7 Enhanced infrastructure among
partners to sustain CSPECE program.
(Strategy B, previously funded under
TS20-2001)

1.8 Increased knowledge among target
audience to identify, reduce, or prevent
health effects from exposure to
hazardous substances. (Component 2)

Intermediate Outcomes
2.1 Increased implementation by
regulatory agencies, and/or individuals
of public health recommendations made
by recipients. (Strategy A)
2.2 Decreased or eliminated site related
exposures. (Strategy A)

2.3 Increased stakeholder practices to
reduce hazardous exposure among
children. (Strategy B, new recipients
funded under TS23-2301)
2.4 Implemented process, systems, and
policy changes to support prevented
exposures (Strategy B, new recipients
funded under TS23-2301)
2.6 Increased actions among target
audience to identify, reduce, or prevent
health effects from exposure to
hazardous substances. (Component 2)
Long-Term Outcomes

· Percentage of stakeholders/partners indicating
understanding public health recommendations
made by recipients to prevent exposure at ECEs

· Percentage of partners indicating increased
knowledge, skills, and abilities around CSPECE
concepts
· Percentage of partners indicating increased
knowledge, skills, and abilities around CSPECE
concepts
· Percentage of target audience (educational target
audience may vary and include inspectors, zoning
and planner officials, providers, and other ECE
stakeholders) indicating increased knowledge to
identify, reduce, or prevent health effects from
exposure to hazardous substances
· Percentage of public health recommendations
made by recipients implemented by regulatory
agencies within one year
· Percentage of sites with decreased or eliminated
exposures based on public health
recommendations made by recipients
implemented by regulatory agencies or policy
makers within the period of performance
· Percentage of ECE programs referred to the
program that make changes because of identified
issues
· Number and type of policy, systems,
environment changes to support prevented
exposures
· Recipients must specify performance measures
based on proposal activities.

Page 20 of 61

3.1 Decreased, eliminated, or prevented
exposures to hazardous chemicals.
(Strategies A and B)

3.2. Increased collection of evidence on
effective practices, policies, and
processes for preventing exposure.
(Strategies A and B)

· Percentage of sites with decreased or eliminated
exposures based on public health
recommendations made by recipients
implemented by regulatory agencies or policy
makers within the period of performance
· Number of individuals protected at sites in which
public health recommendations made by
recipients are implemented by regulatory agencies
or policy makers within the period of performance
· Description of effective practices, policies, and
processes for preventing exposure

Many performance measures will be available through required data collection forms,
applications (e.g., ATSDR’s Request Management Service System), or equivalent collection
processes including:










Site Impact Assessment (SIA): Required to complete SIA submission for each health
assessment (Public Health Assessment, Health Consultation, and Letter Health
Consultation)
Health Education Activity Tracking (HEAT): Required to complete for indirect and
direct educational activities. It is suggested to submit entries on a quarterly or more
frequent basis.
Technical Assist (TA): Required to complete for each TA. It is suggested to submit
entries on a quarterly or more frequent basis.
Success stories: Required to complete one per quarter
soilSHOP: Required to complete reporting for each soilSHOP event completed
ATSDR Community Activities Survey
Annual Performance Report: Required per CDC; recipients will be notified by CDC with
directions and due dates annually (except the last budget period of the 5-year period of
performance). Information pertaining to outcomes 1.5, 1.6, 2.5, 2.6, and 3.2 will be
obtained through narratives in the annual performance report.
Final Performance Report: Required to complete at the end of the period of performance

There are limitations to solely using performance measures to evaluate a program or project. For
example, measures do not always fully represent how strongly or poorly a program/project or
recipient is doing, and often cannot consider contextual factors. Thus, it is important to have
other ways of collecting program/project information to help fully demonstrate its performance,
e.g., success stories, progress calls. ATSDR will rely on a combination of these sources of
information to gauge successes and challenges faced by recipients.
Quantitative and qualitative data (including all required quantitative metrics, success stories, and
narrative reports) may be used without prior notification to produce summary reports, project
accomplishment reports, fact sheets, and other monitoring and evaluation reports. Findings may
Page 21 of 61

be reported at national conferences, online, in peer-reviewed journals, and in other public forums
independently by ATSDR (for aggregate data), or in collaboration with recipients where sitespecific data are to be presented. ATSDR will finalize evaluation and performance measures in
collaboration with recipients within six months of the project start date.
If ATSDR approves an exposure investigation (described in the Strategies and Activities section)
during the period of performance, recipients must add a Data Management Plan to their
Evaluation and Performance Measurement Plan. The Data Management Plan must include the
following:






Description of the data to be collected or generated in the proposed project;
Standards to be used for the collected or generated data;
Mechanisms for, or limitations to, providing access to the data, including a description
for the provisions for the protection of privacy, confidentiality, security, and intellectual
property, or other rights;
Statement of the use of data standards that ensure all documentation that describes the
method of collection, what the data represent; and
Plans for archiving and long-term preservation of the data, or explaining why long-term
preservation and access are not justified.

ii. Applicant Evaluation and Performance Measurement Plan
Applicants must provide an evaluation and performance measurement plan that demonstrates
how the recipient will fulfill the requirements described in the CDC Evaluation and Performance
Measurement and Project Description sections of this NOFO. At a minimum, the plan must
describe:


How the applicant will collect the performance measures, respond to the evaluation
questions, and use evaluation findings for continuous program quality improvement.



How key program partners will participate in the evaluation and performance
measurement planning processes.



Available data sources, feasibility of collecting appropriate evaluation and performance
data, and other relevant data information (e.g., performance measures proposed by the
applicant)



Plans for updating the Data Management Plan (DMP) as new pertinent information
becomes available. If applicable, throughout the lifecycle of the project. Updates to
DMP should be provided in annual progress reports. The DMP should provide a
description of the data that will be produced using these NOFO funds; access to data;
data standards ensuring released data have documentation describing methods of
collection, what the data represent, and data limitations; and archival and long-term data
preservation plans. For more information about CDC’s policy on the DMP,
see https://www.cdc.gov/grants/additional-requirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, the
applicant should be directed to:


Describe the type of evaluations (i.e., process, outcome, or both).
Page 22 of 61



Describe key evaluation questions to be addressed by these evaluations.



Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement
plan, including a DMP, if applicable, within the first 6 months of award, as described in the
Reporting Section of this NOFO.
Applicants must develop a Evaluation and Performance Measurement Plan for all strategies in
the application. Component 1 applicants should:







Describe proposed process measures of implementation and outcome measures of
effectiveness. Measures should be consistent with the strategies/activities and outcomes
in the work plan and should measure performance related to the NOFO’s logic model and
goals.
Describe the type of evaluation, key evaluation questions, methods and data sources
applicant will use to collect measures. Evaluation questions should relate to logic model
activities and goals. Methods and data sources should be feasible and any limitations to
data quality or barriers in collecting data should be clearly articulated.
Describe how the applicant will use evaluation findings for continuous program
improvement.
Identify project team member(s) that will conduct performance measurement and
evaluation activities and description of respective experience with planning,
implementing, and evaluating programs. Relevant education, trainings, and practical
experience should be detailed.

Component 2 applicants should:


Show/affirm the ability to collect data on the process and outcome performance measures
presented by the applicant in their approach.



Describe clear monitoring and evaluation procedures and how evaluation
and performance measurement will be incorporated into planning, implementation, and
reporting of project activities.
Describe how performance measurement and evaluation findings will be reported
and used to demonstrate the outcomes of the NOFO and for continuous program
quality improvement.



Applicants are encouraged to use the CDC Evaluation Framework to assist in developing their
plan. Recipients should develop a more detailed plan within the first six months of award as part
of first year activities and should build on the elements in the initial evaluation plan described in
this proposal. The more detailed plan should:
Be no more than 20 pages, excluding tables and diagrams.



Be organized around Strategies A (Site Assessment and Community Engagement required), B (Choose Safe Places for Early Care and Education - optional), and C
(Capacity Development and Applied Prevention Science - optional).
Specify performance measures, how applicant will collect measures (methods), and
where applicant will obtain measures (data source).
Page 23 of 61










Describe the type of evaluation(s) to be conducted (i.e., process, outcome, or both).
Describe how key program partners will participant in the evaluation and performance
measurement planning process.
Describe the key evaluation questions to be addressed by the evaluation(s).
Describe indicators and data sources.
Describe the availability and feasibility of collecting evaluation and performance
measurement data.
Describe how evaluation findings will be used, including how findings will be used for
continuous program quality improvement.
Describe dissemination channels and audiences for performance measure and evaluation
findings.
Affirm ability to collect performance measures and respond to evaluation questions.

Recipients are encouraged to participate in any trainings and webinars offered by ATSDR on
program evaluation and consult with their Technical Project Officer in the first six months of the
award to prepare to submit their more detailed Evaluation and Performance Measurement Plan.
c. Organizational Capacity of Recipients to Implement the Approach
Applicants must fully demonstrate sufficient existing or planned staff capacity to accomplish the
goals and objectives of this program. Specifically, Component 1 Strategy A applicants should
describe:








An integrated team to achieve the cooperative agreement goals and objectives. Integrated
teams consist of, at a minimum, a principal investigator, health assessor/toxicologist, and
health educator/community involvement specialist. It is acceptable and encouraged for
applicants to demonstrate required expertise through in-kind support, contracts, or
external partnerships. Applicants should include information (organization name, scope
of work, and method of accountability) about any contractual organization(s) that will
have a significant role(s) in implementing program strategies and achieving project
outcomes. Curriculum vitae for all staff working on the project must be provided.
Ability to expeditiously execute contracts, hire staff, and engage in kind support staff for
the cooperative agreement if staffing changes are needed.
Appropriate qualifications, experience, leadership ability, and percentage of time the
Project Manager and/or Principal Investigator will commit to the project.
Commitment to participating in ATSDR-sponsored trainings, seminars, workshops,
technical workgroups, teleconferences, and in-person meetings with ATSDR staff.
Proposed project and ability to coordinate site activities with stakeholders such as EPA,
tribal governments, state and local health and environmental offices and agencies, state
environmental and/or public health labs, and communities.
Experience responding to specific public health issues that occur as a result of actual or
potential human exposure to a hazardous substance, including, methods to evaluate
pathways of exposure and to analyze toxicological data, community health concerns, and
environmental health data. This also includes the ability to conduct exposure
investigations including analysis and reporting of data. Specific examples of conducting
these activities must be provided.

Page 24 of 61




Ability and experience identifying, coordinating, and implementing appropriate public
interventions to reduce exposures and educate health professionals and communities.
Successful collaborations with communities, local, state, and federal agencies, and
national organizations to respond to specific public health issues related to harmful
environmental exposures to hazardous substances.

Component 2 applicants must describe:


Prior knowledge and experience working in the Focus Area(s) selected.



Target population(s) and ability to collect and use data to demonstrate impact.



Staffing plan and project management structure sufficient to achieve the proposed project
outcomes that clearly defines staff roles and sufficient workload for the additional
activities selected.

Supporting information should be included in the application appendices and labeled as separate
appendices (i.e., curriculum vitae, letters of support, etc.). The appendices will not be counted
toward the narrative page limit. This additional information includes the following:





CVs/Resumes
Indirect Cost Rate Agreements
Organizational Charts
Letters of Support (see Collaborations section)

Applicants must the file(s) “CVs/Resumes”, “Indirect Costs”, or “Organizational Charts” and
upload it at www.grants.gov.
d. Work Plan
The work plan integrates and delineates more specifically how the recipient plans to carry out
achieving the period of performance outcomes, strategies and activities, and evaluation and
performance measurement. Applicants are required to provide a work plan that provides
both a high-level overview of the entire 5-year period of performance (Components 1
and 2 as appropriate) and a detailed description of the first year of the award. If funded,
ATSDR will provide feedback and technical assistance to help finalize the work plan postaward.
The high-level 5-year work plan should include a table for each component and strategy with
the following (or similar) columns and headings. Component 1 (Strategy A) activity
description must include the hazardous waste site name and primary exposure
concern(s). An example work plan entry is provided below.
Specify the Component, Strategy, Performance measure (from Evaluation and
Performance Measurement Plan)
Activity
Output(s Related
Person(s) or
Projected Projected
Descriptio )
outcome(s) from
role(s)
Start
Completion
n
logic model
responsible
Date
Date

Page 25 of 61

EXAMPLE work plan entry
Component 1 (Strategy A), Performance measures (process/outcome) - Proportion of sitespecific health assessments disseminated from work plan within one year from the date
adequate data was received
Activity
Output(s)
Outcome(s)
Responsibl Projecte Projected
Description
e role(s)
d Start
Completio
Date
n Date
ABC NPL site Health
Decreased or
Health
April 1,
December
(metals in soil), Consultation eliminated site- assessor,
2023
31, 2023
high priority
, Fact Sheet related
Health
exposures
Educator
The detailed year 1 work plan should, at a minimum, include:
i. outcomes for the 12-month period
ii. strategies and activities planned to achieve each outcome
iii.
process measure for the strategies and activities
iv. barriers and facilitators to reach each outcome
v.
timeline for projected start and completion date for each activity
Specific Annual Work Plan Guidance:
COMPONENT 1:
Strategy A1 (Site Health Assessment): Site health assessment products on the work plan
include PHAs, health consultations (HCs), letter health consultations (LHCs), and technical
assists. PHAs, HCs, and LHCs on the work plan must be site-specific. Applicants are
required to develop their work plan based on requests for involvement and state landscape
of the following: NPL, ATSDR-accepted petition, Comprehensive Environmental
Response, Compensation, and Liability Information System (CERCLIS), state-identified,
RCRA, Brownfields and other redevelopment sites, and facilities or releases within the
recipient’s jurisdiction. Each recipient is expected to focus on high-priority sites on their
work plan including ATSDR-accepted petition sites and sites proposed to or listed on the
NPL. Other sites of high public health impact, Congressional (State or Federal) interest,
community or media interest, and sites otherwise deemed an ATSDR priority should also
receive high priority on the work plan.
Applicants should demonstrate a clear public health burden related to potential, or actual,
exposures to hazardous substances in the environment. Indicators of burden should include
five (5) or more NPL sites, and/or sites with significant community, media, or
Congressional interest. Applicants should indicate on their work plan the priority-level of
each Strategy A activity (high or low) and include justification for this classification.
Strategy A2 (Community Engagement): For sites on the work plan where environmental
health assessments are conducted, recipients must engage the community and assess the
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needs and resources of the target audience. Applicants must list applicable
community/stakeholder engagement activities for each PHA, HC, or LHC (see Strategy
A1) listed in the work plan. Community/stakeholder engagement activities on the work
plan may include, but are not limited to, developing community profiles and fact sheets and
participating in public meetings.
Strategy B1 (New to TS23-2301) and Strategy B2 (Previously funding under TS202001): Applicants should list activities in a work plan table and provide a narrative
overview of their Choose Safe Places for Early Care and Education program plans.
COMPONENT 2:
Applicants must include a work plan table and narrative overview for up to three Focus
Area(s) being advanced and the activities selected. The work plan table, at a minimum,
should:





Describe SMART goals and objectives and be consistent with this NOFO's "Work
Plan" section.
Include a detailed first-year work plan and a high-level plan for subsequent years.
Outline the activities necessary to accomplish the purpose of the proposal.
Provide a reasonable and complete timeline for implementing and completing all
activities and objectives.

The work plan narrative should describe:




Possible barriers to, or facilitators for, reaching each outcome.
Multi-sector collaboration that will be formed to assist in carrying out the proposed
activities.
Staff and administrative roles and functions to support implementation of the
award, including evaluation functions.

e. CDC Monitoring and Accountability Approach
Monitoring activities include routine and ongoing communication between CDC and recipients,
site visits, and recipient reporting (including work plans, performance, and financial reporting).
Consistent with applicable grants regulations and policies, CDC expects the following to be
included in post-award monitoring for grants and cooperative agreements:


Tracking recipient progress in achieving the desired outcomes.



Ensuring the adequacy of recipient systems that underlie and generate data reports.



Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:


Ensuring that work plans are feasible based on the budget and consistent with the intent
of the award.

Page 27 of 61



Ensuring that recipients are performing at a sufficient level to achieve outcomes
within stated timeframes.



Working with recipients on adjusting the work plan based on achievement of
outcomes, evaluation results and changing budgets.



Monitoring performance measures (both programmatic and financial) to assure
satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management
officers and specialists, and project officers) in the identification, notification, and management
of high-risk recipients.
ATSDR will actively monitor recipient compliance with ATSDR’s policies and procedures
through monthly calls, annual audits and formal assessments which may include collaboration
with the Technical Project Team (TPT). The TPT includes the recipient jurisdiction's Technical
Project Officer, Regional Representatives, and a health outcome data review subject matter
expert. The TPT is responsible for approving each recipient’s work plan. ATSDR requires
recipients to actively participate in monthly TPT conference calls.
ATSDR will monitor how funds are allocated and expended at the recipient level through fiscal
tracking tools and annual budget reviews. Progress toward achieving specific project outputs and
outcomes will also be assessed through annual progress reports. TPOs will review process
measures and recipient reporting during project implementation. If a recipient is not conducting
required activities, or failing to adhere to required protocols, ATSDR will initiate technical
and/or capacity building assistance for program improvement. ATSDR may require additional
monitoring or recipient reporting during a defined time frame (up to six months). Recipients
performing at a less than acceptable level beyond the agreed-upon time frame will be required to
work with ATSDR to identify factors negatively affecting performance, develop a formal action
plan for program improvement, and to use that plan to guide the work until the recipient is
meeting performance standards. During such periods, more extensive and frequent engagement
between the recipient and ATSDR is expected. In subsequent budget periods, funding may be
contingent on meeting performance expectations.
f. CDC Program Support to Recipients
ATSDR Technical Project Officers (TPOs) are substantially involved with APPLETREE
recipients. The TPO leads a Technical Project Team (TPT) for each recipient, that includes
representatives from the ATSDR Office of Capacity Development and Applied Prevention
Science (OCDAPS) and ATSDR’s Office of Community Health and Hazard Assessment
(OCHHA). The TPT is responsible for providing technical assistance to the recipient. The TPT
arranges subject matter expertise as needed and ensures the planning, implementation, and
program improvement of public health actions for each site. The TPT will work with the
recipients to improve their ability to assess and respond to environmental public health issues
through the application of current science and sound public health practices.
The TPT reviews certified site health assessments for technical/scientific accuracy,
comprehensiveness, clarity, and adherence to ATSDR policy. The TPT will monitor and evaluate
the performance of recipients. ATSDR regional staff are also available to provide support and
Page 28 of 61

coordination for recipients. Regional staff can especially support sites with strong community
interest or where liaison with the EPA or other health or environmental agencies are needed.
ATSDR will provide updated guidance on emerging contaminants and maintain updated
chemical-specific comparison values based on the best available science. ATSDR will maintain
and make available the Public Health Assessment Site Tool (PHAST), the ATSDR Shower and
Household Water-use Exposure (SHOWER) Model, other tools, and informational websites.
ATSDR will also facilitate peer-to-peer information sharing through the maintenance of
ATSDR’s SharePoint site and Cooperative Agreement Listserv.
The TPO will facilitate the clearance of certified environmental health assessment reports (via
the current NCEH/ATSDR Policy on Clearance of Information Products) as outlined under
Strategy A2 in the ‘Work Plan’ section above.
B. Award Information
1. Funding Instrument Type:
CA (Cooperative Agreement)
CDC's substantial involvement in this program appears in the CDC Program Support to
Recipients Section.
2. Award Mechanism:
U61
Preventive Health Activities Regarding Hazardous Substances
3. Fiscal Year:
2023
Estimated Total Funding:
$73,250,000
4. Approximate Total Fiscal Year Funding:
$14,650,000
This amount is subject to the availability of funds.
5. Approximate Period of Performance Funding:
$73,250,000
6. Total Period of Performance Length:
5
year(s)
7. Expected Number of Awards:
34
Component 1: 34
Component 2: Up to 10 (as funding is available)
8. Approximate Average Award:

Page 29 of 61

$420,000
Per Budget Period
Component 1: $420,000
Component 2: $185,000, subject to the availability of funds
9. Award Ceiling:
$0
Per Budget Period
This NOFO does not have an award ceiling.
10. Award Floor:
$0
Per Budget Period
This NOFO does not have an award floor.
11. Estimated Award Date:
March 01, 2023
Throughout the project period, CDC will continue the award based on the availability of funds,
the evidence of satisfactory progress by the recipient (as documented in required reports), and
the determination that continued funding is in the best interest of the federal government. The
total number of years for which federal support has been approved (project period) will be shown
in the “Notice of Award.” This information does not constitute a commitment by the federal
government to fund the entire period. The total period of performance comprises the initial
competitive segment and any subsequent non-competitive continuation award(s).
12. Budget Period Length:
12 month(s)
13. Direct Assistance
Direct Assistance (DA) is not available through this NOFO.
If you are successful and receive a Notice of Award, in accepting the award, you agree that the
award and any activities thereunder are subject to all provisions of 45 CFR Part 75, currently in
effect or implemented during the period of the award, other Department regulations and policies
in effect at the time of the award, and applicable statutory provisions.
C. Eligibility Information
1. Eligible Applicants
Eligibility Category:
00 (State governments)
01 (County governments)
02 (City or township governments)
Page 30 of 61

04 (Special district governments)
07 (Native American tribal governments (Federally recognized))
11 (Native American tribal organizations (other than Federally recognized tribal governments))
Additional Eligibility Category:
Government Organizations:
State (includes the District of Columbia)
Local governments or their bona fide agents
Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the
Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam,
the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of
Palau
American Indian or Alaska Native tribal governments (federally recognized or state-recognized)
2. Additional Information on Eligibility
Eligibility for funding under this announcement is limited by statute to States or political
subdivisions thereof as described in Sections 104(i)(15) of the Comprehensive Environmental
Response, Compensation, and Liability Act (CERCLA) of 1980, as amended by the Superfund
Amendments and Reauthorization Act (SARA) of 1986 [42 U.S.C. 9604(i)(15)].
Under 42 U.S.C. Section 9604(i)(15), the activities of the Administrator of ATSDR shall be
carried out by the Administrator of ATSDR, either directly or through cooperative agreements
with States (or political subdivisions thereof) which the Administrator of ATSDR determines are
capable of carrying out such activities. Thus, the eligible applicants for this award, per the
statutory language, are States and political subdivisions thereof.
3. Justification for Less than Maximum Competition
N/A
4. Cost Sharing or Matching
Cost Sharing / Matching Requirement:
No
Cost sharing or matching funds are not required for this program. Although no statutory
matching requirement for this NOFO exists, leveraging other resources and related ongoing
efforts to promote sustainability is strongly encouraged.
5. Maintenance of Effort
Maintenance of effort is not required for this program.
D. Required Registrations
1. Required Registrations
An organization must be registered at the three following locations before it can submit an
application for funding at www.grants.gov.
Page 31 of 61

PLEASE NOTE: Effective April 4, 2022, applicants must have a Unique Entity Identifier
(UEI) at the time of application submission (SF-424, field 8c). The UEI is generated as part of
SAM.gov registration. Current SAM.gov registrants have already been assigned their UEI and
can view it in SAM.gov and Grants.gov. Additional information is available on the GSA website,
SAM.gov, and Grants.gov- Finding the UEI.
a. Unique Entity Identifier (UEI):
All applicant organizations must obtain a Unique Entity Identifier (UEI) number by registering
in SAM.gov prior to submitting an application. A UEI number is a unique twelve-digit
identification number assigned to the registering organization.
If funds are awarded to an applicant organization that includes sub-recipients, those subrecipients must provide their UEI numbers before accepting any funds.
b. System for Award Management (SAM):
The SAM is the primary registrant database for the federal government and the repository into
which an entity must submit information required to conduct business as a recipient. All
applicant organizations must register with SAM, and will be assigned a SAM number and a
Unique Entity Identifier (UEI). All information relevant to the SAM number must be current at
all times during which the applicant has an application under consideration for funding by CDC.
If an award is made, the SAM information must be maintained until a final financial report is
submitted or the final payment is received, whichever is later. The SAM registration process can
require 10 or more business days, and registration must be renewed annually. Additional
information about registration procedures may be found at SAM.gov and the SAM.gov
Knowledge Base.
c. Grants.gov: The first step in submitting an application online is registering your organization
atwww.grants.gov, the official HHS E-grant Web site. Registration information is located at the
"Applicant Registration" option atwww.grants.gov.
All applicant organizations must register at www.grants.gov. The one-time registration process
usually takes not more
than five days to complete. Applicants should start the registration process as early as possible.
Step

1

System

Requirements

Duration

Follow Up

1. Go to SAM.gov and
designate an E-Biz POC (You
System for
will need to have an active
3-5 Business Days but up to 2
Award
SAM account before you can weeks and must be renewed
Management
register on grants.gov). The once a year
(SAM)
UEI is generated as part of
your registration.

For SAM
Customer
Service
Contact https://
fsd.gov/ fsdgov/
home.do Calls:
866-606-8220

Page 32 of 61

1. Set up an individual
account in Grants.gov using
organization's new UEI
number to become an
Authorized Organization
Representative (AOR)

2

It takes one day (after you
2. Once the account is set up enter the EBiz POC name and
EBiz POC email in SAM) to
the E-BIZ POC will be
Grants.gov
receive a UEI (SAM) which
notified via email
3. Log into grants.gov using will allow you to register with
the password the E-BIZ POC Grants.gov and apply for
federal funding.
received and create new
password

Register early!
Applicants can
register within
minutes.

4. This authorizes the AOR to
submit applications on behalf
of the organization
2. Request Application Package
Applicants may access the application package at www.grants.gov.
3. Application Package
Applicants must download the SF-424, Application for Federal Assistance, package
associated with this funding opportunity at www.grants.gov.
4. Submission Dates and Times
If the application is not submitted by the deadline published in the NOFO, it will not
be processed. Office of Grants Services (OGS) personnel will notify the applicant that their
application did not meet the deadline. The applicant must receive pre-approval to submit a paper
application (see Other Submission Requirements section for additional details). If the applicant is
authorized to submit a paper application, it must be received by the deadline provided by OGS.
a. Letter of Intent Deadline (must be emailed)
Due Date for Letter Of Intent 10/28/2022
10/28/2022
Letter of Intent due date: 10/28/2022 (recommended but not required).
b. Application Deadline
Due Date for Applications 12/09/2022
12/09/2022
11:59 pm U.S. Eastern Time, at www.grants.gov. If Grants.gov is inoperable and cannot receive
applications, and circumstances preclude advance notification of an extension, then applications
must be submitted by the first business day on which Grants.gov operations resume.
December 9, 2022, by 11:59 pm U.S. Eastern Standard Time
Page 33 of 61

Due Date for Information Conference Call
Call-in details for the Informational Conference Call will be posted to
https://www.atsdr.cdc.gov/states/ no later than October 7, 2022. This web site may be updated
periodically with additional information and/or materials.
5. Pre-Award Assessments
Risk Assessment Questionnaire Requirement
CDC is required to conduct pre-award risk assessments to determine the risk an applicant poses
to meeting federal programmatic and administrative requirements by taking into account issues
such as financial instability, insufficient management systems, non-compliance with award
conditions, the charging of unallowable costs, and inexperience. The risk assessment will include
an evaluation of the applicant’s CDC Risk Questionnaire, located
at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, as well as a
review of the applicant’s history in all available systems; including OMB-designated repositories
of government-wide eligibility and financial integrity systems (see 45 CFR 75.205(a)), and other
sources of historical information. These systems include, but are not limited to: FAPIIS
(https://www.fapiis.gov/), including past performance on federal contracts as per Duncan Hunter
National Defense Authorization Act of 2009; Do Not Pay list; and System for Award
Management (SAM) exclusions.
CDC requires all applicants to complete the Risk Questionnaire, OMB Control Number 09201132 annually. This questionnaire, which is located
at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, along with
supporting documentation must be submitted with your application by the closing date of the
Notice of Funding Opportunity Announcement. If your organization has completed CDC’s Risk
Questionnaire within the past 12 months of the closing date of this NOFO, then you must submit
a copy of that questionnaire, or submit a letter signed by the authorized organization
representative to include the original submission date, organization’s EIN and UEI.
When uploading supporting documentation for the Risk Questionnaire into this application
package, clearly label the documents for easy identification of the type of documentation. For
example, a copy of Procurement policy submitted in response to the questionnaire may be
labeled using the following format: Risk Questionnaire Supporting Documents _ Procurement
Policy.
Duplication of Efforts
Applicants are responsible for reporting if this application will result in programmatic,
budgetary, or commitment overlap with another application or award (i.e. grant, cooperative
agreement, or contract) submitted to another funding source in the same fiscal
year. Programmatic overlap occurs when (1) substantially the same project is proposed in more
than one application or is submitted to two or more funding sources for review and funding
consideration or (2) a specific objective and the project design for accomplishing the objective
are the same or closely related in two or more applications or awards, regardless of the funding
source. Budgetary overlap occurs when duplicate or equivalent budgetary items (e.g.,
equipment, salaries) are requested in an application but already are provided by another
source. Commitment overlap occurs when an individual’s time commitment exceeds 100
percent, whether or not salary support is requested in the application. Overlap, whether
Page 34 of 61

programmatic, budgetary, or commitment of an individual’s effort greater than 100 percent, is
not permitted. Any overlap will be resolved by the CDC with the applicant and the PD/PI prior
to award.
Report Submission: The applicant must upload the report in Grants.gov under “Other
Attachment Forms.” The document should be labeled: "Report on Programmatic, Budgetary,
and Commitment Overlap.”
6. Content and Form of Application Submission
Applicants are required to include all of the following documents with their application package
at www.grants.gov.
7. Letter of Intent
Is a LOI:
Recommended but not Required
The purpose of an LOI is to allow CDC program staff to estimate the number of and plan for the
review of submitted applications. Letters of Intent should include the following:





Number and title of this funding opportunity
Components and strategies planned for the application
Name, address, telephone number, and email address of the Principal Investigator/Project
Director
Participating institutions

LOI must be sent via email to:
Audra Henry, MS
ATSDR, Office of Capacity Development and Applied Prevention Science
Email address: [email protected]
8. Table of Contents
(There is no page limit. The table of contents is not included in the project narrative page
limit.): The applicant must provide, as a separate attachment, the “Table of Contents” for the
entire submission package.
Provide a detailed table of contents for the entire submission package that includes all of the
documents in the application and headings in the "Project Narrative" section. Name the file
"Table of Contents" and upload it as a PDF file under "Other Attachment Forms"
at www.grants.gov.
9. Project Abstract Summary
A project abstract is included on the mandatory documents list and must be submitted
at www.grants.gov. The project abstract must be a self-contained, brief summary of the proposed
project including the purpose and outcomes. This summary must not include any proprietary or
confidential information. Applicants must enter the summary in the "Project Abstract Summary"
text box at www.grants.gov.

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10. Project Narrative
Multi-component NOFOs may have a maximum of 15 pages for the “base” (subsections of the
Project Description that the components share with each other, which may include target
population, inclusion, collaboration, etc.); and up to 4 additional pages per component for
Project Narrative subsections that are specific to each component.
Text should be single spaced, 12 point font, 1-inch margins, and number all pages. Page limits
include work plan; content beyond specified limits may not be reviewed.
Applicants should use the federal plain language guidelines and Clear Communication Index to
respond to this Notice of Funding Opportunity Announcement. Note that recipients should also
use these tools when creating public communication materials supported by this NOFO. Failure
to follow the guidance and format may negatively impact scoring of the application.
a. Background
Applicants must provide a description of relevant background information that includes the
context of the problem (See CDC Background).
b. Approach
i. Purpose
Applicants must describe in 2-3 sentences specifically how their application will address the
problem as described in the CDC Background section.

ii. Outcomes
Applicants must clearly identify the outcomes they expect to achieve by the end of the period of
performance. Outcomes are the results that the program intends to achieve. All outcomes must
indicate the intended direction of change (e.g., increase, decrease, maintain). (See the logic
model in the Approach section of the CDC Project Description.)
iii. Strategies and Activities
Applicants must provide a clear and concise description of the strategies and activities they will
use to achieve the period of performance outcomes. Applicants must select existing evidencebased strategies that meet their needs, or describe in the Applicant Evaluation and Performance
Measurement Plan how these strategies will be evaluated over the course of the period of
performance. (See CDC Project Description: Strategies and Activities section.)
1. Collaborations
Applicants must describe how they will collaborate with programs and organizations either
internal or external to CDC. Applicants must address the Collaboration requirements as
described in the CDC Project Description.
2. Target Populations and Health Disparities
Applicants must describe the specific target population(s) in their jurisdiction and explain how
such a target will achieve the goals of the award and/or alleviate health disparities. The
Page 36 of 61

applicants must also address how they will include specific populations that can benefit from the
program that is described in the Approach section. Applicants must address the Target
Populations and Health Disparities requirements as described in the CDC Project Description.
c. Applicant Evaluation and Performance Measurement Plan
Applicants must provide an evaluation and performance measurement plan that demonstrates
how the recipient will fulfill the requirements described in the CDC Evaluation and Performance
Measurement and Project Description sections of this NOFO. At a minimum, the plan must
describe:


How applicant will collect the performance measures, respond to the evaluation
questions, and use evaluation findings for continuous program quality
improvement. The Paperwork Reduction Act of 1995 (PRA): Applicants are
advised that any activities involving information collections (e.g., surveys,
questionnaires, applications, audits, data requests, reporting, recordkeeping and
disclosure requirements) from 10 or more individuals or non-Federal entities,
including State and local governmental agencies, and funded or sponsored by the
Federal Government are subject to review and approval by the Office of
Management and Budget. For further information about CDC’s requirements
under PRA see https://www.cdc.gov/od/science/integrity/reducePublicBurden/.



How key program partners will participate in the evaluation and performance
measurement planning processes.
Available data sources, feasibility of collecting appropriate evaluation and
performance data, data management plan (DMP), and other relevant data
information (e.g., performance measures proposed by the applicant).



Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should
be directed to:




Describe the type of evaluations (i.e., process, outcome, or both).
Describe key evaluation questions to be addressed by these evaluations.
Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement
plan (including the DMP elements) within the first 6 months of award, as described in the
Reporting Section of this NOFO.
d. Organizational Capacity of Applicants to Implement the Approach
Applicants must address the organizational capacity requirements as described in the CDC
Project Description.
11. Work Plan
(Included in the Project Narrative’s page limit)
Applicants must prepare a work plan consistent with the CDC Project Description Work Plan
section. The work plan integrates and delineates more specifically how the recipient plans to
carry out achieving the period of performance outcomes, strategies and activities, evaluation and
performance measurement.
Page 37 of 61

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

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

Indirect costs could include the cost of collecting, managing, sharing and preserving data.
Indirect costs on grants awarded to foreign organizations and foreign public entities and
performed fully outside of the territorial limits of the U.S. may be paid to support the costs of
compliance with federal requirements at a fixed rate of eight percent of MTDC exclusive of
tuition and related fees, direct expenditures for equipment, and subawards in excess of $25,000.
Negotiated indirect costs may be paid to the American University, Beirut, and the World Health
Organization.
If applicable and consistent with the cited statutory authority for this announcement, applicant
entities may use funds for activities as they relate to the intent of this NOFO to meet national
standards or seek health department accreditation through the Public Health Accreditation Board
(see: http://www.phaboard.org). Applicant entities to whom this provision applies include state,
local, territorial governments (including the District of Columbia, the Commonwealth of Puerto
Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American
Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the
Republic of Palau), or their bona fide agents, political subdivisions of states (in consultation with
states), federally recognized or state-recognized American Indian or Alaska Native tribal
governments, and American Indian or Alaska Native tribally designated organizations. Activities
include those that enable a public health organization to deliver public health services such as
activities that ensure a capable and qualified workforce, up-to-date information systems, and the
capability to assess and respond to public health needs. Use of these funds must focus on
achieving a minimum of one national standard that supports the intent of the NOFO. Proposed
activities must be included in the budget narrative and must indicate which standards will be
addressed.
Vital records data, including births and deaths, are used to inform public health program and
policy decisions. If applicable and consistent with the cited statutory authority for this NOFO,
Page 38 of 61

applicant entities are encouraged to collaborate with and support their jurisdiction’s vital records
office (VRO) to improve vital records data timeliness, quality and access, and to advance public
health goals. Recipients may, for example, use funds to support efforts to build VRO capacity
through partnerships; provide technical and/or financial assistance to improve vital records
timeliness, quality or access; or support vital records improvement efforts, as approved by CDC.
Applicants must name this file “Budget Narrative” and upload it as a PDF file
at www.grants.gov. If requesting indirect costs in the budget, a copy of the indirect cost-rate
agreement is required. If the indirect costs are requested, include a copy of the current negotiated
federal indirect cost rate agreement or a cost allocation plan approval letter for those Recipients
under such a plan. Applicants must name this file “Indirect Cost Rate” and upload it at
www.grants.gov.
Applicants applying for Component 1 Strategies A and B should submit one combined budget
that includes line items for Strategy B expenses. Applicants applying for Component 2 should
submit a separate budget.
Component 1 Strategy B activities will not be ranked or scored. All Component 1 Strategy B
applicants that include expenses in their Component 1 budget will receive funding for
Component 1 Strategy B. ATSDR anticipates providing funding of up to $100,000 for
Component 1 Strategy B. Component 1 Strategy B funding is included in the Component 1
annual average award amount stated in this NOFO. Component 1 Strategy B funding will be
based on the applicant’s proposed budget and the availability of funds. Applicants must be
approved and receive an award for Component 1 Strategy A to receive funding for Component 1
Strategy B. ATSDR may award more or less than the expected average award amount for all
components and strategies.
Budgets must include funding for two to four staff members to travel to Atlanta for a 2-3 day
recipient meeting within the first year of the period of performance. Applicants should also
include travel for two to four staff to attend a regional meeting (at or near ATSDR Regional
Offices) during (any year) the period of performance.
For assistance in preparing the budget narrative, please refer to the CDC Budget Guidelines
https://www.cdc.gov/grants/documents/Budget-Preparation-Guidance.pdf.
13. Pilot Program for Enhancement of Employee Whistleblowers Protections
Pilot Program for Enhancement of Employee Whistleblower Protections: All applicants will be
subject to a term and condition that applies the terms of 48 Code of Federal Regulations
(CFR) section 3.908 to the award and requires that recipients inform their employees in
writing (in the predominant native language of the workforce) of employee whistleblower rights
and protections under 41 U.S.C. 4712.
13a. Funds Tracking
Proper fiscal oversight is critical to maintaining public trust in the stewardship of federal funds.
Effective October 1, 2013, a new HHS policy on subaccounts requires the CDC to set up
payment subaccounts within the Payment Management System (PMS) for all new grant awards.
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Funds awarded in support of approved activities and drawdown instructions will be identified on
the Notice of Award in a newly established PMS subaccount (P subaccount). Recipients will be
required to draw down funds from award-specific accounts in the PMS. Ultimately, the
subaccounts will provide recipients and CDC a more detailed and precise understanding of
financial transactions. The successful applicant will be required to track funds by P-accounts/sub
accounts for each project/cooperative agreement awarded.
Applicants are encouraged to demonstrate a record of fiscal responsibility and the ability to
provide sufficient and effective oversight. Financial management systems must meet the
requirements as described 45 CFR 75 which include, but are not limited to, the following:







Records that identify adequately the source and application of funds for federallyfunded activities.
Effective control over, and accountability for, all funds, property, and other assets.
Comparison of expenditures with budget amounts for each Federal award.
Written procedures to implement payment requirements.
Written procedures for determining cost allowability.
Written procedures for financial reporting and monitoring.

13b. Copyright Interests Provisions
This provision is intended to ensure that the public has access to the results and accomplishments
of public health activities funded by CDC. Pursuant to applicable grant regulations and CDC’s
Public Access Policy, Recipient agrees to submit into the National Institutes of Health (NIH)
Manuscript Submission (NIHMS) system an electronic version of the final, peer-reviewed
manuscript of any such work developed under this award upon acceptance for publication, to be
made publicly available no later than 12 months after the official date of publication. Also at the
time of submission, Recipient and/or the Recipient’s submitting author must specify the date the
final manuscript will be publicly accessible through PubMed Central (PMC). Recipient and/or
Recipient’s submitting author must also post the manuscript through PMC within twelve (12)
months of the publisher's official date of final publication; however the author is strongly
encouraged to make the subject manuscript available as soon as possible. The recipient must
obtain prior approval from the CDC for any exception to this provision.
The author's final, peer-reviewed manuscript is defined as the final version accepted for journal
publication, and includes all modifications from the publishing peer review process, and all
graphics and supplemental material associated with the article. Recipient and its submitting
authors working under this award are responsible for ensuring that any publishing or copyright
agreements concerning submitted articles reserve adequate right to fully comply with this
provision and the license reserved by CDC. The manuscript will be hosted in both PMC and the
CDC Stacks institutional repository system. In progress reports for this award, recipient must
identify publications subject to the CDC Public Access Policy by using the applicable NIHMS
identification number for up to three (3) months after the publication date and the PubMed
Central identification number (PMCID) thereafter.
13c. Data Management Plan
As identified in the Evaluation and Performance Measurement section, applications involving
data collection or generation must include a Data Management Plan (DMP) as part of their
evaluation and performance measurement plan unless CDC has stated that CDC will take on the
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responsibility of creating the DMP. The DMP describes plans for assurance of the quality of the
public health data through the data's lifecycle and plans to deposit the data in a repository to
preserve and to make the data accessible in a timely manner. See web link for additional
information: https://www.cdc.gov/grants/additional-requirements/ar-25.html.
14. Funding Restrictions
Restrictions that must be considered while planning the programs and writing the budget are:










Recipients may not use funds for research.
Recipients may not use funds for clinical care except as allowed by law.
Recipients may use funds only for reasonable program purposes, including
personnel, travel, supplies, and services.
Generally, recipients may not use funds to purchase furniture or equipment. Any
such proposed spending must be clearly identified in the budget.
Reimbursement of pre-award costs generally is not allowed, unless the CDC
provides written approval to the recipient.
Other than for normal and recognized executive-legislative relationships, no funds
may be used for:
 publicity or propaganda purposes, for the preparation, distribution, or use
of any material designed to support or defeat the enactment of legislation
before any legislative body
 the salary or expenses of any grant or contract recipient, or agent acting
for such recipient, related to any activity designed to influence the
enactment of legislation, appropriations, regulation, administrative action,
or Executive order proposed or pending before any legislative body
See Additional Requirement (AR) 12 for detailed guidance on this prohibition
andadditional guidance on lobbying for CDC recipients.
The direct and primary recipient in a cooperative agreement program must
perform a substantial role in carrying out project outcomes and not merely serve
as a conduit for an award to another party or provider who is ineligible.

15. Other Submission Requirements
a. Electronic Submission: Applications must be submitted electronically by using the forms and
instructions posted for this notice of funding opportunity atwww.grants.gov. Applicants can
complete the application package using Workspace, which allows forms to be filled out online or
offline. All application attachments must be submitted using a PDF file format. Instructions and
training for using Workspace can be found at www.grants.gov under the "Workspace Overview"
option.
b. Tracking Number: Applications submitted through www.grants.gov are time/date stamped
electronically and assigned a tracking number. The applicant’s Authorized Organization
Representative (AOR) will be sent an e-mail notice of receipt whenwww.grants.gov receives the
application. The tracking number documents that the application has been submitted and initiates
the required electronic validation process before the application is made available to CDC.
c. Validation Process: Application submission is not concluded until the validation process is
completed successfully. After the application package is submitted, the applicant will receive a
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“submission receipt” e-mail generated by www.grants.gov. A second e-mail message to
applicants will then be generated bywww.grants.gov that will either validate or reject the
submitted application package. This validation process may take as long as two business days.
Applicants are strongly encouraged to check the status of their application to ensure that
submission of their package has been completed and no submission errors have
occurred. Applicants also are strongly encouraged to allocate ample time for filing to guarantee
that their application can be submitted and validated by the deadline published in the NOFO.
Non- validated applications will not be accepted after the published application deadline date.
If you do not receive a “validation” e-mail within two business days of application submission,
please contact www.grants.gov. For instructions on how to track your application, refer to the email message generated at the time of application submission or the Grants.gov Online User
Guide.
https://www.grants.gov/help/html/help/index.htm?callingApp=custom#t=GetStarted%2FGetStart
ed.htm
d. Technical Difficulties: If technical difficulties are encountered at www.grants.gov, applicants
should contact Customer Service atwww.grants.gov. The www.grants.gov Contact Center is
available 24 hours a day, 7 days a week, except federal holidays. The Contact Center is available
by phone at 1-800-518-4726 or by e-mail at [email protected]. Application submissions sent
by e-mail or fax, or on CDs or thumb drives will not be accepted. Please note
thatwww.grants.gov is managed by HHS.
e. Paper Submission: If technical difficulties are encountered at www.grants.gov, applicants
should call thewww.grants.gov Contact Center at 1-800-518-4726 or e-mail them
at [email protected] for assistance. After consulting with the Contact Center, if the technical
difficulties remain unresolved and electronic submission is not possible, applicants may e-mail
CDC GMO/GMS, before the deadline, and request permission to submit a paper application.
Such requests are handled on a case-by-case basis.
An applicant’s request for permission to submit a paper application must:
1. Include the www.grants.gov case number assigned to the inquiry
2. Describe the difficulties that prevent electronic submission and the efforts taken
with the www.grants.gov Contact Center to submit electronically; and
3. Be received via e-mail to the GMS/GMO listed below at least three calendar days
before the application deadline. Paper applications submitted without prior
approval will not be considered. If a paper application is authorized, OGS will
advise the applicant of specific instructions for submitting the application via
email.
E. Review and Selection Process
1. Review and Selection Process: Applications will be reviewed in three phases
a. Phase 1 Review
All applications will be initially reviewed for eligibility and completeness by the Office of
Grants Services. Complete applications will be reviewed for responsiveness by Grants
Management Officials and Program Officials. Non-responsive applications will not advance to
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Phase II review. Applicants will be notified that their applications did not meet eligibility and/or
published submission requirements.
b. Phase II Review
A review panel will evaluate complete, eligible applications in accordance with the criteria
below.
i. Approach
ii. Evaluation and Performance Measurement
iii. Applicant’s Organizational Capacity to Implement the Approach
Not more than thirty days after the Phase II review is completed, applicants will be notified
electronically if their application does not meet eligibility or published submission requirements.
Approach – COMPONENT 1: Core Activities
Maximum Points: 50
The applicant should clearly describe a proposed approach for carrying out the activities
listed in the “Work plan” section of the Project Description in the full text of this announcement.
The application will be scored based on the extent to which the applicant:
Strategy A (50 points):


Demonstrates a clear public health burden related to potential, or actual, exposures to
hazardous substances in the environment. Indicators of burden should include five (5) or
more NPL sites, and/or sites with significant community, media, or Congressional
interest on their work plan. (10 points)



Describes specific examples of successful partnerships and collaborations between the
applicant and environmental regulatory agencies and communities in achieving the
desired outcome of reducing exposure to hazardous chemicals in the environment.
Strong applicants will demonstrate effective communications in getting the
environmental regulatory agencies and communities to accept public health
recommendations from the applicant. Specific outcomes achieved should be included.
(10 points)



Includes two letters of support (dated between July 1, 2022, and December 9, 2022) from
environmental regulatory agencies, community groups, state environmental labs, or
federal/state/local agencies that detail the applicant’s role and success with reducing
exposure to hazardous chemicals in the environment and engaging communities. These
letters should be included in an appendix to the application. (10 points)



Includes one letter of support (dated between July 1, 2022, and December 9, 2022) from
their program or leadership staff (e.g., Director, Principal Investigator) stating their
intent to follow ATSDR’s guidance (e.g., the use of comparison values, public health
assessments guidance in non-certified and certified products), policies, and procedures
(e.g., ATSDR clearance and release of HCs/PHAs) in carrying out the cooperative

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agreement goals and objectives. These letters should be included in an appendix to the
application. (10 points)


Describes strategies for effectively engaging communities and other stakeholders and
ensuring communication materials are effective. Health education/community
engagement activities should be included on the work plan. (10 points)

ii. Evaluation and Performance Measurement –
Maximum Points: 25
COMPONENT 1: Core Activities
 Describes proposed process measures of implementation and outcome measures of
effectiveness. Measures should be consistent with the strategies/activities and outcomes
in the work plan and should measure performance related to the NOFO’s logic model
and goals. (7 points)


Describes the type of evaluation, key evaluation questions, methods and data sources
applicant will use to collect measures. Evaluation questions should relate to logic model
activities and goals. Methods and data sources should be feasible and any limitations to
data quality or barriers in collecting data should be clearly articulated. (6 points)



Describes how the applicant will use evaluation findings for continuous program
improvement. (6 points)



Identifies project team member(s) that will conduct performance measurement and
evaluation activities and description of respective experience with planning,
implementing, and evaluating programs. Relevant education, trainings, and practical
experience should be detailed. (6 points)

iii. Applicant's Organizational Capacity to Implement the
Approach – COMPONENT 1: Core Activities
Program Personnel (15 points)

Maximum Points: 25



Describes an integrated team to achieve the cooperative agreement goals and objectives.
Integrated teams consist of, at a minimum, a principal investigator, health
assessor/toxicologist, and health educator/community involvement specialist.
Curriculum vitae for all staff working on the project must be provided. (4 points)



Describes ability to expeditiously execute contracts, hire staff, and engage in kind
support staff for the cooperative agreement if staffing changes are needed. (4 points)



Demonstrates appropriate qualifications, experience, leadership ability, and percentage
of time the Project Manager and/or Principal Investigator will commit to the project. (4
points)



Commits to participating in ATSDR-sponsored trainings, seminars, workshops, technical
workgroups, teleconferences, and in-person meetings with ATSDR staff. (3 points)

Capability (10 points)


Describes the proposed project and ability to develop an integrated program focusing on
coordinating site assessment and community engagement activities with stakeholders
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such as EPA, tribal governments, state and local health and environmental offices and
agencies, state environmental labs, and communities. (3 points)


Describes experience responding to specific public health issues that occur as a result of
actual or potential human exposure to a hazardous substance, including, methods to
evaluate pathways of exposure and to analyze toxicological data, community health
concerns, and environmental health data. This includes the ability to conduct exposure
investigations including analysis and reporting of data. Specific examples of conducting
these activities must be provided. (3 points)



Describes ability and experience identifying, coordinating, and implementing
appropriate public interventions to reduce exposures and educate health professionals
and communities. (2 points)



Describes successful collaborations with communities, local, state, and federal agencies,
and national organizations to respond to specific public health issues related to harmful
environmental exposures to hazardous substances, including the safe siting of ECE
facilities or related children’s health initiatives. (2 points)

Budget – COMPONENT 1: Core Activities
Maximum Points: 0
Proposed budgets will be evaluated for alignment with the stated objectives and
planned program activities. Budgets will be reviewed but not scored.
i. Approach - COMPONENT 2: Capacity Development
and Applied Prevention Science
Program Activities (20 points)

Maximum Points: 50



Identifies up to three the Focus Area(s) advanced by the proposal. Each applicant must
provide a description of relevant background information that includes the context of the
issue being addressed, nationally and in the applicant’s jurisdiction. (2 points)



Describes, in 2-3 sentences, specifically how their application will address the Focus
Area(s) for which activities are being proposed. (2 points)



Identifies the outcomes they expect to achieve by the end of the period of performance.
All outcomes must indicate the intended direction of change (e.g., increase, decrease,
maintain). (6 points)



Provides a clear and concise description of the strategies and activities they will use to
achieve the period-of-performance outcomes. (8 points)



Describes how the interventions to be improved or evaluated target high-risk groups to
achieve the greatest health impact, as described in the "Target Populations" section of
this NOFO. (2 points)

Work Plan (30 points)


Describes SMART goals and objectives. Applicants will be scored on their preparation
of a work plan consistent with this NOFO's "Work Plan" section. It must include a
detailed first-year work plan and a high-level plan for subsequent years. (10 points)
Page 45 of 61



Outlines the activities necessary to accomplish the purpose of the proposal. (15 points)



Provides a reasonable and complete timeline for implementing and completing all
activities and objectives. (5 points)

ii. Evaluation and Performance Measurement COMPONENT 2: Capacity Development and Applied
Maximum Points: 25
Prevention Science
 Shows/affirms the ability to collect data on the process and outcome
performance measures presented by the applicant in their approach. (9 points)


Describes clear monitoring and evaluation procedures and how evaluation
and performance measurement will be incorporated into planning, implementation, and
reporting of project activities. (8 points)



Describes how performance measurement and evaluation findings will be reported
and used to demonstrate the outcomes of the NOFO and for continuous program
quality improvement. (8 points)

iii. Applicant’s Organizational Capacity to Implement the
Approach - COMPONENT 2: Capacity Development and
Maximum Points: 25
Applied Prevention Science
 Describes prior knowledge and experience working in the Focus Area(s) selected. (9
points)


Describes target population(s) and ability to collect and use data to demonstrate impact.
(8 points)



Provides a staffing plan and project management structure sufficient to achieve the
proposed project outcomes that clearly defines staff roles and sufficient workload for the
activities selected. (8 points)

Budget - COMPONENT 2: Capacity Development and
Maximum Points: 0
Applied Prevention Science
Proposed budgets will be evaluated for alignment with the stated objectives and
planned program activities. Budgets will be reviewed but not scored.
c. Phase III Review
ATSDR will use an objective review with full discussion panel to examine applications and
inform award decisions. The following factors may also affect the funding decision: geographic
diversity. The purpose of this cooperative agreement program is to support the ability of public
health officials to build capacity to respond to hazardous substances. As such, ATSDR does not
plan to fund more than one recipient to serve the same geographic area.
Review of risk posed by applicants.
Prior to making a Federal award, CDC is required by 31 U.S.C. 3321 and 41 U.S.C. 2313 to
review information available through any OMB-designated repositories of government-wide

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eligibility qualification or financial integrity information as appropriate. See also suspension and
debarment requirements at 2 CFR parts 180 and 376.
In accordance 41 U.S.C. 2313, CDC is required to review the non-public segment of the OMBdesignated integrity and performance system accessible through SAM (currently the
Federal Recipient Performance and Integrity Information System (FAPIIS)) prior to making a
Federal award where the Federal share is expected to exceed the simplified acquisition threshold,
defined in 41 U.S.C. 134, over the period of performance. At a minimum, the information in the
system for a prior Federal award recipient must demonstrate a satisfactory record of executing
programs or activities under Federal grants, cooperative agreements, or procurement awards; and
integrity and business ethics. CDC may make a Federal award to a recipient who does not fully
meet these standards, if it is determined that the information is not relevant to the current Federal
award under consideration or there are specific conditions that can appropriately mitigate the
effects of the non-Federal entity's risk in accordance with 45 CFR §75.207.
CDC’s framework for evaluating the risks posed by an applicant may incorporate results of the
evaluation of the applicant's eligibility or the quality of its application. If it is determined that a
Federal award will be made, special conditions that correspond to the degree of risk assessed
may be applied to the Federal award. The evaluation criteria is described in this Notice of
Funding Opportunity.
In evaluating risks posed by applicants, CDC will use a risk-based approach and may consider
any items such as the following:
(1) Financial stability;
(2) Quality of management systems and ability to meet the management standards prescribed in
this part;
(3) History of performance. The applicant's record in managing Federal awards, if it is a prior
recipient of Federal awards, including timeliness of compliance with applicable reporting
requirements, conformance to the terms and conditions of previous Federal awards, and if
applicable, the extent to which any previously awarded amounts will be expended prior to future
awards;
(4) Reports and findings from audits performed under subpart F 45 CFR 75 or the reports and
findings of any other available audits; and
(5) The applicant's ability to effectively implement statutory, regulatory, or other requirements
imposed on non-Federal entities.
CDC must comply with the guidelines on government-wide suspension and debarment in 2 CFR
part 180, and require non-Federal entities to comply with these provisions. These provisions
restrict Federal awards, subawards and contracts with certain parties that are debarred, suspended
or otherwise excluded from or ineligible for participation in Federal programs or activities.
2. Announcement and Anticipated Award Dates
Notification of selection is anticipated in February 2023. Recipients are expected to receive
awards in March 2023 to start the period of performance on April 1, 2023.
F. Award Administration Information
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1. Award Notices
Recipients will receive an electronic copy of the Notice of Award (NOA) from CDC OGS. The
NOA shall be the only binding, authorizing document between the recipient and CDC. The
NOA will be signed by an authorized GMO and emailed to the Recipient Business Officer listed
in application and the Program Director.
Any applicant awarded funds in response to this Notice of Funding Opportunity will be subject
to annual SAM Registration and Federal Funding Accountability And Transparency Act Of 2006
(FFATA) requirements.
Unsuccessful applicants will receive notification of these results by e-mail with delivery receipt.
2. Administrative and National Policy Requirements
Recipients must comply with the administrative and public policy requirements outlined in 45
CFR Part 75 and the HHS Grants Policy Statement, as appropriate.
Brief descriptions of relevant provisions are available at https://www.cdc.gov/grants/additionalrequirements/index.html.
The HHS Grants Policy Statement is available
at http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.








AR-9: Paperwork Reduction Act Requirements
AR-11: Healthy People 2030
AR-12: Lobbying Restrictions
AR-18: Cost Recovery – ATSDR
AR-19: Third Party Agreements – ATSDR
AR-25: Data Management and Access
AR-37: Prohibition on certain telecommunications and video surveillance services or
equipment

The full text of the Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for HHS Awards, 45 CFR 75, can be found at: https://www.ecfr.gov/cgi-bin/textidx?node=pt45.1.75
Should you successfully compete for an award, recipients of federal financial assistance (FFA)
from HHS must administer their programs in compliance with federal civil rights laws that
prohibit discrimination on the basis of race, color, national origin, disability, age and, in some
circumstances, religion, conscience, and sex (including gender identity, sexual orientation, and
pregnancy).This includes taking reasonable steps to provide meaningful access to persons with
limited English proficiency and providing programs that are accessible to and usable by persons
with disabilities. The HHS Office for Civil Rights provides guidance on complying with civil
rights laws enforced by HHS. See https://www.hhs.gov/civil-rights/for-providers/providerobligations/index.html and https://www.hhs.gov/civil-rights/forindividuals/nondiscrimination/index.html.
• Recipients of FFA must ensure that their programs are accessible to persons with limited
English proficiency. For guidance on meeting your legal obligation to take reasonable steps
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to ensure meaningful access to your programs or activities by limited English proficient
individuals, see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limitedenglish-proficiency/fact-sheet-guidance/index.html and https://www.lep.gov.
• For information on your specific legal obligations for serving qualified individuals with
disabilities, including providing program access, reasonable modifications, and taking
appropriate steps to provide effective communication, see
http://www.hhs.gov/ocr/civilrights/understanding/disability/index.html.
• HHS funded health and education programs must be administered in an environment free of
sexual harassment, see https://www.hhs.gov/civil-rights/for-individuals/sexdiscrimination/index.html.
• For guidance on administering your project in compliance with applicable federal religious
nondiscrimination laws and applicable federal conscience protection and associated antidiscrimination laws, see https://www.hhs.gov/conscience/conscience-protections/index.html
and https://www.hhs.gov/conscience/religious-freedom/index.html.
3. Reporting
Reporting provides continuous program monitoring and identifies successes and challenges
that recipients encounter throughout the project period. Also, reporting is a requirement
for recipients who want to apply for yearly continuation of funding. Reporting helps CDC and
recipients because it:


Helps target support to recipients;



Provides CDC with periodic data to monitor recipient progress toward meeting the Notice
of Funding Opportunity outcomes and overall performance;



Allows CDC to track performance measures and evaluation findings for continuous
quality and program improvement throughout the period of performance and to determine
applicability of evidence-based approaches to different populations, settings, and
contexts; and



Enables CDC to assess the overall effectiveness and influence of the NOFO.

The table below summarizes required and optional reports. All required reports must be sent
electronically to GMS listed in the “Agency Contacts” section of the NOFO copying the CDC
Project Officer.
Report
Recipient Evaluation and
Performance Measurement
Plan, including Data
Management Plan (DMP)
Annual Performance Report
(APR)
Federal Financial Reporting
Forms

When?
6 months into award

Required?
Yes

No later than 120 days before
Yes
end of budget period. Serves as
yearly continuation application.
90 days after the end of the budget period Yes
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Final Performance and
March 31, 2028
Financial Report
Payment Management System Quarterly reports due January
(PMS) Reporting
30; April 30; July
30; and October 30 every year

Yes
Yes

a. Recipient Evaluation and Performance Measurement Plan (required)
With support from CDC, recipients must elaborate on their initial applicant evaluation and
performance measurement plan. This plan must be no more than 20 pages; recipients must
submit the plan 6 months into the award. HHS/CDC will review and approve the recipient’s
monitoring and evaluation plan to ensure that it is appropriate for the activities to be undertaken
as part of the agreement, for compliance with the monitoring and evaluation guidance established
by HHS/CDC, or other guidance otherwise applicable to this Agreement.
Recipient Evaluation and Performance Measurement Plan (required): This plan should provide
additional detail on the following:
Performance Measurement
• Performance measures and targets
• The frequency that performance data are to be collected.
• How performance data will be reported.
• How quality of performance data will be assured.
• How performance measurement will yield findings to demonstrate progress towards
achieving NOFO goals (e.g., reaching target populations or achieving expected outcomes).
• Dissemination channels and audiences.
• Other information requested as determined by the CDC program.
Evaluation
• The types of evaluations to be conducted (e.g. process or outcome evaluations).
• The frequency that evaluations will be conducted.
• How evaluation reports will be published on a publicly available website.
• How evaluation findings will be used to ensure continuous quality and program improvement.
• How evaluation will yield findings to demonstrate the value of the NOFO (e.g., effect on
improving public health outcomes, effectiveness of NOFO, cost-effectiveness or cost-benefit).
• Dissemination channels and audiences.
HHS/CDC or its designee will also undertake monitoring and evaluation of the defined activities
within the agreement. The recipient must ensure reasonable access by HHS/CDC or its designee
to all necessary sites, documentation, individuals and information to monitor, evaluate and verify
the appropriate implementation the activities and use of HHS/CDC funding under this
Agreement.
b. Annual Performance Report (APR) (required)
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The recipient must submit the APR via www.Grantsolutions.gov no later than120 days prior to
the end of the budget period. This report must not exceed 45 pages excluding administrative
reporting. Attachments are not allowed, but web links are allowed.
This report must include the following:


Performance Measures: Recipients must report on performance measures for each
budget period and update measures, if needed.



Evaluation Results: Recipients must report evaluation results for the work completed to
date (including findings from process or outcome evaluations).



Work Plan: Recipients must update work plan each budget period to reflect any changes
in period of performance outcomes, activities, timeline, etc.



Successes
o Recipients must report progress on completing activities and progress towards
achieving the period of performance outcomes described in the logic model and
work plan.
o Recipients must describe any additional successes (e.g. identified through
evaluation results or lessons learned) achieved in the past year.
o Recipients must describe success stories.



Challenges
o Recipients must describe any challenges that hindered or might hinder their
ability to complete the work plan activities and achieve the period of performance
outcomes.
o Recipients must describe any additional challenges (e.g., identified through
evaluation results or lessons learned) encountered in the past year.



CDC Program Support to Recipients
o Recipients must describe how CDC could help them overcome challenges to
complete activities in the work plan and achieving period of performance
outcomes.



Administrative Reporting (No page limit)
o SF-424A Budget Information-Non-Construction Programs.
o Budget Narrative – Must use the format outlined in "Content and Form of
Application Submission, Budget Narrative" section.
o Indirect Cost Rate Agreement.

The recipient must submit the Annual Performance Report via https://www.grantsolutions.gov
120 days prior to the end of the budget period.
c. Performance Measure Reporting (optional)
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CDC programs may require more frequent reporting of performance measures than annually in
the APR. If this is the case, CDC programs must specify reporting frequency, data fields, and
format for recipients at the beginning of the award period.
Recipients will be required to provide a final comprehensive report at the end of the period
of performance. This is the only additional performance measure reporting outside of the
annual APR.
This is not to be confused with regular data entry and required reporting described in section
b.i. CDC Evaluation and Performance Measurement Strategy, which includes SIA, HEAT, TA,
and success story required reporting metrics, which should be entered on a more frequent basis
as previously indicated.
d. Federal Financial Reporting (FFR) (required)
The annual FFR form (SF-425) is required and must be submitted 90 days after the end of the
budget period through the Payment Management System (PMS). The report must include only
those funds authorized and disbursed during the timeframe covered by the report. The final FFR
must indicate the exact balance of unobligated funds, and may not reflect any unliquidated
obligations. There must be no discrepancies between the final FFR expenditure data and the
Payment Management System’s (PMS) cash transaction data. Failure to submit the required
information by the due date may adversely affect the future funding of the project. If the
information cannot be provided by the due date, recipients are required to submit a letter of
explanation to OGS and include the date by which the Grants Officer will receive information.
e. Final Performance and Financial Report (required)
The Final Performance Report is due 90 days after the end of the period of performance. The
Final FFR is due 90 days after the end of the period of performance and must be submitted
through the Payment Management System (PMS). CDC programs must indicate that this report
should not exceed 40 pages. This report covers the entire period of performance and can include
information previously reported in APRs. At a minimum, this report must include the following:






Performance Measures – Recipients must report final performance data for all
process and outcome performance measures.
Evaluation Results – Recipients must report final evaluation results for the period
of performance for any evaluations conducted.
Impact/Results/Success Stories – Recipients must use their performance measure
results and their evaluation findings to describe the effects or results of the work
completed over the period of performance, and can include some success stories.
A final Data Management Plan that includes the location of the data collected
during the funded period, for example, repository name and link data set(s)
Additional forms as described in the Notice of Award (e.g., Equipment Inventory
Report, Final Invention Statement).

The report should be emailed to the Project Officer and the GMS listed in 'Agency Contacts'
section of this NOFO.

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4. Federal Funding Accountability and Transparency Act of 2006 (FFATA)
Federal Funding Accountability and Transparency Act of 2006 (FFATA), P.L. 109–282, as
amended by section 6202 of P.L. 110–252 requires full disclosure of all entities and
organizations receiving Federal funds including awards, contracts, loans, other assistance, and
payments through a single publicly accessible Web site, http://www.USASpending.gov.
Compliance with this law is primarily the responsibility of the Federal agency. However, two
elements of the law require information to be collected and reported by applicants: 1)
information on executive compensation when not already reported through the SAM, and 2)
similar information on all sub-awards/subcontracts/consortiums over $25,000.
For the full text of the requirements under the FFATA and HHS guidelines, go to:


https://www.gpo.gov/fdsys/pkg/PLAW-109publ282/pdf/PLAW-109publ282.pdf,



https://www. fsrs.gov/documents /ffata_legislation_ 110_252.pdf



http://www.hhs.gov/grants/grants/grants-policies-regulations/index.html#FFATA.

5. Reporting of Foreign Taxes (International/Foreign projects only)
A. Valued Added Tax (VAT) and Customs Duties – Customs and import duties, consular fees,
customs surtax, valued added taxes, and other related charges are hereby authorized as an
allowable cost for costs incurred for non-host governmental entities operating where no
applicable tax exemption exists. This waiver does not apply to countries where a bilateral
agreement (or similar legal document) is already in place providing applicable tax exemptions
and it is not applicable to Ministries of Health. Successful applicants will receive information on
VAT requirements via their Notice of Award.
B. The U.S. Department of State requires that agencies collect and report information on the
amount of taxes assessed, reimbursed and not reimbursed by a foreign government against
commodities financed with funds appropriated by the U.S. Department of State, Foreign
Operations and Related Programs Appropriations Act (SFOAA) (“United States foreign
assistance funds”). Outlined below are the specifics of this requirement:
1) Annual Report: The recipient must submit a report on or before November 16 for each foreign
country on the amount of foreign taxes charged, as of September 30 of the same year, by a
foreign government on commodity purchase transactions valued at 500 USD or more financed
with United States foreign assistance funds under this grant during the prior United States fiscal
year (October 1 – September 30), and the amount reimbursed and unreimbursed by the foreign
government. [Reports are required even if the recipient did not pay any taxes during the reporting
period.]
2) Quarterly Report: The recipient must quarterly submit a report on the amount of foreign taxes
charged by a foreign government on commodity purchase transactions valued at 500 USD or
more financed with United States foreign assistance funds under this grant. This report shall be
submitted no later than two weeks following the end of each quarter: April 15, July 15, October
15 and January 15.

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3) Terms: For purposes of this clause:
“Commodity” means any material, article, supplies, goods, or equipment;
“Foreign government” includes any foreign government entity;
“Foreign taxes” means value-added taxes and custom duties assessed by a foreign government
on a commodity. It does not include foreign sales taxes.
4) Where: Submit the reports to the Director and Deputy Director of the CDC office in the
country(ies) in which you are carrying out the activities associated with this cooperative
agreement. In countries where there is no CDC office, send reports to [email protected].
5) Contents of Reports: The reports must contain:
a. recipient name;
b. contact name with phone, fax, and e-mail;
c. agreement number(s) if reporting by agreement(s);
d. reporting period;
e. amount of foreign taxes assessed by each foreign government;
f. amount of any foreign taxes reimbursed by each foreign government;
g. amount of foreign taxes unreimbursed by each foreign government.
6) Subagreements. The recipient must include this reporting requirement in all applicable
subgrants and other subagreements.

6. Termination
CDC may impose other enforcement actions in accordance with 45 CFR 75.371- Remedies for
Noncompliance, as appropriate.
The Federal award may be terminated in whole or in part as follows:
(1) By the HHS awarding agency or pass-through entity, if the non-Federal entity fails to comply
with the terms and conditions of the award;
(2) By the HHS awarding agency or pass-through entity for cause;
(3) By the HHS awarding agency or pass-through entity with the consent of the non-Federal
entity, in which case the two parties must agree upon the termination conditions, including the
effective date and, in the case of partial termination, the portion to be terminated; or
(4) By the non-Federal entity upon sending to the HHS awarding agency or pass-through entity
written notification setting forth the reasons for such termination, the effective date, and, in the
case of partial termination, the portion to be terminated. However, if the HHS awarding agency
or pass-through entity determines in the case of partial termination that the reduced or modified
portion of the Federal award or subaward will not accomplish the purposes for which the Federal
award was made, the HHS awarding agency or pass-through entity may terminate the Federal
award in its entirety.
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G. Agency Contacts
CDC encourages inquiries concerning this NOFO.
Program Office Contact
For programmatic technical assistance, contact:
First Name:
Audra
Last Name:
Henry
Project Officer
Department of Health and Human Services
Centers for Disease Control and Prevention
Address:
ATSDR, Office of Capacity Development and Applied Prevention Science
4770 Buford Hwy NE
MS-S106-5
Atlanta, GA 30341-3717
Telephone:
(770) 488-3758
Email:
[email protected]
Grants Management Office Information
For financial, awards management, or budget assistance, contact:
First Name:
Lakita
Last Name:
Reid
Grants Management Specialist
Department of Health and Human Services
Office of Grants Services
Address:
Office of Financial Resources
2939 Flowers Road, MS: TV-1
Atlanta, GA 30341
Telephone:
(770) 488-2742
Email:
[email protected]
For assistance with submission difficulties related to www.grants.gov, contact the Contact
Center by phone at 1-800-518-4726.
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Hours of Operation: 24 hours a day, 7 days a week, except on federal holidays.
CDC Telecommunications for persons with hearing loss is available at: TTY 1-888-232-6348
H. Other Information
Following is a list of acceptable attachments applicants can upload as PDF files as part of their
application at www.grants.gov. Applicants may not attach documents other than those listed; if
other documents are attached, applications will not be reviewed.


Project Abstract



Project Narrative



Budget Narrative



Report on Programmatic, Budgetary and Commitment Overlap



Table of Contents for Entire Submission

For international NOFOs:


SF424



SF424A



Funding Preference Deliverables

Optional attachments, as determined by CDC programs:
Resumes / CVs
Position descriptions
Letters of Support
Organization Charts
Indirect Cost Rate, if applicable
Memorandum of Agreement (MOA)
Memorandum of Understanding (MOU)
Bona Fide Agent status documentation, if applicable
I. Glossary
Activities: The actual events or actions that take place as a part of the program.
Administrative and National Policy Requirements, Additional Requirements(ARs):
Administrative requirements found in 45 CFR Part 75 and other requirements mandated by
statute or CDC policy. All ARs are listed in the Template for CDC programs. CDC programs
must indicate which ARs are relevant to the NOFO; recipients must comply with the ARs listed
in the NOFO. To view brief descriptions of relevant provisions, see
https://www.cdc.gov/grants/additional-requirements/index.html. Note that 2 CFR 200
supersedes the administrative requirements (A-110 & A-102), cost principles (A-21, A-87 & A122) and audit requirements (A-50, A-89 & A-133).
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Approved but Unfunded: Approved but unfunded refers to applications recommended for
approval during the objective review process; however, they were not recommended for funding
by the program office and/or the grants management office.
Assistance Listings: A government-wide collection of federal programs, projects, services, and
activities that provide assistance or benefits to the American public.
Assistance Listings Number: A unique number assigned to each program and NOFO
throughout its lifecycle that enables data and funding tracking and transparency.
Award: Financial assistance that provides support or stimulation to accomplish a public purpose.
Awards include grants and other agreements (e.g., cooperative agreements) in the form of
money, or property in lieu of money, by the federal government to an eligible applicant.
Budget Period or Budget Year: The duration of each individual funding period within the
period of performance. Traditionally, budget periods are 12 months or 1 year.
Carryover: Unobligated federal funds remaining at the end of any budget period that, with the
approval of the GMO or under an automatic authority, may be carried over to another budget
period to cover allowable costs of that budget period either as an offset or additional
authorization. Obligated but liquidated funds are not considered carryover.
Continuous Quality Improvement: A system that seeks to improve the provision of services
with an emphasis on future results.
Contracts: An award instrument used to acquire (by purchase, lease, or barter) property or
services for the direct benefit or use of the Federal Government.
Cooperative Agreement: A financial assistance award with the same kind of interagency
relationship as a grant except that it provides for substantial involvement by the federal agency
funding the award. Substantial involvement means that the recipient can expect federal
programmatic collaboration or participation in carrying out the effort under the award.
Cost Sharing or Matching: Refers to program costs not borne by the Federal Government but
by the recipients. It may include the value of allowable third-party, in-kind contributions, as well
as expenditures by the recipient.
Direct Assistance: A financial assistance mechanism, which must be specifically authorized by
statute, whereby goods or services are provided to recipients in lieu of cash. DA generally
involves the assignment of federal personnel or the provision of equipment or supplies, such as
vaccines. DA is primarily used to support payroll and travel expenses of CDC employees
assigned to state, tribal, local, and territorial (STLT) health agencies that are recipients of grants
and cooperative agreements. Most legislative authorities that provide financial assistance to
STLT health agencies allow for the use of DA. https://www.cdc.gov/grants/additionalrequirements/index.html.
Evaluation (program evaluation): The systematic collection of information about the activities,
characteristics, and outcomes of programs (which may include interventions, policies, and
specific projects) to make judgments about that program, improve program effectiveness, and/or
inform decisions about future program development.

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Evaluation Plan: A written document describing the overall approach that will be used to guide
an evaluation, including why the evaluation is being conducted, how the findings will likely be
used, and the design and data collection sources and methods. The plan specifies what will be
done, how it will be done, who will do it, and when it will be done. The NOFO evaluation plan is
used to describe how the recipient and/or CDC will determine whether activities are
implemented appropriately and outcomes are achieved.
Federal Funding Accountability and Transparency Act of 2006 (FFATA): Requires that
information about federal awards, including awards, contracts, loans, and other assistance and
payments, be available to the public on a single website at www.USAspending.gov.
Fiscal Year: The year for which budget dollars are allocated annually. The federal fiscal year
starts October 1 and ends September 30.
Grant: A legal instrument used by the federal government to transfer anything of value to a
recipient for public support or stimulation authorized by statute. Financial assistance may be
money or property. The definition does not include a federal procurement subject to the Federal
Acquisition Regulation; technical assistance (which provides services instead of money); or
assistance in the form of revenue sharing, loans, loan guarantees, interest subsidies, insurance, or
direct payments of any kind to a person or persons. The main difference between a grant and a
cooperative agreement is that in a grant there is no anticipated substantial programmatic
involvement by the federal government under the award.
Grants.gov: A "storefront" web portal for electronic data collection (forms and reports) for
federal grant-making agencies at www.grants.gov.
Grants Management Officer (GMO): The individual designated to serve as the HHS official
responsible for the business management aspects of a particular grant(s) or
cooperative agreement(s). The GMO serves as the counterpart to the business officer of the
recipient organization. In this capacity, the GMO is responsible for all business management
matters associated with the review, negotiation, award, and administration of grants and
interprets grants administration policies and provisions. The GMO works closely with the
program or project officer who is responsible for the scientific, technical, and programmatic
aspects of the grant.
Grants Management Specialist (GMS): A federal staff member who oversees the business and
other non-programmatic aspects of one or more grants and/or cooperative agreements. These
activities include, but are not limited to, evaluating grant applications for administrative content
and compliance with regulations and guidelines, negotiating grants, providing consultation and
technical assistance to recipients, post-award administration and closing out grants.
Health Disparities: Differences in health outcomes and their determinants among segments of
the population as defined by social, demographic, environmental, or geographic category.
Health Equity: Striving for the highest possible standard of health for all people and giving
special attention to the needs of those at greatest risk of poor health, based on social conditions.
Health Inequities: Systematic, unfair, and avoidable differences in health outcomes and their
determinants between segments of the population, such as by socioeconomic status (SES),
demographics, or geography.

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Healthy People 2030: National health objectives aimed at improving the health of all Americans
by encouraging collaboration across sectors, guiding people toward making informed health
decisions, and measuring the effects of prevention activities.
Inclusion: Both the meaningful involvement of a community’s members in all stages of the
program process and the maximum involvement of the target population that the intervention
will benefit. Inclusion ensures that the views, perspectives, and needs of affected communities,
care providers, and key partners are considered.
Indirect Costs: Costs that are incurred for common or joint objectives and not readily and
specifically identifiable with a particular sponsored project, program, or activity; nevertheless,
these costs are necessary to the operations of the organization. For example, the costs of
operating and maintaining facilities, depreciation, and administrative salaries generally are
considered indirect costs.
Letter of Intent (LOI): A preliminary, non-binding indication of an organization’s intent to
submit an application.
Lobbying: Direct lobbying includes any attempt to influence legislation, appropriations,
regulations, administrative actions, executive orders (legislation or other orders), or other similar
deliberations at any level of government through communication that directly expresses a view
on proposed or pending legislation or other orders, and which is directed to staff members or
other employees of a legislative body, government officials, or employees who participate in
formulating legislation or other orders. Grass roots lobbying includes efforts directed at inducing
or encouraging members of the public to contact their elected representatives at the federal, state,
or local levels to urge support of, or opposition to, proposed or pending legislative proposals.
Logic Model: A visual representation showing the sequence of related events connecting the
activities of a program with the programs’ desired outcomes and results.
Maintenance of Effort: A requirement contained in authorizing legislation, or applicable
regulations that a recipient must agree to contribute and maintain a specified level of financial
effort from its own resources or other non-government sources to be eligible to receive federal
grant funds. This requirement is typically given in terms of meeting a previous base-year dollar
amount. Memorandum of Understanding (MOU) or Memorandum of Agreement(MOA):
Document that describes a bilateral or multilateral agreement between parties expressing a
convergence of will between the parties, indicating an intended common line of action. It is often
used in cases where the parties either do not imply a legal commitment or cannot create a legally
enforceable agreement.
Nonprofit Organization: Any corporation, trust, association, cooperative, or other organization
that is operated primarily for scientific, educational, service, charitable, or similar purposes in the
public interest; is not organized for profit; and uses net proceeds to maintain, improve, or expand
the operations of the organization. Nonprofit organizations include institutions of higher
educations, hospitals, and tribal organizations (that is, Indian entities other than federally
recognized Indian tribal governments).
Notice of Award (NoA): The official document, signed (or the electronic equivalent of
signature) by a Grants Management Officer that: (1) notifies the recipient of the award of a grant;
(2) contains or references all the terms and conditions of the grant and Federal funding limits and
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obligations; and (3) provides the documentary basis for recording the obligation of Federal funds
in the HHS accounting system.
Objective Review: A process that involves the thorough and consistent examination of
applications based on an unbiased evaluation of scientific or technical merit or other relevant
aspects of the proposal. The review is intended to provide advice to the persons responsible for
making award decisions.
Outcome: The results of program operations or activities; the effects triggered by the program.
For example, increased knowledge, changed attitudes or beliefs, reduced tobacco use, reduced
morbidity and mortality.
Performance Measurement: The ongoing monitoring and reporting of program
accomplishments, particularly progress toward pre-established goals, typically conducted by
program or agency management. Performance measurement may address the type or level of
program activities conducted (process), the direct products and services delivered by a program
(outputs), or the results of those products and services (outcomes). A “program” may be any
activity, project, function, or policy that has an identifiable purpose or set of objectives.
Period of performance –formerly known as the project period - : The time during which the
recipient may incur obligations to carry out the work authorized under the Federal award. The
start and end dates of the period of performance must be included in the Federal award.
Period of Performance Outcome: An outcome that will occur by the end of the NOFO’s
funding period
Plain Writing Act of 2010: The Plain Writing Act of 2010 requires that federal agencies use
clear communication that the public can understand and use. NOFOs must be written in clear,
consistent language so that any reader can understand expectations and intended outcomes of the
funded program. CDC programs should use NOFO plain writing tips when writing
NOFOs. Program Strategies: Strategies are groupings of related activities, usually expressed as
general headers (e.g., Partnerships, Assessment, Policy) or as brief statements (e.g., Form
partnerships, Conduct assessments, Formulate policies).
Program Official: Person responsible for developing the NOFO; can be either a project officer,
program manager, branch chief, division leader, policy official, center leader, or similar staff
member.
Public Health Accreditation Board (PHAB): A nonprofit organization that works to promote
and protect the health of the public by advancing the quality and performance of public health
departments in the U.S. through national public health department accreditation
http://www.phaboard.org.
Social Determinants of Health: Conditions in the environments in which people are born, live,
learn, work, play, worship, and age that affect a wide range of health, functioning, and qualityof-life outcomes and risks.
Statute: An act of the legislature; a particular law enacted and established by the will of the
legislative department of government, expressed with the requisite formalities. In foreign or civil
law any particular municipal law or usage, though resting for its authority on judicial decisions,
or the practice of nations.
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Statutory Authority: Authority provided by legal statute that establishes a federal financial
assistance program or award.
System for Award Management (SAM): The primary vendor database for the U.S. federal
government. SAM validates applicant information and electronically shares secure and encrypted
data with federal agencies' finance offices to facilitate paperless payments through Electronic
Funds Transfer (EFT). SAM stores organizational information, allowing www.grants.gov to
verify identity and pre-fill organizational information on grant applications.
Technical Assistance: Advice, assistance, or training pertaining to program development,
implementation, maintenance, or evaluation that is provided by the funding agency.
UEI: The Unique Entity Identifier (UEI) number is a twelve-digit number assigned by
SAM.gov. When applying for Federal awards or cooperative agreements, all applicant
organizations must obtain a UEI number as the Universal Identifier. UEI number assignment is
free. If an organization does not know its UEI number or needs to register for one, visit
www.sam.gov.
Work Plan: The summary of period of performance outcomes, strategies and activities,
personnel and/or partners who will complete the activities, and the timeline for completion. The
work plan will outline the details of all necessary activities that will be supported through the
approved budget.

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