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Funding Opportunity Announcement: American Recovery and Reinvestment Act (Recovery Act), Communities Putting Prevention to Work

Frequently Asked Questions

Funding Opportunity Description
Funding Allocations
Key Days and Letter of Intent
Eligibility Information
Application Submission and Continuation
Application Review and Scoring
Components (I, II, and III)
Component I
Component II
Component III
Staffing
Project Narrative and Work Plans
Strategies (MAPPS, etc.)
Technical Assistance
Nutrition
Physical Activity
Tobacco
Organizational Chart
Letters of Support

 

Funding Opportunity Description

Q: What is the purpose of this Funding Opportunity Announcement (FOA)?

A: The purpose of the announcement is to implement obesity, nutrition, physical activity and tobacco control strategies. This will be accomplished through changing systems, developing and implementing policies, changing the environment in which eating, tobacco use, and physical activity occur, and impacting population groups rather than individuals within the two-year timeframe for this award.

Q: Who should we contact for additional questions?

A: CDC encourages inquiries concerning this announcement.
For general questions, contact:

Technical Information Management Section
Department of Health and Human Services
CDC Procurement and Grants Office
2920 Brandywine Road, MS E-14
Atlanta, GA 30341
Telephone: 770-488-2700

For program technical assistance, contact: ARRA@cdc.gov

For financial, grants management, or budget assistance, contact: support@grants.gov, or 1-800-518-4726.

CDC Telecommunications for the hearing impaired or disabled is available at: TTY 770-488-2783.

Q: Where can we find Grants.gov support?

A: Please e-mail support@grants.gov, or call 770-488-2700 or 1-800-518-4726 (1-800-518-GRANTS) for help with Grants.gov.

Q:Who is eligible to apply to the CPPW FOA?

A: All applicants previously funded under Announcement DP09-901 and DP09-902.

Q: I noticed that the FOA is missing the Sample Implementation Work plan, Appendix C. Can we get any guidance on this?

A: We apologize that the sample implementation work plan was not included in the FOA. However, the items to include in an implementation plan are listed in the FOA in the section, Application Content for Component I, on pages 20-21.

Work plans should at a minimum address the following:

  1. Goals
  2. Objectives
  3. Action steps
  4. Milestones for implementation of action steps and progress on objectives
  5. Key partners
  6. Evaluation strategies, including key output and outcome measures related to the action steps and objectives, and data source for collection of these measures.

Q: Who/what is Office of the Regional Health Administrator?

A: This refers to the Department of Health and Human Services’ Regional Health Administrators. More information, including a directory of Regional Health Administrators, is available here: http://www.hhs.gov/ophs/rha/index.html

Q: Page 88 (Appendix B) of the announcement under Current Status of Policy/Environmental Supports and Barriers refers to a table in Appendix C. However, there is no table in Appendix C. Please indicate where the table can be located.

A: Appendix B, under Current Status of Policy/Environmental Supports and Barriers asks for Policy or Environmental Change Strategy to be selected from the table in Appendix C. The referenced Appendix should be A. We apologize for the error.

Q: During the conference call on October 6th I asked a question on a couple of references in the State supplement FOA. In Appendix B the 3rd item references the table in Appendix C: Intervention Strategies for State and Territory Policy, Environmental Change. The same appendix and title are also referenced on page 27 (line 594). Was the reference for both supposed to be to Appendix A: MAPPS interventions for Communities Putting Prevention to Work?

A: Appendix B, under Current Status of Policy/Environmental Supports and Barriers asks for Policy or Environmental Change Strategy to be selected from the table in Appendix C. The referenced Appendix should be A. We apologize for the error.

Q: On page 88 under Coordination with other recovery act efforts makes a reference to Appendix X? Where is Appendix X?

A: We apologize for the error. The correct Appendix for information regarding Coordination with other Recovery Act Efforts is Appendix C.

Q: With the component 2 workplan starting on Feb 1, 2010, would the ARRA quarterly reporting just be shortened for the first quarter (ie., Feb. 1 – March 31) or will component 2 be on a different quarterly reporting system (ie., Feb 1 – April 30, etc. )?

A: Reporting is by federal quarter so we would collect it for the shortened period Feb 1—March 31.

Q: Is the budget period and also workplan period for component II, February 1, 2010 and then 24 months from there or will it actually only be a 23 month period to coincide with the component 1 & 3 (ie., meaning that they all end on the same day). Please clarify all the specific work plan and budget start and end dates.

A: The budget period for each component is 24 months.

Q: On page 15, Section C (Statewide Support for Community Level Change), the FOA mentions:

1: "Implement state level policy and environmental changes … in communities, and schools state wide, including, but not limited to communities that will be awarded Recovery Act funding through the CPPW Initiative

4: "States should coordinate the efforts proposed here with any community activities funded as part of CPPW in large cities, urban areas, tribal areas or state-coordinated small cities and rural areas."

Are these consistent?

A: In both cases, you should plan to coordinate and work with any community funded through CPPW. However, you are not limited to just working with those communities and should plan to coordinate with other communities as appropriate.

Q: How are you defining sustainability? (Pg 18)

A: Sustainability refers to continuing the impact of program efforts beyond the project period, including sustaining and pursuing non-federal sources of funding and the sustained effect of policy changes after Recovery Act funding has ended. (pg. 22-23)

Q: I see that the FOA states that only current recipients of CDC funding are eligible for this funding- can a state use a bona fide agent to receive funds?

A: If a bona fide agent originally received the 901 collaborative agreement, then they are eligible to apply for this supplement.

Q: On the 10/7 Conference Call, CDC representatives referred to a "national media campaign" that states were to coordinate their efforts with. In response to a question on the 10/7 call, we were told: "The national media campaign is forthcoming, but no details are available" This is referenced on page 6 of the FOA where the goals of this project are stated as: 80,000 additional successful quitters (above the number that would have quit) via the Quitlines nationally if coupled with a national media strategy" Is there any other reference to a "national media strategy" or "national media campaign" in the FOA? If so, please provide a specific page reference. [Note. Page 41 only references statewide media messages]

A: There are no additional National Media Campaign references. Updates of the National Media Campaign will be provided.

Q: What criteria will be used to select states for "state study evaluation" as a "case study site"?

A: An HHS evaluation workgroup has been convened to give expert input on the protocols for the case studies, including the criteria for site selection. These will be developed in the next few months’ we expect to select the actual case study sites early in the funded period even though the preponderance of the work may not occur until later in the funded period.

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Funding Allocations

Q: How much funding is available for this initiative?

A: The total amount of funding available to states and territories is $120 million.

Q: How much will each awardee receive?

A: For physical activity, nutrition and tobacco control: approximately $45 million dollars will be non-competitively awarded based on population size and the remaining $30 million dollars will be competitively awarded based on special policy initiatives proposed. The non-competitive awards will range from $300,000 - $2,200,000 for the 24 month project period based on a formula that includes a base of $300,000 per state with a proportional increase based on the state’s population. A table of maximum base funding per state can be found in Appendix D.

For quitlines specifically: up to $44,500,000 is available to significantly expand and enhance tobacco cessation services through the Quitlines. The award will range from $400,000 - $2,200,000 for the 24 month project period based on a formula that includes a base of $400,000 per state with a proportional increase based on the population of tobacco users in the state. A table of maximum base funding per state can be found in Appendix E.

Q: What about the Pacific islands?

A: There is a total of $350,000.00 for the Pacific Islands. There will be approximately 6 awards.

Q: Can we apply for funding above the allocation listed in the announcement?

A: A table of maximum base funding per state can be found in Attachment D. Applicants must not request funding above the maximum amount designated for their state. Funds not awarded according to the population-based formula will be awarded through a competitive process for special policy and environmental change initiatives. (See Component II).

Q: Is it possible that we would get funded for only part of what we applied for under the competitive component?

A: Yes. Each workplan will be scored separately, and funding will be based on rankings.

Q: When will the funding be awarded?

A: Non-competitive awards will be made in December 2009 and Competitive awards will be made in January 2010.

Q: Why are you giving out this money now? Our fiscal year begins in July and this makes it complicated

A: Recovery Act funding is available now to help improve the health of the population and promote economic recovery.

Q: What is meant by the goal of using at least 50 percent of the funds for activities that can be initiated no later than 120 days after the date of the enactment of the Recovery Act? If we receive a grant award in December 2009 then 120 days would be 4 months. Grants and contracts to partners may many months to execute and we do not generally pay in advance for work outlined in these business agreements.

A: This is a supplemental award for only 2 years. Your activities should be planned for initiation as soon as possible to accomplish the goals of this 2 year project.

Q: Would workforce training be an allowable use of these funds?

A: The goal of Recovery Funds is to stimulate the economy by also creating jobs or retaining employees whose jobs were slated to be cut. The goals for this initiative are for applicants to plan and implement evidence-based policy and environmental changes to support and institutionalize healthy behaviors. Applicants have two years to implement these changes. If staff must be trained in order to comply with the FOA, the applicant must provide a training and development plan and describe how this training will assist the applicant with accomplishing the recipient activities as described in the announcement.

Q: Our state has implemented a law to conduct fitness assessments in grades 1-12 in all schools in the state. Could this grant be used to pay for the one-time IT requirements, training, software, and equipment required at the state and local schools?

A: No, a state cannot use ARRA funds to pay for the one-time IT requirements, training, software, and equipment required to conduct fitness assessments at the state and local schools. One MAPPS strategy in the ARRA application is to develop and implement evidence-based policy and environmental changes in order to require daily quality physical education in schools. A quality physical education program addresses curriculum, policies and environment, instruction, and student assessment. For more information on daily quality physical education program please refer to the CDC Physical Education Curriculum Analysis Tool (PECAT), page 4: http://www.cdc.gov/healthyyouth/PECAT/pdf/PECAT.pdf [516K–PDF]

Additional MAPPS strategies to address school-based physical activity include the planning and implementing evidence-based policy and environmental changes in providing safe, attractive, accessible places for activity; implementing safe routes to school; and requiring daily physical activity in afterschool/childcare settings.

Q: Is the maximum funding per state $3 million, or is that the maximum funding per area?

A: The maximum funding amount per state is $3 million for component II.

Q: Is the funding available for Territories for a 12-month period or for the duration of 24 months?

A: The funding is for a 24 month project period.

Q: In FOA 902: Recommended expenditures (30% media), maximum of 5% of total award for NRT, etc. The entire amount will not allow for hiring of staff to monitor this separate financial accounting and online reporting requirement. Due to the budget award, if successful in our request the additional duties shall fall upon existing staff. Are we allowed to contract some of the services?

A: You are allowed to utilize contractual support to support you in accomplishing the objectives of the Supplemental FOA.

Q: If the State Health Department contracts with a University or other entity to manage the Quit Line contract, and this entity in turn works directly with a Quit Line vendor, are the funds received by this entity considered pass-though funds? Does this qualify as “substantial role in carrying out project objectives?” Or would the State Health Department need to reconfigure and contract directly with the Vendor?

A: The FOA states that “cooperative agreement funds must be used to support a core infrastructure for the delivery of quitline services that include proactive counseling and promotion/outreach.” We understand that state health departments achieve this core infrastructure through a variety of arrangements, including partnerships, contracts, and memoranda of understanding, and these arrangements will continue under this Supplement. As part of core infrastructure, states need to be certain that they can accomplish the quitline monitoring and evaluation recipient activities described in the FOA (pp 41-42), including collection of designated Recovery Act performance and evaluation measures according to the time schedule provided. Because the purpose of this funding is to "create 80,000 additional tobacco quitters [nationally] beyond what states and jurisdictions have achieved in the past, by expanding and promoting tobacco cessation quitlines," it is important that states provide accurate and thorough information.

Q: Can these funds be used to support communities in purchasing playground equipment and conducting initiatives such as KaBoom?

A: No, these funds are for policy, environmental and systems change initiatives. Policies and environmental changes should be implemented to provide for better and more physical activity within the state or communities such as schools and daycare programs.

Q: Can we use funding for walking trails, bike lanes?

A: Recovery Act funds cannot be used to construct or build walking trails or bike lines. Costs for trail promotion, such as signage, are acceptable. Keep in mind that the program’s philosophy is for making widespread policy and environmental changes throughout the state. The policies should have broad reach to large, diverse populations throughout the state. Program efforts should focus on enhancing community capacity to identify other funding sources for substantial local environmental change costs.

Q: Can we spend all of our money on a media campaign?

A: No. Our primary goal is sustainable policy change. A media campaign by itself will not achieve this. A media campaign should support other activities you are implementing from the MAPPS strategies. For example, in Component I, applicants are requested to provide a comprehensive plan to reduce tobacco use through legislative, regulatory, and educational arenas (page 12). A media campaign is only part of a comprehensive plan.

Q: Regarding the award money, how and when will we receive it? Can we expect to receive all of the award money up front or will it be distributed some other way? (e.g. half for year 1 and half for year 2)?

A: The entire amount of the 2 year award will be awarded in the initial award.

Q: If it is based on population, how did you come up with an amount of $300,000 for the Pacific Jurisdiction to be equally shared among the 6 jurisdictions? Guam’s population is estimated at 178,000 in 2009 compared to the other islands where they have less population. What was the formula used to determine this amount? Can we submit a proposal with a budget over $50,000?

A: After careful consideration of your concerns regarding your ability to produce the Supplemental Funding Opportunity Announcement (FOA) desired results with the amount of resources allotted, a decision was made to allow funding request of up to $100,000 for each jurisdiction.

Q: Can stimulus funding for quitlines (Component III) cover medications as core services i.e. Chantix/Verinicline?
We understand that only 5% can be used for NRT but can funds be used to cover other medications? We know that medications can increase the likely of quitting but do not see in the application verbiage that either ‘allows’ or ‘disallows’ quitline expansion to cover medications.

A: No, funds cannot be used for medications other than NRT.

Q: On the October 6th TA call, it was stated that state health departments could submit proposals for multiple policy initiatives, with a separate 20 page proposal for each initiative. Please further clarify the budgets that are to accompany these. Each 20 page proposal should include a separate budget, so can a state health department apply for $3M for EACH initiative or do all initiatives submitted for component 2 from the same state health department have to total $3M when combined?

A: For each applicant, there is a maximum award of 3 million for Component II. This does not change if you propose more than one initiative.

Q: I have a clarification question concerning sub-award contracts. If we want to contract with an agency, and their annual amount is less that $25,000, but over 2 years exceeds $25,000 (i.e. $20,000 per year), would we need a sub-contract?

A: If you contract with an agency as the award recipient this would be considered a sub-contract if it exceed or was less than $25.000. The $25,000 sub-contract requirements are related to reporting individual sub-contracts; greater $25,000 and above or as an aggregate report; less than $25,000 from multiple sub-contracts.

Q: If state health departments are restricted to $3M total for multiple initiatives submitted under component 2, but only one initiative is actually awarded, the submitted budget for the awarded initiative will potentially be less than what we could have applied for (up to $3M as listed in the FOA). How should we plan for this? Will state health departments be permitted to resubmit a budget if only one initiative receives funding?

A: If an applicant submits more that one initiative, each initiative budget request should be for the total amount needed to successfully accomplish the proposed activities/goals. The state health departments will not be permitted to resubmit a budget because the initial proposal should include a budget that is appropriate for the strategies proposed in the initiative.

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Key Days and Letter of Intent

Q: When is the application due?

A: The application is due on Tuesday, November 24, 2009 at 5:00 pm Eastern Standard Time.

Q: Is a letter of intent required?

A: The program is not requesting or requiring letters of intent. Please do not submit letters of intent.

Q: Is it possible for you to please extend the due date from 11/24?

A: Unfortunately, we can not extend the deadline for either application due date.

Q: Is the Governor's letter of support counted against the total narrative pages for Components I, II and III or is it a separate document like the executive summary?

A: Letters of support do not count against page limits.

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Eligibility Information

Q: Who is eligible to apply? What if we don't have a CDC cooperative agreement for Physical Activity and Nutrition?

A: The Recovery Act funding is a supplement to CDC Cooperative Agreement DP09-901, the Chronic Disease Collaborative FOA. Programs in state and territorial health departments and their bona fide agents that received funding under DP09-901 are eligible.

Q: Is a match required?

A: Matching funds are not required.

Q: Which components do we have to apply for? Are we required to apply for all three?

A: You are not required to apply for any component, but will not be eligible for funds unless you apply.

Q: If we don't apply this year, can we apply next year?

A: No. The Recovery Act funding in this announcement is for a project period 24 months, beginning in 2010. If further funding becomes available, we will inform states and territories.

Q: Please clarify if the Pacific Jurisdiction including Guam could apply for the RFA – DP09 – 912. Based on the FOA issued on September 17 under III. Eligibility Information, on page 24, the Pacific Jurisdiction qualifies under the “State Coordinated small cities and rural areas”.

A: The Pacific Jurisdictions are eligible to apply as a State coordinated small city or rural area applicant.

Q: For the current State Supplemental Funding FOA under CPPW/ARRA (DP09-90101ARRA09), can the California Department of Public Health, as the current recipient of CDP09-901 elect a bona fide agent to act on their behalf and submit the State Supplemental application?

A: The State Supplemental funding FOA (DP09-90101ARRA09) states that only current recipients funded under Announcement DP09-901 are eligible to apply. The California Department of Public Health is the recipient of funding under Announcement DP09-901. States may not elect a bona fide agent to act on their behalf and submit the State Supplemental application

Announcement DP09-901 stated the following:

III.1. Eligible Applicants

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

  • State governments or their Bona Fide Agents (this includes the District of Columbia, the Commonwealth of Puerto Rico, and the Virgin Islands).

A Bona Fide Agent is an agency/organization identified by the state as eligible to submit an application under the state eligibility in lieu of a state application. If applying as a bona fide agent of a state or local government, a letter from the state or local government as documentation of the status is required. Attach with “Other Attachment Forms” when submitting via www.grants.gov.

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Application Submission and Continuation

Q: How do I submit the application?

A: The applicant must submit the application electronically by utilizing the forms and instructions posted for this announcement on www.Grants.gov, the official Federal agency wide E-grant Web site. If access to the Internet is not available or if there is difficulty accessing the forms on-line, contact the CDC Procurement and Grants Office Technical Information Management Section (PGO-TIMS) staff at 770-488-2700 and the application forms may be considered for submission and acceptance by U.S. Postal Service.

Q: Is a cover letter required?

A: No.

Q: Will we have to come in for a continuation application on this next year?

A: There will not be a continuation application. However, applicants will need to report progress on achieving their goals. The project period is for 24 months.

Q: Is the evaluation plan submitted with the application as an appendix?

A: No, the evaluation plan is included in the application content section. If an appendix is needed, a reference can be made.

Q: How will we indicate on the budget that we prefer that CDC cover the travel costs plus the 20% administrative fee?

A: Include travel costs in the budget and state in the budget justification that you would like CDC to cover the travel costs. Include estimates of those costs and administrative fee in separate lines in the budget. CDC will withhold that amount from the award to be used for travel for the individuals.

Q: What constitutes a “sustainability plan”, which is one of the output measures for the grant?

A: The “sustainability plan” language referenced occurs in the list of potential modifications/improvements to the quality and capacity of quit lines---the output measure for the quit line component. In that context, “sustainability plan” means evidence that the state has a plan to maintain the improvements or modifications to quit line quality or capacity beyond the funded period, for example, by seeking other sources of funding or by engaging partners to support the quit line, etc.

Q: Is it 5 appendices per component or entire application?

A: Each component can have up to 5 appendices. This means Component I can have 5 appendices, Component II can have 5 appendices, and Component III can have 5 appendices.

Q: Is it one budget to include Component’s I & III with a line item for Component II?

A: Each component should have a separate itemized budget and justification. If you propose more than one initiative for Component II, each initiative should have its own separate budget and justification.

Q: What happens if I encounter submission problems with Grant.gov and my application is late because the system did not function properly?

A: In addition to following the Grant.gov submission instructions listed in the funding opportunity announcement, a single applicant who claims a software or systems failure through Grants.gov resulted in the rejection of an otherwise properly prepared and timely application, the applicant claim is to be thoroughly reviewed by the Grants Management Official (GMO).

  1. The applicant must demonstrate or affirm in writing in sufficient detail to satisfy the reasonable inquiry of the GMO and the Project Officer that the rejected application was attempted on time using the correct automated methodology but was erroneously rejected because of a problem with an automated system that was beyond the applicant’s control.
  2. The applicant must have responded to the rejection promptly and before the accepted applications have undergone Objective or Peer Review. “Promptly” means within 5 working days after the receipt of the rejection. The letter or electronic mail that communicates the rejection should inform the applicant that any rejection based solely on allegations of lateness must be contested within 5 working days, and that the applicant’s response must contain an explanation in sufficient detail and with sufficient evidence to convince a reasonable person that the lateness was due to a system failure beyond the control of the applicant.

Q: If a state has an intervention that could support two such areas, may it submit only one application?

A: Only one application per state or territory is required. For component II, whether you propose one initiative, two, or three. You must submit separate detailed implementation plans and justified budgets for each initiative proposed. Component II initiatives cannot be combined and must be designated for nutrition, physical activity, or tobacco only – we cannot accept initiatives that have combined strategies for component II.

Q: Should states submit Components I & II together with two separate budgets on grants.gov or could two different individuals submit each component separately?

A: One application per state should include Components I, II and III if applying for all three components. If Component II addresses more than one topic area, a detailed description of each initiative and separate budgets should be included in that one application.

Q: Does the application for each component get uploaded to Grants.gov separately, or must they be combined?

A: There should be only one application that includes Components I, II and III, if applying for all 3. Each component must contain a separate budget and budget justification.

Q: Is the amount listed in Appendix D and Appendix E an allocation for 1 year or the entire 2 year award period?

A: The amount listed is for the entire 2 year award period.

Q: It is my understanding that only one application has to be submitted. If our state wants to apply for all three components, then only one application has to be submitted. Is my understanding correct?

A: Only one application per state or territory is required, whether you propose one intervention, two, or three. You must submit separate detailed implementation plans and justified budgets for each initiative proposed.

Q: On page 54 of the announcement, it states that no more than 5 electronic attachments should be uploaded per application. However, on the conference call on October 6, it was stated that 5 attachments were allowed for each component. Which is correct?

A: Five electronic “attachments” are permitted for each component of the application in a PDF file.

Q: The grant guidance requires a letter from the Governor. Please provide the name, title and address to be used. Thank you.

A: The letter should be addressed to the eligible applicant in the form of expressing support for their submission of an application and the proposed activities.

Q: Does the required Sustainability Plan (requirement listed on p. 63 of the FOA) count as part of the 15 page limit for Component III (Tobacco Cessation through Quitlines and Media)? We want to know if we can submit it as an appendix.

A: Information on the sustainability plan should be included the 15 page limit but additional information could be provided as a PDF file attachment.

Q: If the work plan is included in the narrative does the workplan table need to follow the same formatting requirements - double spaced and 12pt. font?

A: Contents of the application should adhere to the requirements listed on pages 52-53. Tables do not have to be double spaced, but should be 12pt font.

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Application Review and Scoring

Q: If a state applies for funding for a rural area/tribal community through the Communities Cooperative Agreement, does this give us an advantage on the competitive application?

A: The competitive applications will be scored by an objective review panel solely on the merits of the application based on evaluation criteria.

Q: Will you need experienced peer reviewers for this program?

A: All reviews for these awards will be completed by Federal employees and we are unable to accept reviewers from outside of the Federal government.
 

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Components (I, II, and III)

Q: Which components do we have to apply for? Are we required to apply for all three?

A: You are not required to apply for any component, but will not be eligible for funds unless you apply.

Q: Is a separate Executive Summary and Project Abstract required for each component?

A: Yes. The Executive Summary and Project Abstract are the same document. We apologize for the confusion.

Q: Are the Executive Summary and Project Abstract documents excluded from the page limits on page 52 of the FOA?

A: No. The Executive Summary/Project Abstract are the same document, and will be posted on a public website and is intended to provide a description of your program. The executive summary/project abstract is limited to 2-3 paragraphs. Information is found on page 51 – 52 of FOA 901.

Q: Do we have to involve the state and/or the local education agency in the planning and writing of the application, and, if funded, in the approved and funded activities?

A: It is the expectation of the initiative that a specific investment be made in people and entities that will achieve changes to school policies and the school environment. Years of experience have suggested that it is critical to find effective ways to engage with school systems to achieve these types of changes, and this is often best accomplished by supporting staff within the school system at the local and/or state level as part of the initiative. Changes to school policy and the school environment often cannot be made without the direct involvement of the education agency. Also see Q85 for the further information determining if the applicant should be working with the state education agency or a local education agency.

Q: What is a local education agency?

A: A local education agency is an entity which operates local public primary and secondary schools. They are commonly referred to as school districts.

Q: May states use a table format for the implementation plan in components 1 and 2 as long as all 6 elements are included?

A: Yes, you can use a table.

Q: Is the budget and budget narrative included in the page limit?

A: The budget and budget narrative do not count towards page limits.

Q: It is my understanding that only one application has to be submitted. If our state wants to apply for all three components- then only one application has to be submitted. Is my understanding correct?

A: Only one application per state or territory is required, whether you propose one intervention, two, or three. You must submit separate detailed implementation plans and justified budgets for each initiative proposed under component II.

Q: On page 29 at the top it states, Applications will be considered for more than one special initiative. (Component II) Does that mean for example, Tobacco and Physical Inactivity. Or can that mean two Tobacco initiatives?

A: You can choose to address physical activity, nutrition, or tobacco use or a combination of the three.

Q: If there is a decision to go with Tobacco Free Schools Policies for Component I, can the state go for Tobacco Retail Licensure for Disparity Elimination for Component II; or does the Disparity Elimination work for Component II have to be totally connected to Component I? Page 26

A: Policy initiatives undertaken in Component I and Component II do not need to be connected. Applicants are encouraged to select initiatives that can be accomplished and show impact within the 24 month project period.

Q: May we use funding from component 1 or 2 for media to promote the Quitline?

A: No. There are dedicated Quitline funds to support media efforts. Funds received for policy and environmental change efforts for component I and component II, if successful, must be used to support those activities.

Q: May we submit the same policy/environmental change initiative for both components 1 and 2, with component 2 building on component 1?

A: Component II awards will be issued under a competitive process that will not include information from the component one application. Therefore the review panel members will not know what was proposed in the component 1 application when rating your application. Therefore, you may submit the same initiative for components 1 and 2 but you must submit sufficient information for the reviewer to consider the initiative proposed in component 2.

Component I

Q: Will there be a defined goal for each state that contributes towards the overarching goal that 75% of the US population will live in states with improved obesity-related and tobacco policies?

A: The 75% coverage is an aspirational statement indicating what we believe a concerted effort like this might accomplish nationwide. The “defined goal” for each state is to make progress on the outcome measures in Section VI.6 related to submission and approval of your chosen policy, system, and environmental change. By accomplishing these outcomes your efforts, by definition, contribute to the 75% coverage aspiration.

Q: Do we need to select interventions from each of the MAPPS category for tobacco, physical activity, and nutrition or can we identify the status and prioritize which interventions we believe are best suited for state implementation over the 2 year period?

A: For component I of the state/territories initiative, it is necessary to implement at least one high-impact policy, environment or system change strategy for each area – physical activity, nutrition, and tobacco – from the MAPPS table. Therefore, at minimum, each state will be implementing three strategies. It should be noted that it is not necessary to choose one strategy from each of the pillars of the MAPPS table (Media, Access, Pricing, Point of Decision Information, and Social Support).

Awardees may also propose evidence-based interventions not listed within the prescribed MAPPS menu, but must provide a strong justification of how the proposed intervention will have sufficient reach and potential impact consistent with the short and long-term goals of the initiative.

Q: In Component I, do we have to address all three topical areas- nutrition, physical activity and tobacco use?

A: Yes, for component I, you need to implement at least one high-impact policy, environment or system change strategy for each area – physical activity, nutrition and tobacco use.

Q: The FOA specifies the content for the application narrative for Component I on page 20, Component 2 on page 28, and Component 3 on page 45. However, on page 53, the FOA specifies a completely different list of items that must be addressed in the narrative. How do these two sets of required narrative content relate to each other?

A: Both sets of items should be included in the narrative. The narrative requirements listed on page 53 ensure that critical information is not omitted from the application

Q: I understand that Component I requires implementing at least 1 policy, environment or system change for each area (physical activity, nutrition, tobacco). I am unclear regarding how MAPPS relates to the requirement. Must each chosen change have a strategy under each MAPPS category? It seems like some of them are actually policy changes that would not necessarily be a strategy for some policy interventions.

A: For Component I, it is not necessary to select a strategy from each MAPPS category (Media, Access, Point of Purchase/Promotion, Price, and Social Services and Support). However, when the five evidence-based MAPPS strategies are combined, it can have a profound influence on improving health behaviors by changing community environments. Each applicant must implement at least one high-impact policy, environment or system change strategy for each area (physical activity, nutrition and tobacco). You may choose to combine all five or combine less than five or use one MAPPS category. It is also permissible to propose evidence-based interventions not listed within the prescribed MAPPS menu, but you must provide a strong justification of how the proposed intervention will have sufficient reach and potential impact consistent with the short and long-term goals of the initiative.

Q: On pg 25 in component I, you discuss statewide support for community level change - what percent of our time should we be allowed to spend on statewide support for community level change vs. implementing state level policy changes?

A: You need to determine how best to achieve statewide impact.

Q: In Component I, pg 12, if we do not have a statewide tobacco ban, should our work plan state that we are going to achieve a statewide ban in 2 years?

A: Yes, you are to address how you will meet that goal. Your work plan needs to address how your state will achieve a statewide smoking ban.

Q: For Component I, if states without a comprehensive smoke-free air law are REQUIRED to include a detailed plan for implementation of one (page 10), can this be the only policy change chosen, or will a second policy change also be required?

A: Yes, a state without a comprehensive smoke-free air law can choose this as its only policy intervention for tobacco control

Q: Is a statewide complete street initiative acceptable for component 1?

A: Yes, that would be acceptable as long as it has not been passed and is statewide. You need to show impact on population.

Q: Can a state apply for two completely unrelated tobacco initiatives from component 1 and component 2 or do they have to be related somehow?

A: The initiatives you choose for component 1 do not have to be related to component 2. However, Component 1 requires applicants to address all 3 risk factor areas.

Q: For component 1, we are able to get a letter of support from our governor that supports physical activity and nutrition, but not tobacco. Does this make us ineligible to apply?

A: The application should identify commitment from the Governor’s Office to hire or retain appropriate staff and to support program staff travel to attend required training. An application that does not include the governor's letter of support is not eligible for the funding.

Q: If states without a comprehensive smoke-free air law are REQUIRED to include a detailed plan for implementation of one (page 10), can this be the only policy change chosen, or will a second policy change also be required?

A: Working toward a statewide comprehensive smoke-free air law can be the only policy change undertaken in states without such a law.

Q: Can a state apply for funding with this application to work on strategies for only ONE risk factor or must it develop initiatives and split budget across each risk factor?

A: States must develop initiatives and split the budget across each risk factor direct cost as appropriate, but reported to CDC as one budget.

Q: If each risk factor must be addressed, is it up to the state in allocating percentages of the budget across the initiatives/risk factors? (Specifically because our Chronic Disease Unit only includes tobacco prevention and no other risk factor included in this FOA) An Example would be: 30% - Obesity; 20% - Physical Activity; 10% - Nutrition; 40% - Tobacco

A: Yes, states may determine the percentages of the budgets across risk factors that support cost of activities.

Q: Page 20 states the narrative should follow the order of the sections provided on pages 20-23, but on page 53 states the narrative should address activities and must include items in the order listed. How are both instructions to be accomplished when they are in contradiction?

A: Both sets of items should be included in the narrative. The narrative requirements listed on page 53 ensure that critical information is not omitted from the application

Q: Our state does not yet have a comprehensive smoke-free air law, but we continue to work toward it. Based on our infrastructure and experience, we think that a robust, statewide initiative to approve and implement smoke-free public housing policies (30 of 125 housing commissions have already implemented) for affordable housing units is the most strategic effort to synergize support for a statewide law. Does this meet the MAPPS intervention under the Access column for ‘Usage bans’ as an acceptable strategy in light of the fact that we don’t have a comprehensive smoke-free air law?

A: Applicants may propose evidence-based interventions not listed within the prescribed MAPPS menu, but must provide a strong justification of how the proposed intervention will have sufficient reach and potential impact consistent with the short and long-term goals of the initiative.

Q: If a state applicant utilizes local coalitions to pass a group of local policy initiatives to build critical mass for a future statewide policy, would that be sufficient for the required "statewide reach/impact"?

A: The applicant needs to determine how best to achieve statewide impact. State efforts should promote evidence-based policies and interventions at the state and local levels, which establish healthy social norms providing for healthier, affordable choices.

Q: If a state applicant works on a statewide policy, is it acceptable to fund local coalition activities to support statewide policy?

A: State efforts should promote evidence-based policies and interventions at the state and local levels, which establish healthy social norms providing for healthier, affordable choices.

Q: Under Component I, is it appropriate to propose using ARRA funds to create a database and website as a tool to collect Health Impact Assessment information to rate existing built environments and initiate environmental change strategies?

A: It is not appropriate to use ARRA funds to create a database and website to collect Health Impact Assessment information. That is not the objective of this initiative. The purpose of this initiative is to create and implement policy and build environment changes statewide that will decrease obesity risk factors; increase levels of physical activity; improve nutrition, decrease smoking prevalence; decrease teen smoking initiation; and decrease exposure to secondhand smoke.

Q: In the implementation portion of Component I. should the work plan which includes: Goals, Objectives, Action steps, Milestones, Key partners and Evaluation strategies, be including in the narrative portion or can the work plan be a separate attachment?

A: The workplan must be included in the narrative.

Q: For the CPPW initiative, it is stated on Pg. 15 that "the state comm. mgmt. team should include participation from the SHD's Collab. FOA designated Healthy Communities Coordinator." If a state did not apply for the Healthy Communities portion of the Collab. FOA and therefore does not have a Healthy Communities Coordinator, how should this be addressed in the application? (this is also a part of the eval. criteria.)

A: Each applicant should provide a plan to work with communities within the state, whether or not the state applies or is awarded funds for a rural/small city. The plan should state how you will engage communities within the state. If a community within the state happens to receive Recovery Act funds for CPPW activities, the plan should also apply to that community.

Q: What if state’s political environment will not support a comprehensive statewide tobacco ban within 24 months? Does this disqualify such a state from applying for Component I with other policy initiatives?

A: No, this does not disqualify an applicant. The letter of support is not required to address specific interventions. Rather, the letter of support should indicate commitment from the Governor’s Office to hire or retain appropriate staff and to support program staff travel to attend required training.

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Component II

Q: How is Component II different than Component I? I understand that in Component II, we focus more on the burden, disparate groups and broad reach, but does it have to be innovative or can it continue to expand upon Component I?

A: Component II provides an opportunity for additional funds to be awarded on a competitive basis to applicants that demonstrate readiness to implement special large scale, statewide policy or environmental change initiatives.

Q: For Component II, do we have to address all three topical areas- nutrition, physical activity and tobacco use?

A: No, you can choose to address physical activity, nutrition, or tobacco use.

Q: In the evaluation criteria for Component II, Rationale (p. 33) reference is made to factors in Appendix A. What does this mean?

A: This was a typo and should read: "...initiatives should address factors in Appendix B."

Q: Can a state submit for two different areas, such as tobacco and nutrition?

A: Yes, a state can submit one application and submit to an initiative for tobacco and nutrition but a separate budget and budget justification must be submitted for each initiative.

Q: Can you clarify what is meant by the number of (unduplicated) quitline callers specified as an output measure?

A: Unduplicated means each caller should be counted only once in a calendar year since receiving a service (counseling and/or medication). More information can be found in the NAQC Issue Paper: Measuring Reach of Quitline Programs.

Q: If we have state policy that has been passed, but money has been lost to implement it, can we apply for implementation funds under Component II?

A: The purpose of Component II is to fund State Health Departments that demonstrate readiness to implement special large scale, statewide policy or environmental change initiatives. Component II is competitive and applications will be judged on the evaluation criteria provided in the FOA.

Q: For Component II, can we apply for $3 million for each special policy initiative or is there an overall limit of $3 million?

A: For each applicant, there is a maximum award of 3 million for Component II. This does not change if you propose more than one initiative.

Q: For Component II, what is the page limit for each policy initiative proposed?

A: In Component II, the limit is 20 pages for each policy initiative proposed. Each proposed policy initiative should include a separate budget and budget justification.

Q: I understand that Component II requires implementing one special, large scale, statewide policy, environment or system change. If I understand, this means that if we have an intervention that could use additional funding and would support our chosen policy intervention in Component I, we could submit an application for this component. I am unclear regarding how MAPPS relates to the requirement. Must there be a strategy under each MAPPS category as part of the intervention? It seems like some of them are actually policy changes that would not necessarily be a strategy for some policy interventions.

A: Applicants are expected to use this list of evidence-based strategies to design a comprehensive and robust set of activities to produce the desired outcomes for the initiative. When combined, the five evidence-based MAPPS strategies can have a profound influence on improving health behaviors by changing the environment. However, other evidence-based strategies may be proposed as long as proper justification is provide which also indicates broad reach.

Q: Regarding Component II, are we able to submit a proposal for an initiative that combines nutrition and physical activity or integrates all three topic areas together?

A: Applicants may propose multiple initiatives for Component II, each with their own separate narrative and budget. Each initiative should clearly indicate whether it is a tobacco initiative, a physical activity initiative, or a nutrition initiative. We cannot accept initiatives that combine topic areas (i.e., nutrition and physical activity) because we will have three separate review panels—one for physical activity, one for nutrition, and one for tobacco. Proposals that combine two or three of the topic areas will be considered nonresponsive and not entered into the objective review process.

To clarify, this is only the case for Component II in the State FOA. For Component I, activities that combine the topic areas are acceptable. For the Community FOA applicants may submit applications in two categories: Category A (obesity/physical activity/nutrition) and Category B (tobacco prevention and control).

Q: For component 2, we’re proposing an integrated effort that doesn’t lend itself to 3 separate narrative descriptions of what we’re going to do. Can we describe the implementation plan in a comprehensive way or will we be required to have 3 separate narratives and budgets? Can we have one 20 page submission for an integrated project (i.e., physical activity, nutrition and tobacco)?

A: For component 2, we need a separate narrative and budget for each area initiative you propose. Please clearly indicate whether your initiative is a tobacco initiative, a physical activity initiative, or a nutrition initiative. We cannot accept integrated initiatives because we will have 3 separate review panels – 1 for physical activity, 1 for nutrition and 1 for tobacco.

Q: For component 2, can we propose multiple initiatives that each total $3 million?

A: Yes, but the maximum amount of funding an applicant can receive for component 2 is $3 million.

Q: In component II, would it be allowable to apply for funds to support infrastructure and implementation of a new statewide policy that was enacted in 2008 and lost all funding in 2009?

A: No, it would not be allowable to apply for funds to support a policy enacted in 2008.

Q: On the conference call, it was stated (based on someone's question) that for component II, if we wanted to address two initiatives - one for physical activity and one for tobacco, we were allowed to write 20 pages for each initiative (a total of 40 pages). Is this truly the case? On page 52 of the announcement- it says that the maximum number of pages for component II is 20 pages. So which is correct?

A: 20 pages for each initiative.

Q: It was my understanding that for component two if we addressed two initiatives they would have to both be addressed in 20 pages. Also the budget for both initiatives combined would be from 1 to 3 million dollars. Is my understanding correct? Or if under component II, we are allowed to submit 20 pages for each initiative (as mentioned on the conference call) - does this mean that each initiative would be judged separately and in essence compete with each other? Would each initiative be able to have a budget for 1 to 3 million or would both initiatives still have to total 1 to 3 million?

A: For each applicant, there is a maximum award of 3 million for Component II. This does not change if you propose more than one initiative and the page limit is 20 pages for each initiative. The initiatives will be competed by topic area.

Q: Our state quitline is operated by a separate non-profit organization, [that was] created and funded by our state’s tobacco settlement. This non-profit organization also does all the statewide media work to promote cessation and use of the quitline and works collaboratively with the State Health Department and other groups in the state working in tobacco control. Will there be a problem with our state contracting those activities which enhance quitline services, the media pieces and their respective evaluation to the non-profit organization? This is the only way to effectively carry out this work in our state and builds on the infrastructure already in place.

A: The FOA states that “cooperative agreement funds must be used to support a core infrastructure for the delivery of quitline services that include proactive counseling and promotion/outreach.” We understand that state health departments achieve this core infrastructure through a variety of arrangements, including partnerships, contracts, and memoranda of understanding, and these arrangements will continue under this Supplement. As part of core infrastructure, states need to be certain that they can accomplish the quitline monitoring and evaluation recipient activities described in the FOA (pp 41-42), including collection of designated Recovery Act performance and evaluation measures according to the time schedule provided. Because the purpose of this funding is to "create 80,000 additional tobacco quitters [nationally] beyond what states and jurisdictions have achieved in the past, by expanding and promoting tobacco cessation quitlines," it is important that states provide accurate and thorough information. The administrative and oversight responsibility of the award remains with the award recipient.

Q: Our state is interested in upgrading the phone system for the state quitline. By updating the phone system, the quitline would increase the time counselors spend counseling, increase the number of callers counseled, and improve follow-up with callers to the quitline. The upgraded phone system is expected to significantly increase the capacity of the quitline to counsel callers. Is this an expenditure approved with ARRA funds to "expand and enhance tobacco cessation services through quitlines"?

A: The applicant should quantify how the investment will increase services to accomplish the FOA objectives. The purpose of this component of the FOA is to strengthen the abilities of states, the District of Columbia, and eligible Territories to enhance the national network of tobacco cessation quitlines to significantly increase the number of smokers who quit each year. However, capital investments can not be supported.

Q: I wanted to find out if there are any plans to develop a partnership with pediatric organizations and establishing a fax to quit program for pediatric health care professionals. If so, would this include an educational component? Could this fax to quit program include training of health care professionals?

A: The purpose of the ARRA quitline funding is to strengthen the abilities of states, the District of Columbia, and US. Territories to enhance and expand the national network of tobacco cessation quitlines to significantly increase the number of smokers who quit each year to reduce mortality and morbidity from tobacco use, and associated healthcare costs. CDC plans to foster the transfer of successful evidence- and practice-based interventions and program models. However, this is not a healthcare provider targeted initiative.

Q: Is the expectation that states will be responsible for transferring de-identified individual level data (intake, utilization and follow-up) only for individuals consenting to participate in the evaluation?

A: Most states do not consent people at intake because their answers are part of the treatment they receive. In that case, we would expect all de-identified intake survey data to be sent to CDC. The evaluation occurs at 7-month follow-up and consent is typically obtained. If the individual does not consent to answer the 7-month follow-up survey questions then no follow-up data should be sent on that individual.

Q: What is the expected frequency of individual-level data transfer?

A: Quarterly

Q: Is it possible to conduct fewer follow-up surveys and dedicate more of the evaluation resources to ensure a high response rate?

A: We suggest that you try to get at least 800 follow-up surveys completed during a given year. This number of completes will depend on both the number of follow-up surveys you conduct and the response rates for those surveys that you achieve. The higher the response rate the lower the number of individuals you will need to contact to achieve the target of 800 completed follow-up surveys.

Q: Does the 30% cap for media apply to direct + indirect charges or 30% of direct charges?

A: The recommended maximum of 30% for media cost is related to the total award; direct and indirect cost.

Q: Is statewide support for community level change applicable to Component II to address health disparities, the competitive section? Page 15 and 22. Meaning: Multiple Community level policy changes around the state. Please advise, thanks.

A: Yes, especially when coordinating your efforts with any community activities funded as part of this initiative in large cities, urban areas, tribal areas or state-coordinated small cities and rural areas that focus on health disparities.

Q: On page 29 at the top it states, Applications will be considered for more than one special initiative. (Component II) Does that mean for example, Tobacco and Physical Inactivity. Or can that mean two Tobacco initiatives?

A: You can choose to address physical activity, nutrition, or tobacco use or a combination of the three.

Q: Is statewide support for community level change applicable to Component II, competitive section? Page 15 and 22.

A: Yes. The FOA states: “Applicants are expected to propose strategies that are most likely to affect statewide burden and therefore, where appropriate, emphasize plans to achieve health equity.”

Q: Under Component II, if we submit 2 policy initiatives addressing the same topic area (i.e. nutrition) is this correct:

  1. Each policy initiative submitted will be 20 pages for a total of 40 pages with separate budge and budget justification?
  2. Each policy initiative submitted can request up to a maximum of $3 million, although the award total for Component II is $3 million?

A: Each policy initiative is allowed 20 pages. Each initiative must have a budget and justification. Each policy initiative can request a maximum of $3M. Each applicant will be awarded a total of $3M no matter how many initiatives are submitted.

Q: I understand that the total award for Component II will not exceed $3 million. My question is: does this limit apply to the applications. Can a state submit two separate initiatives for $3million each, knowing that they will not receive more than $3 million for Component II initiatives? In other words, is a state considered non-responsive to Component II if it submits separate initiatives in Component II that total more than $3 million?

A: A state can submit more than one initiative for $3M each and will only be funding for one. A state will not be considered non-responsive for submitting more than one initiative for $3M each.

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Component III

Q: Will there be a defined goal or number of quitters for each state that contributes towards the overarching goal that 80,000 additional individuals will successfully quit through quitlines?

A: No, there will not be a defined goal for the number of quitters in each state.

Q: Please define what is meant by enhance and expand integration of on-line and other electronic information support technologies? Does it mean electronic medical records or on-line support for smokers who are enrolled in quit lines?

A: This means that there will be on-line support for smokers who are enrolled in quitlines.

Q: Will the reporting requirements create more of a burden on callers during the intake process?

A: No. We do not anticipate that callers will have to answer additional questions during the intake process because the CDC surveys at both intake and 7-month follow-up are based on NAQC’s MDS.

Q: Will states have time to demonstrate that prevalence rates have decreased?

A: The ARRA measures do not include a measure of decreased prevalence. They include three outcome measures – Total number of quitline calls; Number of (unduplicated) quitline callers who receive a service; and Number of (unduplicated) quitline callers who received a service who quit-and one Output measure – Number of site-appropriate modifications to improve quality and/or capacity of state quitline per inventory of potential improvements. The ARRA measures can be found in the FOA on p.61-62.

Q: What is the proposed time frame for quit rates?

A: CDC is requesting you use a 7-month follow-up survey to determine the number who quit and quit rates. This is consistent with NAQC’s MDS. CDC also supports the recommendations in the NAQC Issue Paper: Measuring Quit Rates, available at: http://www.naquitline.org/resource/resmgr/docs/naqc_issuepaper_measuringqui.pdf [257K–PDF]

Q: How will quitlines differentiate tobacco users reached as a result of stimulus funds versus those reached through normal operating funds? Will separate reporting be required?

A: CDC will evaluate overall reach – not just the reach associated with ARRA funding. Separate reporting is not required.

Q: Has CDC made recommendations regarding types of promotions?

A: Guidance on media is on p.41 of the FOA.

Q: Has CDC made recommendations regarding focus on priority populations?

A: CDC is asking all states to define their own priority population(s) of interest and to report the following ARRA measures for this population as part of the services survey (1) Define high risk population(s) and (2) Give number of (unduplicated) quitline callers from selected population(s) who received a service. P. 63

P. 39 of the FOA states that populations with a disproportionate burden of tobacco use and who tend to experience disparities in access to and use of preventive and tobacco cessation services include: racial and ethnic minorities, low-income persons, the medically underserved, persons with disabilities, persons affected by mental illness, or persons affected by substance abuse.

Q: What additional reporting will the service provider need to provide? Can they do it?

A: Make sure your contract with your service provider/evaluator ensures that you will receive individual-level data at both intake and follow-up and not just aggregate reports. You will be required to conduct 7-month follow-up surveys so that the number of persons who received a service who quit can be determined. CDC will provide you with the intake and 7-month follow-up surveys which are based on NAQC’s MDS as well as the data elements and file specifications for sending the data to CDC.

Q: Complying with Reporting and Other Requirements of the CDC

  • It is likely that we will have to provide new quarterly reports on services delivered and outcomes?
  • Can my service provider do that?
  • What resources do I need to make sure the quality of reporting is good?

A: As part of ARRA funding you will be required to report quarterly on the ARRA measures. When CDC receives OMB clearance you will report on your services and other ARRA-related measures through a CDC web-based online services survey. Many of the questions on the survey are similar to NAQC’s Annual Survey. Detailed definitions will be provided for each measure you are reporting and the definitions follow those recommended in the NAQC Issue Paper: Measuring Reach of Quitline Programs and the NAQC Issue Paper: Measuring Quit Rates. Until receipt of OMB clearance, you will report these items as part of your quarterly reporting to CDC.

You need to ask your service provider and your evaluator to provide you with individual-level caller data. CDC will not accept aggregate reports of intake or follow-up data. You can have your services provider/evaluator directly mail the de-identified individual-level data to CDC. CDC will provide you with the data elements and file specifications for quarterly data submission to CDC via US mail.

Q: Can funds be used for research project(s)?

A: FOA funding can not be used to conduct research.

Q: What are the surveys?

A: CDC has created an Intake Survey and a 7-month follow-up survey that are based on NAQC’s MDS. The quarterly web-based on-line services survey contains the ARRA measures and is similar to NAQC’s Annual Survey.

Q: Should our state start to complete follow-up surveys? Currently, this survey is not one that we administer and collect data from.

A: You will need to implement the follow-up survey at 7-months post intake. We expect that, at a minimum, you will have at least 800 follow-up surveys completed. Callers who received a service who are selected for the 7-month follow-up survey should be representative of all callers who received a service (i.e., a random sample of those who completed the intake survey and received a service). CDC supports NAQC recommendations for follow-up contained in the NAQC Issue Paper: Measuring Quit Rates, available at: http://www.naquitline.org/resource/resmgr/docs/naqc_issuepaper_measuringqui.pdf [516K–PDF]

Q: Is a sustainability plan required in the application, or is it to be a "deliverable" of the funding?

A: The sustainability plan is required in the application.

Q: Page 38 of the FOA states that "Evidence regarding optimal use of quitlines demonstrates that 30 percent of funds should be used for media campaigns." Does this mean that an applicant's media budget should be 30% (or a minimum of 30%)? Are applicants limited to the percentage of fundng that can be used for media?

A: The FOA cites evidence for using 30% of funds for a media campaign. The FOA states, “A portion of funds awarded with this Supplemental Program Announcement must be used to develop or expand media campaigns that drive tobacco users to quit. (Page 37) The amount of media needed should be justified by the applicant as it relates to current efforts and demand for the Quitline and other cessation services.” (Page 38)

Q: Can you clarify what is meant by the number of (unduplicated) quitline callers specified as an output measure?

A: Unduplicated means each caller should be counted only once in a calendar year since receiving a service (counseling and/or medication). More information can be found in the NAQC Issue Paper: Measuring Reach of Quitline Programs.

Q: Would it be permissible to use tobacco sales information collected by states as a dependent variable for statewide impact.

A: This is a non-research funding opportunity. Applicants can use population level data for analyses, interpretation, and monitoring, as a guide for creating public health policies and environmental changes. The applicant should provide a detailed plan to document the short and long term impact of the program activities which include existing data systems, communication of program achievements to partners, collaborators, policy makers; and detailed plan for all required reporting to the CDC and FederalReporting.gov.

Q: This question pertains to the latitude state tobacco control programs have regarding media funding available through Component III - Tobacco Cessation through Quitlines and Media. Page 38 of the above referenced FOA states that the "amount of media needed should be justified by the applicant as it relates to current efforts and demand for Quitline and other cessation services."

Compared to the previous year, our state-funded smokers' quitline is currently funded to accommodate a near doubling of callers who receive basic quitline coaching and a 33% increase in the number of tobacco users who receive free NRT. In order for our state to contribute to the national goal of 80,000 additional tobacco quitters beyond what would occur without ARRA funding, we must increase our media efforts to further motivate smokers to quit and to prompt additional calls to the existing quitline service. The FOA suggests a 30% allocation of funds for media campaigns. If our proposal clearly demonstrates that our state has already used state funds to expand quitline services and that our ability to contribute to the national goal requires a stronger investment in media campaigns, may we propose more than the recommended 30% allocation for media?

A: The FOA cites evidence for using 30% of funds for a media campaign. The FOA states, “A portion of funds awarded with this Supplemental Program Announcement must be used to develop or expand media campaigns that drive tobacco users to quit. (Page 37) The amount of funds needed for media should be justified by the applicant as it relates to current efforts and demand for the Quitline and other cessation services.” (Page 38)

Q: The FOA limits purchase of NRT to 5% of the award amount. Does the cap on NRT apply to the total amount of the award or only the amount for the Component III, Quitlines?

A: Purchase of NRT is limited to 5% of the amount awarded for Component III, Quitlines.

Q: For component 3, can we use the projected number of quitters based on our revised budget for this year? We won’t be able to get more quitters than what we normally have due to budget cuts- is this ok?

A: The 80,000 fewer smokers is our national target for this ARRA funding. We will be looking for each state to make a contribution to 80,000 above the number who would have quit without this new funding.

Q: Concerning the goal of increasing the number of quitters by 80,000 ---- Is there a state-by-state listing somewhere of the current number of quitters? Just looking at this to plan outcome measures, and I am not sure what the data source is.

A: The 80,000 number is based on lessons learned from previous efforts. Each state is expected to expand and enhance existing cessation efforts and contribute towards the national target of 80,000 additional quitters above what normally is seen.

Q: We would like to use the quitline to increase cessation among pregnant women. Are incentives allowed in this proposal?

A: No, incentives are not allowed.

Q: When will the CDC Intake Survey and the 7 month Follow-up Survey with the ARRA measures be available? We need to know the specific questions and data elements for reporting to CDC as soon as possible.

A: The CDC Intake Survey and the 7 month Follow-up survey with the ARRA measures will be available when CDC receives OMB clearance in early 2010. Both surveys are based on NAQC’s MDS available at http://www.naquitline.org/?page=technical .

Q: Will CDC be creating the 7 month follow-up survey? Will CDC be analyzing the data? If CDC is doing analysis, will they be reporting to the states?

A: Yes, CDC is creating the CDC Intake Survey and the 7 month Follow-up surveys for use by states. These will be available when CDC receives OMB clearance in early 2010. Both surveys are based on NAQC’s MDS available at http://www.naquitline.org/?page=technical CDC will be analyzing the data. State reports will be shared with the state and eventually posted to the CDC’s STATE system. These analyses, however, should not replace the detailed analyses that a state conducts as part of their evaluation plan.

Q: Individual level data needs be linked with evaluation data. Is the state responsible for this or will the CDC do this when analyzing the data (if they are doing the analysis)?

A: The states will need to link the intake data to the 7-month follow-up data before they send the 7-month follow-up data to CDC. CDC will not have the ability to link the data.

Q: If a state invests the equivalent of 30% of ARRA funding from other sources into cessation media, is use of some of the ARRA funding for media still required?

A: The FOA cites evidence for using 30% of funds for a media campaign as a recommended maximum. The Recovery Act encourages the use of funding from other sources as evidence of sustainability.

Q: Are the Intake and 7-month outcome surveys completed from a random sample of QL participants or from the target population of this specific ARRA proposal?

A: Intake surveys should be administered at intake to all quitline callers. Follow-up surveys should be administered at seven months post-intake to a random sample of quitline callers who received a service.

Q: Are incentives allowed as part of this project proposal? We would like to enhance the utilization and retention of the QL among the prenatal population and would like to provide a small gift card for completed coaching sessions?

A: Incentives are not an allowable expense.

Q: Is health care provider training and outreach an allowable expense if the intended outcome is increased referral of patients (ie, pregnant women) to the QuitLine?

A: Applicants can propose to expand outreach to health care systems for referrals as part of the recipient activities for proactive quitline services to competent providers. The preferred enhancement/expansion sequence to reach to goal of 80,000 additional quitters is listed in the FOA on pp 38-39.

Q: Is it only the evaluation data that individual level data is required? What about the quarterly reports - is that aggregate?

A: Both the de-identified intake data and the follow-up data sent to CDC need to be at the individual level. The quarterly reports will require aggregate reporting.

Q: When do you expect to release the exact reporting specifications?

A: We plan to release the reporting specifications in early 2010, pending OMB clearance.

Q: I heard on the TA call that it was expected that 800 individuals per year be recruited for evaluation. The FAQ seems to include 800 people in total for the grant period. Can you clarify? I want to make sure that for this funding, you require one 7-month follow up survey, with a minimum of 800 completes for the entire funding period (800 total, NOT 800 per year). Please confirm.

A: We recommend that quitlines recruit participants for follow up surveys on a rolling basis. States should conduct 7-month follow-up surveys on a sample of quitline callers who completed the intake survey and received a service during the ARRA funding period. Therefore, follow-up surveys should begin approximately 7 months after start of the funding. States should try to get 800 completes in any given year.

Q: Should our state start to complete follow-up surveys? Currently, this survey is not one that we administer and collect data from.

A: You will need to implement the follow-up survey at 7-months post intake. We expect that, at a minimum, you will have at least 800 follow-up surveys completed. Callers who received a service who are selected for the 7-month follow-up survey should be representative of all callers who received a service (i.e., a random sample of those who completed the intake survey and received a service). CDC supports NAQC recommendations for follow-up contained in the NAQC Issue Paper: Measuring Quit Rates, available at: http://www.naquitline.org/resource/resmgr/docs/naqc_issuepaper_measuringqui.pdf [516K–PDF]

Q: Our Quitline has developed a telephonic weight loss, physical activity and nutrition program. We are interested in offering this program to smokers. Would this be something that we could fund under Quitline expansion?

A: No. The purpose of the ARRA Quitline funding is to strengthen the abilities of states, the District of Columbia, and U.S. Territories to enhance and expand the national network of tobacco cessation quitlines to significantly increase the number of smokers who quit each year to reduce mortality and morbidity from tobacco use, and associated healthcare costs.

Q: Is there a clear definition of “emotional and graphic messaging” and will someone review messaging before distribution to ensure it meets this criteria? I’m concerned is that emotional and graphic could be subjective.

A: Messaging will not be reviewed before distribution to ensure it meets the performance criteria. The National Cancer Institute's Monograph 19, The Role of the Media in Promoting and Reducing Tobacco Use, listed in the references to the MAPPS Interventions in Appendix A, contains further information about media messaging.

Q: Can the ARRA money for component III be used to build a new state-based quit line?

A: The funding is to support enhancement/expansion sequence for proactive quitline services to reach the goal of 80,000 additional tobacco quitters above the current number of quitters is in the FOA on pp 38-39.

Q: In our state one of our disparate population groups is smokers who are in lower socio-economic groupings. We currently do not ask an income question on our Quitline intake. We do ask for education level and type of insurance. For the purpose of measuring reach of our Quitline to this population, will the CDC accept education and/or insurance type as a proxy for socio-economic status, or should we look to add a question about income to our Quitline intake.

A: We plan to include a question on education level in the quitline intake survey. At this point in time, we do not plan to include questions on income or type of insurance in the quitline intake survey. However, states can choose to add their own questions to their surveys.

Q: Will "case study sites" be selected for Category III state awardees?

A: No, the case studies will include 5-6 states addressing the policy and environmental change aspects of Category I

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Staffing

Q: We have a hiring freeze right now and can't add staff. Can we apply for this funding?

A: Staff needed to carry out the policy initiatives in this FOA can be full or part-time staff or hired on a contractual basis. An application will need to show that there are sufficient current or contract staff for proposed activities.

Q: Can we use or hire contractors to implement our work?

A: Yes, you may hire or retain staff or contractors with the appropriate competencies to implement the work plan.

Q: What happens after this money goes away? What do we do with the staff we hired with this funding?

A: One of the recipient activities is to develop and implement a sustainability plan to retain staff and sustain programmatic activities after Recovery Act funding has ended.

Q: Is a position description needed if subcontracting staff?

A: Yes. We recommend that all staff filling a substantive role in the program (whether contracted or agency employee, paid for by the project’s funds or from in-kind resources) should have a position description.

Q: Is the application asking exclusively for information about the State Tobacco Program or is information and justification for staffing levels at the chosen quitline vendor requested as well?

A: Applicant should describe plans to hire or retain staff or contractors to implement a quitline program.

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Project Narrative and Work Plans

Q: Please clarify the number of budgets and workplans for each component and each topic area.

A: For Component I, the non-competitive component, submit one workplan and one supporting budget. Applicants need to address tobacco control, nutrition, and physical activity initiatives with one combined workplan and supporting budget for all proposed initiatives.

The same is true for the competitive component, i.e. one workplan and supporting budget for each initiative. If more than one tobacco control (or physical activity or nutrition) initiative is selected, each requires a separate budget and workplan. If there is sharing of staff or other resources, divide the costs as appropriate.

Q: The FOA is missing the Sample Implementation Work plan Appendix C.

A: We apologize that the sample implementation work plan was not included in the FOA. However, the items to include in an implementation plan are listed in the FOA in the section, Application Content for Component I, on pages 20-21.

Work plans should at a minimum address the following:

  1. Goals
  2. Objectives
  3. Action steps
  4. Milestones for implementation of action steps and progress on objectives
  5. Key partners
  6. Evaluation strategies, including key output and outcome measures related to the action steps and objectives, and data source for collection of these measures.

Q: Is broad reach defined as statewide, or are multiple communities within the state sufficient?

A: The intent of this effort is jurisdiction-wide policy change, therefore the emphasis in your proposal should be on statewide reach. However, there are instances, which would need to be justified in your proposal, when some of your proposed efforts might focus on a problem that occurs in select communities (i.e. the state’s largest cities) or in select subpopulations. In these instances it will be important to demonstrate the impact these focused efforts are likely to have on statewide burden.

Q: Does the detailed implementation plan have to be a part of the application narrative or can this be included as an appendix?

A: Implementation plans should be a part of the narrative, but additional information can be a part of the appendix.

Q: What should the start date be for the implementation plan Components I and II?

A: The implementation plan start date will be the award date.

Q: Detailed implementation plans—can those be appendices or do they have to be part of the limited number of pages?

A: Implementation plans should be a part of the narrative, but if you need space for additional description, they can be a part of the appendix.

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Strategies

Q: Are applicants required to address all three topic areas (physical activity, nutrition and tobacco) or can applicants choose one or two to address?

A: Applicants must address all three topic areas in the non-competitive application- physical activity, nutrition and tobacco

Q: What if we want to pursue strategies that are not in MAPPS?

A: Awardees may also propose evidence-based interventions not listed within the prescribed MAPPS menu, but must provide a strong justification of how the proposed intervention will have sufficient reach and potential impact consistent with the short and long-term goals of the initiative.

Q: What if we choose to work on a statewide policy, and can't get it done in two years?

A: It is the desire of this announcement that states are able to achieve their goals within the 2 year project period. Technical Assistance will be provided by the CDC to assist states in achieving their goals. States and territories will need to show the progress they achieve in reaching their policy initiatives. The purpose is to also demonstrate sustainability of efforts beyond Recover Act funds.

Q: We have a large local health department applying for the Communities Grant. Do we have to select the same strategies they have selected?

A: No, however you should coordinate so that the maximum benefit from this limited funding is achieved.

Q: Could you outline what the implications are for diabetes prevention and control efforts in the state policy and environmental change efforts in tobacco cessation and physical activity and nutrition? Would be acceptable to write in a component for diabetes prevention through these efforts?

A: There is no specific component in this announcement for diabetes activities. Funds should be targeted toward initiatives related to physical activity, nutrition and tobacco control and prevention, not diabetes activities.

Q: A key issue in predicting obesity and tobacco use is childhood trauma- if a state chooses to make childhood trauma a priority- would that be permissible?

A: It is important to remember that this program focuses on chronic disease prevention and control activities and the focus is on physical activity, nutrition and tobacco control and prevention. While childhood trauma may be a key issue in predicting obesity and tobacco use, it is not the focus of this initiative. You may propose evidence-based strategies other than those listed in the MAPPS table, but you must also provide justification that the strategy is an evidence-based strategy with broad impact.

Q: How does breastfeeding fit in to the stated goals of the project (page 6 of the FOA)? Can we add an additional goal?

A: These goals are for the national program so it is not acceptable to add another goal. Breastfeeding strategies are included under the first and third goals which reference nutrition and obesity-related policies. It is appropriate for applicants to add specific state breastfeeding goals and related indicators to their state implementation and evaluation plans.

Q: In MAPPS, breastfeeding is under social support and not under other MAPPS strategies- can we use breastfeeding under the other MAPPS strategies?

A: You can use another evidence-based strategy other than those listed in the MAPPS table, but must provide justification of strong evidence and broad impact.

Q: Can we use other nutrition strategies not listed in the social support section in the MAPPS strategies?

A: You can use an evidence-based strategy other than those listed in the MAPPS table, but you must provide justification of evidence and broad impact.

Q: If individual consumers become significant purchasers of products like bicycle helmets to reduce obesity—is that an example of sustainability?

A: The expected outcome of the proposed activities is sustained policy, system and/or environmental changes. Consumer purchasing of bicycle helmets does not fit within this definition. Our impact is not targeted to individuals.

Q:  In the Farm to Institution component in the MAPPS strategies, do we need to address every one of those examples (e.g., schools, worksites, hospitals, etc.) in our workplan or just what we think we can accomplish in 2 years?

A: For the Farm to Institution component, these are just examples of settings. You do not need to address all of them.  You need to have an appropriate workplan for the 2 year funding period.  In the TA guidance on the website we give examples of what we are looking for. www.cdc.gov/chronicdisease/recovery/  found in the “Application and Submission” section.

Q: I understand the interventions listed in Appendix A, MAPPS Interventions, complement, but do not duplicate the FDA regulations that will take effect over the next year. Our state recently passed legislation on a number of the MAPPS interventions. Would it be appropriate to request funding to assist with the implementation and enforcement of these new state laws?

A: No, it would not be appropriate to request funding to support a policy that has already been passed.

Q: During our Pacific Jurisdiction conference call CDC advised us not to use Media if that is expensive. We are confused because the guidance stressed to use the MAPPS strategies and Media is one of the best practices. Media is expensive everywhere, exactly, how do you want us to proceed?

A: You can utilize the available resources provided to purchase the appropriate amount of media to support accomplishing the FOA objectives. Our primary goal is sustainable policy change. A media campaign by itself will not achieve this. A media campaign should support other activities you are implementing from the MAPPS strategies. A media campaign is only part of a comprehensive plan.

Q: Can a statewide policy be for all State of Arkansas agencies, boards and commissions? Or must it include all businesses? We are in a good position to make policy for state agencies at this time.

A: Selection of evidence-based interventions to pursue should be based on a thorough analysis of gaps and opportunities that exist in the state and should reflect the potential for broad reach, impact, and successful implementation. To the extent the proposed strategy demonstrates a jurisdiction wide approach and a good likelihood of achieving the stated goals for this program it would be acceptable.

Q: In reviewing the interventions in the MAPPS strategies (p 75), we noticed the references provided are often "place based". For example some of the references related to interventions under Access/Nutrition are from studies related to schools. Does this mean our proposed strategies for Access/Nutrition have to be school based? That is, do we need to consider and build our program around the references provided under the MAPPS options or are those only to show what makes them evidence based and we can propose to implement them in any setting we choose (worksite, community, school, etc)?

A: The settings included in the Appendix A MAPPS strategies are meant to be used as examples. The references are to show the evidence base for the strategies. Applicants can propose to implement strategies in other settings as long as there is justification for the setting choice. However, it is important to also remember that this initiative is intended to address adults and children, therefore your strategies should be inclusive of schools, worksite and community as needed for your state.

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Technical Assistance

Q: If our city gets funded through the Communities FOA, they will need a lot of technical assistance from us. Can we apply for funding to provide them help? Are we expected to provide technical assistance even if we do not get funded?

A: A state health department can select the same policy initiative as a local community and include technical assistance as part of the workplan. States and local communities can strengthen their applications through coordination. Providing technical assistance is a recipient activity under Statewide Support including Community Level Change in this FOA

Q: Are states expected to coordinate with tribes for all components (FOA page 7)? Does this have to be as a sub-grants or some other method of coordination?

A: Each state needs to decide the appropriate way to engage their tribal community in the application process. It is expected that applicants coordinate with tribes located in their state.
A letter of support that clearly describes this collaboration would be acceptable.

Q: How do we coordinate activities listed in this application with activities in communities that are awarded Recovery Act funding through CPPW if we don’t know who get funded since those award are made after the applications are due?

A: Your application should explain your plan to coordinate with CPPW funded communities as well as other communities within your state. You will be expected to coordinate with CPPW communities after funding is awarded.

Q: For this funding, are we going to have separate Project Officers?

A: We have not decided how technical and program support will be structured for these funds.

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Nutrition

Q: What nutrition interventions are allowed?

A: Strategies should follow the MAPPS framework of Media, Access, Pricing, Point of Decision Information, and Social Support. For more information on MAPPS, please refer to APPENDIX A of the funding announcement.

Q: What if we want to pursue nutrition interventions that are not in MAPPS?

A: Awardees may also propose evidence-based interventions not listed within the prescribed MAPPS menu, but must provide a strong justification of how the proposed intervention will have sufficient reach and potential impact consistent with the short and long-term goals of the initiative.

Q: Is there any requirement in this FOA similar to the United States Department of Agriculture (USDA) Food Stamp Nutrition Education or Women, Infants and Children (WIC) programs, in particular their not allowing negative nutrition messages about sodas or junk foods?

A: There is currently no similar requirement in this FOA to USDA’s messaging requirement. States are encouraged to be aware of these potential issues and plan their program accordingly.

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Physical Activity

Q: What physical activity interventions are allowed?

A: Interventions should follow the MAPPS framework of Media, Access, Pricing, Point of Decision Information, and Social Support. For more information on MAPPS, please refer to APPENDIX A in the funding announcement.

Q: What if we want to pursue interventions that are not in MAPPS?

A: Awardees may also propose evidence-based interventions not listed within the prescribed MAPPS menu, but must provide a strong justification of how the proposed intervention will have sufficient reach and potential impact consistent with the short and long-term goals of the initiative.

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Tobacco

Q: Do we still have to collaborate with the other programs in the collaborative FOA?

A: Yes. This FOA does not invalidate the current collaborative cooperative agreement.

Q: The FOA says that media that exclusively promotes availability of quitlines are not allowable. What types of ads and promotions should we use if we can't spend on advertising the quitline?

A: This FOA recommends using media designed to motivate quitting among all smokers, including those who may not seek quitline assistance.

Q: The quitline limits funding on NRT to 5% of the total, but NRT is what we really need. Can we justify higher NRT spending?

A: No. Funding for NRT is limited to 5% of total funding for the quitline.

Q: The Collaborative FOA, DP09-901, does not allow us to purchase NRT. However, under this supplement, purchase of NRT is permissible. Does this mean we can now use our Collaborative funds for NRT?

A: No. Activities and budgets for this supplemental funding announcement must be tracked and reported separately.

Q: How does this relate to what states may be expected to do for FDA?

A: This initiative is separate from possible FDA activities.

Q: We already have a smoke free policy for businesses and schools—can we work on a smoke free policy for housing?

A: You can use a strategy other than those listed in the MAPPS table, but must provide justification of strong evidence and broad impact.

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Organizational Chart

Q: Do we need to submit an organizational chart?

A: No, you do not need to submit an organizational chart.

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Letters of Support

Q: What letters of support are required?

A: A letter of support from the Governor must be included with the application.

Q: Are other letters of support from partner agencies and organizations required:

A: No other letters of support are required. However, states will need to include evidence regarding state partnerships and collaboration with other agencies and programs.

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