U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention (CDC)

Integrating Colorectal Cancer Screening within Chronic Disease Programs

 

Announcement Type: New – Type 1

Funding Opportunity Number: CDC-RFA-DP09-903

Catalog of Federal Domestic Assistance Number: 93.283    

Key Dates:

Letter of Intent Deadline: March 11, 2009

Application Deadline: April 10, 2009

 

I. Funding Opportunity Description

Authority: This program is authorized under section 301(a) of the Public Health Service Act, [42 U.S.C. section 241(a)], as amended.

 

Background: Colorectal Cancer (CRC) is the second leading cause of cancer-related deaths in the United States, following lung cancer (1). Screening for CRC allows for the prevention of colorectal cancer, through the identification and removal of precancerous polyps, and for early detection of cancers. Strong scientific evidence indicates that regular screening is effective in reducing CRC incidence and mortality (2-6). Based on the evidence, the US Preventive Services Task Force (USPSTF) recommends regular CRC screening for average-risk persons beginning at age 50 (http://www.ahrq.gov/clinic/uspstf08/colocancer/colors.htm).

National survey data show that only approximately half of eligible adults have been screened for CRC according to recommended guidelines (8). A number of factors are likely contributing to low screening rates including those at the individual, provider, community, and system-level (9-12). Evaluation results from CDC’s Colorectal Cancer Screening Demonstration Project, funded in 2005, suggest that establishing community-based CRC screening programs is feasible and that multiple program models are viable (13). Results also suggest potential programmatic and cost benefits through integrating CRC screening programs with other chronic disease programs (14-15).

 

Purpose:

The purpose of the program is to establish and integrate evidence-based colorectal cancer screening programs with existing CRC screening programs and/or other cancer screening or chronic disease programs, in order to increase population-based CRC screening among persons 50 years and older, focusing on asymptomatic persons at average risk for CRC with low incomes and inadequate or no health insurance coverage for CRC screening. Long-term program goals are to attain state-, tribal-, or territorial-wide screening coverage for the eligible population, contribute towards increasing population-level CRC screening rates, and reduce health disparities in colorectal cancer screening, incidence, and mortality. This program addresses the “Healthy People 2010” focus area of Cancer, specifically to increase the proportion of adults who receive a colorectal screening examination. See: http://www.healthypeople.gov/Document/pdf/Volume1/03Cancer.pdf.  

 

No CDC Government Performance and Results Act (GPRA) measure currently addresses CRC screening.

 

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be reviewed.  For the definition of research, please see the CDC Web site at the following Internet address:  http://www.cdc.gov/od/science/regs/hrpp/researchDefinition.htm  

 

Special Guidance for Technical Assistance: Technical assistance will be available for potential applicants via a one-hour conference call. Two calls will be conducted, one morning and one afternoon, to accommodate varying schedules and time zones. The first technical assistance conference call will be conducted at 3:00 – 4:00 p.m. EST on February 17, 2009. Please call 1- 800-779-3181 and enter conference passcode 2469333. The second technical assistance conference call will be held at 10:00 – 11:00 a.m. EST on February 18, 2009. Please call 1-800-779-3181 and enter conference passcode 2469333. The purpose of the technical assistance conference call is to help potential applicants to:

Participation in a conference call is not mandatory. Potential applicants are requested to call in using only one telephone line. If during the call you need technical assistance, press *0 to speak to an operator. The Questions and Answers from the conference calls can be accessed through the Internet at http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/ or by contacting the program technical assistant contacts listed in section VII. Agency Contacts.

 

Recipient Activities:

Eligible applicants may apply for one of two unique funding categories: Comprehensive Colorectal Cancer Screening Programs or Surveillance of Publicly Funded CRC Screening Programs. Regardless of the funding category for which an applicant applies, all applicants must demonstrate that all program components described in the section below will be implemented, whether supported by CDC funding or other funding sources (e.g., state funding, private funding). An individual awardee’s performance will be measured only for those program components funded by CDC. However, CDC expects that high quality standards are met across all program components.

 

Comprehensive Colorectal Cancer Screening Programs

The first funding category, Comprehensive Colorectal Cancer Screening Programs, provides support for a colorectal cancer screening program designed to be integrated with other existing cancer screening or chronic disease programs wherever possible. The applicant must support each of the program components listed below (e.g., provision of screening and diagnostic follow-up, clinical and cost data collection and tracking, public education and patient recruitment, quality assurance and professional development), and may request CDC funds for all components if other funding sources have not been secured (e.g., state funding, private funding). The applicant is not required to request CDC funding for all program components if other resources have already been identified for some of the program components. However, in this funding category, the applicant must at least request funds for the following two program components: 1) provision of screening and diagnostic follow-up and 2) clinical and cost data collection and tracking to expand existing efforts.

 

Surveillance of Publicly Funded CRC Screening Programs

The second funding category, Surveillance of Publicly Funded CRC Screening Programs, is intended for applicants who have established state-wide colorectal cancer screening programs using other sources of funding (e.g., state funding, private funding), and are seeking resources to support program-related data collection and tracking. Under this funding category, the applicant may only request funds for the data collection (clinical and cost) and tracking component, number 6 under Program Components below.

 

Program Components for both Categories of Funding:

 

1. Program Management

a.       Establish specific, measurable, and realistic short-term (one year) and long-term (five year) objectives consistent with the purpose of this program announcement for the accomplishment of the program activities, including the establishment of realistic screening goals.

b.      Identify and maintain staff to manage the program. Core staff must include persons to manage the program, fulfill data management functions, and provide clinical consultation.

c.       As appropriate, integrate program management functions with existing CRC screening programs and/or other cancer screening or chronic disease programs to improve the effectiveness and efficiency of public health programs and services. 

d.      Convene a medical advisory board (MAB) to provide oversight of the quality of screening services delivered throughout the five year funding period. MAB membership should reflect relevant expertise to CRC screening (e.g., primary care physicians, endoscopists, oncologists, pathologists, radiologists, nurses, nurse practitioners, patient navigators).

e.       Establish any necessary contract(s), grants, or memoranda of agreements with program partners (e.g., health care providers) in a timely manner to assure service delivery.

f.        Develop a fiscal system that tracks and monitors program expenditures and ensures the accurate and timely reimbursement for services provided by the program.

g.       Ensure non-CDC resources (e.g. private funds or other public funding) are in place to support treatment for persons diagnosed with cancer through the program and those experiencing medical complications from screening and diagnostic procedures.

h.       Demonstrate readiness to begin delivering screening services within six months of award consistent with the CDC readiness checklist (http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/).

 

Performance will be measured by the extent to which the program 1) establishes and achieves specific, measurable and realistic objectives (including realistic, annual screening goals); 2) hires/identifies and maintains qualified staff; 3) increases efficiencies in program management and service delivery through sharing and leveraging resources; 4) establishes and maintains an active medical advisory board; 5) manages an effective service delivery network (e.g., primary care providers, endoscopists, patient navigators); 6) successfully completes program start-up and meets established readiness criteria, and 7) spends funding efficiently and effectively.

 

2. Provision of Screening and Diagnostic Follow-up Services

a.       Provide CRC screening and diagnostic follow-up services for the program priority population. The program priority population is: persons ages 50-64, asymptomatic and at average risk for CRC, with inadequate or no health insurance for CRC screening, and are low-income, typically at 200% or 250% of the Federal Poverty Guidelines (FPG). Regardless of the FPG level chosen by the awardee, CDC will evaluate program activities based on reaching the population at 200% of the FPG level. Awardees may define a demographic sub-population(s) of the program priority population for emphasized screening efforts. Awardees, in consultation with their medical advisory boards, will define “average risk.” Ineligible patients include those who have gastrointestinal symptoms, inflammatory bowel disease, or genetic syndromes associated with the development of colorectal cancer (e.g., familial adenomatous polyposis, hereditary non-polyposis colorectal cancer). Awardees must assure appropriate medical referral for these clinically ineligible patients.

b.      Collaborate with health care delivery systems that serve the priority population to assure that patients are currently enrolled with a primary care provider prior to receiving services through this program.

c.       Given the continued existence of an evidence-based menu of CRC screening tests, awardees will have flexibility in their selection of CRC screening tests with two important caveats: 1) awardees can only offer screening tests for which test availability has been assessed and capacity has been demonstrated; 2) awardees can only offer screening tests recommended by the U.S. Preventive Services Task Force (USPSTF) (http://www.ahrq.gov/clinic/uspstf08/colocancer/colors.htm) and approved by CDC for reimbursement.

d.      Offer a single screening test or multiple recommended screening tests. The selection of screening tests offered in the program may change over the five year period pending prior approval from CDC and availability of funds.

e.       Establish realistic, annual screening projections for the five-year program period taking into consideration the size of the eligible population and previous experience in providing CRC screening services. State-level estimates for the program priority population are available at the following website: http://www.census.gov/hhes/www/sahie/data/index.html

f.        Project a realistic and feasible five year increase in the CRC screening rate (number or percentage) among the priority program taking into consideration any related objectives established in the state, tribe, or territory’s comprehensive cancer control plan.

g.       Assure that patients scheduled for endoscopy (e.g., colonoscopy, flexible sigmoidoscopy) are clinically evaluated prior to the procedure.

h.       Implement a patient tracking and reminder system to support screening adherence, the provision of appropriate and timely follow-up of all abnormal screening results, and rescreening.

i.         Develop a plan and identify resources (e.g., financial, in-kind) to provide treatment for patients diagnosed with cancer through the program.

j.        Develop a plan and identify resources (e.g., financial, in-kind) to provide treatment for patients who incur an unanticipated medical complication from services offered within the program.

k.      When and where appropriate, integrate screening and diagnostic follow-up services with existing CRC screening programs and/or other chronic disease programs and partners to improve the effectiveness and efficiency of public health programs and services.

l.         Begin delivering screening services within six months of award.

 

Performance will be measured by the extent to which the applicant 1) meets the projected annual number of screens or the proportional increases in screening as set by the program; 2) maintains high screening and diagnostic adherence rates (i.e., fecal occult blood test (FOBT)/fecal immunochemical test (FIT) return rate; adherence rate for screening and diagnostic endoscopic procedures); 3) assures treatment for patients diagnosed with cancer in the program or who incur an unanticipated medical complication from services offered within the program; 4) successfully and effectively integrates screening and diagnostic follow-up services with existing CRC screening programs and/or other chronic disease programs, and 5) contributes to an increase in the colorectal cancer screening rate among the priority population.

 

3. Public Education and Patient Recruitment

a.       Build on existing local, state, and national public education efforts to increase awareness about CRC screening. Programs are encouraged to utilize campaign materials from CDC’s Screen for Life: National Colorectal Cancer Action Campaign (SFL), including (but not limited to) brochures, fact sheets, print and broadcast public service advertising, posters, and other promotional and educational resources. (See: http://www.cdc.gov/screenforlife). These materials may be localized for individual program use. Programs are encouraged to collaborate with the state, tribal or district department of health Screen for Life contact. Programs are also encouraged to implement evidence-based interventions recommended in the Community Guide to Preventive Services (See: http://www.thecommunityguide.org)

b.      Through program integration and partnership efforts (e.g., comprehensive cancer control program funding support), develop and implement outreach strategies to support patient recruitment that include a mix of broad-based activities and one-on-one outreach, using methods known to be effective in reaching the program priority population and demographic sub-populations for CRC screening.

c.       Through program integration and partnership efforts, develop and implement in-reach strategies to recruit existing patients enrolled in standing prevention or clinical services programs (e.g., National Breast and Cervical Cancer Early Detection Program, WISEWOMAN Program, Health Resources Services Administration’s (HRSA) federally qualified health centers, community health centers, Centers for Medicaid and Medicare’s (CMS) rural health clinics).

 

Performance will be measured by the extent to which the program 1) can demonstrate the appropriate and effective use of public education, outreach, and in-reach strategies; 2) meets the projected number of annual screens or the proportional increases in screening as set by the program; and 3) contributes to increasing CRC screening rates among the priority population.

 

4. Quality Assurance and Professional Development

a.       Establish standards, systems, policies, and procedures to maintain high quality services, including tracking and follow-up systems to assure the provision of appropriate and timely follow-up of all abnormal screening results and/or diagnoses of cancer.

b.       Modify/develop systems or policies to better support high quality CRC screening and related care based on an assessment and prioritization of needs.

c.        Develop or enhance initiatives to educate and train health professionals in the prevention, detection, and control of CRC, including the provision of high quality screening and follow-up care.

 

Performance will be measured by the extent to which the program 1) meets CDC’s screening quality indicators (See CRCSDP Policy Manual, Appendix 5 at http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/planning.htm); and 2) establishes and uses systems and policies/procedures to monitor and measure the quality of services provided and to take steps to improve when problems are identified.

 

5. Partnership Development and Maintenance

a.       Maintain a relationship with the CDC-funded comprehensive cancer control (CCC) implementation program(s) (and their coalitions) within the applicant’s geographic area served to ensure coordination and integration of program activities with related CCC activities, including alignment of CRC program activities with CCC plans.

b.      Develop and maintain collaborative partnerships with a diverse set of entities (e.g., patients, cancer survivors, community-based organizations, groups that serve or represent priority populations, human service agencies, local public health agencies, local and national voluntary agencies, public and private local businesses and employers, nonprofit agencies and institutions, medical providers and community health care system representatives, the CDC-funded National Breast and Cervical Cancer Early Detection Programs, the CDC-funded WISEWOMAN Programs, Health Resources and Services Administration’s (HRSA) federally qualified health centers, Centers for Medicare & Medicaid Services’ (CMS) rural health clinics) to support program implementation, enhance integration across all program components, and leverage program resources.

c.       For states, develop and maintain collaborative partnerships with local health jurisdictions (e.g., county, district) and with American Indians/Alaska natives (other than those funded under this program announcement) to increase geographic coverage and access to eligible populations.

d.      Develop and maintain collaborative relationships and data sharing agreements with central cancer registries to enable annual linkages of the clinical data and cancer registry data.

 

Performance will be measured by the extent to which the program 1) demonstrates a strong association with the CCC program/coalition; 2) demonstrates active collaboration and appropriate program integration with program partners; and 3) obtains a data sharing agreement with the cancer registries program.

 

6. Clinical and Cost Data Collection and Tracking

a.       Establish a patient data tracking system that supports adherence to the appropriate cascade of clinical services following the initial screening recommendation.

b.      Design or adapt a pre-existing data collection system in order to collect and report patient-level, clinical data to CDC. These data will include information on patient demographics, screening and diagnostic services provided, and clinical outcomes related to this program. Awardees will be required to submit these clinical data to CDC semi-annually. The submitted data will be similar to the data collected in the Colorectal Cancer Clinical Data Elements (CCDEs), a standardized clinical data set developed by CDC and used to monitor current CDC funded CRC screening programs, but will be modified for this program in an effort to reduce burden on awardees. The current CCDEs are available for review at the following website:  http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/planning.htm  The clinical data will be used to support on-going monitoring of the quality, timeliness, and appropriateness of services provided by the program and will adhere to current standards related to data-sharing, data security, and patient confidentiality. All data submitted to CDC must be de-identified. Awardees are required to submit these data on all persons who are screened through this program supported by CDC funds. Additionally, to measure population-level screening of the eligible population, awardees are encouraged to also submit these data on persons screened through other, publicly-funded organized screening efforts managed by an awardee in a given state, tribe, or territory supported by non-CDC funds.

c.       Collect and report cost-related data to CDC using a data collection instrument provided by CDC for program start-up and implementation periods. The cost data support analysis of cost and cost-effectiveness for the program. A description of the cost analysis currently used for the CRCSDP is available at the following website: http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/evaluation.htm .

 

Performance will be measured by: 1) the extent to which tracking and data collection procedures are in use and form the basis for monitoring and quality assurance processes; 2) the submission of timely and complete clinical and cost data as described above to CDC; and 3) the extent to which the awardee meets CDC’s screening quality indicators (See CRCSDP Policy Manual, Appendix 5 at http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/planning.htm).  

 

7. Patient Support Services

Programs will establish patient support or patient navigation services to assist patients through the screening and diagnostic testing process and facilitate access to medical care for persons identified with cancer. Staff should work with patients to overcome patient-specific and system barriers by providing the following kinds of support: education about CRC screening; instructions about proper completion and return of FOBT/FIT screening tests; assistance with scheduling appointments for endoscopic procedures; education about the required bowel preparation instructions; organization of transportation services; organization of translation services; completion of appropriate post-procedure follow-up with patients; and, for patients diagnosed with cancer, assistance with access to cancer treatment services. If appropriate, programs should integrate patient support services with similar services for other chronic disease programs.

 

Performance will be measured by the extent to which the program establishes a system for patient support to assure effective advancement of patients through each stage of the testing cascade (e.g., FOBT/FIT return rate, adherence rate for those referred to endoscopic services, timeliness and adequacy of patient follow-up, rate of clients initiating cancer treatment).

 

8. Program Monitoring and Evaluation

Collaborate with CDC in the monitoring and evaluation of the program through collection and reporting of clinical and cost data and in other evaluation efforts initiated by CDC. Programs are encouraged to design their own plan to conduct evaluation and on-going monitoring of their program and to use evaluation and monitoring data to improve the quality, effectiveness, and efficiency of program operations.

 

Performance will be measured by the extent to which programs 1) use objective, quantitative measures to demonstrate the accomplishment of program goals, objectives, and intended outcomes; and 2) use evaluation data as collected by CDC or the awardee for the on-going improvement of program implementation, policies, and future program priorities.

 

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

 

CDC activities for this program are as follows:

         Assist with design and implementation of program components (e.g., adaptation or development of assessment tools to determine patients’ level of risk and clinical eligibility, adaptation of existing data collection strategies and tools to be able to collect clinical and cost data to monitor program effectiveness and tracking).

         Provide patient and health care provider education materials from CDC’s Screen for Life: National Colorectal Cancer Action Campaign, such as brochures, fact sheets, medical office displays which can be adapted as necessary.

         Interpret current scientific literature and national colorectal cancer screening guidelines.

         Develop regular data monitoring feed-back reports based on clinical data submissions to support data use for quality assurance, program improvement, and program evaluation.

         Support data linkage with the awardee’s state or territorial cancer registry data. 

         Support improving the quality of the clinical and cost data.

         Conduct site visits as needed.

 

II. Award Information

Type of Award: Cooperative Agreement

CDC’s involvement in this program is listed in the Activities Section above.

Award Mechanism: Chronic Disease Control Cooperative Agreement U58               

Fiscal Year Funds: 2009

Approximate Current Fiscal Year Funding: $3 – 20 million

Approximate Total Project Period Funding: $15 – 100 million over five years

Approximate Number of Awards for each Funding Category:

Approximate Average Award for each Funding Category:

Floor of Individual Award Range: None

Ceiling of Individual Award Range: None

Anticipated Award Date: June 30, 2009

Budget Period Length: 12 months

Project Period Length: 5 years

Throughout the project period, CDC’s commitment to continuation of awards will be conditioned on the availability of funds, evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the Federal government. Awardees are expected to report clinical and cost data on all services provided through the program. Given data lags, some clinical and cost data will be reported after the project period.

 

III.1. Eligibility Information

III.1. Eligible Applicants

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

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.   

 

First Round of Competition

For the first round of competition for both funding categories of this program, eligible applicants will be limited to those that are uniquely positioned to develop, implement, and evaluate state-, tribal-, or territorial-wide population-based colorectal cancer screening programs that are integrated with other chronic disease programs. Applications receiving a quality score of 75 or above for either funding category will be considered for funding. 

Second Round of Competition
Pending the availability of funds, eligible applicants who received a score of 74 or lower for either funding category during the first round of competition, and all other applicants meeting the eligibility requirements listed at the beginning of the Eligible Applicants section, may re-compete during a single second round of competition, in the second program year only. Specific guidance with exact due dates for the second round of competition will be announced at a later date.

III.2. Cost Sharing or Matching

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

 

III.3. Other

Special Requirements:

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

 

IV. Application and Submission Information

IV.1. Address to Request Application Package

To apply for this funding opportunity use the application forms package posted in Grants.gov.

 

Electronic Submission:

CDC strongly encourages the applicant to 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.  Only applicants who apply on-line are permitted to forego paper copy submission of all application forms.

 

Registering your organization through www.grants.gov is the first step in submitting applications online. Registration information is located in the “Get Registered” screen of www.grants.gov. While application submission through www.grants.gov is optional, we strongly encourage you to use this online tool.

 

Please visit www.grants.gov at least 30 days prior to filing your application to familiarize yourself with the registration and submission processes. Under “Get Registered,” the one-time registration process will take three to five days to complete; however, as part of the Grants.gov registration process, registering your organization with the Central Contractor Registry (CCR) annually could take an additional one to two days to complete. We suggest submitting electronic applications prior to the closing date so if difficulties are encountered, you can submit a hard copy of the application prior to the deadline.

 

Paper Submission:

Application forms and instructions are available on the CDC Web site, at the following Internet address: http://www.cdc.gov/od/pgo/funding/grants/app_and_forms.shtm

 

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 can be mailed.

 

IV.2. Content and Form of Submission

Letter of Intent (LOI): 

Prospective applicants are asked to submit a letter of intent that includes the following information: 

 

Your LOI must be written in the following format:

 

Application:

Regardless of the category for which an applicant is requesting funds (Comprehensive Screening Programs or Surveillance of Publicly Funded CRC Screening Programs), all applicants must prepare a complete application consistent with the instructions below. A Project Abstract must be submitted with the application forms. All electronic project abstracts must be uploaded in a PDF file format when submitting via Grants.gov. The abstract must be submitted in the following format, if submitting a paper application:

 

The Project Abstract must contain a summary of the proposed activity suitable for dissemination to the public. It should be a self-contained description of the project and should contain a statement of objectives and methods to be employed. It should be informative to other persons working in the same or related fields and, insofar as possible, understandable to a technically literate lay reader. This Abstract must not include any proprietary/confidential information. 

 

A project narrative must be submitted with the application forms. All electronic narratives must be uploaded in a PDF file format when submitting via Grants.gov. The narrative must be submitted in the following format, if submitting a paper application:

 

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

 

Executive Summary (1 page)

Applicants should provide a clear, concise executive summary to include:

 

Program Capability (Up to 5 pages)

Applicants should provide the following information:

 

Organizational Support (up to 4 pages)

Applicants should provide the following information:

 

Description of Program Need (Up to 2 pages)

Applicants should describe the CRC cancer burden and background screening rates in their jurisdiction using population data, NPCR Cancer Registry/SEER data, and population screening rates (e.g., BRFSS data) as appropriate. The applicant should also describe barriers to CRC cancer screening services such as individual, system, and geographic constraints.

 

Identification of Priority Populations (Up to 3 pages)

Applicants should provide the following information:

 

Program Narrative (Up to 5 pages)

Applicants should provide a brief narrative addressing the following:

 

Program Workplan (Up to 5 pages)

Applicants should provide a workplan for the proposed budget period that includes specific, time-phased, and measurable short-term (one year) and long-term (five year) objectives consistent with the intent of this program announcement, including annual targets for screening. Specific activities and strategies that will be undertaken to achieve each of the proposed short-term objectives during the first budget period should be included in the workplan. The elements for each program component that are defined in the Activities section should be addressed in the workplan. The workplan should list staff responsible for each activity. Include a description of the evaluation measures to determine progress towards achieving workplan objectives.  These evaluation measures should include specific time intervals for reviewing progress towards achieving workplan objectives. Applicants are encouraged to use the Workplan Template, Appendix 1.

 

Evaluation (Up to 2 pages)

The applicant should describe existing or proposed evaluation activities that are in addition to the CDC supported monitoring and evaluation efforts (e.g., clinical and cost data collection and analysis). Describe who will be responsible for conducting evaluation activities and working with CDC on monitoring and evaluation activities.

 

Budget and Justification (narrative justification will not be counted toward application page limit)

·        Two persons to Atlanta, Georgia to participate in a reverse site visit to discuss program implementation progress and for consultation and technical assistance (two days, one trip per year.)

·        Up to two additional two-person trips to Atlanta, or other destinations, to attend or assist with national workgroups, task forces, or committees (one to three days.)

 

Additional information may be included in the application appendices.  The appendices will not be counted toward the narrative page limit.  This additional information could include:

 

Additional information submitted via Grants.gov should be uploaded in a PDF file format, and should be named:

 

The agency or organization is required to have a Dun and Bradstreet Data Universal Numbering System (DUNS) number to apply for a grant or cooperative agreement from the Federal government.  The DUNS number is a nine-digit identification number, which uniquely identifies business entities.  Obtaining a DUNS number is easy and there is no charge.  To obtain a DUNS number, access the Dun and Bradstreet website or call 1-866-705-5711. 

 

Additional requirements that may request submission of additional documentation with the application are listed in section “VI.2.  Administrative and National Policy Requirements.”

 

IV.3. Submission Dates and Times

Letter of Intent (LOI) Deadline Date: March 11, 2009

 

Application Deadline Date: April 10, 2009

 

Explanation of Deadlines: CDC requests that you send a LOI if you intend to apply for this program. Although the LOI is not required, is not binding, and does not enter into the review of your subsequent application, the LOI will be used to gauge the level of interest in this program and to allow CDC to plan the application review.

 

Applications must be received in the CDC Procurement and Grants Office by 5:00 p.m. Eastern Time on the deadline date. 

 

Applications may be submitted electronically at www.grants.gov.  Applications completed on-line through Grants.gov are considered formally submitted when the applicant organization’s Authorizing Organization Representative (AOR) electronically submits the application to www.grants.gov.  Electronic applications will be considered as having met the deadline if the application has been successfully submitted electronically by the applicant organization’s AOR to Grants.gov on or before the deadline date and time.

 

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

 

If submission of the application is by the United States Postal Service or commercial delivery service, the applicant must ensure that the carrier will be able to guarantee delivery by the closing date and time.  The applicant will be given the opportunity to submit documentation of the carrier’s guarantee, if HHS/CDC receives the submission after the closing date due to: (1) carrier error, when the carrier accepted the package with a guarantee for delivery by the closing date and time; or (2) significant weather delays or natural disasters.  If the documentation verifies a carrier problem, HHS/CDC will consider the submission as having been received by the deadline. 

 

If a hard copy application is submitted, HHS/CDC will not notify the applicant upon receipt of the submission.  If questions arise on the receipt of the application, the applicant should first contact the carrier.  If the applicant still has questions, contact the PGOTIMS staff at (770) 488-2700.  The applicant should wait two to three days after the submission deadline before calling.  This will allow time for submissions to be processed and logged.

 

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

 

IV.4. Intergovernmental Review of Applications

Executive Order 12372 does not apply to this program.

 

IV.5. Funding Restrictions

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

 

If requesting indirect costs in the budget, a copy of the indirect cost rate agreement is required.  If the indirect cost rate is a provisional rate, the agreement should be less than 12 months of age.  The indirect cost rate agreement should be uploaded as a PDF file with “Other Attachment Forms” when submitting via Grants.gov.

 

The recommended guidance for completing a detailed justified budget can be found on the CDC Web site, at the following Internet address:

http://www.cdc.gov/od/pgo/funding/budgetguide.htm.

 

IV.6. Other Submission Requirements

LOI Submission Address: Submit the LOI by express mail, delivery service, fax, or E-mail to:

Andrea Middlebrooks

Centers for Disease Control and Prevention

Division of Cancer Prevention and Control

4770 Buford Highway, MS K-52

Atlanta, Georgia 30341

Telephone: (770) 488-4242

Fax: (770) 488-4639

E-mail address: AMHall@cdc.gov

 

Application Submission Address:

Electronic Submission:

HHS/CDC strongly encourages applicants to submit applications electronically at www.grants.gov.  The application package can be downloaded from www.grants.gov.  Applicants are able to complete it off-line, and then upload and submit the application via the Grants.gov Web site.  E-mail submissions will not be accepted.  If the applicant has technical difficulties in Grants.gov, customer service can be reached by E-mail at support@grants.gov or by phone at 1-800-518-4726 (1-800-518-GRANTS).  The Customer Support Center is open from 7:00a.m. to 9:00p.m. Eastern Time, Monday through Friday. 

 

HHS/CDC recommends that submission of the application to Grants.gov should be prior to the closing date to resolve any unanticipated difficulties prior to the deadline.  Applicants may also submit a back-up paper submission of the application.  Any such paper submission must be received in accordance with the requirements for timely submission detailed in Section IV.3. of the grant announcement. The paper submission must be clearly marked:  “BACK-UP FOR ELECTRONIC SUBMISSION.”  The paper submission must conform to all requirements for non-electronic submissions.  If both electronic and back-up paper submissions are received by the deadline, the electronic version will be considered the official submission.

 

The applicant must submit all application attachments using a PDF file format when submitting via Grants.gov.  Directions for creating PDF files can be found on the Grants.gov Web site.  Use of file formats other than PDF may result in the file being unreadable by staff.

OR

Paper Submission:

Applicants should submit the original and two hard copies of the application by mail or express delivery service to:

     Technical Information Management – RFA 903
     Department of Health and Human Services       
CDC Procurement and Grants Office
2920 Brandywine Road, MS E-14
Atlanta, GA 30341

 

V. Application Review Information

V.1. Criteria

Applicants are required to provide measures of effectiveness that will demonstrate the accomplishment of the various identified objectives of the cooperative agreement.  Measures of effectiveness must relate to the performance goals stated in the “Purpose” section of this announcement.  Measures must be objective and quantitative and must measure the intended outcome.  The measures of effectiveness must be submitted with the application and will be an element of evaluation.

 

The application will be evaluated against the following criteria:

Comprehensive Colorectal Cancer Screening Programs

Program Capability (15 points)

(a) Overall preparedness: Does the applicant demonstrate the capability to carry out the proposed objectives of this program, including having relationships with key partners (e.g., clinical, health care system, public health agencies, community based organizations, local and national organizations) to support client recruitment and service delivery? Does the applicant demonstrate the capability to achieve readiness and initiate screening within six months of the award? Does the applicant demonstrate the capability to establish needed contracts, grants, and/or MOAs with program partners in a timely fashion?

(b) Prior performance:  Does the applicant demonstrate past success with similar screening programs? Does the applicant demonstrate past success with CRC screening programs, specifically? Does the applicant demonstrate past success in collecting and reporting CRC clinical and cost data to CDC?

(c) Program integration: Does the applicant demonstrate previous efforts of program integration?

(d) If the applicant is a Tribe, is a signed and dated tribal resolution(s) or letter of support from Board of Directors provided?

 

Organizational Support (20 points)

 (a) Management and staffing plan: Does the applicant provide a management plan that can reasonably be expected to facilitate the achievement of program goals and objectives and the resolution of problems? Does the applicant provide a staffing plan reflecting appropriate experience and expertise (e.g., program management, data management, clinical expertise) adequate to facilitate the achievement of program goals and objectives and the resolution of problems?

(b) Medical Advisory Board (MAB): Does the applicant describe how a MAB will be convened, the types of expertise that will be represented on the MAB, and the activities planned for the MAB?

(c) Fiscal system: Does the applicant describe a fiscal system that will adequately track expenditures and assure timely reimbursement of services provided by the program?

(d) Linkage with CCC: Is a linkage established with a CDC-funded CCC implementation program(s) and coalition? Does the applicant provide a letter of support from the CCC program/coalition providing details of its relationship to the applicant and commitment to ensuring linkages to CCC plan implementation?

 

Description of Program Need (5 points)

Does the applicant clearly articulate the need for the program and provide supporting data? Does the applicant describe the CRC burden in their jurisdiction using population data and NCPR Cancer Registry/SEER data as appropriate? Does the applicant also describe barriers to CRC screening services such as individual, system, and geographic constraints?

 

Identification of Priority Population (10 points)

(a)    Description of priority population: Does the applicant describe the priority population using population data, when available, and provide supporting data to reflect characteristics of the priority population? Are estimates of the eligible priority population provided and sources of estimates provided (e.g., census data)?

(b)   Screening projections: Does the applicant provide projections for the number of patients to be screened and/or rescreened for each of the five years according to test type? Are screening projections sound (i.e., based on past screening performance, estimated cost per person screened based on test type and previous screening experience) and ambitious?

(c)    Screening rates: Does the applicant provide a feasible five year projected increase in the CRC screening rate among the priority population, provide a baseline screening rate among the priority population, and describe the data sources used to establish that baseline (numerator data and denominator data)? Does the projected increase consider CRC related efforts supported across the state, not only by this program? Does the applicant provide a justification for the projection?

 

Program Narrative (25 points)

(a) Screening tests used: Are the screening and diagnostic tests selected adequately described, including a rationale for selection? Are the proposed tests consistent with USPSTF guidelines? Does the applicant describe adequate availability of selected tests and demonstrate the capacity to offer these tests?

(b) Health care systems: Does the applicant include a plan for collaborating with the health care delivery system to assure that patients are enrolled with a primary care provider prior to receiving services through the screening program?

(c) Treatment and complications: Has the applicant addressed how resources will be secured to support treatment costs if a cancer is detected, and how complications will be managed fiscally and clinically?

(d) Clinical data: Has the applicant described clinical data elements currently collected and described how the data will be gathered? Has the applicant provided information about how data will be secured and how patient confidentiality will be protected? Has the applicant described a plan to link data elements with comparable information in the state or territorial center cancer registry?

(e) Program integration: Does the applicant describe how the proposed program will be integrated with existing CRC screening programs and/or other chronic disease programs? Does the applicant include recent letters of support from relevant partners verifying their commitment to program integration activities with the proposed?

 

Workplan (20 points)

(a) Appropriate objectives: Are proposed short-term (one year) and long-term (five year) objectives specific, time-phased, measurable, realistic, related to identified needs, and consistent with the purpose of this program announcement? Do the objectives address program integration?

(b) Appropriate strategies: Does the applicant’s plan for achieving the proposed activities appear realistic and feasible and relate to the programmatic requirements and purposes of this program announcement?

 

Evaluation (5 points)

Does the applicant describe program evaluation and monitoring activities? Does the applicant describe how evaluation and monitoring results will be used for program improvement?

 

Budget with Justification (Not Weighted)

The extent to which the applicant provides a proposed budget that is reasonable, justified, consistent and in compliance with the program requirements. The extent to which the budget reflects an understanding that the costs of providing direct clinical and support services to eligible patients should form the core of the budget request. The extent to which additional funding, when available, is used to maximize the impact of federal dollars.

 

Surveillance Programs

Program Capability (30 points)

(a) Overall preparedness: Does the applicant demonstrate the capability to carry out the proposed objectives of this program, including having relationships with key partners (e.g., clinical, health care system, public health agencies, community based organizations, local and national organizations) to support client recruitment and service delivery? Does the applicant demonstrate the capability to achieve readiness and initiate screening within six months of the award? Does the applicant demonstrate the capability to establish needed contracts, grants, and/or MOAs with program partners in a timely fashion? Does the applicant demonstrate past success in collecting CRC clinical and cost data?

(b) Prior performance:  Does the applicant demonstrate past success with similar screening programs? Does the applicant demonstrate past success with CRC screening programs, specifically?

(c) Program integration: Does the applicant demonstrate previous efforts of program integration?

(d) If the applicant is a Tribe, is a signed and dated tribal resolution(s) or letter of support from Board of Directors provided?

 

Organizational Support (30 points)

 (a) Management and staffing plan: Does the applicant provide a management plan that can reasonably be expected to facilitate the achievement of program goals and objectives and the resolution of problems? Does the applicant provide a staffing plan reflecting appropriate experience and expertise (e.g., program management, data management, clinical expertise) adequate to facilitate the achievement of program goals and objectives and the resolution of problems?

(b) Medical Advisory Board (MAB): Does the applicant describe how a MAB will be convened, the types of expertise that will be represented on the MAB, and the activities planned for the MAB?

(c) Fiscal system: Does the applicant describe a fiscal system that will adequately track expenditures and assure timely reimbursement of services provided by the program?

(d) Linkage with CCC: Is a linkage established with a CDC-funded CCC implementation program(s) and coalition? Does the applicant provide a letter of support from the CCC program/coalition providing details of its relationship to the applicant and commitment to ensuring linkages to CCC plan implementation?

 

Description of Program Need (5 points)

Does the applicant clearly articulate the need for the program and provide supporting data? Does the applicant describe the CRC burden in their jurisdiction using population data and NCPR Cancer Registry/SEER data as appropriate? Does the applicant also describe barriers to CRC screening services such as individual, system, and geographic constraints?

 

Identification of Priority Population (10 points)

(a)    Description of priority population: Does the applicant describe the priority population using population data, when available, and provide supporting data to reflect characteristics of the priority population? Are estimates of the eligible priority population provided and sources of estimates provided (e.g., census data)?

(b)   Screening projections: Does the applicant provide projections for the number of patients to be screened and/or rescreened for each of the five years according to test type? Are screening projections sound (i.e., based on past screening performance, estimated cost per person screened based on test type and previous screening experience) and ambitious?

(c)    Screening rates: Does the applicant provide a feasible five year projected increase in the CRC screening rate among the priority population, provide a baseline screening rate among the priority population, and describe the data sources used to establish that baseline (numerator data and denominator data)? Does the projected increase consider CRC related efforts supported across the state, not only by this program? Does the applicant provide a justification for the projection?

 

Program Narrative (25 points)

(a) Screening tests used: Are the screening and diagnostic tests selected adequately described, including a rationale for selection? Are the proposed tests consistent with USPSTF guidelines? Does the applicant describe adequate availability of selected tests and demonstrate the capacity to offer these tests?

(b) Health care systems: Does the applicant include a plan for collaborating with the health care delivery system to assure that patients are enrolled with a primary care provider prior to receiving services through the screening program?

(c) Treatment and complications: Has the applicant addressed how resources will be secured to support treatment costs if a cancer is detected, and how complications will be managed fiscally and clinically?

(d) Clinical data: Has the applicant described clinical data elements currently collected and described how the data will be gathered? Has the applicant provided information about how data will be secured and how patient confidentiality will be protected? Has the applicant described a plan to link data elements with comparable information in the state or territorial center cancer registry?

 

Workplan (Not weighted)

(a) Appropriate objectives: Are proposed short-term (one year) and long-term (five year) objectives specific, time-phased, measurable, realistic, related to identified needs and consistent with the purpose of this program announcement?

(b) Appropriate strategies: Does the applicant’s plan for achieving the proposed activities appear realistic and feasible and relate to the programmatic requirements and purposes of this program announcement?

 

Evaluation (Not weighted)

Does the applicant describe program evaluation and monitoring activities? Does the applicant describe how evaluation and monitoring results will be used for program improvement?

 

Budget with Justification (Not Weighted)

The extent to which the applicant provides a proposed budget that is reasonable, justified, consistent and in compliance with the program requirements.  The extent to which the budget reflects an understanding that the costs of providing direct clinical and support services to eligible patients should form the core of the budget request. The extent to which additional funding, when available, is used to maximize the impact of federal dollars

 

V.2. Review and Selection Process

Applications will be reviewed for completeness by the Procurement and Grants Office (PGO) staff, and for responsiveness jointly by the Division of Cancer Prevention and Control and PGO. Incomplete applications and applications that are non-responsive to the eligibility criteria will not advance through the review process. Applicants will be notified the application did not meet submission requirements.

 

An objective review panel will evaluate complete and responsive applications according to the criteria listed in the “V.1.  Criteria” section above.  The objective review process will follow the policy requirements as stated in the GPD 2.04 at http://198.102.218.46/doc/gpd204.doc.  Objective reviewers will include CDC and other federal employees.

 

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

In addition, the following factors may affect the funding decision:

o       success in meeting the program standards and screening goals

o       effectively spent funds awarded for CRCSDP activities during the budget period

 

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

 

V.3. Anticipated Announcement Award Dates: May 22, 2009

 

VI. Award Administration Information

VI.1. Award Notices

Successful applicants will receive a Notice of Award (NoA) from the CDC Procurement and Grants Office.  The NoA shall be the only binding, authorizing document between the recipient and CDC.  The NoA will be signed by an authorized Grants Management Officer and emailed to the program director and a hard copy mailed to the recipient fiscal officer identified in the application.

 

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

 

VI.2. Administrative and National Policy Requirements

Successful applicants must comply with the administrative requirements outlined in 45 CFR Part 74 and Part 92, as appropriate.  The following additional requirements apply to this project:

 

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

 

CDC Assurances and Certifications can be found on the CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/grants/foamain.shtm

 

For more information on the Code of Federal Regulations, see the National Archives and Records Administration at the following Internet address: http://www.access.gpo.gov/nara/cfr/cfr-table-search.html

 

VI.3. Reporting Requirements

The applicant must provide CDC with an annual interim progress report via www.grants.gov:

1.      The interim progress report is due no less than 90 days before the end of the budget period. The progress report will serve as the non-competing continuation application, and must contain the following elements:

a.       Standard Form (“SF”) 424S Form.

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

c.       Budget Narrative.

d.      Indirect Cost Rate Agreement.

e.       Project Narrative.

 

Additionally, the applicant must provide CDC with an original, plus two hard copies of the following reports:

2.      Financial status report and annual progress report no more than 90 days after the end of each budget period.

  1. Final performance and financial status reports, no more than 90 days after the end of the project period.
  2. Final clinical and cost data submission no more than 90 days after the end of the project period.
  3. Recipients are required to submit the Colorectal Cancer Clinical Data Elements (CCDEs) to CDC semiannually - OMB Control No. 0920-0745, expiration 07-31-2010.
  4. Recipients are required to perform data linkages between CCDE data and the state/territorial central cancer registry as scheduled, in accordance with CDC specifications, to enhance the completeness and quality of data in both programs. Results from linkages should be used to:

·        update CCDE data with central cancer registry staging and final diagnosis data,

·        identify missing cancer cases either in the central cancer registry or the CRC screening program, and

·        reconcile differences between the two data sets.

These reports (other than the CCDE semi-annual submissions and annual data linkage) must be submitted to the attention of the Grants Management Specialist listed in the “VII. Agency Contacts” section of this announcement.

 

VII. Agency Contacts

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,

     Laura Seeff, MD
Department of Health and Human Services
Centers for Disease Control and Prevention
     4770 Buford Highway, MS K-52
     Atlanta, Georgia 30341.
Telephone: 770-488-3223
Email address: lseeff@cdc.gov

OR

Amy DeGroff, MPH
Department of Health and Human Services
Centers for Disease Control and Prevention
     4770 Buford Highway, MS K-52
     Atlanta, Georgia 30341.
Telephone: 770-488-2415
Email address: adegroff@cdc.gov

 

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

Veronica Davis, Grants Management Specialist
Department of Health and Human Services
     CDC Procurement and Grants Office
     2920 Brandywine Road, MS E-09
     Atlanta, GA 30341
     Telephone: 770-488-2743
     E-mail: vad4@cdc.gov

 

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

 

 

 

VIII. Other Information

Other CDC funding opportunity announcements can be found on the CDC Web site, Internet address: http://www.cdc.gov/od/pgo/funding/FOAs.htm.

 

Applicants may access the application process and other awarding documents using the Electronic Research Administration System (eRA Commons).  A one-time registration is required for interested institutions/organizations at http://era.nih.gov/ElectronicReceipt/preparing.htm

Program Directors/Principal Investigators (PD/PIs) should work with their institutions/organizations to make sure they are registered in the eRA Commons.

1.      Organizational/Institutional Registration in the eRA Commons

2.  Project Director/Principal Investigator (PD/PI) Registration in the eRA Commons: Refer to the NIH eRA Commons System (COM) Users Guide.

Note that if a PD/PI is also an HHS peer-reviewer with an Individual DUNS and CCR registration, that particular DUNS number and CCR registration are for the individual reviewer only. These are different than any DUNS number and CCR registration used by an applicant organization. Individual DUNS and CCR registration should be used only for the purposes of personal reimbursement and should not be used on any grant applications submitted to the Federal Government.

Several of the steps of the registration process could take four weeks or more. Therefore, applicants should check with their business official to determine whether their organization/institution is already registered in the eRA Commons.  HHS/CDC strongly encourages applicants to register to utilize these helpful on-line tools when applying for funding opportunities.


 

REFERENCES

  1. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 2003 Incidence and Mortality. Atlanta: U.S. Department of Health and Human Services, Center for Disease Control and Prevention and National Cancer Institute; 2007.
  2. Mandel JS, Bond, JH, Church TR, Snover DC, Bradley GM, Schuman LM, Ederer F. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 1993;328:1365-71.
  3. Mandel JS, Church TR, Bond, JH, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 2000;343:1603-7.
  4. Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS. A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 1992;326:653-7.
  5. Kronburg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard. Randomized study of screening for colorectal cancer with fecal-occult-blood test. Lancet 1996;348:1467-71.
  6. Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomized controlled trial of fecal-occult-blood screening for colorectal cancer. Lancet 1996;348:1472-77.
  7. United States Preventive Services Task Force. Available at: http://www.ahrq.gov/clinic/3rduspstf/colorectal. Accessed August 13, 2008.
  8. Shapiro JA, Seeff LC, Thompson TD, Nadel MR, Klabunde CN, Vernon SW. Colorectal cancer test use from the 2005 national health interview survey. Cancer Epidemiol Biomarkers Prev 2008;17(7):1623-30.
  9. Adams KE, Thorpe KE, Becker ER, Joski PJ, Flome J. Colorectal cancer screening 1997-1999: role of income, insurance and policy. Preventive Medicine 2004;38:551-557.
  10. Beeker C, Kraft JM, Southwell BG, Jorgensen CM. Colorectal cancer screening in older men and woman: qualitative research findings and implications for intervention. Journal of Community Health 2000;25(3):263-278.
  11. Friedemann-Sanchez G, Griffin JM, Partin MR. Gender differences in colorectal cancer screening barriers and information needs. Health Expectations 2007;10:148-160.
  12. Miller DP, Brownlee CD, McCoy TP, Pignone MP. The effect of health literacy on knowledge and receipt of colorectal cancer screening: A survey study. BMC Family Practice 2007;8(16).
  13. DeGroff, A, Holden D, Green SG, Boehm J, Seeff LC, Tangka F. CDC’s colorectal cancer screening demonstration project: Lessons learned from start-up from five unique program models. http://www.cdc.gov/pcd/issues/2008/apr/07_0205.htm. Accessed August 13, 2008.
  14. DeGroff A, Boehm J, Green SG, Holden D, Seeff LC. Facilitators and challenges to start-up of the colorectal cancer screening dmonstration program. Prev Chronic Dis 2008;5(2). http://www.cdc.gov/pcd/issues/2008/apr/07_0205.htm. Accessed August 13, 2008.
  15. Tangka FKL, Subramanian S, Bapat B, Seeff LC, DeGroff A, Gardner J, Ryerson AB, Nadel M, Royalty J. Cost of starting colorectal cancer screening programs: results from five federally funded demonstration programs. Prev Chronic Dis 2008;5(2). http://www.cdc.gov/pcd/issues/2008/apr/07_0202.htm. Accessed August 13, 2008.

 


 

Appendix 1: Workplan Template

 

Program Component: _______________

 

 

Goals For This Year:

 

Measures of Effectiveness

 

 

 

Objectives

 

Activities Planned To Achieve This Objective

 

 

Data

 

Timeframe for

Assessing Progress

 

Team Members Responsible

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


CDC Home Page: http://www.cdc.gov

CDC Funding Web Page: http://www.cdc.gov/od/pgo/funding/FOAs.htm  

CDC Forms Web Page: http://www.cdc.gov/od/pgo/funding/grants/app_and_forms.shtm