STD AAPPS FOA Frequently Asked Questions
Evaluation, Work Plan, and Performance Measure Plan
1. Are applicants required to complete and submit the work plan template posted on the STD AAPPS resource page, or is the template meant to serve as a guide?
Yes, CDC expects all applicants to complete and submit the provided work plan template as a PDF attachment.
CDC is working to harmonize evaluation and performance measurement with the work plan to reduce paperwork.
CDC is interested in your feedback on the template; please share any concerns via email (STDAAPPSFOA@cdc.gov).
There will also be a webinar on Thursday, July 11, 2-3 pm (ET) to discuss the work plan template as well as the FOA program evaluation requirements.
For more information about the webinar, visit the STD AAPPS web page: http://www.cdc.gov/std/foa/aapps/default.htm (July 9, 2013)
2. The FOA suggests that the Awardee Evaluation and Performance Measurement Plan is not meant to be submitted with the initial application but will be developed later, during year one of the project period. Please confirm that only the Applicant Evaluation and Performance Measurement Plan is to be submitted with the initial application and not the Awardee Plan.
Applicants should focus only on the Applicant Evaluation and Performance Measurement Plan during the application process.
The Awardee Evaluation and Performance Measurement Plan is not part of the initial application (done during 1st year of grant).
This information is noted in the FOA so that applicants are aware that, if awarded funds, a more detailed Evaluation and Performance Measurement Plan will be required as a work product for the cooperative agreement. (July 9, 2013)
3. The Project Narrative/Organization Capacity of Awardees to Execute the Approach section of the FOA states applicants should have a strong evaluation and performance measurement plan. Should an evaluation and performance measurement plan be includedin the Evaluation and Performance Measurement section instead?
The Evaluation and Performance Measurement section in the review criteria describes how the Evaluation and Performance Measurement Plan will be scored.
Under the Organizational Capacity section, applicants are scored based on their ability to execute the plan, not the plan itself. (July 9, 2013)
4. What is the relationship between the Program Narrative and the Work Plan? We are concerned that there will be a duplication of the explanation as it is difficult to discuss our program’s outcomes, strategy and evaluation without having our objectives in the same place.
While there may be some duplication between sections of the Program Narrative and Work Plan, duplication should be minimized in order to keep within the page limit of the narrative portion and to avoid unnecessary effort.
The Program Narrative could offer a broad description of the content in the Work Plan. The narrative could reference the Work Plan as appropriate.
The Program Narrative could also provide additional information that the template does not provide sufficient space for, particularly related to the rationale for selecting certain program strategies in general, barriers, plans for later years, and any other contextual information applicants feel would be useful. (July 9, 2013)
5. It is clear in the FOA that we can use Year 1 to conduct the assessment and develop an approach for our activities. However, it seems as if a listing of programmatic activities is required for the Work Plan for Year one. Should applicants list the activities that we know we will conduct during Year one and state that we will reassess whether these activities will be scaled up, reduced, or remain the same after a thorough assessment is conducted? Or, does the Work Plan for Year one describe the assessment activities that will be conducted in order to develop a program plan for Years two through five?
The Work Plan should focus on those activities that the applicant plans to carry out in Year one that aligns with those outlined in the FOA.
The section of the template that relates to ‘Plans for years 2-5’ can include some information about intentions to re-assess certain activities.
The narrative portion of the application related to Evaluation and Performance Measurement is also an appropriate place to discuss, in more detail, applicant plans to assess particular programmatic activities in Year one and determine what direction they should take. (July 9, 2013)
6. What size paper is allowed for the Work Plan? The template defaults to printing on legal size paper. Are applicants permitted to use legal size paper towards the 20-page maximum, should the template be reduced to fit on 8.5 x 11 inch paper?
The applicant must submit all application attachments using a PDF file format when submitting via www.grants.gov.
For the Work Plan attachment only, the pages in the PDF can be legal sized. Applicants can reduce the size of the Work Plan template to letter sized, if they choose.
For all others documents required to be submitted, as listed in the FOA, the PDF should be letter size. (July 9, 2013)
7. Should applicants list the activities included on the Work Plan verbatim and transfer them into the table under Year one activities?
Applicants should not copy the activities verbatim into the Work Plan tables. The Work Plan row entries for each of the tables should be more detailed than the activities listed above each table. CDC is not looking for great detail, but at least more than what each required activity says. The cover page to the Work Plan document instructs applicants to list up to 3-4 objectives or activities per required item.
The first column of each Work Plan table asks applicants to reference which required activity a proposed activity or set of activities relates to. That cross-reference should be enough to show how proposed activities or objectives align with the required items.
To further clarify these issues, please reference the example provided on the FOA resource website and plan to attend the webinar on July 11 related to responding to the Work Plan and Evaluation and Performance Measurement sections of the STD AAPPS FOA. (July 9, 2013)
8. Can CDC clarify expectations related to developing an evaluation plan? Specifically, is the expectation that a global (e.g., program science) plan be proposed or a general approach to evaluating individual interventions that lack an evidence- or practice-base? Alternatively, is the expectation that each new program include a detailed evaluation component?
For the application process, applicants need to describe an evaluation plan, following the questions provided in the FOA related to “Applicant evaluation and performance measurement strategy.” The Work Plan template also includes components related to evaluation. Completing those two sections are sufficient for the application process.
In the narrative portion of the application related to evaluation and performance measurement, applicants can describe their general approach to evaluation, as well as how they plan to focus their evaluation efforts.
It is not expected that every single program or activity has a detailed evaluation plan. Part of the process of developing a fuller evaluation plan will involve making decisions about what parts of the program most need evaluation. Applicants that already have a sense of how they would focus their efforts should describe that in the narrative portion of the application.
Awardees must provide a detailed global STD AAPPS evaluation and performance plan within the first year of funding, including the development of program performance measures.
This plan should be developed by awardees with support from CDC staff as part of first year activities and will be an iterative process.
Since evaluation including performance measurement is an important component of the STD AAPPS FOA for the entire project period, funds should be allocated for evaluation expertise through personnel or contracts, as appropriate to the project area. (July 9, 2013)
9. Given that the required policy activity #1 says “monitor and evaluate impact” and #2 is to educate stakeholders on the “positive potential or proven impact of policies,” what kind of evaluation is expected? Is it acceptable to conduct process evaluation in #1? For policy required activity #1, what is considered “relevant policies?”
To determine whether a policy achieved its intended goals, programs are expected to conduct outcomes evaluation.
The evaluation may include policies that will impact any or all of the outcomes identified in the sequence presented in the logic model (i.e. short/medium- and long-term outcomes), including:
a) changes in community and provider knowledge of STD-related policies);
b) increased community screening and treatment;
c) changes in the environment (e.g. increase access to care or improved integration of STD prevention into clinical care; and
d) changes in trends in morbidity (e.g. reduced incidence of chlamydia, gonorrhea, and syphilis) and their sequelae.
Relevant policies are those that may impact morbidity and mortality directly or indirectly, for example policies that improve access to STD prevention and treatment services for populations at risk. (July 9, 2013)
10. When are the detailed evaluation and performance measure plans due?
A due date for the detailed evaluation and performance measure plans has not yet been determined.
The detailed evaluation and performance measure plans will be developed and finalized as soon as is reasonable depending on the awardees initial plan and CDC input.
Optimally, they will be completed by the middle of year one, so that evaluation and performance measurement activities can be implementing during part of year one. (July 9, 2013)
11. Which year of data should applicants use as baseline data for the STD-AAPPS application?
For any baseline data provided in the application (e.g., as part of the rationale for some Work Plan activities), applicants should use the latest annual data available, which we anticipate is 2012 figures.
Performance measures will be further developed as part of the evaluation and performance plan during 2014, the first year of this project. As part of this process, applicants will collect data for (at least part of) 2014, for both the proposed project area’s performance measures and national outcome measures. (July 9, 2013)
12. When will the new national performance measures be released and how close do they mirror the examples provided in the Evaluation and Performance Measurement section of the FOA?
CDC will launch a process to obtain input on a set of national AAPPS outcome measures soon after funding has been awarded.
The process is intended to be collaborative with funded project areas and NCSD and thus will likely take a few months.
It is not clear how closely they will reflect the examples provided in the FOA with the exception of the need to measure the number of females who are screened using funds from this cooperative agreement including the number uninsured and underinsured and the number of new HIV infections identified as the result of STD prevention efforts supported by this cooperative agreement. These will be defined for Project Areas after award. (July 9, 2013)
13. What are the total points for the Evaluation and Performance Measurement section? The Evaluation and Performance Measurement states 15 points and the sub-section, Evaluation Plan states 10 points. Not all the points are accounted for.
The Evaluation and Performance Measurement section is correct: 15 points.
The sub-section, Evaluation Plan should read 15 points and encompasses performance measurement. (July 9, 2013)
14. Is there a Work Plan template for the Part B- GISP application?
No, CDC has not provided a work plan template for Part B of the application. However, a work plan is required as part of the Part B GISP application. (July 11, 2013, updated August 14, 2013)
15. The organizational capacity section in the FOA states, “readiness to establish contracts in a timely manner” is necessary. What is the expectation for timeliness?
The contract time period should be within the budget/project period. Therefore, based on the scope of work, the applicant should plan to procure the contract so that the work is scheduled for completion prior to or at the end of the budget/project period. (July 11, 2013)
16. May a suggested activity be substituted for a required activity if a required activity is not feasible with available resources?
If a required activity is not feasible with available resources, a detailed explanation must be provided as to why not.
A suggested activity may be included, if the other minimum activity requirements of STD AAPPS have been addressed and funds remain to support the implementation and evaluation of the suggested activity.
The suggested activity must be an essential public health capability or implementation of an effective intervention that can be brought to scale with population impact.
A justification as to why this suggested activity is a local priority and how it fits into the overall awardee’s STD prevention program approach must be provided. (July 11, 2013)
17. If a project area is only allowed to fund certain counties rather than all counties, would they only be required to work with Tribal Governments in those funded counties?
Federally Recognized Tribal governments are Indian Tribes with whom the Federal Government maintains an official government-to-government relationship; usually established by a Federal treaty, statute, executive order, court order, or a Federal Administrative Action. The Bureau of Indian Affairs (BIA) maintains and regularly publishes the list of federally recognized Indian Tribes.
Awardees are required to work directly with Tribal Governments in their project area. The FOA notes requirements related to working with Tribal Governments, "At a minimum, applicants must describe their plans and provide a timeline to work with and/or support Tribal Governments, if there are any in their project areas.“
Tribal Governments should be considered full partners during the design and implementation of programs supported with DSTDP funds.
In accordance with the United States Department of Health and Human Services (HHS) Tribal consultation policy it is the responsibility of states (or other funded programs) to consult with Tribes when HHS has transferred the authority and funding for programs to state governments that are intended to benefit Tribes.
The applicant must address how they are proposing to work with and support Tribal Governments, regardless of whether they are in funded counties or not.
It should also be noted that awardees are not prohibited from funding all counties but resources should be matched with burden of disease and need. Thus, funds should be directed to counties with the greatest burden and need. (July 11, 2013)
18. If a jurisdiction has already accomplished an activity that is required in the FOA, are they required to repeat the activity, report on what has already been achieved, or propose a slightly different but related activity that builds on work already completed?
If activities are already completed, report on what has been achieved and how it will be maintained.
Resources can then be directed to related activities that build on the work completed or to alternative priority activities. (July 11, 2013)
19. How much do you expect applicants’ evaluations, being conducted with minimal resources, to inform programmatic decisions at our state or a national level?
CDC does not expect funded project areas will independently launch major evaluation initiatives that will assess long-term outcomes (e.g., decreased incidence).
Smaller scale evaluations are encouraged and expected; these help evaluate smaller components of your project, looking at whether and how certain outputs were achieved and, in some cases, some shorter-term outcomes (e.g. increased screening rates).
Quality improvement efforts are also expected and are in the same spirit. CDC will direct some of its own evaluation resources towards tracking short/long term outcomes as well. In fact, CDC is planning that now and hopes to collaborate with some project areas on this area of evaluation. (July 22, 2013)
20. Should applicants include the FOA required activities and suggested activities on the Work Plan? I understand applicants will have their own. But do you want to see them at the top of the work plan like the template?
If space permits, applicants are advised to leave the activities listed at the top of each table in the template. If you are adding an activity, you do not also have to add an item to the list that appears at the top of each table. However, please make it clear on any new Work Plan table where that set of objectives fit. The application narrative should also explain and justify any additional activities and how they fit into the FOA’s activity domains. (July 22, 2013)
21. What are the required activities for an applicant whose jurisdiction is not considered high morbidity for gonorrhea?
The applicant should first document that the entire jurisdiction is not a high morbidity area, and does not contain any major metropolitan service areas that meet the definition of a high gonorrhea morbidity area. Activities should include the following:
- Establishing an outbreak response infrastructure to respond to any emerging threats is essential for all STD prevention programs.
- Awardees in project areas not considered high gonorrhea morbidity, should be able to respond and investigate suspected gonorrhea treatment failure cases and their partners and have a laboratory with gonorrhea culture capacity.
- Keeping providers informed of current STD treatment guidelines recommendations including recommended gonorrhea treatment is an important activity and falls under the required policies activities.
- Monitoring effective treatment of STDs (including gonorrhea cases) through surveillance activities is recommended and should be done as STD surveillance systems are strengthened.
(July 22, 2013)
22. We agree that the four priority activities under the “Assurance/Screening and Treatment of Individuals per CDC Guidance” section of the STD AAPPS FOA are very important for a quality STD Program but we are concerned that we will have difficulty complying with them. Three of the priority activities (i.e. increase chlamydia screening among 15-24 year old females; increase syphilis and rectal gonorrhea screening in high volume HIV providers; increase proportion of gonorrhea patients correctly treated) hold applicants responsible for individual physician/provider behavior. While grantees can certainly attempt to change this behavior, ultimately it is not within our control. How should we address this?
- STD prevention programs will need to develop collaborations with Medicaid programs, FQHCs and HIV clinical settings funded by HRSA or with others in the Health Department working with these providers to facilitate the assessment of chlamydia screening among young females and STD screening rates among MSM.
- The goal over the project period is to work with electronic health record systems or other administrative data systems to best monitor screening rates.
- CDC will share best practices and provide technical assistance for programs that need assistance with this activity.
(July 22, 2013)
23. One of the four priority assurance activities is, “Increase CT screening rates among young females (15–24 years) enrolled in Medicaid programs, and seen in Title X and other family planning clinics, as ideally measured by the CT HEDIS measure.” The HEDIS measure is for women aged 16–24. Why is there an age discrepancy?
CDC recommends using the latest HEDIS measure for standardization purposes, recognizing that it does not include 15-year-olds (and recognizing it often also includes 25-year-olds). At the same time, CDC encourages project areas to include 15-year-olds in their screening efforts, given burden of illness among that age also. (July 30, 2013)
24. Under the Assurance/Screening and Treatment of Individuals per CDC Guidance section of the FOA, a suggested activity is, “increase syphilis and rectal GC screening rates among MSM seen in setting providing health care to MSM.” Is CDC collaborating with HRSA to adjust the core clinical measures used by Ryan White programs?
Yes, CDC is trying to collaborate with HRSA to adjust the core measures. (July 30, 2013)
25. Since the FOA requires activities associated with HIV, what portion of the funding was determined with HIV-related weighting?
Only the three priority STDs (chlamydia, gonorrhea, and syphilis) were used to determine the formula. HIV-related data was not used as a factor. However, HIV funding represents approximately 10% of the overall funding for each project area, and applicants may take that into consideration in their planning and application. (July 30, 2013)