CDC-RFA-DP-23-0003: WISEWOMAN: Well-Integrated Screening and Evaluation of WOMen Across the Nation Frequently Asked Questions (FAQs)

Is the Work Plan meant to be uploaded as a separate attachment, or included in the Project Narrative? The list of attachments (required and optional) in the NOFO also does not call out the Work Plan as a distinct document, but the FAQ makes this somewhat unclear.

The Work Plan should be a separate document from the rest of the Project Narrative and uploaded as a separate attachment. To clarify, the Work Plan is not included in the Project Narrative’s 20-page limit.

 

The font size for the NOFO project narrative is font 12? The spacing is single-spaced. Is there a preferred theme font such as Arial or Times New Roman?

Font type is not specified, but the Project Narrative is limited to a maximum of 20 pages, single spaced, 12-point font, 1-inch margins, and all pages must be numbered.

 

Are there standard social determinants of health (SDOH) measures that will be required in the MDE? Will WISEWOMAN require the use of a specific SDOH measurement tool?

Applicants are encouraged to propose the use of the same social needs assessment tool across providers for consistency and data-driven decision-making. National health agencies and other credible sources offer social needs assessments for consideration. The required minimum data elements (MDEs) for this cooperative agreement are being prepared for Office of Management and Budget (OMB) approval. CDC will provide MDE guidance to successful applicants post award.

 

The Notice of Funding Opportunity (NOFO) does not mention required staffing. Are there required staff needed?

In the Notice of Funding Opportunity (NOFO), the following evaluation criteria for staffing, program management, and organizational capacity are provided:

• Evaluation and Performance Measurement (Section G. Executive Summary, b. Evaluation and Performance Measurement)

• • Applicants must demonstrate a clear plan to work with professional evaluators (either internal or external) to meet the evaluation and performance reporting requirements of this NOFO by identifying these efforts in the workplan, evaluation plans, and budget.
• Capacity (Section E., iii. Applicant’s Organizational Capacity to Implement the Approach)

• • Nature and scope of the organization’s work, organizational structure, and the capacities of staff who will implement cardiovascular or chronic disease programs, monitor program performance including hiring and contract execution, and taking necessary steps to address identified problems in a timely manner.
  • Existing or potential social support service organizations which includes a description of their experience addressing participants’ social service needs.
  • Experience working with partners to collect, report, and use program data, and address potential challenges.
  • Plans for partnering with community groups who represent the priority population, provide evidence-based and evidence-informed healthy behavior support services (HBSS), and refer participants to those HBSS.
• Program Management (Section E., iii. Applicant’s Organizational Capacity to Implement the Approach)

• • Proposed staff and entities responsible for key tasks, including building and maintaining a social services and support network, project leadership, implementing program strategies, monitoring progress, collecting data and preparing reports, budget review and monitoring, program evaluation, and communication with partners and CDC. Resumes for key staff must be included.
  • Process for recruitment and retention of a regional or local coordinator who can build a comprehensive network of social services and support to address identified social needs of program participants.

 

Are there no letters of support required?

As noted in the Notice of Funding Opportunity (NOFO), letters of support (LOS), memoranda of understanding (MOU), or memoranda of agreement (MOA) with a firm commitment from providers and partners that outline the relationship, needs, and resources provided should be included in the application. Please see section H., the Other Information section in the NOFO for requirements related to format and naming conventions.

 

Is there a funding opportunity for the innovation component of WISEWOMAN this grant cycle?

This iteration of WISEWOMAN does not have a separate innovation component.

 

Can individuals participate without bloodwork? Is bloodwork required and do participants have to be fasting?

The clinical assessment results are required during the cardiovascular disease (CVD) risk assessment to determine a participant’s risk for cardiovascular disease and to guide subsequent risk reduction counseling.  Fasting and non-fasting lab values are acceptable.

 

What does CDC consider evidence-based for lifestyle change programs in this Notice of Funding Opportunity (NOFO)? Will the Healthy Heart Ambassador Blood Pressure Self-Monitoring Program be eligible?

Lifestyle programs that are evidence-based for hypertension are supported by published literature. The Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA BPSM) Program is eligible to be proposed as a healthy behavior support service (HBSS).  CDC will provide technical assistance to successful applicants regarding HBSS post award.

 

Are integrated office visits required in the new Notice of Funding Opportunity (NOFO)?  What flexibilities exist in regard to timing for NBCCEDP screenings and WISEWOMAN initial screenings?

The initial baseline assessment may be an integrated office visit with the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).  Additionally, applicants should propose clear and detailed processes and systems describing how they intend to partner with NBCCEDP recipients to identify and leverage opportunities to enhance their work. CDC will provide additional guidance to successful applicants post award regarding integrated office visits with NBCCEDP.

 

Could we have a blank template for the work plan if we want to use?

A blank template is not available. A sample work plan format is provided in the Notice of Funding Opportunity (NOFO). If desired, applicants can recreate it. Applicants are not required to use the sample work plan format but are required to include all the elements. Applicants must name this file “Workplan Name of Applicant” and upload it as a PDF file. The Workplan is not included in the 20-page limit. CDC will provide guidance to successful applicants to finalize the work plan activities post award.

 

Do program participants have to meet the NBCCEDP eligibility, or do they have to be screened? Many NBCCEDP programs are doing navigation. Are navigated participants eligible for WISEWOMAN?  If eligibility is met, but their NBCCEDP screening is not paid for by the NBCCEDP but rather self-paid or paid by other funds. Are those participants still eligible?

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) determines eligibility; meaning if an individual is eligible for NBCCEDP, they are eligible for WISESWOMAN.  NBCCEDP navigated individuals are eligible for WISEWOMAN as eligibility requirements have already been determined.

 

Are the LOS and MOU part of the 20-page limit?

Letters of Support (LOS), Memorandum of Understanding (MOUs), and Memorandums of Agreement are not part of the 20-page limit. Please see section H. (Other Information) in the Notice of Funding Opportunity (NOFO) for requirements related to format and naming conventions.

 

Is the Work Plan included in the 20-page limit for the Project Narrative?

The Work Plan is NOT included in the 20-page limit for the Project Narrative.

 

What is specifically included in the cardiovascular disease (CVD) risk assessment? Is this the CVD risk assessment and measures taken as part of the NBCCEDP Visit (i.e., Blood Pressure, Height, Weight, Tobacco use) that are used to refer participants to WISEWOMAN?

During a cardiovascular disease (CVD) risk assessment (i.e., a clinical health assessment/screening) WISEWOMAN participants should be assessed for cardiovascular disease risk factors (e.g., blood pressure, height, weight, cholesterol, A1C). Based on clinical health and social needs assessment results, participants should receive risk reduction counseling and referral to appropriate clinical follow up, healthy behavior support services, and social services and support. Additional guidance will be provided to successful applicant post award.

 

What is included in complete screening results?

A complete clinical health and social services and support needs assessment will include a range of known cardiovascular disease risk factors and social risk factors that impact health. CDC will provide technical assistance to successful applicants post award.

 

Can recipients work with providers that do not have optimal systems in place to improve or control CVD? 

Applicants must focus proposed program work where the population experiences disparities in cardiovascular disease risk factors, morbidity, and/or mortality. WISEWOMAN program providers should have the capacity to implement WISEWOMAN strategies outlined in this NOFO to improve control of hypertension and other cardiovascular disease (CVD) risk factors in the eligible population. Additional guidance will be provided to successful applicants post award.

 

Can more items be added to the workplan that are not in the lettered items under each strategy? For example, Strategy 1 includes 1A, 1B, 1C, 1D, and 1E. Can applicants add 1F or should all activities be under the 5 lettered items?

At a minimum, applicants should propose activities that relate to the strategies outlined in the WISEWOMAN program logic model. A sample work plan format is provided in the NOFO. Applicants are not required to use it but are required to include all the identified work plan elements.

 

How is this Notice of Funding Opportunity (NOFO) different from the last WISEWOMAN NOFO?

A change from the previous NOFO is the inclusion of women from 35-64 years of age. Additionally, this NOFO focuses on addressing a participant’s social services and support needs to facilitate engagement with WISEWOMAN services and improve cardiovascular disease (CVD) related health outcomes.

 

Will this cooperative agreement always be on a September funding cycle?

The Period of Performance for CDC-RFA-DP-23-0003 is September 30, 2023, through September 29, 2028. Each Project and Budget Year will begin on September 30^th.

 

What are the formatting requirements for the Project Narrative and what components are required?

The Project Narrative must be a maximum of 20 pages, single-spaced, in 12-point font, with 1-inch margins, and with page numbers included. Content beyond the specified page number will not be reviewed. These requirements apply to all applicants. The Work Plan is NOT included in the 20-page limit for the Project Narrative. The page limit also does not include the additional attachments referenced in the Notice of Funding Opportunity (NOFO), such as the Project Abstract and Budget Narrative.

The Project Narrative should include the following components:

• Background.
• Approach (includes Purpose, Outcomes, Strategies and Activities, Collaborations, and Target Populations and Health Disparities).
• Applicant Evaluation and Performance Measurement Plan.
• Organizational Capacity of Applicants to Implement the Approach.

 

What information should be included in the Letter of Intent?

The Letter of Intent (LOI) should state the descriptive title of the proposed project along with the applicant’s assertion of its eligibility and intent to apply for the NOFO. The LOI should be sent via email to WISEWOMAN23-0003@cdc.gov no later than Monday May 1, 2023.

 

What should an applicant include in Letters of Support, Memorandums of Understanding (MOUs), or Memorandums of Agreement (MOAs)?

As stated in the Notice of Funding Opportunity (NOFO), Letters of Support, and MOUs or MOAs with a firm commitment from providers and partners are expected to be included in the application. These Letters of Support should be from organizations and providers that will have a role in helping to achieve specific NOFO activities and outcomes. These letters must state the role of organizations and clinics and specify how they will help the applicant achieve the goals and outcomes of the NOFO. Letters of support included in the application must be dated within 45 days of the application submission.

 

What types of data should be included in the Project Narrative? 

Applicants are expected to use data to propose criteria for selecting health systems and communities in which to work based on a robust analysis of overall health burden across population subgroups.  They are encouraged to use a variety of data and technologies to establish an achievable health equity goal. Applicants are required to describe their location of focus, using available data such as race, ethnicity, census geography, socioeconomic status, social vulnerability, health literacy, screening rates, and cardiovascular disease incidence, prevalence, and mortality. The use of Geographic Information Systems (GIS), or other geo-mapping tools, are required to identify priority populations where heart disease and stroke are prevalent.

 

Why do we submit the application through Grants.gov and not Grant Solutions?

All new applications are submitted through Grants.gov. However, Grants.gov and Grant Solutions systems are connected. Once an application is submitted in Grants.gov, it is received and reviewed in Grant Solutions.

 

What is a unique entity identifier (UEI) and how is it obtained?

A UEI number is a unique twelve-digit identification number assigned when an organization registers at SAM.gov. Current SAM.gov registrants have already been assigned a UEI and can view it at SAM.gov and Grants.gov.  An applicant without a UEI number must obtain one by registering at SAM.gov prior to submitting an application. Please refer to NOFO Section D., Application and Submission Information, for detailed registration and application instructions.

 

Does an organization’s UEI or SAM registration need to be renewed?

All applicant organizations must register at SAM.gov and will be assigned a Unique Entity Identifier (UEI). If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process may take 10 or more business days. SAM registration must be renewed annually. Additional information about registration procedures may be found at SAM.gov and in the SAM.gov Knowledge Base.

Who is eligible to apply for this Notice of Funding Opportunity (NOFO)?

Eligible applicants must be recipients of National Breast and Cervical Cancer Early Detection Program (NBCCEDP) funding, per Congressional statute, Title XV, Section 1509 of the Public Health Service Act (PHS Act) (42 U.S.C. 300n-4a). Section 1502 of the PHS Act (42 U.S.C. 300l) and the FY 2023 Consolidated Appropriations Act (Pub. L. 117-328, Div. H).

Under the NBCCEDP, WISEWOMAN is authorized to expand screening services to include cardiovascular risk. To receive WISEWOMAN services, WISEWOMAN program recipients must be NBCCEDP recipients; thus, only organizations that are currently receiving NBCCEDP funding may apply. Current recipients of the National Breast and Cervical Cancer Early Detection Program are available at: https://nccd.cdc.gov/dcpc_Programs/index.aspx#/1

 

We have selected a Bona Fide Agent for the Centers for Disease Control and Prevention (CDC) cancer funding in our state. Does this mean that the health department cannot be the lead applicant?

Eligibility is limited by Congressional statute, which states that an applicant must be a recipient of National Breast and Cervical Cancer Early Detection Program (NBCCEDP) funding. WISEWOMAN is authorized under NBCCEDP to expand screening services inclusive of cardiovascular risk. WISEWOMAN program participants must be eligible for NBCCEDP to receive WISEWOMAN services; therefore, only organizations that are currently receiving NBCCEDP awards may apply. CDC cannot decide who should submit the application for an organization. Check with your state to determine if your organization or Bona Fide Agent should submit the application. Current recipients of the National Breast and Cervical Cancer Early Detection Program are available at: https://nccd.cdc.gov/dcpc_Programs/index.aspx#/1

Can WISEWOMAN funds be used to engage women who are not yet NBCCEDP clients (i.e., engaging hard to reach into getting NBCCEDP and WISEWOMAN services)?

Applicants must propose a process to ensure any potential WISEWOMAN participants are connected to NBCCEDP services, prior to enrolling into WISEWOMAN.

 

Are applicants able to include women who do NOT fall in the age range? Or are not US citizens?

WISEWOMAN participants must be low-income individuals ages 35-64 who are uninsured or under-insured and who are eligible to participate in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

 

Can applicants request to serve eligible WISEWOMAN Program participants 30-64 years of age, rather than 40-64? 

Applicants are expected to include plans to serve participants in the age range of 35-64 years old.

 

Do WISEWOMAN Program participants need to be screened by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to be eligible for WISEWOMAN services?

WISEWOMAN participants must be low-income individuals ages 35-64 who are uninsured or under-insured and who are eligible to participate in NBCCEDP. Technical assistance regarding the flow of services between NBCCEDP and WISEWOMAN will be provided to recipients post award.

What definition or parameters are being used for bidirectional referral systems and what types of arrangements will count toward this requirement?  Some social services are unable to report back client participation information.  What is the expectation for referrals to these types of services?

The applicant is responsible for proposing clear and detailed processes or systems for identifying, enhancing, or building systems that facilitate provider and community bidirectional referrals that are appropriate and support medical follow up, healthy behavior support services (HBSS), and social services and support. A bidirectional referral or closed-loop mechanism should have the ability to document service utilization and associated participant outcomes as a result of the service.  CDC will provide additional technical assistance post award.

 

The Notice of Funding Opportunity (NOFO) states that WISEWOMAN may only offer services to individuals participating in the NBCCEDP program. Persons aged 35 – 40 are only eligible to participate in this program every 3-5 years, depending on their pap screening schedule. Considering this schedule, will individuals of this age group only be eligible for WISEWOMAN services every 3-5 years, too?

The WISEWOMAN priority population is low-income persons ages 35-64 years who are uninsured or under-insured and eligible to participate in National Breast and Cervical Cancer Early Detection Program (NBCCEDP). CVD risk assessments should be conducted during an integrated office visit with NBCCEDP when possible. Additionally, applicants are expected to partner with NBCCEDP recipients to identify and leverage opportunities to enhance their work. CDC will provide additional guidance to successful applicants post award regarding integrated office visits with NBCCEDP.

 

Can the cardiovascular risk assessment be based on self-reporting?  For example, using eligibility criteria for the Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA-BPSM) program to help assess risk and need for referrals?

Currently, self-reported values for clinical and laboratory data are not acceptable to report as part of the cardiovascular disease (CVD) risk assessment. Every program participant must receive a CVD baseline risk assessment and reassessment, interpretation of the results, and appropriate recommendations in accordance with national clinical care guidelines. The participant must receive CVD assessment information verbally and in writing using health literacy and plain language standards.

 

What is the WISEWOMAN program flow? 

In the program flow, shown below, health care providers assess individuals for cardiovascular risk. Based on risk factors and results from the patient-centered risk reduction counseling, individuals receive referrals to healthy behavior support services (HBSS). These include evidence-based lifestyle programs, health coaching, and community-based resources, that support bidirectional referrals, self-management, and lifestyle change.  Applicants are expected to work with health care providers that have systems in place to optimize control of hypertension and other cardiovascular disease (CVD) risk factors through the use of electronic health records and health information technology, delivery, system designs, decision support, and team-based care.  This program flow aligns with the program strategies of tracking and monitoring clinical measures, implementation of team-based care, and linking community and clinical services. As the participant progresses through the program flow, the participant’s clinical and social needs are assessed.  The participant may be referred to new or additional social services and support at any step of the program flow.

Do HBSS referrals need to be made to an external community-based provider? More specifically, if a clinical provider offers HBSS services to the target population are they able to refer to their own internal HBSS services, and can these referrals count toward objective 3B?

Applicants should propose a plan for working with partners and organizations who can provide evidence-based HBSS and social services and support networks and referral systems. There are no restrictions on the kind of partner providing these services; however, the applicant must clearly describe how any proposed partner will meet the requirements outlined in the NOFO. CDC will provide relevant assessments and final approval or denial to successful applicants post award.

 

Based on Objective 1B, is it required for providers conducting WISEWOMAN services to have an EHR?  Are small or rural clinical organizations that do not have electronic health records still eligible to participate in the program?

Applicants should propose clear and detailed processes and systems to ensure providers use standardized processes or tools to identify assess, track, address, and monitor the social needs of participants. Applicants should propose clear and detailed processes and systems to ensure providers increase use of electronic health records (EHR) and health information technology (HIT) to query, monitor, and track clinical and social services and support needs data for improved identification, management, and treatment of hypertension. Additional guidance will be provided to successful applicants post award.

 

What are the definitions for protocols (as referred to in PM #1) and standardized processes (as referred to in PM #2 and PM #3)?  How are these terms differentiated and what are the expectations for each?

Protocols, in reference to performance measure (PM) #1, should be thought of as a more formalized and institutionalized procedure utilizing EHR and HIT to query, monitor, and track clinical data to identify, manage, refer, and treat patients at risk of cardiovascular disease (CVD), particularly those with hypertension. Standardized processes, in reference to PM #2 and PM #3, should be thought of more as a series of standardized tasks, integrated into practice within a setting, to produce an action or outcome related to identification, referral, and utilization social services and support needs among participants. CDC will provide additional guidance to successful applicants regarding program implementation and performance measurement post award.

 

Does CDC have a comprehensive resource that identifies specific actions that can be taken to address heart disease, stroke, and other cardiovascular conditions?

CDC’s Division for Heart Disease and Stroke Prevention released the Best Practices for Heart Disease and Stroke: A Guide to Effective Approaches and Strategies. The Best Practice Guide includes 18 evidence-based strategies, highlighting the public health, economic, and health equity impacts of each strategy. The document also provides information and resources to support and guide strategy implementation, as well as policy and law-related considerations. Brief, setting-specific stories highlight examples of successful strategy implementation.

The Best Practices Clearinghouse is a complementary website designed to organize best practices resources that will aid in improving heart disease and stroke prevention as well as reducing health disparities. The purpose of the Best Practices Clearinghouse is to provide a centralized, sustainable system to national, state, local, and tribal public health leaders with a tool to access information and the ability to index and easily search for available resources. By providing better linkages between topics and the breadth of resources within the comprehensive Best Practices Clearinghouse, health systems and community organizations can make changes to eliminate barriers to quality care and improve the health of many people.

Notice: As of 5/1/2023, Download GIS Data for census tracts is not working properly. We are working to get this issue resolved as quickly as possible.

However, it remains possible to create and display census tract level maps [PDF – 377 KB] for social determinants of health, demographic, CVD prevalence, and risk factor data. It also remains possible to download all census tract level data as a table with the Export tool.

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In the NOFO, on page 3, it says: The use of Geographic Information Systems (GIS), or other Geo-mapping tools, will be required to identify priority populations where heart disease and stroke are prevalent and use data to propose criteria for selecting health systems and communities in which to work based on a robust analysis of overall health burden across population subgroups.  Does this mean that maps or other visuals should be included in the WISEWOMAN application? If not required, would it be allowable to include maps or other visuals?

Maps and other visuals are not allowable as separate attachments but may be included as part of the Project Narrative and included in the 20-page limit. In the Notice of Funding Opportunity (NOFO) under section H. Other Information, a list of acceptable attachments is included that applicants can upload as PDF files as part of their application at www.grants.gov.

 

Why is the use of Geographic Information System (GIS) so important in the CDC-RFA-DP-23-0003 WISEWOMAN NOFO?

• GIS uses a variety of tools and methods to merge complex data sets and information to create detailed geographical maps that can be used for problem solving and decision making.
• GIS uses CDC-recognized data sources at the census tract or neighborhood (block) level.
• GIS helps to advance health equity by focusing on geographies with the highest burden of disease.
• GIS helps to identify segments of the population who are disproportionally impacted by all conditions addressed in the NOFO.

 

What are some CDC Geographic Information Systems (GIS) or other Geo-mapping resources available to meet the NOFO requirements to identify priority populations and select health systems and communities?

The CDC Division for Heart Disease and Stroke Prevention has a series of online tools to create local-level maps of heart disease and stroke outcomes, as well as risk factors, socioeconomic conditions, health care facilities, sociodemographic populations, and more.  Here are two examples:

• Interactive Atlas of Heart Disease and Stroke: The Atlas contains a wide range of high-quality local-level data that can be easily mapped and downloaded. Mortality and hospitalization data are available by racial or ethnic group, gender, and age.  Socioeconomic and sociodemographic data are available down to the census tract level, and locations of health care facilities – such as stroke centers, Federally Qualified Health Care Centers, and emergency room services – are also available. Instructions for how to use the Atlas can be found here.
• Local Trends in Heart Disease and Stroke Dashboard: The Dashboard provides local-level data on temporal trends in heart disease and stroke mortality by racial or ethnic group, gender, and age. Visitors to the Dashboard can create and download maps and graphs charting recent increases and decreases in heart disease and stroke mortality in their communities.  Instructions for how to use the Dashboard can be found here.  The following is a recent manuscript from the American Journal of Public Health discussing dashboards: “Data Dashboards for Advancing Health and Equity: Proving Their Promise”: https://doi.org/10.2105/AJPH.2022.306847.

The NOFO states that programs and services can be supported, however, it doesn’t state what that means. Can applicants purchase screening supplies and hypertension self-management materials?

Applicants should propose activities to address CVD and associated risk factors, particularly hypertension and high cholesterol, in alignment with the WISEWOMAN legislative authority and the broad evidence-based, evidence-informed, required strategies detailed in the Notice of Funding Opportunity (NOFO). CDC will provide additional guidance to successful applicants post award regarding budget allocation and appropriate use of funds.

 

Can we pay for clinical services such as hypertension check-up sessions with a healthcare provider?

WISEWOMAN funds may be used for clinical assessment, management, medical follow-up, and HBSS referrals to improve cardiovascular health among participants. CDC will provide additional guidance to successful applicants post award regarding covered services and appropriate use of funds, with WISEWOMAN program funds being used only as the payor of last resort.

 

Can funds be used to pay for clinical screening tests for cardiovascular disease, such as cholesterol and blood glucose?

Yes, WISEWOMAN funds may be used for cardiovascular disease (CVD) risk assessments, inclusive of labs.  However, WISEWOMAN must remain the payor of last resort.  The only exception to this is when Indian Health Services (IHS) funds are available; in which case, IHS is the payor of last resort. CDC will provide additional guidance related to budget allocation and appropriate use of funds to successful applicants post award.

 

Are applicants allowed to fund vehicles for community health workers or outreach with this?

Purchasing vehicles is not permitted through this Notice of Funding Opportunity (NOFO).

 

Please explain more about the 10% administrative cost. Does this include indirect cost?

Indirect costs are not authorized under this Notice of Funding Opportunity (NOFO). As specified by PL 101-354, not more than 10% of cooperative funds awarded may be spent annually for administrative expenses. These administrative expenses are in lieu of and replace indirect costs [Section 1504(f) of the PHS Act, as amended].

 

Are non-Medicaid expanded states allowed to designate funds for direct services?

WISEWOMAN funds may be used for direct services for program participants; however, WISEWOMAN must be the payor of last resort. The only exception to this is when Indian Health Services (IHS) funds are available; in which case IHS is, the payor of last resort. Applicants should consult with their organization regarding any limitations to providing direct services.

 

Is the overall budget required to have a 60:40 split between direct services and non-direct services?

A 60:40 split between direct and non-direct services is not a requirement in this Notice of Funding Opportunity (NOFO).

 

Can the difference between the fair and reasonable cost of screening services and the amount the program will be paid be used as match (not treatment medical costs but those associated with screening)?

The match requirement may include third-party in-kind contributions, as well as expenditures from the applicant. The matching funds may be cash, in-kind or donated services or equipment. (See Section C. Eligibility Information, 4. Cost Sharing in the Notice of Funding Opportunity.)

Matching funds may not include:

• payment for treatment services or the donation of treatment services;
• services assisted or subsidized by the Federal government; or
• the indirect or overhead costs of an organization.

CDC will provide additional guidance to successful applicants post award to ensure their budgets align with the requirements of the Notice of Funding Opportunity (NOFO) and associated legislation.

 

Can funds be used to pay for units of time (e.g., community health workers (CHWs))?

Staff may be paid for time spent carrying out the duties related to implementation of the program. Details regarding staffing costs and plans should be included in the budget narrative. CDC will provide technical assistance regarding budget allocation and use of funds to successful applicants post award.

 

Regarding the budget- after we go to https://www.cdc.gov/grants/applying/application-resources.html, what do we select to get guidance on budget preparation?

Once you have navigated to the Application Resources web page at https://www.cdc.gov/grants/applying/application-resources.html, click on “CDC Budget Preparation Guidelines.” This will open a PDF document with details for the required budget categories.  Please note that per the authorizing legislation for the WISEWOMAN program [Section 1504(f) of the PHS Act, as amended], administrative costs are required in lieu of indirect costs for this Notice of Funding Opportunity (NOFO).

 

Are applicants allowed to include screening supplies, such as blood pressure monitors, rapid A1c machines, etc. in the budget narrative as line items?

Items related to the provision of direct services may be included within supplies. Any items proposed within the budget should be directly aligned with a program activity that advances the strategies as outlined in the Notice of Funding Opportunity (NOFO).  Final assessment and approval or denial will be provided by CDC post award.

 

Is CDC requiring out of state travel?

Travel to Atlanta is not required in year one of this Notice of Funding Opportunity (NOFO).

 

Can funds be used to develop and expand electronic health records (EHR) and health information technology (HIT) systems to include social determinants of health assessment and referral tracking?

Applicants should propose work with identified WISEWOMAN program providers that include processes and capacity to assess their systems’ ability to query, monitor, and track social services and support needs, and data for improved identification, management, and treatment of participants at risk of CVD.

 

If no bidirectional or closed loop referral back to the primary care provider is available from the referral entity (i.e., the social service organization has no system to get back to the program/provider on outcome), should the program budget for the cost to create processes at referral entities including purchasing/upgrading software for the referral entity or primary care provider EHR?

Applicants should propose to work with their partners to establish, maintain, coordinate, and track outcomes for all referrals to social support services. This should be clearly reflected in the Project Narrative and supported with letters of support or memoranda of understanding. Applicants should identify a state, regional, and local coordinator who will garner all social services and support needs for WISEWOMAN participant referrals and propose a system or process that will facilitate connections to other programs and resources.

 

What are some specific examples of what can be included as matching funds?

Matching funds must be tied to services or activities that directly benefit the WISEWOMAN Program.  Examples of matching funds include:

• Donated staff time paid for by non-federal funds.
• Donated staff time, or professional development provided by partners such as American Heart Association, American Lung Association, Department of State Parks and Recreation, and State universities.
• Donated memberships to health/wellness facilities.
• Donated materials or literature on heart health.
• Contributions to the cost of mailings.
• Donated media time for public education and awareness, and to promote WISEWOMAN.
• Donated services provided by local service providers.
• Uncompensated time providers/staff/volunteers spend in WISEWOMAN trainings and advisory meetings.

 

Can funds be used to purchase home blood pressure monitors?

Any proposal to purchase blood pressure monitors on a limited basis will require a very strong justification of how this will be part of a systematic, sustainable approach. Determination of appropriateness of such proposals will be made on an individual recipient basis post-award. As much as possible, leveraging other resources will be important to support this type of work.

 

Are we allowed to include indirect costs in the WISEWOMAN budget using our federally-negotiated indirect cost rate agreement?

As specified in Public Law 101-354, not more than 10% of the award may be spent annually for administrative expenses. These administrative expenses are in lieu of and replace indirect costs (Section 1504(f) of the Public Health Service (PHS) Act, as amended).  Successful applicants will receive recipient-specific guidance post- award to address required and recommended adjustments to budget allocations originally proposed during the application process.

 

Are applicants required to submit a budget for the first 12 months only?

Yes, an applicant is expected to submit a budget for the first 12-month budget period of the program only.

The answer to a previous question stated that there is some shared data between NBCCEDP and WISEWOMAN in the MDE fields.  Once recipients are awarded and reporting begins, will MDEs for NBCCEDP and WISEWOMAN be reported separately or combined as one submission?

Minimum data elements (MDEs) for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and WISEWOMAN are reported separately and are separate MDE submissions. CDC will provide additional MDE guidance to successful applicants post award.

 

What specific MDE are called out in social services and support needs?

The required minimum data elements (MDEs) to be collected and reported for this cooperative agreement are being prepared for review by the Office of Management and Budget (OMB). CDC will provide MDE guidance to successful applicants post award.

 

Where can applicants find a prior list of MDEs?

Prior minimum data elements (MDEs) may not be reflective of MDEs for DP23-0003. Key areas for required data collection include demographics, clinical values, health behaviors, risk reduction counseling, and participation in services.

 

What lab values are included in the CVD screening?

Lab values to calculate a cardiovascular disease risk score will be included in the minimum data elements (MDEs). The MDEs required to be collected and reported for this cooperative agreement are being prepared for review by the Office of Management and Budget (OMB). CDC will provide additional MDE guidance to successful applicants post award.

 

When will the minimum data elements (MDEs) will be submitted for public comment?

The MDEs required for DP-23-0003 are being prepared for Office of Management and Budget (OMB) approval. CDC will provide additional MDE guidance to successful applicants post award.

 

What data are required for the MDEs or for programs to track regarding referral and use of services?

The required minimum data elements (MDEs) for this cooperative agreement are being prepared for Office of Management and Budget (OMB) approval. CDC will provide additional MDE guidance post award.

 

Will any documentation on the Social Services and Support network referrals be required in the MDE? If so, what information will be required?  Will any specific information about referrals and outcomes be required at a participant level?                                                                                                          

Applicants should ensure WISEWOMAN participants are referred to social services and support networks that are tailored to the priority populations. Additionally, applicants should ensure a bidirectional or closed-loop referral mechanism is available to document utilization of social services and participant outcomes. The required minimum data elements (MDEs) for this cooperative agreement are being prepared for Office of Management and Budget (OMB) approval. CDC will provide additional MDE guidance post award.

 

What is the data collection mechanism required to collect and report? Will this data system be required to report data to the MDE?

Applicants must propose to establish, implement, and use a data system that collects all required minimum data elements (MDEs) and other program data for program monitoring and reporting MDEs.

 

What are the Minimum Data Elements (MDEs) collection and reporting requirements?

MDEs are a set of standardized data variables tailored to this Notice of Funding Opportunity (NOFO) and capture consistent and complete participant information throughout the WISEWOMAN program flow. These are used to describe, monitor, and assess individual and program progress. The MDEs required to be collected and reported for this cooperative agreement are being prepared for review by the Office of Management and Budget (OMB). Recipients will receive this information after OMB approval.

 

Are recipients required to develop a data system to capture Minimum Data Elements (MDEs)?

Recipients must establish, implement, and use a data system that collects all required MDEs and other program data for program monitoring and reporting.

 

Are WISEWOMAN and National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Minimum Data Elements (MDEs) linked?

Some of the MDE fields will contain shared data between NBCCEDP and WISEWOMAN. The MDEs required to be collected and reported for this cooperative agreement are being prepared for review by the Office of Management and Budget (OMB).

Are the elements listed within section “b. Evaluation and Performance Measurement, ii. Applicant Evaluation and Performance Measurement Plan” a requirement for the NOFO application or the Evaluation and Performance Measurement plan due within the first six months of the award?

The elements listed in the Applicant Evaluation and Performance Measurement Plan section should be included in the Evaluation and Performance Measurement Plan (EPMP) submitted as a part of the Notice of Funding Opportunity (NOFO) application. Recipients will be required to submit a more detailed EPMP within the first 6 months of award, as described in section F. Award Administration Information, 3. Reporting in the NOFO.

 

If the performance measure is new, one our program is not currently measuring, should the baseline be zero/zero percent, or should we report our best estimate?

For each measure, please provide an estimate of the baseline in your application. Post award, CDC will provide specific and detailed definitions for each performance measure.

 

For performance measures 1-4 and 6, should the denominator be all sites where a WISEWOMAN participant could be served, or a subset of provider sites funded to work on specific quality improvements activities?

The denominator for these measures should align with your proposed programmatic activities. Post award, CDC will provide specific and detailed definitions for each performance measure.

 

Is the evaluation and performance measure plan a narrative for the application? And then if awarded, it’s a more detailed table like plan/template?

Applicants will submit a draft Evaluation and Performance Measurement Plan (EPMP) as part of their application. Applicants may address each element of the Evaluation and Performance Measurement Plan in a format that works for your application. A table format or narrative format may be appropriate.  Please refer to the specific guidance on developing an EPMP in the Applicant Evaluation and Performance Measurement section. Six months after the award, with support from CDC, successful applicants will be required to submit a more detailed Evaluation and Performance Measurement Plan. Post award, CDC will provide more detailed guidance to successful applicants for developing this plan.

 

Is the Data Management Plan (DMP) required and included in the evaluation plan? Also is it part of the 20-page count?

Yes, the Data Management Plan (DMP) count towards the 20-page limit for the application Project Narrative. The Evaluation and Performance Measurement Plan (EPMP) and DMP are drafts. Successful applicants will have an opportunity to provide more detailed information six months post award.

 

With regard to performance measure #2, does the identification, assessment, tracking, and addressing of social services and support needs have to be carried out by a healthcare provider? We currently work with a community-based organization that is able to provide this service for our participants.

In addition to a healthcare provider, there are a variety of organizations that have the capacity to identify, assess, track, and address social services and support needs. Applicants should propose clear processes and systems by which they intend to engage with all identified entities and organizations. Participant referral to social services and support can occur at any point in the WISEWOMAN program flow.

 

For the strategies in the Evaluation and Performance Measurement Plan (EPMP), we are required to develop evaluation questions. Do these need to address the overarching evaluation questions?

The Evaluation and Performance Measurement Plan (EPMP) should address the overarching evaluation questions as described in the CDC Evaluation and Performance Measurement Strategy section. Applicants are also expected to develop recipient-specific evaluation questions that correspond to the overarching CDC core evaluation questions. Please refer to the specific guidance on developing an EPMP in the Applicant Evaluation and Performance Measurement section.

 

What are the Data Management Plan (DMP) requirements in terms of what is meant by disseminating findings to the public? For instance, if we intend to create fact sheets, evaluation snapshots, etc., and share them with partners and stakeholders, does this mean we would then need a DMP?

Please refer to Centers for Disease Control and Prevention (CDC) guidance on DMPs at https://www.cdc.gov/grants/additional-requirements/ar-25.html. Additional guidance and a template from National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) can be found at https://www.cdc.gov/chronicdisease/programs-impact/nofo/index.htm.

 

The Notice of Funding Opportunity (NOFO) says that the Centers for Disease Control and Prevention (CDC) strongly encourages allocating at least 10% of total funding to evaluation and performance measurement. Can you provide examples of what counts toward the 10%?

Funding used for resources (such as staffing, contracting, etc.) that support evaluation and performance measuring activities can be attributed to this allocation. Examples of evaluation and performance measuring activities include evaluation planning, data collection, analysis, reporting, and dissemination. An applicant is encouraged to work with professional evaluators (either internal or external) to meet the evaluation and performance measure reporting requirements of this NOFO.

 

Will recipients report on the performance measures for all strategies?

Applicants are required to address all strategies and report all short-term and intermediate performance measures. Applicants are expected to provide baselines, year 1 targets, and data sources for all performance measures. Recipients will report performance measures annually to track progress over the five-year performance period.

 

Are recipients responsible for long-term outcomes?

As indicated in the logic model, recipients will be responsible for short and intermediate outcomes within this cooperative agreement. These outcomes should lead to the long-term outcomes, but recipients are not responsible for achieving long-term outcomes or reporting long-term measures within the five-year performance period.

 

For performance measures, does Centers for Disease Control and Prevention (CDC) want statewide data, or data that reflects the work we are doing in specific WISEWOMAN provider sites?

The applicants can provide baselines and targets focused on their proposed work with WISEWOMAN provider sites and populations of focus. Performance measures will be further defined and operationalized by CDC in collaboration with recipients prior to the first year of reporting.