CDC-RFA-DP-23-0004: The National Cardiovascular Health Program Frequently Asked Questions (FAQs)

Is there a standard/uniform file naming convention required or preferred for application documents?

Please use the following naming convention: Document name_Name of Applicant (e.g., Work Plan_AL).

 

Can we submit only Letters of Support and not any Memorandums of Agreement or Memorandums of Understanding? If we do only submit Letters of Support, should the naming convention of the document with all Letters of Support included remain: “MOUs/MOAs.Applicant Name”?

Yes. Per the NOFO, the applicant should include letters of support, memoranda of understanding (MOU), or memoranda of agreement (MOA) with a firm commitment from providers and partners that outline the relationship, needs, and resources to be provided. The applicant should submit letters of support from organizations and providers that will have a role in helping to achieve specific NOFO activities and outcomes. Letters and Memoranda must be dated within 45 days of the application. Applicants should name this file as follows: MOUs_MOAs_applicant name.pdf

 

Should we include the Risk Questionnaire in our application, as described on page 35?

Yes. Per the NOFO, a Risk Questionnaire must be submitted with your application by the deadline. Label this supporting documentation as “Risk Questionnaire Supporting Documents_Applicant Name”. If your organization has completed CDC’s Risk Questionnaire within the past 12 months of the closing date of this NOFO, then you must submit a copy of that questionnaire, or submit a letter signed by the authorized organization representative to include the original submission date, organization’s EIN and UEI.

 

Are all questions and answers from the DP-23-0004 Informational Call posted on the National NOFO website?

Yes. Responses to all questions received during the DP-23-0004 National CVH NOFO Informational Webinar are posted on the National NOFO website in the FAQ section, which continues to be updated regularly. The National Informational Webinar slides also contain all key messages from the call. Links to the webinar recording and to the accompanying slides are posted on the National NOFO website.

 

Is there a page limit to the work plan, which we now know should be uploaded as a separate attachment and is not part of the project narrative page limit?

Applicants must submit a detailed Work Plan for Year 1 of the award and provide a general summary of Work Plan activities for Years 2–5. Work Plan activities should be specific and succinct and must also describe how the applicant will address all strategies to achieve NOFO outcomes.  These activities must be in alignment with the NOFO logic model and should include the required performance measures for accomplishing tasks. Baselines, Year 1 targets, and data sources should be provided for all performance measures (short-term and intermediate).

 

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

Eligible applicants under this NOFO are State governments and the District of Columbia, or their bona fide agents.

 

Are there any specific staffing and/or FTE requirements for staff positions that applicants must budget for?

The Organizational Capacity section describes the need to have staff that can manage program and resources ensuring the administrative, financial, and staff support necessary to sustain activities. This includes describing an adequate Staffing Plan, providing CVs/Resumes for proposed personnel, an Organizational Chart, and a project management structure that clearly defines staff roles and reporting structure, and as it applies to this funding opportunity.  Must describe previous experience in management of CVD programs specific to hypertension within the highest at-risk populations.

Must have dedicated staff explicitly included in the work plan and budget, who will focus on health inequities and build relationships at the designated levels to decrease health care disparities and advance health equity.

 

Is there a deadline for submitting questions for this NOFO? Also, where and when will all questions and answers be posted?

Questions may be submitted up to 2 weeks before the application deadline, though it would be advisable to send them as soon as possible to allow for timely responses. Questions and answers will be posted at the NOFO website: DHDSP Funding Opportunities | cdc.gov. Please check the website for ongoing updates.

 

How can I make sure I will be notified if changes are made to the NOFO?

Per the Grants.gov help desk, in Grants.gov, click on the “Login to Subscribe” link on the Synopsis page and log in. That will sign you up for email notifications regarding the NOFO. This does not affect the application process in any way, but if changes are made to the opportunity, you will receive notification.

 

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

All new applications are submitted through Grants.gov; they will be uploaded into Grant Solutions once the awards have been made.

 

What is the font type required for the writing?

As stated in the Project Narrative section on p 36 of the NOFO, “Text should be single spaced, 12 point font, 1-inch margins. Number all pages.”

 

Is the indirect cost rate based on the agency’s federally approved indirect rate?

Yes. As stated in the Budget Narrative section, “If requesting indirect costs in the budget, a copy of the indirect cost-rate agreement is required. If the indirect costs are requested, include a copy of the current negotiated federal indirect cost rate agreement or a cost allocation plan approval letter for those Recipients under such a plan.”

 

Can the Principal Investigator and the Program Manager be the same person?  

Yes.

 

Is the Work Plan included as a part of the Project Narrative or should it be a separate attachment?

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.

 

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

The Work Plan is not included in the Project Narrative’s 20-page limit.

 

What is the recommended number and/or maximum number of letters of support?

There is no recommended or maximum number of letters of support/memorandum of agreement (MOA)/memorandum of understanding (MOU). The quality and specificity of collaboration are the most important aspects of the letters of support/MOAs, MOUs.

 

Are Work Plan tables enough or do you need that in Project Narrative as well?

A sample Work Plan template is not included in the NOFO. Applicants are not required to use the sample Work Plan format but are required to include the elements. The Work Plan is not included in the Project Narrative’s 20-page limit. There is a typo on page 37 and 39.

 

What is the earliest date we can submit CDC-RFA-DP-23-0004?

Applications for CDC-RFA-DP-23-0004 are due by April 25, 2023, 11:59 p.m., EDT. Since the notice of funding opportunity announcement has been issued, applicants may submit as soon as their applications are ready.

 

What is the start date for CDC-RFA-DP-23-0004?

The start date for CDC-RFA-DP-23-0004 is June 30, 2023, with an estimated award date of May 30, 2023 (the date by which the Notices of Award will be issued).

 

What components are included in the Project Narrative’s 20-page limit? There are conflicting statements (pages 23-24 vs 37 of the NOFO)? Second, each section of the narrative lists “Maximum Points: 0”.  What is the point system?

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 20-page limit. The Project Narrative, maximum 20-pages, must include all of the following headings (including subheads): Background, Approach, Applicant Evaluation and Performance Measurement Plan, and Organizational Capacity of Applicants to Implement the Approach.  Applications will not be scored. A technical review will be conducted by the CDC Program staff using the criteria noted in the Phase II Review Criteria Section.

 

The NOFO rubric does not have scores. Is that a typo?

Applications will not be scored. A technical review will be conducted by the CDC Program staff using the criteria noted in the Phase II Review Criteria Section.

 

Are position descriptions (e.g., staffing plans) separate from the Project Narrative, or should they go under organizational capacity? Please advise.

The application’s staffing plan description must be included in the Organizational Capacity section which is part of the 20-page Project Narrative. Additionally, position descriptions, CVs/resumes, and organizational charts should be attached separately from the Project Narrative and labeled as described in the NOFO’s Organizational Capacity section.

 

Are references included in the 20-page limit for the Project Narrative?

References are not included in the page limit. The Project Narrative must include the following headings: Background, Approach, Applicant Evaluation and Performance Measurement Plan, and Organizational Capacity of Applicants to Implement the Approach. Any CVs and resume files should be named “CVs/Resumes” and uploaded as a PDF in grants.gov.

 

Can you explain a little more about the review and selection process?

All applications will be initially reviewed for eligibility and completeness. A technical review will be conducted by the CDC Program staff using the criteria noted in the Phase II Review Criteria Section.

 

Any updates on when the Innovative CVH project NOFO will be released on grants.gov?

Please keep checking Grants.gov for when CDC-RFA-DP-23-0005: The Innovative Cardiovascular Health Program NOFO will be available.

 

Can you repeat who are the eligible applicants? Are stand-alone community hospitals eligible?

Eligible applicants under this NOFO are State governments and the District of Columbia, or their bona fide agents.

 

My agency is a non-profit hospital, can I apply for this CDC-RFA-DP-23-0004 grant opportunity? If not, are there any similar opportunity that is available for us to apply?

Only State governments or their bona fide agents (including the District of Columbia) are eligible for this funding. Please check Grants.gov for other related funding opportunities with different applicant eligibility across the federal government. For other funding opportunities managed by the Division for Heart Disease and Stroke Prevention, you can also check here through Summer 2023: https://www.cdc.gov/dhdsp/funding-opps/index.htm.

 

In the Year 2-5 summary portion of the Work Plan section is it, a maximum one-page narrative per strategy or a maximum one-page narrative for all strategies?

A general summary of Work Plan activities for Years 2-5 should be provided. A maximum of one page narrative for this section. This could be in a paragraph or bulleted format. A sample Work Plan format was provided in the NOFO.

 

Has the document upload/submission process been tested with success in Grants.gov?

Yes.

 

Is a Letter of Intent required? If not, can one be sent optionally, and to whom?

A Letter of Intent is not requested or required as part of the application for this NOFO.

 

How many letters of support can we submit?

The applicant should provide as many as they can. The letters of support should be from organizations and providers that will have a role in helping to achieve specific NOFO activities and outcomes.

 

Can you please clarify the meaning of the statement on page 13 of the NOFO that relates to Letters of Support and Memos of Understanding: “…must be dated within 45 days of the application.” Does that mean no more than 45 days after the due date of the application, which is April 25, 2023?

The applicant should submit recent letters of support from organizations and providers with their application submission that is due on April 25, 2023.

 

Is the work plan included in the page limit and does need it to be in 12-point font, or can it be in an 11 or 10-point font? 

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, there was a typo on page 37 of the NOFO. It should also be in 12-point font.

 

Could you confirm whether the following are optional components of the application?

• Resumes / CVs
• Letters of Support
• Organization Charts
• Indirect Cost Rate, if applicable
• Memorandum of Agreement (MOA)
• Memorandum of Understanding (MOU)
• Bona Fide Agent status documentation, if applicable

These documents are required for this NOFO but are not included in the Project Narrative page limit.

Is hiring a consultant to conduct a more in-depth environmental assessment around identification, screening, referrals, programming and participation in Lifestyle programs an allowable cost?

It is under an applicant’s discretion to staff a FTE, consultant, or contractor to conduct activities under the NOFO. Final assessment and approval or denial will be provided by CDC post award.

 

Is developing an updated training module for CHWs on cardiovascular disease prevention an allowable cost? 

Applicants should assess existing resources before developing updated training modules. As needs are identified, this could be an appropriate activity. Final assessment and approval or denial will be provided by CDC post award.

 

Is partially supporting CHWs salaries while attending a CHW training certification an allowable cost? 

Some support for CHW time to attend training certification may be appropriate. Final assessment and approval or denial will be provided by CDC post award.

 

Is providing vouchers to a Prescription Fruit and vegetable program for participants enrolled in a Lifestyle program an allowable cost?  

On a case-by-case basis a CDC may consider approving vouchers, if the applicant can demonstrate how it is building the case for developing a sustainable model. Final assessment and approval or denial will be provided by CDC post award.

 

Are behavioral support items such as measuring cups, scales, recipe books, water bottles etc. allowable costs?  

Applicants must provide budget justifications for all proposed cost allocations. Final assessment and approval or denial will be provided by CDC post award.

 

Are updates to state HIT and/or health system/FQHC EHR systems in the identification, screening, referral and tracking of people at risk for or diagnosed with cardiovascular disease an allowable cost?  

Some HIT support, including software updates with tools for addressing people who at highest risk for cardiovascular disease, could be appropriate with adequate budget justification. However, this NOFO should not be the only source of fiscal support for state or other HIT system updates. Final assessment and approval or denial will be provided by CDC post award.

 

Are position descriptions required to be submitted for all staff included in the proposed budgets for the National CVH Program (DP-23-0004) application? 

Position descriptions should be submitted for all key positions, including the dedicated staff person who will focus on health inequities and build relationships at the designated levels to decrease health care disparities and advance health equity.

 

Should states budget for travel to an in-person convening of CDC-RFA-DP-23-0004 recipients (arranged by CDC)?

There will not be an in-person meeting in Year 1, therefore applicants should not allocate funds in the budget for travel to an in-person CDC-hosted meeting.

 

Can the dedicated staff person, written into the budget and work plan, that will focus on health inequities also be the LC lead?
Yes, per the LC description at the end of the Strategies and Activities section.

 

Our program is partnering with the Office of Health Equity and has a Health Equity Liaison. Can this person be identified in the Organizational Capacity section and identified in the grant budget as providing in-kind services during the grant period?
The liaison could be appropriate to list as an in-kind support. However, if the inferred question is whether that person would serve as the NOFO-required dedicated staff person who must be identified, as evidenced by explicit inclusion in the work plan and budget, the state would need to determine whether adequate available time exists for the liaison to accomplish all that is required via the NOFO. This includes dedicated staff to lead the LC (see Strategies and Activities section) and to accomplish all that’s listed in Organizational Capacity to focus on health inequities and build relationships at the designated levels to decrease health care disparities and advance health equity.

 

Are there any specific staffing and/or FTE requirements for staff positions that applicants must budget for?

The Organizational Capacity section describes the need to have staff that can manage program and resources ensuring the administrative, financial, and staff support necessary to sustain activities. This includes describing an adequate Staffing Plan, providing CVs/Resumes for proposed personnel, an Organizational Chart, and a project management structure that clearly defines staff roles and reporting structure, and as it applies to this funding opportunity. Applicants must describe previous experience in management of CVD programs specific to hypertension within the highest at-risk populations.

Dedicated staff must be explicitly included in the Work Plan and Budget, who will focus on health inequities and build relationships at the designated levels to decrease health care disparities and advance health equity.

 

Is the indirect cost rate based on the agency’s federally approved indirect rate?

Yes. As stated in the Budget Narrative section, “If requesting indirect costs in the budget, a copy of the indirect cost-rate agreement is required. If the indirect costs are requested, include a copy of the current negotiated federal indirect cost rate agreement or a cost allocation plan approval letter for those Recipients under such a plan”.

 

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. Funds may not be used to purchase monitors for individuals. Determination of appropriateness of such proposals will be made on an individual basis. As much as possible, leveraging other resources will be important to support this type of work.

 

Should grant funds be used to build up the availability of lifestyle change programs specific to heart disease (i.e., expanding the implementation of the HHA-BPSM program) or should we focus on referring to existing programs (i.e. existing HHA-BPSM programs at the YMCA or Check.Change.Control. with AHA)?

Applicants are encouraged to build on the accomplishments and outcomes achieved via CDC-RFA-DP18-1815 and CDC-RFA-DP18-1817 to work more deliberately on systems change and the advancement of health equity.  This includes referring to existing programs and expanding the availability of lifestyle change programs such as the National Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA-BPSM) program. It should also be noted that applicants are encouraged to leverage current and existing partnerships to support the needs of their priority population. These funds are not intended to be used for curriculum development.

 

When applying, are States limited to the max funding identified in the funding structure?

Yes.

 

Can funding be used to help clinics pay for something like Unite Us/211?

Establishing and strengthening health and social service referral sources within populations at highest risk of cardiovascular disease (CVD) is an important part of this NOFO. Some support could be appropriate for the type of referral sources referenced in the question. However, this NOFO should not be the only source of fiscal support.

 

Can community health worker (CHWs) salaries be covered by the budget?

No. However, on a case-by-case basis a CDC Project Officer may consider approving a part-time CHW for a pilot initiative if the recipient can demonstrate how it is building the case for developing a sustainable model. The recipient should first consider leveraging all cost-sharing options.

 

Can funds be used to establish and sustain the Learning Collaborative (LC)?

Yes.

Will we be able to use expanded authority for unobligated funds from our current program year (PY5) to use in the first year of this new 5-year award?

No.

 

Will this grant allow the purchase of point-of-care cholesterol/glucose/HgbA1C testing devices? (CLIA-Waived/Portable)

No.

 

Will this grant allow support purchasing/licensing of EHR/EMR for pharmacies involved in this work?

No, however, more limited health information technology support may be appropriate.

 

Will this grant support funding for educational cost vouchers for HHA-BPSM program facilitators?

NOFO funds may be used to support the training of HHA-BPSM program facilitators.

 

Will this grant support the purchase (year 1) and licensing fees (years 2-5) for WELLD data management platform?

All Work Plan activities and proposed budget items must address the NOFO strategies via sustainable systems changes, beyond the five-year Period of Performance for this NOFO, among and appropriate for populations at highest risk of cardiovascular disease (CVD). Any proposed support for data management platforms would need to be specific, and strongly justified in relation to the purpose of this NOFO. Final assessment and approval or denial will be provided by CDC post award.

Can CDC provide a list of the measures of most interest – “Track and Monitor Clinical and Social Services and Support Needs Measures”?

Program activities for tracking and monitoring clinical measures should focus on hypertension and high cholesterol, though at a minimum must include hypertension control measures by race, ethnicity, and other populations of focus. Measures for social services and support needs may vary depending on local context and could include services such as food assistance, transportation, housing, childcare, etc.

 

Can you clarify the difference between the Y’s Blood Pressure Self-Monitoring (BPSM) Program and the National Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA-BPSM) Program? 

The National Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA-BPSM) Program builds upon the YMCA’s evidence-based Blood Pressure Self-Monitoring Program (BPSM). The main distinction is that the National HHA-BPSM program is only offered in non-YMCA locations (i.e., community sites). When implemented with fidelity, the HHA-BPSM program can serve as an approved healthy behavior support service offering for hypertension management.

 

Medication Therapy Management (MTM) is not specifically mentioned in the NOFO or in the FAQ. Would it be appropriate to use it as an intervention in Strategy 3?

Promoting MTM for hypertension control and high cholesterol management could be an appropriate activity and would fit best under Strategy 2 for team-based care approaches. Pharmacists should be considered when developing strategic partnerships for the LC.

 

 Is ‘social services and support needs’ the same as ‘social determinates of health risk factors’?

The World Health Organization (WHO) defines Social Determinants of Health as, “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” A social need on the other hand, is better described as the need of an individual as a result of social determinants of health.

 

Is there a difference between social services and support needs and if so, could you define what that means?

Social services and support needs refer to a spectrum of services including, but not limited to, providing traditional social services, such as referrals to social workers or clinical case managers, connections to community-based organizations, and other support services an individual may need.

 

Is the National DPP or Walk with Ease considered approved lifestyle programs for hypertension or high cholesterol?

Please see the previous response about National DPP. Walk with Ease was designed for individuals with arthritis rather than those with high blood pressure and tends to focus on older adults. National data show increasing prevalence of hypertension among younger adult populations (35-64 years). Focusing on that age group will also have more of a preventive impact.

 

Do activities related to establishing and sustaining a LC  meet the intent of Strategy 2C? Can the LC be written into the work plan under this strategy?

While activities related to the LC are appropriate to anchor under Strategy 2C, it really is an overarching effort, with aspects likely to be relevant for all three major strategy areas.

 

What are the approved lifestyle programs?

Examples of programs that are appropriate for systematic referral of adults with hypertension and/or high blood cholesterol include the following:

• YMCA’s Blood Pressure Self-Monitoring Program.
• National Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA-BPSM) Program
• Weight Watchers
• Supplemental Nutrition and Assistance Program and Education (SNAP-ED)
• Expanded Food and Nutrition Education Program (EFNEP)
• Taking Off Pounds Sensibly (TOPS)
• Curves Complete

 

For defining priority populations, is CDC requesting one overall priority population or populations specific to each objective?

Applicants must identify criteria for selecting their overall priority populations based on disease and risk factor burden data and combined potential to impact large numbers of adults across the state. Priority populations should include those affected disproportionately by hypertension and high cholesterol due to socioeconomic or other factors, including inadequate access to care, poor quality of care, or low income. Emphasis should be placed on achieving maximum reach and impact across populations who can benefit from the strategies included in this NOFO.

 

Can you provide examples on community-clinical links?

Community-clinical links are connections between community and clinical sectors to improve population health.  Examples can be found in CDC’s Community-Clinical Linkages for the Prevention and Control of Chronic Diseases: A Practitioner’s Guide (https://www.cdc.gov/dhdsp/pubs/docs/CCL-Practitioners-Guide.pdf [PDF – 2 MB]).  

 

Regarding Strategy 3C, does the promotion of self-measured blood pressure monitoring (SMBP) have to be done in clinics or can we count community partner events? Basically, what is the extent of clinical support for SMBP?

Self-measured blood pressure monitoring (SMBP) could be implemented in a clinic or in the community but regardless of setting it should be tied to clinical support with a feedback loop.

 

Do we have to implement all subcomponents of the three strategies? Or can we choose to do A or B or C?

As noted in the funding announcement, recipients must address all strategies and corresponding strategies.

 

Should activities be repeated annually (e.g., enrollment and outreach)?

Work Plan activities can be repeated and modified on a yearly basis to make the greatest impact on the identified priority populations to have improved health outcomes.

 

What are examples of a CHW equivalents? Would peer support specialists qualify?

Community health workers (CHW) are frontline public health workers who are trusted members of and/or have a close understanding of the community served. CHWs includes patient navigators, promotores de salud, community representatives, community health advisors, and others.

 

What does the application mean when it says “deploy CHWs”?

This refers to the concept of expanding the utilization of CHWs in community and clinical settings to address social services and support needs. Recipients should help to convene and facilitate planning efforts to establish protocols, plans, and policies to inform, infuse, and integrate CHWs into clinical and community systems of care.

 

Are we allowed to use an established state approved SMBP program that incorporates comprehensive patient education with data collection?

Yes. Recipients should establish a systematic process to engage health care systems and implement policies and interventions in clinical settings that focus on educating and enrolling populations at highest risk for hypertension into an SMBP program tied to clinical support. This could include an already established program that you want to continue to build upon prior progress made.

 

Is there a focus on COVID-19 as it was outlined in the forecast?

This NOFO supports implementing and evaluating evidence-based and evidence-informed strategies to prevent and manage CVD. The populations of focus are those impacted by high prevalence of CVD, exacerbated by health inequities and disparities, and social determinants. This could include those disproportionately impacted by COVID-19. The applicant should describe if they will collaborate with other funded programs such as CDC’s Community Health Workers for COVID Response and Resilient Communities.

 

Given the focus on hypertension (HTN) and high cholesterol, are we able to consider anti-obesity interventions (lifestyle change programs) to folks at risk for cardiovascular disease (CVD) or can our only direct care intervention be self-measured blood pressure monitoring (e.g., National DPP)?

Referrals to lifestyle programs that address social determinants of health, as well as respond to the social services and support needs of those who are at increased risk for CVD, are supported in this cooperative agreement.  Anti-obesity interventions that are lifestyle change programs which fit these criteria may be referral options. The only direct program support is for either the Y’s Blood Pressure Self-Monitoring (BPSM) Program or the National Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA-BPSM) Program.

 

What is a certified/approved Lifestyle Change Program for hypertension (HTN), high blood cholesterol? Can the National DPP be used w/regard to healthy eating, stress reduction, physical activity, regular health care, etc.?

Requirements for evidence-based lifestyle programs: 1) show effectiveness in improving diets, weight control, and physical activity; 2) incorporate national diet and lifestyle recommendations; and 3) are culturally appropriate and delivered using easy-to-understand language. One example of an approved lifestyle change program is the National HHA-BPSM Program.

 

Is the National DPP considered an evidence-based program for hypertension control?

National DPP maybe allowable as a referral source for individuals with hypertension, high cholesterol, and prediabetes if the recipient can describe how hypertension and high cholesterol will be tracked and reportable for the applicable performance measure. Funds should not be used to directly support implementation.

Why is Geographic Information System (GIS) so important in the CDC-RFA-DP-23-0004 National Cardiovascular Health NOFO?

• GIS uses a variety of tools and methods to merge complex data sets and information to graphically visualize onto maps for problem solving and decision making.
• Uses CDC recognized and authoritative data sources that are available at the census tract or neighborhood (block) level.
• Helps to advance health equity by focusing on geographies with the highest burden of disease.
• Helps to identify segments of the population who are disproportionally impacted by all conditions addressed in the NOFO.
• Helps the Learning Collaborative (LC) and partners focus efforts in areas where co-morbidities, social determinants and risk which coexist at their highest levels.

 

How can partners in the LC use GIS in their work?

• Utilizing GIS data will help LC partners gain consensus on areas to prioritize to program interventions.
• Using this data to understand where cardiovascular health (CVH) priorities converge and co-exist at their highest levels in the same neighborhood.

 

What are census tracts and why are they used for the unit of analysis instead of zip codes and counties?

Census tracts are small statistical subdivisions of a county. They contain a population between 1, 200 to 8.000, with an average size of 4,000. Census tracts are considered neighborhood level geographies and depict disease burden with greater precision than what is possible using zip codes or county level geographies

 

Are there any GIS resources that can help recipients gather data and focus on geographies with the highest burden of disease?

The Division for Heart Disease and Stroke Prevention has a series of on-line tools to create local-level maps of heart disease and stroke outcomes, as well as risk factors, socioeconomic conditions, healthcare facilities, sociodemographic populations, and more. The following on-line tools are particularly relevant for the NOFOs:

• 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/ethnic group, gender, and age.  Socioeconomic and sociodemographic data are available down to the census tract level, and locations of healthcare 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 /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.  These maps and graphs are particularly important given widespread increases in heart disease and stroke mortality, especially among younger age groups.  Instructions for how to use the Dashboard can be found here.

For 51% representation (pg. 11 of the NOFO), is this who the agency can reach or bodies/seats at the LC table?

The 51% representation refers to partners and collaborators actively involved with the LC .

 

Who can be the LC point person?

The dedicated staff person required by the NOFO can be the LC lead. It could also be another appropriately experienced individual.

 

Should the LCs have specific components and how should they be structured?

In addition to the LC information provided on this FAQ site, further guidance will be provided post-award.

 

For the LC expectation, “Within the first three (3) months, use Geographic Information System (GIS) mapping technology to identify census areas with priority populations at the highest risk for cardiovascular health conditions”. Will there be additional guidance and workshops from CDC to help states develop our GIS maps? Or is the intent to use CDC’s “Interactive Atlas of Heart Disease and Stroke”?

Please see the GIS section of this NOFO FAQ page for the most current DHDSP GIS resources. Post award, further guidance will be available to assist states use GIS to ensure the priority populations at the highest rick for cardiovascular health conditions are the focus of this funding.

 

Under the LC description (page 11 of the NOFO), there is a dedicated staff person required to focus on health inequities and build relationships. Is this staff person expected to be full-time dedicated to the Learning Collaborative?

This is a state decision. Given the extent of responsibilities, it would be appropriate as a full-time position.

 

What partners should be included in the Heart Disease and Stroke Learning Collaborative (LC)?

A LC is a framework to engage partners with shared aims to improve outcomes.  The LC quickly identifies the drivers for change and with partners, test models towards the shared outcome. The LC may include public health, housing, commerce, and transportation agencies, health care providers, clinical quality improvement organizations, health information technology experts, public and private payers, pharmacists, mental and behavioral health professionals, community-based health care professionals, community organizations, safety net providers, local health departments (LHDs), and others. These partners may also directly intervene on a clinical or community basis to address the social determinants of health.

There should be no duplication in the establishment of the LC in the same local or regional jurisdictions identified under DP23-0005: The Innovative Cardiovascular Health Program.

Newly established LC and partnerships with existing LCs must ensure at least 51% of participating collaborators and partners represent approved priority populations of focus.

 

What is expected of the LC?

The LC is expected to drive outcomes and facilitate communication, and the exchange of ideas between health systems, community health organizations and public health entities.  The goals of the LC are:

• Prioritizing population and communities with the highest prevalence of CVD, with a focus on advancing health equity for individuals with hypertension and high cholesterol.
• Serving populations and communities affected disproportionately by CVD, specifically hypertension, high cholesterol, or stroke, due to unfair opportunity structures and social determinants, such as limited access to care, inadequate or poor quality of care, or economic instability.
• Achieving optimal health outcomes for priority populations through culturally informed program services that use focused strategies to advance universal health equity goals that are mindful of the social determinants.

 

We noticed that in the section on Learning Collaboratives (LCs), there is a mention about not overlapping any LCs that operate in support of the CVD Innovation funding. When will the CVD Innovation NOFO be released?

Please keep checking Grants.gov for when the Innovative NOFO will be available.  There should be no duplication in the establishment of the LC in the same local or regional jurisdictions identified under DP-23-0005: The Innovative Cardiovascular Health Program.

 

Does each State have to develop an LC if they have not previously been funded for one? Or can they join one?

The recipient can join an existing learning collaborative if it fits the criteria in the funding announcement. As stated in the Executive Summary of the NOFO, the applicant must accomplish these outcomes by aligning with and joining an existing, or creating a new, learning collaborative.

 

For States starting a new LC, what are the key partners to include?

The LC may be an alliance of public health entities, housing, commerce, and transportation agencies, health systems, health care providers, clinical quality improvement organizations, health information technology experts, public and private payers, pharmacists, mental and behavioral health professionals, community-based health care professionals, community organizations, safety net providers, health departments, tribal organizations, and others. These partners may also directly intervene on a clinical or community basis to address the social determinants of health (SDOH).

 

Please expand upon participation of priority populations in the LC.

Priority populations should include those affected disproportionately by hypertension and high cholesterol due to socioeconomic or other factors, including inadequate access to care, poor quality of care or low income. Newly established LCs and partnerships with existing LCs must ensure at least 51% of participating collaborators and partners represent approved priority populations of focus.

 

Can you please clarify if the objective of the LCs is intended to be more focused on cardiovascular health outcomes, addressing social determinants of health, or both?  Also, can you please provide examples of how “LCs should directly intervene on a clinical or community basis to address the social determinants of health”?

Regarding the intent of the LCs, recipients must be able to document, explain, and report on the effects of efforts to address the impact of SDOH, racism and other social injustices on cardiovascular health outcomes, specifically hypertension, high cholesterol, and stroke. The LCs partner organizations should have the ability to influence and enhance factors such as access to care, quality of care, and economic stability.

 

Do we clearly know if the LC must be statewide for the duration of the cooperative agreement, or can it be region-specific and rotate to different regions or something else?

The LC is expected to facilitate communication and the exchange of ideas between health systems, community health organizations, and public health entities throughout the duration of the NOFO. It is up to the discretion of the recipient to develop/participate in a regional LC, in addition to their state focused LC.

 

Are we expected to participate in a national LC or LCs that CDC will designate? This part of the NOFO was hard to parse.

The recipient is not required to join a national LC. Applicants are required to follow the guidance listed in the funding announcement regarding LCs.

 

Is there a required or suggested number of LCs that should be included in the application?

Recipients are required to collaborate with or establish at least one learning collaborative.

 

If states develop their own LCs, is there a minimum to maximum number of organizations that states need to include to achieve the overarching goals?

Recipients must align with and join an existing LC or create a new one. A single LC is described in the funding announcement for each applicant. The LC is expected to facilitate communication and the exchange of ideas between health systems, community health organizations, and public health entities.

 

Under the LC description on page 11 of 63, there is a dedicated staff person required, to focus on health inequities and build relationships. Can this person be a contractor?

The learning collaborative lead can be a full-time employee or contractor and must be designated by the recipient in the Work Plan and Budget.

 

For the LCs, it sounds like you are saying that previous to DP-23-0004, there were already State-based LCs funded by the CDC?  Can you provide more information about this? For example, were these created/funded by recipients of 1817 Category B? Are we able to request a list of existing LCs focused on cardiovascular health in our state?

For the purposes of this NOFO, an LC is defined as a group of public health entities, health systems, health care providers, and community leaders and their partners with experience working to address and implement evidence-based or evidence-informed practices for CVD prevention, detection, control, and management among approved priority populations of focus. The LC is expected to facilitate communication and the exchange of ideas between health systems, community health organizations, and public health entities. The following links are to articles that provide the evidence-base for the framework and lessons learned from a state-level LC.

1. A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative
2. ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative: Lessons Learned from the Payers Cohort

 

Can States propose separate LC for each strategy?

This is not advised. However, recipients can establish or join LCs that will allow them to facilitate communication and the exchange of ideas between health systems, community health organizations, and public health entities. Please refer to “CDC Project Description” for detailed mandatory characteristics for the heart disease and stroke LC.

Is the Data Management Plan (DMP) submitted as an attachment?

The Data Management Plan (DMP) is part of the Project Narrative and not a separate attachment. This is a draft plan and recipients will be given an opportunity to provide a more detailed DMP with their Evaluation and Performance Measurement Plan 6 months post award.

 

Evaluation Plan

For the selected 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?

Yes, the Evaluation and Performance Measurement Plan (EPMP) should address the overarching evaluation questions as described in the CDC Evaluation and Performance Measurement section. Applicants are also expected to develop state-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 of the NOFO.

 

Data Management Plan

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 CDC guidance on DMPs at https://www.cdc.gov/grants/additional-requirements/ar-25.html. Additional guidance and a template from NCDDPHP can be found at https://www.cdc.gov/chronicdisease/programs-impact/nofo/index.htm

 

Performance Measures

The formatting on pages 17-18 of the NOFO has part of the measure cut off. What is the full measure?

This is the first intermediate performance measure “# and % of adults within partner health care and community settings with known hypertension who have achieved or are currently maintaining blood pressure control.” This measure, and all measures, can be found in the Work Plan section of the NOFO.

 

Will states report on the performance measures for all strategies?

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

 

Are we 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.

 

How will CDC solicit input for performance measures definitions?

CDC will provide draft definitions for performance measures based on evidence, previously used indicators or measures, and programmatic experience. CDC will seek input from recipients and collaborate to operationalize the measures once funding is awarded. We want to ensure that all recipients receive guidance that operationalizes all performance measures within a reasonable timeframe for collecting and reporting Year 1 data. Therefore, recipients that volunteer to collaborate with CDC to operationalize performance measures will need to work closely with CDC on a rapid timeline.

 

National Evaluation

Will all recipients participate in the data collection process for the National Evaluation, or only certain recipients? 

The National Evaluation will include components that all recipients will participate in (e.g., performance measure reporting) and components (e.g., case studies) that may include only some recipients.

 

Funding

The NOFO says that the CDC strongly recommends allocating at least 10% of total funding to evaluation and performance measurement. Can you provide examples of what counts towards this 10% for evaluation and performance measurement?

Funding used for resources (such as staffing, contracting, etc.) that support evaluation and performance measurement activities can be attributed to this allocation. Examples of evaluation and performance measurement activities include evaluation planning, data collection, analysis, reporting, and dissemination.

 

Is the Evaluation and Performance Measurement Plan (EPMP) and Data Management Plan (DMP) part of the 20-page limit for the narrative?

Yes, the EPMP and DMP count towards the 20-page limit for the application Project Narrative. The EPMP and DMP are drafts, and you will have an opportunity to provide more detailed information 6 months post award.

 

It appears in the NOFO that the evaluation and performance measurement plan will be submitted 6 months after the project starts. Can you please confirm if a full, complete evaluation and performance measurement plan (that includes specific evaluation questions, indicators, data sources, etc. in table format for each strategy such as Evaluation Plans submitted annually for 1815/1817) is a requirement for application submission for this NOFO?

Applicants will submit a draft Evaluation and Performance Measurement Plan as part of their application. Please refer to the specific guidance in the Applicant Evaluation and Performance Measurement Plan section of the NOFO for more details. Six months after the award, with support from CDC, recipients will be required to submit a more detailed Evaluation and Performance Measurement Plan. Post award, CDC will provide more detailed guidance for developing this plan.

 

Do we need to use the DMP template provided by CDC or can States create our own individual DMP layouts inclusive of the content laid out in the template?

Applicants need to address each required element of the DMP but are not required to use the CDC template. Applicants will provide a draft DMP and submit a detailed DMP with their detailed EPMP 6-months post award.

 

Is there a 5-year evaluation framework that you want us to use, similar to the diabetes NOFO? The diabetes NOFO utilized the Approach-Efficiency-Effectiveness-Sustainability-Impact Framework. Can we use the same one for the CVD EPMP?

The overall evaluation approach is outlined in the CDC Evaluation and Performance Measurement Strategy section, including the overarching evaluation questions. Your Evaluation and Performance Measurement Plan in your application should align with the structure of the evaluation questions and your programmatic activities. Additional guidance will be provided for the detailed EPMP post award.

 

Measure 2C asks that we provide the # and type of social services and support within the recipient’s network that address the social needs at the highest risk of CVD. Are the recipients responsible for defining the type of social services or will CDC be defining the type of social services for this measure?

The types of social services should align with the partnerships and activities you propose in your programmatic Work Plan. Post award, there may be opportunities to select the most common types from a list to help with data reporting and analysis, but for your application, please propose baselines, year-1 targets, and data sources that align with proposed Work Plan.

 

All these outcomes/goals focus on hypertension. Does that mean you are not prioritizing high cholesterol?

Program activities may address a spectrum of work that aligns with the NOFO strategies, including addressing cholesterol control. Recipients are expected to include cholesterol management where indicated in program strategies and are encouraged to track cholesterol management measures internally. However, recipients will not be asked to report specific cholesterol management measures to CDC.

 

For the evaluation, do we need to create an evaluation plan(s) that covers all strategies? Or can we select one or two of the strategies for evaluation?

For the application, there is not a specific number of strategies required. Please refer to the elements listed in the Applicant Evaluation and Performance Measurement Plan section. Post award, CDC will provide more detailed guidance for developing the Evaluation and Performance Measurement Plan.

 

Do all 3 strategies (and the sub-strategies) of the NOFO need to be evaluated?

For the application, there is not a specific number of strategies required for the Evaluation and Performance Measurement Plan (EPMP). Please refer to the required elements listed in the Applicant Evaluation and Performance Measurement Plan section. Post award, CDC will provide more detailed guidance for developing the 6-month EPMP.

 

The evaluation seems to be process and outcome focused, does this mean that we can choose if we do a stepwise approach for the evaluation as long as there are process and outcome measures being evaluated?

Please refer to the required elements listed in the Applicant Evaluation and Performance Measurement Plan section and the overall evaluation approach described in the CDC Evaluation and Performance Measurement Strategy section, including the overarching evaluation questions. Your Evaluation and Performance Measurement Plan in your application should align with the structure of the evaluation questions and your programmatic activities. Additional guidance will be provided post award for the detailed EPMP.

 

For the recipient led evaluation are States expected to develop and propose their own 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 state-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.

 

Will an Evaluation and Performance Measurement Plan (EPMP) in paragraph format in the Project Narrative meet the requirements or does the EPMP have to be in table format (such as the Evaluation Plans submitted annually for 1815/1817)?

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.