Public Health Infrastructure Grant: Frequently Asked Questions

What is the total period of performance?

• For A1 Workforce; A3 Laboratory Data Exchange (LDX) and Data Modernization Initiative (DMI) Acceleration; and Component B, the period of performance is five years (12/1/2022-11/30-2027).
• For A2 and A3 DMI Core, the period of performance aligns with the budget period and are awarded on an annual basis. (Updated 3/14/2024)

What is the start date of the budget period?

• For A1 Workforce; A3 LDX and Data Modernization Initiative (DMI) Acceleration; and Component B, the budget periods are 12/1/2022-11/30/2027.
• A2 and A3 DMI Core budgets are awarded on an annual basis based on Congressional appropriations and have 12-month terms (e.g., 12/1/2022-11/30/2023; 12/1/2023-11/30/2024, etc.) (Updated 3/14/2024)

When was this NOFO published on grants.gov? The NOFO was published on June 16, 2022. (7/8/2022)

What is the purpose of this funding? This open-competition, multi-component grant will provide cross-cutting support to public health agencies for critical infrastructure needs including workforce, foundational capabilities, and data modernization. (7/8/2022)

What are the program strategies for this effort? The three Strategies for Component A are Workforce, Foundational Capabilities, and Data Modernization. For Component B, the three Strategies include training and technical assistance for Component A, Grant program evaluation, and Grant coordination and communication. The Strategies outlined in the NOFO are broad by design and intended to provide recipients with maximum flexibility to meet their needs. For detailed information, please consult the Strategies and Activities section of the NOFO. More information on Component A Strategies begins on page 8 of the NOFO. More information on Component B Strategies begins on page 13 of the NOFO. (7/8/2022)

What do the bolded outcomes on page 5 of the NOFO mean? Bolded outcomes are those that are expected to be achieved during the period of performance. (7/19/2022)

What are the intended outcomes? Under Component A, Strategy A1: Workforce, the key outcomes that recipients are expected to achieve by the end of the period of performance include increased hiring of diverse staff and increased size and capabilities of the public health workforce with improved wages and protections. For Strategy A2: Foundational Capabilities, the key outcomes include improved organizational systems and processes and evidence of stronger public health foundational capabilities. For Strategy A3: Data Modernization, key outcomes include a more modern and efficient data environment, increased data interoperability, and increased availability of public health data. Key outcomes specific to Component B include increased hiring and retention mechanisms available to Component A recipients and, in the longer term, improved sharing of lessons learned and evidence among Component A recipients, CDC, and other interested partners. (7/19/2022)

How will PHIG support community health workers? Recipients will be able to hire community health workers as needed and appropriate. (5/31/23)

How can applicants expedite the federal grants process? Applicants may be able to expedite the federal grants process by using an Administrative Partner (AP). An AP is an organization that supports a governmental entity, like a health department, with processing federal grants and assuring compliance with requirements. Partnering with an AP can help increase the competitiveness of the health department in applying for and accepting federal funding and expedite implementation of grant activities. Refer to Expediting the Federal Grant Process with an Administrative Partner for additional information. (7/8/2022)

What is the difference between Component A and Component B? Component A will enable recipients to hire, retain, sustain, and train the public health workforce and strengthen their foundational capabilities. Component A also enables recipients to modernize public health data systems to expand, improve and accelerate public health services and better address public health outcomes including those related to COVID-19. The purpose of Component B is to support Component A recipients to more efficiently and effectively implement Strategies A1-A3. Component B recipients will do this by providing technical assistance, evaluation leadership and support, and mechanisms for communication and coordination across all recipients and CDC. (7/8/2022)

In reference to allowable costs, the Applicant Informational Webinar slides referenced de minimis 10%. What does de minimis 10% mean in the context of this NOFO? In this context, de minimis refers to the option to charge a de minimis rate of 10% of modified total direct costs (MTDC). You can find more information from guidance 45 CFR Part 75. This contains more information about the indirect cost (IDC) rate, including the information about the 10% de minimis. If you do not have a negotiated IDC, you can use the de minimis 10% rate. The specific section is 75.414 which has also been included below for your convenience.

(f) In addition to the procedures outlined in the appendices in paragraph (e) of this section, any non-Federal entity that has never received a negotiated indirect cost rate, except for those non-Federal entities described in paragraphs (c)(1)(i) and (ii) of this section and section (D)(1)(b) of appendix VII to this part, may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) which may be used indefinitely. As described in § 75.403, costs must be consistently charged as either indirect or direct costs, but may not be double charged or inconsistently charged as both. If chosen, this methodology once elected must be used consistently for all Federal awards until such time as a non-Federal entity chooses to negotiate for a rate, which the non-Federal entity may apply to do at any time. (7/8/2022)

In the absence of a negotiated federal indirect rate, what default indirect rate will be acceptable? If there is a no indirect rate, is the only alternative to claim such costs as direct expenses to the extent it is possible to justify them? You can find more information from guidance of 45 CFR Part 75.414 concerning indirect cost and de minimis rate of 10%. If you do not have a negotiated indirect cost rate, you can use the de minimis rate. (7/8/2022)

We already have a full-time Workforce Director within our agency and they must report to the highest level of the agency. Is it permissible to use delegation of authority to assign the responsibilities of the Workforce Director to a deputy director? Our goal is to make sure leadership is informed of the allocation and use of the funding across their agency. Yes, it is acceptable to use the delegation of authority and assign a deputy if appropriate within the confines of your organizational structure. The intent of this grant is to transform and improve the entire public health system. (07/26/22)

Can you explain more about the requirement to support the Workforce Director in Strategy A1, Key Activity 6? The NOFO says the Workforce Director must be “supported” by the grant, but does that mean their full salary has to be paid out of the grant? The Strategies and activities outlined in the NOFO are broad by design and intended to provide recipients with maximum flexibility to meet their needs. As such, how the Workforce Director salary is paid, whether it be from this grant or other resources, is up to the recipient’s discretion. It is requested that a portion of the Workforce Director salary be supported by the grant. At a minimum, funding one percent (1%) of the salary would satisfy this request. As stated in the NOFO, this position must report to the highest level of the recipient organization leadership. Additionally, this position must be available to work directly with CDC as a representative of the recipient organization and participate actively in discussions and meetings with other recipients and CDC about the grant and their experiences under it. Although not explicitly stated in the NOFO, the Workforce Director’s role and responsibilities should mirror the Position Description as described in Appendix 2. (Updated 1/19/2023)

Regarding the requirement to support a Workforce Director as part of Strategy A1, Key Activity 6, does the Workforce Director need to be a new hire? No, it can be filled by an existing employee. Please refer to the position description that was provided on grants.gov. (07/26/2022)

Is it possible for both the State Lab and the State Health Department to hire a Workforce Director, or can there only be one? As stated on page 10 of the NOFO, hiring (or supporting) a Workforce Director is the minimum requirement for Strategy A1: Workforce applicants. There will be no restrictions on the types of positions that can be hired if the minimum requirements are satisfied.

At a minimum, applicants to Component A1 must:

• Support a full-time Workforce Director who has sufficient authority and seniority to effectively manage the work under this grant. This individual must report to the highest level of the recipient organization, be able to represent the recipient organization, and participate actively in discussions and meetings with other recipients and CDC about the grant and their experiences under it. (Required)

• Dedicate at least 1.0 full-time employee to program evaluation and performance measurement for all work proposed under Strategies A1-A3. These evaluation staff will facilitate progress reporting, use of grant performance measures, internal evaluation activities, collaboration with national partners from Component B on evaluation of the grant, and participation in relevant national organizational and workforce assessments. (Required)

Successful applicants may choose to use Strategy A1: Workforce funding to hire a Data Modernization Director. This is an encouraged option, not a requirement. (7/8/2022)

Is a Data Modernization Director the same as a Data Modernization Initiative (DMI) Lead? Yes, the role of DMI Director in this NOFO is the same role previous NOFOs have referred to as a DMI Lead. While the positions are the same, the language has evolved to emphasize the significant roles and responsibilities of the position. Recipients can and will use the grant to support the Data Modernization Director role and related support staff. (05/31/23)

One of the minimum requirements of Component A, Strategy A1: Workforce is to support evaluation staff. Must this person be an employee or are we able to contract this work out? Applicants applying to Strategy A1 may choose to hire contractor for the purposes of Key Activity 6, but please include the resume for the position with your application as noted on page 30 of the NOFO. (7/14/2022)

While Strategy A1: Workforce is intended to increase staff, the sample activities are more geared toward the systems and processes around hiring. How should we be thinking about A1 with regards to managing those resources? As referenced on page 6 of the NOFO, under Component A, Strategy A1: Workforce, the key outcomes recipients are expected to achieve by the end of the period of performance include increased hiring of diverse staff and increased size and capabilities of the public health workforce with improved wages and protections. With that said, we designed this NOFO to give recipients maximum flexibility to support that goal. Please refer to Appendix 1, specifically to A1.1, regarding recruiting and hiring new staff. It is important to note that recipients will need to keep track of their activities to demonstrate successful achievement of outcomes. (07/26/22)

What else do we need to know about the “organizational administrative competency assessment" mentioned in the performance measures section of the NOFO? Are there sample assessment tools we can use as a resource? As referenced on page 9 of the NOFO, recipients also can use this grant to strengthen their own workforce and human resource related planning, systems, processes, and policies. Improving recipients’ organizational administrative competencies related to human resource services may be necessary to accomplish the other Key Activities under this Strategy. Some modifications and improvements may be put in place to assist directly with rapidly hiring, retaining, supporting, and training staff, but recipients may also pursue longer-term system or process improvements whose effects may not be felt immediately. As mentioned on page 23 of the NOFO, one of the short-term outcome measurements for improved workforce systems and processes is the percent improvement on jurisdiction’s organizational administrative competency assessment from baseline. (07/26/22)

What is the intent of asking state-wide recipients of Strategy A1: Workforce funding to provide 40% of funds to local jurisdictions not funded by this grant? How will the grant support local health departments? As referenced on pages 8 and 9 of the NOFO, at least 40% of the funding provided to state health department recipients for Strategy A1: Workforce should be distributed among the local health departments that have not received direct funding from this grant. CDC encourages state health departments to consider how funding for Strategy A2: Foundational Capabilities and Strategy A3: Data Modernization can benefit and reach local health departments that have not received direct funding from this grant. This is essential to ensure that rural and smaller local communities have the public health infrastructure required to address local public health needs. Recipients may apply the 40% allocation to local health departments as necessary and as deemed appropriate based on their state’s specific situation (i.e., centralized public health system.) All recipients should demonstrate how they will reduce or eliminate the administrative requirements and reporting burden put upon local public health departments and nonprofit organizations supporting grant activities. No recipient should request or require additional programmatic reports, Work Plans, or expenditure information from local health departments beyond what is required by the grant unless otherwise required by law. State health departments should ensure that these funds are dispersed to their jurisdictional local health departments within the first year of the grant. (This guidance does not supersede state, and local rules, and regulations, or official funding agreements between state and local public health agencies.) These items should be described in the project and budget narrative.

The intent of the 40% is to ensure that local health departments (LHDs) have the workforce necessary to address local public health needs and achieve local public health goals. This is essential to ensure that rural and smaller local communities have the public health infrastructure required to achieve this. If the State Department of Health can describe and clearly justify how “staff budgeted and hired at the State level but placed in a regional or local offices to provide support to their local health departments within their catchment area” will meet the intent and goal of the “40% distributed to local health departments,” CDC may consider it as part of the 40% direct funding to the LHDs. (7/19/22)

Can workforce funds in Component A be used to provide stipends for positions that the local health departments deem hard to recruit and retain? Stipends could support loan repayment, sign-on bonuses, longevity bonuses or other recruitment or retention strategies. Yes. Please refer to Appendix 1 of the NOFO, where on page 2 it outlines the six Key Activities included in Component A, Strategy A1: Workforce. Below each of these Key Activities are sample activities for recipients to consider for their own agency. Recipients are encouraged to think creatively about the types of activities they would like to support with this funding and are not restricted to the sample activities included in this appendix. For example, sample activities include offering “a range of retention incentives, including bonuses, student loan repayment, benefits, moving expenses, remote work, and telework” among many others. (7/8/2022)

Strategy A3 of the NOFO says “Investments in stand-alone, monolithic systems with limited operability are not allowed”. Please elaborate on the meaning of this statement. Investments in stand-alone, monolithic systems implemented with limited operability lead to redundancy, wasted effort, and higher costs. Recipients should avoid building siloed systems that replicate functionality, cause the same data to be stored multiple times, and inhibit the smooth exchange and integration of information. To be consistent with the North Star Architecture* vision for public health data architecture, recipients should implement systems and functionality as coordinated and interoperable components that are supported by shared services.

Examples of coordinated and interoperable components include:

• A “catcher’s mitt” that receives all data coming into the agency, provides basic validation, and delivers it to the intended recipient.

• A common “data lake” that allows integration and sharing, and where different public health uses (e.g., disease surveillance) might have unique views of these data.

• A shared data linkage service to connect the data on an individual coming through different data flows.

• A data mapping and harmonization process that translates data from different sources to common formats, data elements, and values to support integrated analysis.

• Shared analytic and mapping tools for analysis and visualization, possibly including a shared dashboard that is used to drive public health decision making.

When designing or building systems, decisionmakers should consider interoperability, coordination, and the use of shared services within their own health department and among other recipients. Recipients should also explore centrally hosted solutions and services (e.g., NSSP, AIMS Hub, PRIME SimpleReport).

*Please Note: North Star Architecture aims to accelerate public health readiness by articulating a shared vision of a public health data infrastructure for jurisdictions to share necessary data with each other and CDC. This concept of a cloud-oriented environment (currently called the North Star Architecture) is proposed to help jurisdictions plan for efficient integration of public health data systems using modern technologies, data governance, and infrastructure management approaches. This model describes where data flows and information systems might be coordinated, connected, and interoperable across healthcare and public health at all levels of government. Please see Healthcare Information and Management Systems Society’s Guide to Interoperability in Healthcare and Advancing Interoperability for Public Health to learn more. (9/12/2022)

Can you share the definition of “system” and how we get CDC’s approval to invest in new systems or updating existing systems? Any proposed investments in systems, tools, applications, services, and licenses that are needed to improve data access, processing, sharing, and reporting should be included within the grant application to initiate internal CDC review and approval. It is expected that any system, application, or tool that is being invested in should be interoperable and a shared service. An IT shared service is an information technology function, process or service that is built once for use by multiple parts of an organization or multiple organizations. It fulfills a common need and is sharable and scalable (e.g., services available on the AIMS platform through the Association of Public Health Laboratories). CDC encourages city, county, and local public health agencies to use systems, tools, applications, services, and licenses available through their state public health agency or CDC before building or purchasing any new systems themselves. (8/10/2022)

If a local health department is not expected to apply for Strategy A3: Data Modernization (either because the local health department is not an ELC grantee or otherwise), can a state applicant add the local applicant’s population back into the Strategy A3 funding formula? States should add the populations of local areas that are not expected to apply for Strategy A3 back into their A3 funding formula. As a reminder, Strategy A3: Data Modernization applicants must be direct recipients (that is, ELC grantees) to be eligible to apply for A3 as stated on page 31 of the NOFO. CDC encourages state applicants to coordinate with eligible local health departments as applicable. (07/26/22)

Do funds to support Component B go directly to the entity that applied for Component B? Yes, Component B recipients will receive funds directly to support their work. All Component B funds will be provided in Year 1.

What organizational capacity do applicants to Component B need to demonstrate? As described on pages 31 and 32 of the NOFO, applicants to Component B must demonstrate organizational capacity that is relevant to the Strategies and activities they are applying for. Applicants must also,

• Demonstrate their experience and expertise in providing relevant technical assistance.

• Demonstrate a successful track record of collaborating successfully with governmental public health agencies across the U.S., of varying sizes and geographic regions.

• Demonstrate the capacity to quickly engage a large number of governmental public health agencies across the U.S. soon after award and have the relevant staffing, administrative systems, and partnerships in place to do so.

What is an underserved community? For the purposes of this NOFO, an underserved community is defined by the Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government as a population or geographic community sharing a particular characteristic that has been systematically denied a full opportunity to participate in aspects of economic, social, and civic life.

What do you mean by health equity? Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities. For more information on health equity, please visit the CDC Health Equity.

How does this grant address health equity? This grant attempts to support larger efforts to rebalance public health investments and to serve communities and populations in a more equitable way. This program will help address the historic underinvestment in U.S. communities that have been economically or socially marginalized, are located in rural geographic areas, are composed of people from racial and ethnic minority groups, are medically underserved, or are disproportionately affected by COVID-19 or other priority public health problems.

Across the Strategies outlined in the NOFO, recipients are expected to approach planning and implementation with diversity, health equity, inclusion, and accessibility in mind. How this looks may vary by strategy. For example, workforce investments should include dedicated efforts to recruit staff from the communities they serve and continue to create a public health workforce that can meet the needs of all communities. Investments in data systems should be directed in ways that help strengthen ties with, and services in, U.S. communities that have been economically or socially marginalized, are located in rural geographic areas, are composed of people from racial and ethnic minority groups, are medically underserved, and are disproportionately affected by COVID-19 or other priority public health problems.

What are the key principles that will guide work under Component A: Strengthening Public Health Infrastructure? All work under Component A should be grounded in three key principles: (1) The need for data and evidence to drive planning and implementation (2) The critical role that partnerships will play in success, and (3) The imperative to direct these resources in a way that supports diversity and health equity.

What must applicants demonstrate regarding their capacity to address health equity and health disparities? Component A applicants should describe the specific public health problems, groups, and geographic areas towards which they plan to direct the grant effort. They should describe how this plan should serve the aim of reducing health disparities and promoting health equity in the jurisdiction. Component B applicants should describe their commitment to supporting these goals among Component A recipients they will serve.

Which populations are served by this grant? The populations served by this grant will vary across recipients and will depend on local needs. The population this grant serves are those that use public health services including, U.S. communities that have been economically or socially marginalized, located in rural geographic areas, are composed of people from racial and ethnic minority groups, are medically underserved, and those disproportionately affected by COVID-19 or other priority public health problems.

Applicants should describe how they will use infrastructure investments to advance health equity in their jurisdictions. This should include involving relevant communities in the planning, implementation, and evaluation of applicants’ current and future infrastructure goals, as appropriate

Are the amounts generated by the funding formula (Attachment A) annual amounts or the amounts for the entire 5-year performance period?

• For strategy A1 Workforce; A3 LDX and DMI Acceleration; and Component B, the funding formula was used to generate awards dispersed in FY23 for recipients to use over the five-year period of performance.

• For Strategy A2 Foundational Capabilities and A3 DMI Core, the funding formula is used annually to generate funding amounts that may be dispersed each budget year. (Updated 3/14/2024)

What can the funds be used for? As referenced on page 4 of the NOFO, maximum flexibility will be provided to the recipients to carry out this work consistent with the purpose of the funding and the scope of this NOFO. The scope of possible workforce investments is wide, including hiring, retaining, supporting, and training the workforce; there will be no restrictions on the types of positions that can be hired for public health capacity building. Other investments and improvements to foundational capabilities will help modernize public health agencies and position them to be even better service providers and partners. Investments and improvements to modernize data systems will serve to improve efficiency and effectiveness of those organizations' operations and public health work, including their ability to partner in a complex health and health care environments. These outcomes will lead to improved public health services, and in turn improved public health outcomes including those for COVID-19. Please reference "Appendix 1_Sample Activities for Component A" for a list of suggested activities that may be supported with this funding. (7/8/2022)

Can you tell us more about how the funding formula was developed including the community resiliency estimate? The funding strategy of the grant aims to distribute funds in a transparent, data-driven way that ensures that they are available to areas with the greatest need. Funding for Component A will be allocated depending on the funding available for each strategy and based on a formula. When developing the funding formula:

We first looked at the total amount of available funding and the number of eligible applicants to determine the minimum level that would make a difference for the smallest eligible jurisdictions.

From there, the formula is based on the total population size of the eligible applicants, adjusting for applicants whose population areas may include another eligible applicant’s area. For example, for states that include an eligible local jurisdiction, the state population size used in the formula would be the state population minus the population of the eligible local jurisdiction.

Finally, we adjusted funding based on a measure of community vulnerability. We did this to help redirect some resources towards areas of greater need. We considered various measures of vulnerability, and we opted to use the U.S. Census Bureau’s Community Resilience Estimate.

Accounting for the applicant’s population size and community vulnerability serves to help direct additional resources towards areas with greater need, and recipients are encouraged to adopt similar principles when allocating funding within their coverage areas or jurisdiction. (7/8/2022)

Does the Population Weighted Percentage of 50% used in the funding formula examples vary by each jurisdiction's eligible population, or is it constant? The Population Weighted Percentage of 50% is a constant in each formula and is not a variable that differs by jurisdiction. Please see Attachment A of the NOFO for detailed instructions and examples on how to calculate funding levels for Component A. No formula will be used for determining funding for Component B. (7/8/2022)

Should we allocate funds to county health departments based on their population in need, using the Community Resilience Estimates (CRE) information? Applicants are encouraged to use a similar funding strategy to distribute funds in a transparent, data driven way with an aim to provide funds to areas with the greatest need but are not required to apply the exact same methodology as used in this award. Applicants may elect to use a strategy, and if needed a vulnerability index, that best fits their need and the needs of local health departments. (7/19/22)

How do we leverage, but not replace or duplicate, funded activities and progress made with ELC funds? Should activities that are planned through the ELC DMI grant that require funding beyond FY23 be included in the Public Health Infrastructure grant? The NOFO states “This funding opportunity is expected to coordinate with and leverage, but not duplicate the workforce, laboratory system, and data-related progress made via Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC), Public Health Emergency Preparedness (PHEP), and other funding opportunities and investments. Applicants must specify in their proposals whether or not they are a current recipient of data modernization funding through the CDC ELC supplemental funding.” Data modernization implementation within jurisdictions will likely require coordination and leverage of several funding sources across several periods of performance. It is anticipated, but not guaranteed, that ELC will continue to support modernization efforts covering core Health Information Systems related to infectious disease epidemiology and laboratory capacity. Jurisdictions are welcome to move activities and workforce positions previously funded through ELC to the Public Health Infrastructure Grant if they wish to do so. (8/10/2022)

Is the funding strategy for Component A the same as the CDC-RFA-OT21-2103: National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities? There are similarities in grant eligibility with some slight changes to the funding strategy. Please refer to Attachment A of the NOFO for details on how to apply the funding formula for Component A strategies. (7/8/2022)

Will support for foundational capabilities and data modernization be available to local health departments that don’t receive direct funding from this grant? As referenced on page 8 of the NOFO, at least 40% of the funding provided to state health department recipients for Strategy A1 Workforce should be distributed among the local health departments that have not received direct funding from this grant. CDC encourages state health departments to consider how funding for Strategy A2 Foundational Capabilities and Strategy A3 Data Modernization can benefit and reach local health departments that have not received direct funding from this grant. This is essential to ensure that rural and smaller communities have the public health infrastructure required to address local public health needs.

Can health departments use funds for buying, leasing, and/or repairing buildings, mobile labs, and motor pool vehicles? 2 CFR 200 Subpart E – Cost Principles indicates that the purchase of land or construction of buildings requires prior written approval from the HHS awarding agency. Applications which include requests to buy, lease, and/or repair buildings will be reviewed on a case-by-case basis.

Use of funds for mobile labs is dependent on the activities conducted from the mobile lab. If vehicles are included in the application and used to further the activities in the NOFO, they could be considered. All items are subject to further review during the budget discussions once the funding decisions are made. (7/19/22)

Page 47 of the NOFO states that “recipients may not use funds for clinical care except as allowed by law.” However, Appendix 2 of the NOFO and the Work Plan lists Public Health Physician, Nurse, Other Health Care Providers as some of the types of positions that we may use funding to fill. Can you please clarify whether we can use NOFO funding to support the salaries of positions that may work in a clinical setting? The funding provided under this award is primarily for public health workforce development and not to provide clinical services. As stated on page 9 of the NOFO, the intent of Strategy A1 is to provide funding for recipients to hire, retain, support, and train their workforce. Recipients are encouraged to use funds to support positions necessary to bolster their public health workforce including positions such as public health physicians or nurses. Where, as part of the public health department’s workforce and as part of hiring, retaining, supporting and training that workforce, individuals in these positions may provide services in a clinical setting, those services are allowable. For example: A physician or nurse hired, retained, supported or trained with funds provided under this award is able to provide public health services in a city/county or state health department clinical setting. NOFO funding should not be used to purchase medical supplies or medicine. (7/14/2022)

Do we have the flexibility to hire staff and contractors under all three Component A strategies? Yes. This NOFO has been designed with maximum flexibility to meet the needs of recipients. As stated on page 8 of the NOFO, Strategies A1-A3 overlap to some extent, and recipients can fund and organize their proposed activities under whichever strategy they wish, given their program’s priorities and budget. For example, workforce can be supported under all strategies as appropriate, and work related to data infrastructure can be supported under Strategy A2 Foundational capabilities and under Strategy A3 Data modernization. Similarly, activities to strengthen human resource and workforce related systems and processes can be supported under Strategy A1 Workforce or A2 Foundational capabilities. You may also find Appendix 1, Sample Activities for Component A helpful. (7/8/2022)

Can workforce funds in Component A be used to provide stipends for positions that the local health departments deem hard to recruit and retain? Stipends could support loan repayment, sign-on bonuses, longevity bonuses or other recruitment or retention strategies. Yes. Please refer to Appendix 1 of the NOFO, where on page 2 it outlines the six Key Activities included in Component A, Strategy 1. Below each of these Key Activities are sample activities for recipients to consider for their own agency. Recipients are encouraged to think creatively about the types of activities they would like to support with this funding and are not restricted to the sample activities included in this appendix. For example, sample activities include offering “a range of retention incentives, including bonuses, student loan repayment, benefits, moving expenses, remote work, and telework” among many others. (7/8/2022)

What are the requirements/restrictions related to subcontracts? Successful recipients may be able to subcontract with appropriate organizations, subject to discussion with their CDC project officer. Any items included in the budget proposal of an application that is accepted for funding would be reviewed for allowability, allocability, and reasonableness. (7/8/2022)

What additional funding is expected for Components A and B? Additional funding for Components A and B may be available based on future appropriations. (07/26/22)