FAQs for Racial and Ethnic Approaches to Community Health (REACH) Funding

Q. Do we supply the risk assessment with the application?

A.  The assessment must be submitted with your application.  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 assessment, or submit a letter signed by the authorized organization representative including the original submission date, organization’s EIN and UEI. See the risk assessment questionnaire [PDF-581KB].

Q. We are a department under the City of San Antonio, Texas and we are the public health agency serving the City of San Antonio and Bexar County. With this being said, I wanted to clarify on the risk questionnaire, should our team answer in reference to the City of San Antonio as a whole or just to Metro Health, since we are applying as a department. For example, the “going concern” section should we answer in reference to the City of San Antonio as whole? Or Metro Health?

A. The applicant is expected to fill out the risk assessment relative to the priority population they propose serving.

Q. Can you please provide details on the required attachment “Report on Programmatic, Budgetary, and Commitment Overlap”? Can this be a letter on letterhead addressing the items in the Duplication of Efforts section of page 31 of 63 in the NOFO? Or are there additional specific requirements needed? Is there a specific format required?

A. There is no specific format required. The details on the Report on Programmatic, Budgetary, and Commitment Overlap can be provided in whatever format is easiest for the applicant.

Q. Are there any requirements for citation format? Are footnotes to cite supporting evidence acceptable? Footnotes are typically smaller font.

A. There are no requirements for citation format, including font size. Footnotes to cite supporting evidence are acceptable. All references and footnotes are included in the 20-page project narrative limit.

Q. Can you confirm if the REACH NOFO is subject to Executive Order (EO) 12372–Intergovernmental review of Federal programs? I believe this is the EO that requires applicants to notify participating states about their application.

A. Yes, recipients must comply with the administrative and public policy requirements outlined in 45 CFR Part 75 and the HHS Grants Policy Statement, as appropriate. The AR-7: Executive Order 12372 Review requirement is listed on this NOFO page 44 of 63.

Q. Internally we can implement some of the proposed strategies. There are other strategies that we would need to contract with external partners to implement. If we wanted to develop an RFP process to select those external partners, are we able to write in a TBD for those external partners implementing those particular strategies, and if awarded, we would be able to provide the name of those external partners by the time the grant would be awarded?

A. Yes, you can propose to sub-award to carry out part of the REACH NOFO.

Q. Are state, county or city governments, Federally Qualified Health Clinics, breastfeeding coalitions, non-profit 501c3 organizations, or regional groups such as Licensed Practitioners of the Healing Arts allowed apply to apply for the grant?

A. The REACH NOFO is an Open Competition. To see government, non-profits, and other entity categories that are eligible, please go to page 26 and 27 of the NOFO.

Q. Can previously REACH-funded entities be funded again?

A. Yes, previously REACH-funded entities may apply and be funded again.

Q. Do applicants need to choose the other CDC-funded programs with which we will partner before submitting an application, or will the CDC connect awardees with other CDC-funded programs after the grant is awarded?

A. The selection and relevance of key partners, other CDC-funded programs and otherwise, are determined by the applicant.

Q. When identifying geographic areas, if multiple counties are selected, do they need to be contiguous?

A. If multiple counties are selected, they do not need to be contiguous.

Q. If we are applying for both Component A and Component B, should we complete one narrative and work plan that includes both components, or a separate narrative and work plan for each component?

A. Applicants applying for both Component A and Component B must submit one Project Narrative which includes the Background, Approach, Evaluation, and Performance Plan, Organizational Capacity, and Work Plan and is limited to 20 pages. The Project Narrative and the Work Plan are submitted as two separate documents.

Q. Does the 20-page limit apply to those whose are also applying for Component B – vaccinations?

A. Yes, the 20-page limit for the Project Narrative includes Component A and Component B.

Q. Should the MOU be co-signed by all key collaborators or separate MOUs for each collaborator?

A. The number of signatories is dependent on what is covered by the MOU and is to be determined by the applicant.

Q. The project timeframes are Sept. 30 to Oct. 1 or Oct. 1 to Sept. 30 of the 5-years?

A. The project start date is anticipated to be September 30, 2023. The budget period would be September 30th to September 29th each year.

Q. What is the proposal submission approach for those organizations interested in pursuing Component B? Does this require applicants to prepare two distinct and separate proposals (1. Component A and 2. Component B) with two distinct budget narratives, proposal narratives, separate work plans and evaluation plans, etc.?  For example, for existing REACH grantees this was what was required for renewal applications, budget preparations, reporting, and financial reporting, etc.

A.   The applicant is to submit a single application for both Component A and B which details a single proposal narrative and budget.  The work plan and evaluation plan are part of the project narrative.

Q.  If we are interested in applying for both Component A and Component B.  Does Component B need to be within the same geography of Component A and be integrated in what is being proposed in Component A?  Or can they be separate projects and focus areas?

A.  It is up to the discretion of the applicant if Component A and B are integrated and in the same geographic area.

Q.  Can HOP and REACH work in the same county?

A.  Yes, HOP and REACH can work in the same county provided the work is coordinated, collaborative, and not duplicative.

Q. Can the font on the work plan be smaller than 12 points?

A. No. As noted in the NOFO, unless specified in the “H. Other Information” section, the application narrative must be a maximum of 20 pages, single-spaced, 12-point font, with 1-inch margins, and all pages numbered. This includes the work plan. Content beyond the specified page number will not be reviewed.

Q. The NOFO states the work plan should be one document with a specific file name and the project narrative is another document with a specific file name. Do both documents get uploaded separately or together?

A. The work plan and narrative files should be uploaded separately. However, note that the work plan is part of the narrative 20-page limit and should be page numbered accordingly. The work plan also needs to be single-spaced, 12-point font, with 1-inch margins.

Q. For Component B/Vaccination, can grant funds be used to purchase gift cards as: 1) vaccination incentives, 2) listening session stipends, and/or 3) trusted messenger training participants?

A. REACH funds may not be used to purchase gift cards. However, funding may be used for program support costs, such as removing barriers to participation (e.g., training costs, transportation vouchers, compensation for listening sessions/coalition participation). Additional guidance will be provided by CDC after awards are made.

Q. We would like to ensure we are clear on the budget section. I see the CDC budget preparation guideline, but I wanted to ensure that I was clear on the compensation portion. The only guideline I am seeing is the Executive Level II salary cap. Finally, is there a recommendation for program compensation structure that we should fall within?

A. There is no additional guidance or recommendation regarding compensation structure.

Q. We do not meet the $35 million criteria for a negotiated indirect rate and thus we do not know how to acquire the required agreement. Please advise on:

1. Is the indirect cost-rate agreement a required document for a REACH grant proposal?
2. Can a negotiated indirect cost-rate agreement with a state health department who distributes federal funds act as a federal indirect cost rate agreement?
3. If we must submit a federal indirect cost rate agreement, who should we contact to negotiate such an agreement?

A. Given you do not meet the $35M criteria for a negotiated indirect rate, please submit the negotiated indirect cost-rate agreement from your state department of health.

Q. Can you please advise if the REACH opportunity offers an advance or upfront amount for applicants? If so, what is the percentage?

A. No, the REACH NOFO does not offer an advance or any upfront funding for applicants.

Q. Can you provide additional guidance on how to calculate indirect costs? Do we use the indirect cost rate and multiply it by the total direct cost? Are certain costs excluded?

A. Yes, you multiply the indirect cost rate by the total direct cost. Total costs are excluded from the calculation of indirect costs.

Q. Can we use the funds to purchase memberships to YMCA for the community for the FHWP?

A. No, REACH funds may not be used for individual or family memberships or fees.

Q. Can REACH funds be used to cover program delivery costs, such as paying for substitute ECE teachers while ECE teachers receive training, or hiring community health workers to perform work on REACH strategy-specific activities?

A. In general, staffing costs to support program implementation of NOFO strategies are allowable expenses. Post-award, recipients should discuss specific staffing costs with their CDC project officer when finalizing budgets and work plans.

Q. Can REACH funds be used for health care delivery services such as hiring staff to administer vaccines?

A. No. REACH funds may not be used for health care delivery services such as hiring staff to administer vaccines.

Q. Would breast pumps be an allowable expense with REACH funding?

A. In general, depending on the purpose of program use, a breast pump would be an allowable expense. Recipients are encouraged to discuss such purchases as they relate to program intent with their CDC project officer when finalizing budgets and work plans.

Q. How do we determine if something we need to purchase to support program implementation, either supplies or equipment, is an allowable expense with REACH funds?

A. Post-award, recipients should consult their assigned CDC project officer to help make that determination when finalizing work plans and budgets.

Q. Are vehicles an allowable expense? For example, transport vans to carry economically disadvantaged youth passengers to community youth health events and activities?

A. Purchase of vehicles is not an allowable expense.

Q. Does the CDC have any restrictions on the type of visa someone holds in terms of being a part of the REACH grant as key personnel or other personnel?

A. There are no known restrictions on the visa status of any persons that might be paid with CDC awarded funds.

Q. Can you direct me to a resource to guide or support the process of securing a current negotiated federal indirect cost rate agreement within HHS (or other entity if appropriate for this grant opportunity)?

A. The indirect cost rate depends on the applicant’s affiliation. Therefore, contact the applicant’s financial office for an indirect cost-rate agreement of the current negotiated federal indirect cost rate agreement or a cost allocation plan approval letter.

Q. Can funds be used to purchase equipment to support active transportation – as identified by local communities – such as bicycle racks, repair stations, etc.? Is equipment for purchase considered anything over $5K or another limit?

A.  In general, funds cannot be used to purchase equipment such as bike racks, playground equipment etc. Recipients should leverage the resources of their partners for such items.  Funds may be used to purchase such items for the planning and design of pop-ups and demonstration projects. CDC will work with recipients to finalize budgets and work plans.

Q.  Is subcontracting allowed, and how much of the grant can be applied to subcontracting?

A.  Subcontracting is an allowable cost. There are no limitations on how much of the cooperative agreement can be applied to subcontracting.

Q. Will a budget template be provided?

A. No. Please refer to pages 34 of 63 for items to include in the budget narrative.

Q. Can you elaborate on the recommendation to provide payment to coalition members for their work and effort on working on strategies and activities?

A. Coalition members may be reimbursed for their time and effort on the coalition who are not paid from other sources, such as community volunteers.

Q. Can we have Co-PI’s, i.e., more than one?

A. Yes, the applicant can propose 2 individuals as Co-Principal Investigators.

Q. Can funding be used to cover the cost of vaccines for Component B?

A. No, REACH funding cannot be used to cover the cost of vaccines for Component B.

Q. Can we use funds to operate adult vaccination clinics?

A. No, REACH funding cannot be used to operate adult vaccination clinics.

Q. Will Component A and B Budgets be tracked separately?

A. No, Component A and Component B budget will not be tracked separately but submitted as a single budget.

Q.  Will the payment of rent or lease for space will be allowable?

A. Yes, rent and lease payments are allowable.

Q. What is the indirect rate?

A. The indirect cost rate is dependent on the applicant affiliation. A copy of the indirect cost-rate agreement of the current negotiated federal indirect cost rate agreement or a cost allocation plan approval letter is required for REACH applications.

Q. Is the total for each budget year inclusive of indirect costs?

A. Yes, the total annual budget includes indirect costs.

Q. The max is $1.5 million, however in the NOFO it states $1.112 million. Which figure should we work with?

A. The award ceiling or maximum award amount is $1.5M.  The average award amount is $1.112M. The applicant should provide a reasonable and fiscally sound budget for the scope and work proposed.

Q. As noted in the FAQs and in the Grant Notice, we understand that the CDC works with recipients to develop an evaluation framework within the first 6 months. It also mentions that: “Applicants are advised that any activities involving information collections (e.g., surveys, questionnaires, etc.) from 10 or more individuals or non-Federal entities, including State and local governmental agencies, and funded or sponsored by the Federal Government are subject to review and approval by the Office of Management and Budget.”  Does this mean that we should propose to collect the data we believe would best answer the research questions from the RFA (e.g., “How have communities changed since the implementation of strategies…”), including from individuals, assuming these measures would be approved (possibly with modification) by our IRB and the Office of Management and Budget? Or is this suggesting that we instead focus on utilizing only data that would typically be collected by partnering community organizations without requiring further approval?

A. This announcement is only for non-research activities supported by CDC. CDC does not expect recipients to collect data from individuals. Within the first six months, CDC will work with recipients to finalize an evaluation plan that aligns with the recipient proposed strategies, and activities, including guidance on required performance measure reporting.

Q. Performance Measure clarifications:  Are we required to include measures of population reach in our performance measure plan? Are we allowed to propose additional performance measures? Like # of influencers for Component B? Can you confirm that the performance measure for physical activity does NOT include number of actual linear miles geocoded? Can we count the number of sites for the breastfeeding performance measure?

A. As stated on page 18 of the REACH NOFO, CDC will work collaboratively with recipients to develop an evaluation framework to guide evaluation and performance monitoring activities of the REACH program. Recipients are responsible for reporting short-term outcomes identified in the logic model. Specific performance measures will be finalized in collaboration with CDC and aligned with the required program strategies.

Q. Is an external evaluator required to meet the NOFO’s requirements of “10% of budget to support overall evaluation activities”?

A. No, an external evaluator is not required to meet the NOFO 10% budget requirement. Q. Will CDC provide training on REDCap for use when reporting data for Component B?

A. Yes, CDC will provide training on the REDCap system for Component B reporting.

Q. Will the evaluation and performance measures for Component B be reported in a similar way as Component A?

A.  As stated on page 23, all recipient reports should be distinguished as Component A or B, respectively.   For Component B, CDC plans to have recipients report quarterly using the CDC REDCap Data Collection System.

Q. Our team would like to propose a nutrition standards project at county food service operations that provide meals to low-income seniors, children in emergency placement, adults and juveniles in detention, and patients in the county’s psychiatric facility and skilled nursing facility. This strategy would include our geographic area. Would we only list populations who reside in our geographic area or receive services there? Or can we include the entire population in program reach measures?

A. For this example, you would list the populations who reside in your geographic area or receive services there.

Q. If a current community health needs assessment is unavailable (to justify target populations), is other data from reputable sources acceptable?

A. Yes, there are several acceptable data sources that are available. See page 16 of the NOFO for suggestions.

Q. We believe that the Middle Eastern and North African (MENA) communities in the United States are at high risk for chronic health conditions and would greatly benefit from interventions focused on addressing racial and ethnic health disparities. Can the MENA populations be targeted as part of this funding in addition to other racial and ethnic groups that we had selected? If not, could you please explain why?

A. Applicants must select their priority population(s) from the five populations outlined in the REACH NOFO. The population groups are based on categories established by the Office of Management and Budget (OMB). See revised in 1977 OMB Circular 15, Race and Ethnic Standards for Federal Statistics and Administrative Reporting.

Q. Can you clarify the “up to two” of the five priority population group requirement? Do you still qualify if you serve one of the 5 priority population groups, or do we need to serve at least two?

A. The applicant must choose at least one and not more than two of the priority population groups listed on page 16 of the NOFO.

Q. Can you please elaborate on the 20% of population needing to be below 100 Federal poverty level? Does that mean the entire geographic population or just the target population in the area or county?

A. The entire geographic population does not need to be below 100 Federal poverty level, only 20% of the identified population.

Q. What is the definition of American Indians? Does it include indigenous peoples of Central America such as Maya, Yucatec, Xinca, etc.?

A. American Indian is a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

Q. Can you provide examples of what a “tribally designated organization is?”

A. Examples of tribally designed organizations are Indian tribes, tribal organizations, urban Indian organizations, national or regional Indian organizations, or the Indian Health Service.

Q. Is there a minimum size (population) for the geographic area?

A. There is no minimum or maximum population size for any selected geographic area.

Q. For Option B / Vaccinations, is the geographic region limited to Component A or can Component B program strategies have a broader reach while remaining within the 20% lower than federal poverty threshold?

A. Component A and Component B do not need to have the same geographic region.

Q. Can Component A and B be two separate populations, or do they need to be the same populations?

A. Component A and Component B can be separate populations.

Q. For Component B / Vaccinations:  It is possible to include more than two priority populations from the list provided? Our previous and current year COVID/FLU programs were expanded to three populations.

A. No. REACH funding is limited to one or two priority population groups.

Q. As a refugee resettlement community, and a community that is not segregated by race/ethnicity, we had hoped to see the target population be expanded to include more than 2 priority populations. We have existing partners that serve multiple population groups listed and it is difficult to tell them they can offer services to some of their clients, but not all under this opportunity. Is there any chance this requirement can be expanded to include 3 or more priority populations?

A. The Applicants must select up to two of the five priority populations listed below for work on this award:  1) African Americans and Black, 2) American Indian and Alaska Native; 3) Asian American, 4) Hispanic and Latino; and 5) Native Hawaiian and Other Pacific Islands.

Q. Are we able to give funding directly through contracts to current GusNip grantees to achieve activities and strategies outlined on the “Priority Nutrition Strategy: Fruit and Vegetable Voucher Incentives and Produce Prescriptions” webpage?

A. Yes, directing funding for strategy-specific work using sub-contracts is allowable.

Q. Would you please clarify the clinical care definition? Would either home visits or office visits around lactation or with a dietitian be considered clinical care?

A. In general, home visits and office visits for lactation or a dietitian would be considered clinical care. However, these are not suggested activities or allowable costs for REACH funding.

Q. Does Component B: Adult Vaccination need to be represented in the proposed community coalition? [This is a follow-up to the FAQ on multiple existing topic-specific coalitions.]

A. If Component B is proposed, they should be represented in the proposed community coalition or a topic-specific community coalition.

Q. Component A – the RFA, says that we cannot purchase food (fruits and vegetables). Our health department runs a food voucher program, are we allowed to use some of the funding to expand that voucher program?

A. Yes, you can use the funding to expand to program to more recipients and partners, but not use the funds for purchasing food or reimbursement for the fruit and vegetable vouchers themselves.

Q. Would the development of a transportation program/system be considered “development of transit transportation network” and meet this physical activity metric? As of last October, we opened a medical exercise facility for the Washoe (tribal) community and patients of the health center. This transit network would provide transportation to and from the exercise facility and its classes for those without means.

A. Yes, in general, collaborating with partners on policies that support transit-oriented development, and systems to increase transit, bicycle, and pedestrian network connectivity and access are potential activities that can be proposed. Post award, CDC will work with recipients to finalize work plans and budgets.

Q. The REACH grant funding restrictions include the note “Recipients may not use funds for clinical care except as allowed by law”. Are community outreach activities with teams administering vaccines in priority populations allowable in this grant? We see that vaccination activities appear to be included based on these descriptions, but we want to confirm that.

A. Yes, community outreach activities with teams administering vaccines in priority populations for adults are an allowable cost under optional Component B.

Q. Can our clinical care team that delivers Mind Exercise Nutrition Do it (MEND), a HFWP including a physician assistant and patient navigator include implementing additional MEND programs for our priority population as an approved activity and include the % effort to provide MEND to the REACH grant budget? Is this allowable “clinical care except as allowed by law”?

A.  Yes, programs that meet key program characteristics, such as MEND, can be proposed for addressing the Family Healthy Weight Program strategy in REACH. Post award, CDC will work with recipients to finalize work plans and budgets.

Q. If we are encouraged to use existing coalitions, why is there the requirement for the PI to serve as chair of the community coalition?
A. The requirement for the Principal Investigator to serve as the chair of the community coalition is intended to ensure the coalition is integrated and engaged in the REACH funding efforts and work.

Q. Can we use multiple existing topic-specific coalitions (e.g., a Food Council to guide Nutrition work and a Bicycle/Pedestrian Advisory Committee to guide Physical Activity work?) instead of having one overarching REACH-specific coalition? If we can use existing coalitions, do applicants have to follow NOFO guidance that states that the PI must be co-chair of the coalition?

A. Yes, you may use multiple existing topic-specific coalitions. Yes, applicants must follow the NOFO guidance that states the Principal Investigator must be the co-chair of the coalition to ensure the coalition is engaged and integrated in all the REACH funding efforts and work.

Q. Does the “community coalition” with which we partner need to be a formal, legally connected organization, or can it be an informal network of organizations?

A. The existing community coalition can be an informal network of organizations or a formal, legally connected organization.

Q. On a slide in the REACH Information call, you mention state level policies and work; but said this is for local level PSE. The REACH NOFO is meant for local level PSE work (county, jurisdiction etc.), correct?

A.  Yes. There was an error on the REACH Information Call slide related to the breastfeeding strategy. All REACH activities are at the local level.

Q. Do all 3 areas of focus or selected strategies have to be all the same population?

A. No, the 3 selected strategies do not need to be all the same population.

Q. We can select either Component A or B, and not required to implement both?

A. No, Component A is required. Component B is optional.

Q. Are applicants allowed to select an additional strategy under Component A?  

A. For Component A, applicants must select the nutrition and physical activity strategy plus one additional strategy for a total of three strategies.

Q. We need clarification regarding the stated objective of: “Implement local level policies and activities to connect pedestrian, bicycle, or transit transportation networks (e.g., activity-friendly routes) to everyday destinations with a desired short-term outcome of “increased policies, plans, or community design changes that increase access to physical activity”. Please discuss what is allowable and provide examples.

A. See the Physical Activity Strategy Implementation Guidance as indicated in the NOFO on page 11. Potential activities, resources, and examples can be found on CDC’s Priority Strategy: Increasing Physical Activity Through Community Design.

Q. In terms of the physical activity requirement, is it acceptable for activities to be primarily assessment based?

A. No, assessment is only a part of the implementation of the Physical Activity Strategy. See the Physical Activity Strategy Implementation Guidance as indicated in the NOFO on page 11. Potential activities, resources, and examples can be found on CDC’s Priority Strategy: Increasing Physical Activity Through Community Design.

Q. Since funding cannot be used to purchase food for the Produce Rx program, please provide some examples of how we could collaborate with an entity like SNAP on this at the local level? And/or can we subcontract to local food providers to support the participants in purchasing food for their Rx?

A. See Priority Nutrition Strategy: Fruit and Vegetable Voucher Incentives and Produce Prescriptions for examples.

Q. Are actual projects allowed? For increasing healthy foods, could the funds be used to create an edible landscape and the planting of crops?

A. For the Nutrition Strategy, the proposed work is limited to the implementation of local policies and activities that:
a) Promote food service and nutrition guidelines and healthy associated food procurement in facilities, programs, or organizations where food is sold, served, and distributed; and
b) Coordinate the uptake and expansion of existing fruit and vegetable voucher incentive and/or produce prescription programs.

Q. Can REACH funds support local farmers to participate in the produce prescription or other nutrition intervention?

A. See Priority Nutrition Strategy: Fruit and Vegetable Voucher Incentives and Produce Prescriptions for examples. Post award, CDC will work with recipients to finalize workplans and budgets.

Q. Are activities required to address both nutrition strategies, a) promoting food service and nutrition guidelines, and b) expansion of F&V Voucher/prescription programs?

A.  Yes, for the Nutrition Strategy, the proposed work is the implementation of local policies and activities that:
a) Promote food service and nutrition guidelines and healthy associated food procurement in facilities, programs, or organizations where food is sold, served, and distributed; and
b) Coordinate the uptake and expansion of existing fruit and vegetable voucher incentive and/or produce prescription programs.

Q. The NOFO specifies, “Food service guidelines do not apply to food served to children in childcare or school settings that are governed by federal laws and regulation, including the National School Lunch Program, the School Breakfast Program, the Child and Adult Care Food Program, and the Summer Food Service Food Program (pages 11 and 62) AND it also suggests “park and recreation centers” as a site for the food service nutrition guidelines work (page 11). Can you clarify? Follow Up – If an out of school time program does not participate in CACFP or SFSP, would it be eligible to participate in REACH-funded work?

A. Yes this would be allowable.

Q. The US Affiliated Pacific Island public schools are not required to follow the US federal nutrition guidelines. Can we include their schools as our nutrition intervention setting?

A. As described in your question, yes.

Q. Would restaurants be an allowable setting for the strategy to “promote food service and nutrition guidelines and healthy associated food procurement”?

A. No. Please refer to Priority Nutrition Strategy: Food Service and Nutrition Guidelines for suggested activities.

Q. Can you give an example of a “support” to implement family healthy weight programs? Could you clarify what is meant by “increased supports” for Family Health Weight?

A. See Priority Strategy: Family Healthy Weight Programs for examples.

Q. For the family healthy weight program, can funds be used to establish program delivery, identify costs, and work with partners to sustain at the end of the 5 years?

A. See Priority Strategy: Family Healthy Weight Programs for examples.

Q. Can we integrate breastfeeding into the Family Healthy Weight Program?

A. No, breastfeeding should not be integrated into the Family Healthy Weight Program.

Q. If the ECE policies are state level but have an immediate impact on local level do those qualify?

A. Yes, and post award CDC will work with recipients to finalize workplans and budgets.

Q. Would working with food businesses to develop healthier items (e.g., as Philadelphia has done in the past with a whole-grain, low-sodium hoagies roll) fit into the “promote food serve and nutrition guidelines and healthy associated food procurement” strategy?

A. See Priority Nutrition Strategy: Food Service and Nutrition Guidelines for suggested activities.

Q. If we propose activities under Component A’s Early Care and Education strategy area, are we expected to focus on all topics in the outcomes table on pages 6-7 of the NOFO (i.e., nutrition, physical activity, breastfeeding support and Farm to Early Care), or identify priority topics within this strategy area, per pages 11-12 of the NOFO? If the latter, how many priority topics are we expected to focus on?

A. Yes, if you select ECE, you are expected to focus on the priority topics on pages 11-12 of the NOFO which have the outcomes in the logic model table on page 6 of the NOFO. The applicant is to focus on all the priority topics.

Q. Are there suggestions/recommendations for the health equity assessment?

A. As mention on page 17 of the REACH NOFO, A Framework for Assessing Equity in Federal Programs and Policies may be helpful.

Q. Can Component B be used for outreach and engagement for vaccine distribution for youth under 18?

A. No, Component B can only be used for adult flu, COVID-19, and other adult vaccinations efforts.

Q. Under Activities for Tobacco, there are listed two options. Are these the only two options this NOFO allows? Or are these suggestions? I ask because the first of the four national goals have to do with youth prevention, and there are evidence-based, school-based activities that are not included in the activities list. I would like to know if applicants can propose activities that are not on this list.

A. The applicant should propose work to support the strategy-specific activities listed.

Q. Are applicants required to already have existing produce prescription and fruit and vegetable incentive programs?

A. The intent of this NOFO strategy is to have the recipient coordinate the uptake and expansion of fruit and vegetable voucher incentive and produce prescription programs for high-risk community members. Applicants should have demonstrated engagement with existing food security coalitions, equity task forces, or food policy committees that have collaborated, assessed, and initiated planning to support the proposed work to serve the identified priority population.

Q. Can you provide the definition of “uptake” in the nutrition strategy which states: Coordinate the uptake and expansion of existing fruit and vegetable voucher incentive and produce prescription programs?

A.  Uptake refers to use of available programs.

Q.  For the nutrition strategy, do recipients have to work on both fruit and vegetable incentive and produce prescription programs?

A. Yes. Applicants should propose work to address both fruit and vegetable incentive and produce prescription programs. Recipients can choose to expand implementation in different populations and/or at different times during the funding period.

Q. What partnerships are advised for the work to address produce prescription programs?

A. Proposed activities to increase access to produce prescription programs need to coordinate between key partners such as those who oversee screening and eligibility (e.g., healthcare, community health centers, food assistance benefit agencies), retail partners such as farmers markets, retail stores and/or charitable food venues, and non-governmental organizations. Please refer to the potential activities section of Priority Nutrition Strategy: Fruit and Vegetable Voucher Incentive and Produce Prescriptions for example partnerships to consider.

Q. The REACH NOFO states that nutrition strategy activities must be coordinated through cross-sector community-level nutrition councils or coalitions. What are examples of how recipients can demonstrate that strategy activities are being coordinated through cross-sector community-level nutrition councils or coalitions?

A. Examples of evidence that demonstrates coordination with cross-sector councils or coalitions are letters of support, MOUs, or MOAs which describe partner roles and responsibilities or shared resources.

Q. Can funds be used to purchase foods for fruit and vegetable voucher incentive and produce prescription programs? Does this include providing funding to partners to incentivize participants who attend evidence-based healthy lifestyle classes?

A. No, recipients may not use CDC funds to purchase food for the produce prescription programs, or for the fruit and vegetable incentive programs, nor to provide funding to purchase food to partners to incentivize participants.

Q. Will the NOFO support development or implementation of local or setting-specific nutrition guidelines?

A. The NOFO supports implementation but not development of nutrition guidelines. Please refer to the Priority Nutrition Strategy: Food Service and Nutrition Guidelines for additional implementation information.

Q. What food and nutrition standards should we use for food service guidelines?
A. In settings where food is sold, we recommend using the Food Service Guidelines for Federal Facilities.  In settings where food is distributed, such as food pantries or food banks, we recommend using the Healthy Eating Research Nutrition Guidelines for the Charitable Food System.  If you have your own guidelines for food service or the charitable food system, you can continue to use them as long as they align with the current Dietary Guidelines for Americans.  However, you may not spend time developing your own guidelines as a part of this funding.

Q. Does a program need to have an official health care prescription component for it to qualify as a produce prescription program under the nutrition strategy? For example, we have some existing local programs in our state that provide food boxes to specific populations (e.g., tribal elders, people with diabetes), but do not currently include a prescription from a health care provider. Would this qualify as a prescription program under the nutrition strategy?

A. In a produce prescription program, the referring agency must have connection to a health provider, which could include physicians, nurses, social workers, dietitians, community health workers, WIC staff, etc. These providers can, for example, provide a paper referral coupon or voucher but may not be defined as an official prescription.

Q. For the nutrition strategy in particular, what type of community health needs assessment should we conduct?

A. The needs assessment should include a food systems component that will allow the recipient to identify the food access assets and gaps as well as the unique cultural, linguistic, health, and social needs of their priority populations in their setting. An example of a community needs assessment is included in the local section of the Priority Nutrition Strategy: Fruit and Vegetable Voucher Incentive and Produce Prescriptions potential activities. Recipients may choose to use another assessment.

Q. I understand that we must have “an established principal investigator or designee to serve as a chair for the community coalition” (p.21). Can you define “designee”? Does it have to be a paid staff person of the recipient organization, or can it be an external partner?

A. Trusted relationships are at the core of effective coalition work. A designee is anyone the applicant identifies to represent the REACH program on the community coalition. A designee need not be a paid staff person of the recipient organization. For example, a designee can be a member of the community or a partner organization.