Overview of Notice of Funding Opportunity Announcement (NOFO): PS19-1909

The National Harm Reduction Technical Assistance and Syringe Services Program (SSP) Monitoring and Evaluation Funding Opportunity, also known as PS19-1909external icon, is a three year cooperative agreement supported by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at CDC.

The opioid crisis has had substantial infectious disease consequences, particularly for people who inject drugs. Comprehensive syringe services programs (SSPs) are a proven effective component of community-based programs preventing the spread of infectious disease from injection drug use. PS 19-1909 will strengthen the capacity and improve the performance of SSPs throughout the United States by supporting enhanced technical assistance to ensure the provision of high-quality, comprehensive harm reduction services; implementing a national SSP monitoring and evaluation program; and supporting the development and implementation of best practices for patient navigation from SSPs to community-based health and social services. Activities under this NOFO will also increase our capacity to understand injection drug use and risk in the United States with an injection drug use surveillance demonstration project.


There are three expected long-term outcomes:
  1. Improved health outcomes for persons who inject drugs
  2. Reduced incidence of infectious disease resulting from injection drug use
  3. Reduced injection drug use and other high-risk substance use


To achieve the long-term outcomes, applicants will be required to implement activities under two main components and two demonstration projects:

Component 1: Harm Reduction Technical Assistance
  • Develop a national network that provides harm reduction TA responsive to the needs of states and local jurisdictions
  • Create a toolkit to support the implementation of syringe services programs (SSPs) in urban, suburban, and rural areas
Component 1a: Patient Navigation Programs at SSPs Demonstration Project (1-year project)
  • Develop patient navigation program at 8 SSPs to link clients to medication- assisted therapy and to care and treatment for infectious disease
  • Develop a program to track navigation support provided and outcomes
  • Develop guidance on best practices for patient navigation
Component 2: Monitoring and Evaluation of Syringe Services Programs (SSPs)
  • Develop national standardized metrics for monitoring SSPs
  • Work with SSPs to improve program data collection and reporting for local monitoring and evaluation
  • Develop and implement a national monitoring and evaluation program for SSPs
Component 2a: Injection drug use Surveillance Demonstration Project (1-year project)
  • Develop a survey instrument to collect individual-level data from SSP clients and their peers
  • Work with SSPs nationwide to use a data collection platform to capture client-level data
  • Develop and implement a survey of SSP clients and their drug-using peers in a select sub-sample of SSPs


PS19-1909 is supported by CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention and the National Center for Injury Prevention and Control. Year one is funded at $4,975,000, with Component 1 funded at $850,000 and Component 2 at $125,000. The demonstration projects – Components 1a and 2a – are one year in duration and are funded in year one for a total of $4 million.


Applicant eligibility is unrestricted. Organizations may apply for component 1, 2, or both, but must submit a separate work plan and budget for each component. Approximately two awards will be funded under this NOFO.

Important Dates

Informational Conference Call: May 9, 2019 at 2pm
Phone Number: 866-796-7163
Participant Passcode: 3869899

Letter of Intent due date: May 24, 2019
By email or to
1600 Clifton Rd, MS 6-8
Atlanta, GA 30329

Application Due Date: June 26, 2019 at 11:59 PM (ET)

Informational Call

Slides and transcript from the May 9, 2019 informational call are now available Printable pdfpdf icon | Transcriptpdf icon


1. What does ‘unrestricted’ mean? Can anyone apply?
Any organization may apply for funding under this NOFO, however, eligible applicants must demonstrate a minimum 5 years’ experience and expertise in the subject areas addressed under the component to which they are applying.

For those applying to conduct activities under component 1 (Technical Assistance), a competitive applicant will describe and document the organization’s capacity to deliver a harm reduction technical assistance curricula, develop a toolkit, and demonstrate capacity to reach harm reduction organizations nationally.

For those applying to conduct activities under component 2 (SSP Monitoring and Evaluation), a competitive applicant will describe and document the organization’s capacity to work with SSPs nationally to track locations and services, access data and gain buy-in for a nation-wide monitoring and evaluation program.

2. Is a letter of intent required?
A letter of intent is not required, but appreciated. Notifying CDC of your intention to apply, and which component(s) you will be applying for, helps us prepare for the application review process.

3. Are the demonstration projects optional?
No, the demonstration projects are not optional. Whoever is funded to conduct activities for Component 1 must conduct activities for component 1a in year one. Whoever is funded to conduct activities for Component 2 must conduct activities for component 2a in year one. Separate budgets must be submitted for components and demonstration projects.

4. How long are the demonstration projects funded for?
Currently, resources are only available in year 1 for these activities.

5. How much are the demonstration projects funded for?
Demonstration project 1a (Patient Navigation Programs at SSPs Demonstration Project) is funded for $1,000,000. Demonstration project 2a (Injection drug use Surveillance Demonstration Project) is funded for $3,000,000.

6. The logic model states a long-term outcome is to reduce the infectious disease consequences of the opioid epidemic. Does this mean we can focus on reducing infections such as endocarditis, MRSA or STDs, or should we focus on hepatitis C and HIV?
Components 1 (Harm Reduction Technical Assistance) & 2 (SSP Monitoring and Evaluation) are funded by a Congressional appropriation only which only allows funding to be used to address hepatitis B and C, and HIV. Demonstration project 1a (Patient Navigation Programs at SSPs Demonstration Project) and Demonstration project 2a (Injection drug use Surveillance Demonstration Project) are funded under a different mechanism. Work under these activities allows funding to be used to address all the infectious disease consequences of opioid use and overdose to advance the understanding of the opioid crisis.

7. Is the expectation that a funded recipient will work with all SSPs in the United States?
The target goal is to work with at least 80% of SSPs in the United States in urban, suburban and rural areas. Per the Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 (P.L. 115-245), funds may not be used to purchase syringes or other equipment use solely in the drug injection process. Any SSP receiving technical assistance or engaged in any projects under this NOFO must be located in a jurisdiction that has a Determination of Need concurrence from CDC (see Syringe Service Program Determination of Need. See HHS guidance on use of federal funds for syringe services programs at HHS Implementation Guidance pdf icon[PDF – 368 KB, 22 pages]

8. Demonstration Project 2a (IDU surveillance) mentions use of a customizable electronic data capture system. Is this intended to be a new system or add-on module to existing system? Can we budget for a subcontract for the development of such system?
Many SSPs may already use an electronic data system, but others may need support in adopting this technology. Funds may be used to purchase systems for SSPs. There are existing systems that can be used for this purpose – applicants will not be expected to develop their own.

Per guidance from HHS, subcontracts are allowable under this NOFO. The recipient must enter into a formal written agreement with each subrecipient that addresses the arrangements for meeting the programmatic, administrative, financial, and reporting requirements of the grant, including those necessary to ensure compliance with all applicable Federal regulations and policies.

Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-party contract to perform program activities. Approval by CDC to utilize funds and initiate program activities through the services of a contractor requires the submission of the following information for each contract to CDC:

  1. Name of Contractor: Identify the name of the proposed contractor and indicate whether the contract is with an institution or organization.
  2. Method of Selection: State whether the contract is sole source or competitive bid. If an organization is the sole source for the contract, include an explanation as to why this institution is the only one able to perform contract services.
  3. Period of Performance: Specify the beginning and ending dates of the contract.
  4. Scope of Work: Describe the specific services/tasks to be performed by the contractor and relate them to the accomplishment of program objectives. Deliverables should be clearly defined.
  5. Method of Accountability: Describe how the progress and performance of the contactor will be monitored during and on close of the contract period. Identify who will be responsible for supervising the contract.
  6. Itemized Budget and Justification: Provide and itemized budget with appropriate justification. If applicable, include any indirect cost paid under the contract and the indirect cost rate used.

If the information described above is not known at the time the application is submitted, the information may be submitted later as a revision to the budget. Copies of the actual contracts should not be sent to CDC, unless specifically requested. In the body of the budget request, a summary should be provided of the proposed contacts and amounts for each.

9. A second activity under demonstration project 2a (IDU Surveillance) is the implementation of survey system in 50 SSP and 250 of their drug-using peers. May we budget funds for incentives to ensure participation in this survey?
Yes, applicants may budget in survey incentives. Applicants will be required to prepare a detailed budget as part of the application consistent with instructions in the funding opportunity announcement and application instructions. Among other things, applicants need to understand the types of costs that are allowable under the program or award, the cost principles to which it will be subject, differences between direct and indirect costs, circumstances requiring establishment of an indirect cost rate or research patient care cost rate, and any requirement for non-Federal participation (in the form of matching or cost sharing).

10. The workplan counts towards the 20 page narrative limit. Since the detail requested in the workplan is comprehensive, is it acceptable to upload a separate workplan attachment and have it not count towards the 20 page narrative limit?
Workplans may be submitted separate from the 20-page limit. Please remember that separate workplans are needed for components and demonstration projects.

11. Will awardees be required or asked by the CDC to transfer ownership or possession of the customizable electronic data capture system once funding ends?
Sites may be asked to transfer ownership of the electronic data system to CDC after the program period.

12. Can the Year 1 Demonstration Project Funding for both components 1 and 2 will be able to be carried forward into subsequent project years? Similarly, can it be applied to project activities described in the “core” (non-demonstration) components (in any year of the project)?
Activities for the demonstration projects are to be completed in year one, though no-cost extensions may be available. Each component and demonstration project must have its own work plan and budget. Demonstration projects cannot be ‘folded’ into core (component) activities.

13. The NOFO states that CDC ‘will consider multiple applications from a single applicant or any application that does not clearly indicate selection of one component as nonresponsive, and the application will receive no further review’. Is an institution limited to one application per component?
Applicants must explicitly state to which component(s) they are applying in their applications. Each institution is limited to one application.

14. Component 2 (SSP Monitoring and Evaluation) will likely produce substantial data. Can you please clarify: (1) intent to disseminate methods and results into the peer-reviewed literature; and (2) the role of the successful applicant in any peer reviewed publication either as co-author or primary authors?
CDC and the recipient may publish findings from the survey in peer-reviewed journals, providing that data is all de-identified and meets standards such as appropriate methods and analysis. A successful applicant will be able to publish in peer reviewed journals as primary authors or co-authors with CDC. Recipients will enter into data agreements with CDC to clarify how authors and publications will be determined, including, but not limited to, how papers will be reviewed if they do not include CDC authors but are tied to these specific projects.

15. In demonstration project 2a, the site-specific target sample size is adequate for some outcomes but not others. How modifiable is the information in the NOFO?
CDC will provide program guidance to funded recipients which includes directions on survey implementation, including sample size. However, this funding opportunity is a cooperative agreement mechanism; therefore, there are terms that can be negotiated with CDC.

16. Can we defer demo projects to another year? Is it possible to carry over the funding from the demonstration projects into the 2nd or 3rd years?
Funds for the demonstration projects must be obligated in FY19. A no-cost extension may be possible, but activities must start in the first year of the NOFO.

17. Can you explain how component 2 goes from $3M in year one and then down to $125,00 in years 2 and 3?
Component 2 (SSP Monitoring and Evaluation) is funded at $125,000 for three years. Demonstration Project 2a (IDU Surveillance) is currently funded only in year 1 for $3,000,000.

18. How will CDC support us in year one as we try to set up the infrastructure while also handling a demonstration project?
CDC will provide program guidance and technical assistance, including OMB submissions, to support project implementation.

19. Is the expectation that the organization needs to develop a customizable data capture system for demo project 2a?
Although the NOFO does use the term ‘develop’ in some places, the expectation is that most SSPs have some type of data collection system in place, and many use existing technology. The recipient may work with SSPs to standardize data collected and support SSPs in accessing new technology when necessary. It is unlikely that the recipient will need to develop the system from scratch.

20. If a jurisdiction does not have a DON in place, can a funded organization still provide technical assistance to the jurisdiction?
For the purposes of this NOFO, technical assistance is defined as providing in-person, online, peer-to-peer or other support. TA can also come in the form of resources, manuals, tools or other documents that provide support to organizations. SSPs in jurisdictions may not receive any federal funds. It is possible that they can utilize technical assistance resources such as materials or webinars. Recipients may consult with their programmatic counsel and CDC if there are questions about whether a specific SSP may receive technical assistance.

21. If an organization is intending to apply for both components, is that one application or two separate applications?
Regardless of the number of components to which an organization is applying, only one application should be submitted. Please submit separate work plans and budgets for each component and demonstration project.

22. Do we have to create four distinct work plans? May we submit the work plans outside of the 20 page limit?
Each component and each demonstration project should have their own distinct workplan. We are modifying the NOFO to allow workplans to be submitted outside of the 20-page limit on the project narrative.

23. Does CDC prefer that one organization apply for both components?
CDC will evaluate applications based on the strength of individual components. There is no preference for one organization to apply for both components. Applications will be funded in order by score and rank determined by the review panel. If an organization applies for both components, but only scores highly on one, they may be funded for only that component.

24. Under Component 2, SSP Monitoring and Evaluation, how will the $125,000 be spread to manage data for so many programs?
CDC will provide technical assistance support to Recipients in meeting program expectations.

25. Applications are permitted to submit only one application for each component.” To clarify, does this imply that only one application could be submitted from any institution? Theoretically, there could be multiple PIs/groups within the same institution that respond to the NOFO. I don’t expect that to happen, but it is important for our Office of Research to know about this.
Only one application is allowed per institution. If there are multiple interested groups within an institution, we encourage collaboration and partnership to strengthen applications.

26. The NOFO states that the in-depth survey of SSP clients and their peers will be implemented at 30 SSPs. That is a lot of SSPs and people to engage in a 1-year demonstration project. Is it possible to conduct the survey at fewer SSPs?
The NOFO demonstration project 2a description states that the in-depth survey of SSP clients and their peers will be implemented at up to 30 SSPs. Given the short timeframe for conducting this survey, the Recipient may propose to work with fewer SSPs.

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Page last reviewed: April 26, 2019