Notice of Funding Opportunity (NOFO) – FY2023

Availability of Funds

A total of $19.4 million will be available to the 61 current recipients of the Tuberculosis Elimination and Laboratory Cooperative Agreement (CDC-RFA-PS20-2001). A funding table is included at the end of this document.

Terms of Funding

Under Public Law 117-128, funds will remain available until September 30, 2023. This falls within the funding period of CDC-RFA-PS20-2001 which runs from FY 2020 through FY 2024.

Funding restrictions for CDC-RFA-PS20-2001 also pertain to the funds awarded under the Uniting for Ukraine Tuberculosis Supplement. A notable exception is that purchase of medications for treatment of TB and LTBI is allowable under this supplemental funding, based on language in Public Law 117-128.

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be reviewed. For the definition of research, please see the CDC policy, “Distinguishing Public Health Research and Public Health Non-research” at https://www.cdc.gov/os/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf.

Terms and Conditions

The terms and conditions of funding may be found on page 7 of Public Law 117-128, Title IV.

Termination/Non-compliance

This award may be terminated in whole or in part consistent with 45 CFR 75.372. CDC may impose other enforcement actions in accordance with 45 CFR 75.371- Remedies for Noncompliance, as appropriate.

Goal of the Funds

This funding continues the expansion of ongoing TB prevention, control, and laboratory services in support of the Uniting for Ukraine program. Specifically, to reduce morbidity and mortality caused by TB by–

• Preventing transmission of tuberculosis from persons with infectious disease to uninfected persons,
• Preventing latent TB infection (LTBI) from progressing to TB disease, and
• Ensuring timely and reliable TB laboratory services.

Restrictions and Allowable Costs

This funding builds upon the ongoing work of CDC-RFA-PS20-2001, specifically in support of the Uniting for Ukraine program. The purchase of medication for treatment of LTBI and TB disease is allowable under this supplemental funding.

While planning activities and writing budgets, keep in mind that recipients may not use funds for:

• Research
• Inpatient clinical care, except for TB medication
• Purchasing furniture or equipment
  • Publicity or propaganda purposes for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body
• Salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before any legislative body. See Additional Requirement (AR) 12 for detailed guidance on lobbying restrictions.
• Supplanting state or local health department funds

Restrictions for public health laboratories:

• Laboratories reporting first-line drug susceptibility testing (DST) for < 50 patient isolates/year may not request funding support for reagents and supplies associated with DST. Requests for these items will be denied. Laboratories within this category may request the use of funds for shipping supplies and costs for access to referral services.

Allowable costs include:

• Outpatient services related to TB control and clinical care (e.g., Interferon Gamma Release Assay (IGRA) testing, tuberculin skin testing, chest radiography, medical evaluation, treatment)
• Procurement and provision of medications for the treatment of LTBI and TB disease
• Reasonable program purposes, including personnel, travel, supplies, and services
• Integration of services when it is intended to specifically reduce TB transmission or improve TB screening, testing, or treatment in populations disproportionately affected by other infections or comorbidities including diabetes mellitus, hepatitis B or C virus, STDs, and HIV
• Pre-award costs are allowable retroactive to May 21, 2022 when the President signed PL117-128 into law.
• There are associated costs allocated to program and laboratory based on a pre-determined formula. The monies are not meant to be used interchangeably. However, transfer of funds “may” be considered under extenuating circumstances after consultation with the CDC Laboratory Consultant and CDC project officer.

Emphasis must be given to directing most of the funds to core TB control front-line activities, such as TB case management, targeted testing, and treatment of LTBI, clinical evaluation and treatment initiation and completion for TB disease, contact investigation, and outreach activities with an emphasis on using conventional directly observed therapy (DOT) and/or electronic DOT (eDOT).

Of note: The direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project outcomes and not merely serve as a conduit for an award to another party or provider who is ineligible.

In accordance with the United States Protecting Life in Global Health Assistance policy, all non-governmental organization (NGO) applicants acknowledge that foreign NGOs that receive funds provided through this award, either as a prime recipient or subrecipient, are strictly prohibited, regardless of the source of funds, from performing abortions as a method of family planning or engaging in any activity that promotes abortion as a method of family planning, or to provide financial support to any other foreign non-governmental organization that conducts such activities. See Additional Requirement (AR) 35 for applicability.

This award will be a program supplement intended only for recipients previously awarded under CDC-RFA-PS20-2001, Tuberculosis Elimination and Laboratory Cooperative Agreement.

CDC requires recipients to submit their supplemental requests through www.grantsolutions.gov within 30 days after the supplemental announcement is released (see Deliverables section below). The type of action for this amendment will be “Supplement” under the amendment section. If you encounter any difficulties submitting your application through www.grantsolutions.gov, please contact the GrantSolutions helpdesk at 1-866-577-0771 or email help@grantsolutions.gov, prior to the submission deadline. If you need further information regarding the report process, please contact Terrian Dixon, Grants Management Officer, at 770-488-2774 or Tdixon@cdc.gov. For programmatic information, please contact Martha Boisseau, Deputy Chief, FSB at 770-488-6261 or Mboisseau@cdc.gov.

General Application Packet Tips:

• Properly label each item of the application packet
• Each section should use 1.5 spacing with one-inch margins
• Number all narrative pages only
• CDC requires the use of PDF format for ALL attachments
• Use of file formats other than PDF may result in the file being unreadable by CDC staff

Checklist of required contents of application packet:

1. SF-424 Application for Federal Domestic Assistance Version 2 (short online form)
2. SF-424A Budget Information-Non-Construction (online form)
3. Budget Justification (miscellaneous attachment)
4. Project Narrative
5. Work Plan
6. Indirect Cost Agreement (miscellaneous attachment)
7. Email a courtesy copy of budget justification, supplemental funding project narrative, and workplan to your project officer

1. SF-424 Application for Federal Domestic Assistance-Short Organizational Form:

Complete all sections:

1. 1. In addition to inserting the legal name of your organization in Block #5a, insert the CDC Award Number provided in the CDC Notice of Award under CDC-RFA-PS20-2001, Tuberculosis Elimination and Laboratory Cooperative Agreement. Failure to provide your award number could cause delay in processing your application.
   2. Please insert your organization’s Financial Official information in Block #8.

    

2. SF-424A Budget Information and Justification:

Recipients must submit an itemized budget narrative.

3. Indirect Cost Rate Agreement

Not applicable in-lieu of existing indirect cost rate agreements submitted with initial applications.

4. Project Narrative:

Budget Period Proposed Strategies and Activities (February 1, 2023 – September 30, 2023) 

Recipients must submit a Project Narrative for this supplemental award, name this file “Project Narrative,” and upload it to Grants Solutions. The Project Narrative must be succinct, self-explanatory, and address outcomes and activities to be conducted over the entire period of performance. Recipients should use the federal plain language guidelines and Clear Communication Index to respond to this supplemental Notice of Funding Opportunity (NOFO). Note that recipients should also use these tools when creating public communication materials supported by this supplemental NOFO.

Background

Applicants must provide a description of relevant background information that includes the context of the problem (see Purpose section on page 1).

1. Approach
   1. 1. Purpose
         Applicants must describe in 2–3 sentences specifically how their application will address the public health problem as described in the Purpose section on page 1.
      2. Outcomes
         Applicants must clearly identify the outcomes they expect to achieve using the supplemental funding. Outcomes are the results that the program intends to achieve and usually indicate the intended direction of change (e.g., increase, decrease).
      3. Strategies and Activities
         Applicants must provide a clear and concise description of the strategies and activities they will use to achieve the outcomes. Applicants must select existing evidence-based strategies that meet their needs.
      4. Collaborations
         Applicants must describe how they will collaborate with programs and organizations either internal or external to CDC.
2. Applicant Evaluation and Performance Measurement Plan
   Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the Work Plan, Deliverables, and Reporting Requirements sections.
3. Organizational Capacity of Applicants to Implement the Approach
   Applicants must address the organizational capacity requirements as described in the Purpose section on page 1.

5. Work Plan:

Applicants must prepare a work plan consistent with the CDC Project Description Work Plan section (5.B.1) below. The work plan integrates and delineates more specifically how the recipient plans to carry out achieving the period of performance outcomes, strategies and activities, evaluation, and performance measurement. Name this file “Work Plan” and upload it to Grants Solutions.

Uniting for Ukraine Vaccination and Tuberculosis Requirements

The Ukrainian parolees must meet health requirements under Department of Homeland Security (DHS) rules that were developed in consultation with the CDC. The applicants for parole are instructed to seek medical care and to record the completion of health requirements for vaccinations and tuberculosis testing by submitting a Uniting for Ukraine Vaccine Attestation Form, Uniting for Ukraine Vaccine Attestation | USCIS. The requirement for tuberculosis testing with an interferon-gamma release assay (IGRA) must be met within 90 days of entry.

Ukrainian parolees may be referred to health departments for an IGRA test. If the health department cannot provide this test, please refer them to other resources. A tuberculin skin test will not be accepted in place of an IGRA. DHS is collecting attestations online but is not requesting IGRA reports or other health records; the applicants are instructed to retain these records. CDC’s Electronic Disease Notification System, EDN, does not have information about the Ukrainian parolees because they have not undergone the overseas immigration medical examination. The health requirements under the Program are not the same as the Civil Surgeons Medical History and Physical Examination for the adjustment of status, Civil Surgeons Instructions.

Deliverables

2023. A) The application for funding is due January 4, 2023. This includes the budget, budget narrative and work plan. If you do not wish to receive these Supplemental funds, submit your intentions via Grant Note in GrantSolutions before January 4.
2024. B) Work Plan additional instruction:
2025. Work plans should describe grantee approaches through 9/30/2023 for supporting the Uniting for Ukraine program, including providing outreach, testing, evaluation, and treatment for displaced Ukrainians, and including plans to collaborate with refugee health programs and clinics and/or others involved with this effort. Include a plan to provide CDC/DTBE with the number of people tested and where laboratory testing performed, the number of people evaluated for TB disease, the number of people treated for LTBI and completing treatment, and the number of people treated for TB disease and completing treatment. Within the plan, outline the collaborative effort between program and laboratory for how the laboratory will capture which specimens are part of the Uniting for Ukraine program. For the laboratory workplan, include testing methods performed and how laboratory data will be collected, reported, and stored. For all verified cases of TB, submit a Report of a Verified Case of Tuberculosis (RVCT) to CDC’s National TB Surveillance System as soon as possible after verification of the diagnosis; for TB cases among persons participating in Uniting for Ukraine, enter “U4UKRAINE” in the “Other, specify” free text field under Additional/Other TB Risk Factors (item 16 of the 2020 RVCT; item 34 of the 2009 RVCT). For the program, provide a plan to submit aggregate numbers of U4U screening in the Aggregate Report for Program Evaluation (ARPE), Targeted Testing form. This form is available through the National Tuberculosis Indicators Project database.
2026. Budget and procurement plans sufficient to justify award. The budget justification must be prepared in the general form, format, and to the level of detail as described in the CDC Budget Guidance.

C.) Progress and Fiscal Reports: Reports are required to specifically include a targeted testing and treatment ARPE for persons being tested and treated using these funds. Recipients must submit progress updates and fiscal reports by 6/30/2023 with a final report by 12/31/2023. The narrative of the ARPE report shall be loaded as a Grant Note in Grant Solutions. Progress reports should further describe outreach to Ukrainian communities to facilitate screening and the TB testing and treatment cascade goals at recipient and sub-recipient levels. For the laboratory, data metrics to be submitted to CDC/DTBE will include total number of IGRA tested, total number of IGRA positives, total number of clinical specimens received for smear and culture, number of individuals for whom at least one culture was positive for MTBC (from clinical specimens), number of individuals for whom a referred isolate was positive for MTBC, and number of individuals for whom molecular or growth-based DST indicated MDR TB (resistant to at least rifampin and isoniazid). This will be submitted using the Performance Progress and Monitoring Report: Uniting for Ukraine Workload Volume Data. This data will also be uploaded as a Grant Note into Grant Solutions.

Fiscal reports must summarize progress in obligating and spending the allotted funds for the Uniting for Ukraine activity. Reporting templates will be made available. The Emergency Funding Suffix for Uniting for Ukraine Activities must also be included in these fiscal reports.

6. Budget Narrative:

When developing the budget narrative for this supplemental funding, recipients must consider whether the proposed budget is reasonable and consistent with the purpose, outcomes, and program strategy outlined in the project narrative. Name this file “Budget Narrative” and upload it to Grants Solutions as a miscellaneous attachment.

For guidance on completing a detailed budget, see Budget Preparation Guidelines at–

https://www.cdc.gov/grants/documents/Budget-Preparation-Guidance.pdf

The proposed budget should be based on the federal funding level stated in the attached budget spreadsheet from CDC.

7. Reporting Requirements:

For a complete description of reporting requirements, please refer to the original Notice of Funding Opportunity (NOFO) (CDC-RFA–PS20-2001)

Measures and Metrics: The data for reports are cumulative through the life of the U4U activities, which end 9/30/2023.  Recipients will work with CDC to develop an evaluation plan to assess progress towards intended Uniting for Ukraine TB screening and treatment outcomes. CDC will work with recipients to create evaluation plans that include targeted testing and treatment, Aggregate Reports for Tuberculosis Program Evaluation (ARPE), and collection of laboratory data metrics through the Performance Progress and Monitoring Report: Uniting for Ukraine Workload Volume Data form. National TB Indicators Project (NTIP) objectives for case management and treatment should be utilized.

All verified cases of TB should be reported to CDC’s National TB Surveillance System (NTSS) as soon as possible after verification of the diagnosis using the Report of a Verified Case of Tuberculosis (RVCT). For TB cases diagnosed among persons who recently arrived in the United States through the Uniting for Ukraine Program, enter “U4UKRAINE” in the “Other, specify” free text field under Additional/Other TB Risk Factors (item 16 of the 2020 RVCT; item 34 of the 2009 RVCT).

8. Award Notices:

Recipients will receive an electronic copy of the Notice of Award (NOA) from CDC Office of Grant Services (OGS). The NOA shall be the only binding, authorizing document between the recipient and CDC. The NOA will be signed by an authorized Grants Management Officer (GMO) and emailed to the recipient’s Program Director and Business Officer listed in application.

Estimated Award Date:  February 1, 2023