[Federal Register Volume 68, Number 15 (Thursday, January 23, 2003)]
[Notices]
[Pages 3326-3359]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-1065]



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Part II





Department of Health and Human Services





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Centers for Disease Control and Prevention



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Chronic Disease Prevention and Health Promotion Programs; Notice

  Federal Register / Vol. 68, No. 15 / Thursday, January 23, 2003 / 
Notices  

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 03022]


Chronic Disease Prevention and Health Promotion Programs

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2003 funds for a cooperative agreement 
program for Chronic Disease Prevention and Health Promotion Programs.

Table of Contents

A. Authority and Catalog of Federal Domestic Assistance
B. Purpose
C. Eligible Applicants--See Appendix ``D'' for Current Program 
Announcement Numbers and Titles
D. Funding
    Specific Requirements for Each Component Are Incorporated Under 
Sections D.1. to D.7. Through G.1. to G.7. Sections A Through C and 
H Through J Apply to All Components.
E. Program Requirements
F. Content
G. Evaluation
H. Submission and Deadline
I. Other Requirements
J. Where to Obtain Information

A. Authority and Catalog of Federal Domestic Assistance Number

Components 1 (Tobacco), 2 (Nutrition, Physical Activity, Obesity), 4 
(Oral Disease), 6 (BRFSS), and 7 (Genomics)
    This program is authorized under section 301 (a) and 317 (k) (2) of 
the Public Health Service Act, [42 U.S.C. section 241 (a) and 247b(k) 
(2), as amended]. The Catalog of Federal Domestic Assistance number is 
93.283.
Component 3--WISEWOMAN
    This program is authorized under sections 1501-1509 [42 U.S.C. 
300k-300n-4a] of the Public Health Service Act, as amended. The 
consolidated Appropriations Act, 2000, Public Law 106-113, also 
authorizes this program. The Catalog of Federal Domestic Assistance 
(CFDA) number is 93.283. See http://www.cdc.gov/wisewoman/legislationhighlight.htm for WISEWOMAN authorization and link to BCCEDP 
legislation.
Component 5--Arthritis
    This program is authorized under section 301(a) and 317(k) (2) of 
the Public Health Service Act, [42 U.S.C. section 241 (a) and 247b(k) 
(2), as amended]. The Catalog of Federal Domestic Assistance number is 
93.945.

B. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2003 funds for a cooperative agreement 
program for Chronic Disease Prevention and Health Promotion Programs. 
This program addresses the ``Healthy People 2010'' focus areas of 
Tobacco Use, Physical Activity and Fitness, Nutrition and Overweight, 
Public Health Infrastructure, Oral Health, Arthritis, Osteoporosis, 
Back Conditions, Educational and Community-Based Programs, Cancer, 
Diabetes, Genomics, and Surveillance and Data Systems.
    The purpose of the program is to support capacity building, support 
program planning, development, implementation, evaluation, and 
surveillance for current and emerging chronic diseases conditions.
    The Centers for Disease Control and Prevention, National Center for 
Chronic Disease Prevention and Health Promotion (NCCDPHP) is issuing 
this program announcement in an effort to simplify and streamline the 
grant pre-award and post-award administrative process, provide 
increased flexibility in the use of funds, measure performance related 
to each grantee's stated objectives and identify and establish the 
long-term goals of Health Promotion programs through stated performance 
measures. These efforts include incorporation of improved performance 
measures, enhancement of short and long term objectives, combining 
multiple reports, establishment of consistent reporting requirements, 
and advancing from one public health program funding level to a higher 
level based on performance.
    This program announcement incorporates funding guidance for the 
following seven program components: Tobacco; Nutrition, Physical 
Activity, and Obesity; Well Integrated Screening and Evaluation for 
Women Across the Nation (WISEWOMAN); State-based Oral Disease 
Prevention; Arthritis; Behavior Risk Factor Surveillance Systems 
(BRFSS); and Genomics and Chronic Disease Prevention programs.
    CDC encourages recipients to identify opportunities to link chronic 
disease and health promotion efforts across this and related program 
announcements, where appropriate (i.e. cardiovascular health, diabetes, 
genomics, tobacco, nutrition and physical activity, obesity, etc.). 
These efforts could include co-funding of recipient activities and cost 
sharing of staff time, in support of shared, overlapping objectives 
across program components and cooperative agreements. Such 
complementary activities must meet the program objectives of the funded 
component/program.
    Your application should be submitted as one application but should 
consist of each separate Specific Categorical Component. Applications 
will be due on March 28, 2003. The categorical components and specific 
purposes for each are:
    Component 1: Comprehensive State-Based Tobacco Prevention and 
Control Programs--The purpose of this program is to achieve four 
Program Goals through community interventions and mobilization; 
counter-marketing; policy development and implementation; and 
surveillance and evaluation. The goals are: prevent initiation to 
tobacco use among young people; eliminate exposure to second hand 
smoke; promote cessation among adults and young people who use tobacco; 
and identify and eliminate tobacco-related disparities among specific 
population groups.
    Component 2: State Nutrition and Physical Activity Programs to 
Prevent Obesity and Other Chronic Diseases--The purpose of the program 
is to prevent and control obesity and other chronic diseases by 
supporting States in the development and implementation of science-
based nutrition and physical activity interventions. Major program 
areas are: balancing caloric intake and expenditure; improved nutrition 
through increased breastfeeding and increased consumption of fruits and 
vegetables; increased physical activity; and reduced television time. 
See Goals at http://www.cdc.gov/nccdphp/dnpa/rfainformation.htm.
    Component 3: Well integrated Screening and Evaluation for Women 
Across the Nation (WISEWOMAN)--The purpose of this program is to 
support health promotion efforts through the WISEWOMAN program, 
focusing on early detection of chronic diseases and their associated 
risk factors and prevention of chronic diseases through lifestyle 
interventions. The WISEWOMAN program promotes a healthy lifestyle 
through increased physical activity, improved nutrition, weight 
control, and smoking cessation. The target population is women aged 40-
64 years old who are participants in the National Breast and Cervical 
Cancer Early Detection Program (NBCCEDP) comprehensive screening 
programs funded by the Centers for Disease Control and Prevention 
(CDC). Because eligibility for the NBCCEDP is based on inadequate 
health insurance coverage and lack of financial resources, the 
WISEWOMAN program aims to increase access to quality care through 
screening

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for conditions such as high cholesterol and high blood pressure using 
methods detailed in national clinical guidelines. Along with lifestyle 
interventions, medical referral and follow-up are also important 
components of the program.
    Component 4: State-Based Oral Disease Prevention Programs--The 
purpose of this program is to establish, strengthen and expand the 
capacity of States, Territories, and tribes to plan, implement, and 
evaluate population-based oral disease prevention and health promotion 
programs, targeting populations and oral disease burden, as outlined in 
``Oral Health in America: A Report of the Surgeon General,'' and can be 
found using the following link http://www.surgeongeneral.gov/library/oralhealth.
    Component 5: Arthritis--The purpose of this program is to assist 
States in developing, implementing, and evaluating State level programs 
to control of arthritis and other rheumatic conditions. This program 
emphasizes State-based leadership in coordinating State Health 
Department capacity to reduce the burden of arthritis within the State. 
Programmatic efforts should focus on persons affected by arthritis, 
i.e., persons already experiencing the systems of arthritis, their 
families, and others treating or providing services for persons with 
arthritis. By targeting persons affected by arthritis, prevention 
strategies are secondary and tertiary, focusing on prevention of 
disability and improving quality of life. There will be two levels of 
activities for this component: Capacity Building Program Level A and 
Capacity Building Level B. See ``Recipient Activities'' for specific 
activities for each level.
    Component 6: Behavior Risk Factor Surveillance Systems (BRFSS)--The 
purpose of this program is to provide financial and programmatic 
assistance to State Health Departments to maintain and expand (1) 
specific surveillance using telephone survey methodology of the 
behaviors of the general population that contribute to the occurrence 
of prevention of chronic diseases and injuries, and (2) the collection, 
analysis, and dissemination of BRFSS data to State categorical programs 
for their use in assessing trends, directing program planning, 
evaluating programs, establishing program priorities, developing 
policy, and targeting relevant population groups.
    Component 7: Genomics and Chronic Disease Prevention--The purpose 
of the program is to assist States in developing agency-level genomics 
leadership and coordination capacity that ensures effective planning, 
implementation and evaluation of knowledge and tools for using genetic 
risk factors and family history in improving chronic disease prevention 
and health outcomes. The study of genes and their function has led to 
recent advances in genomics and our understanding of the molecular 
mechanisms of disease, including the complex interplay of genetic and 
environmental factors. This program requires the integration of 
genomics and family history assessments into ongoing and new 
population-based strategies for identifying and reducing the burden of 
specific chronic, infectious and other diseases. Of particular 
importance is enhanced planning and coordination to integrate genomics 
into core State public health specialties of genomics within State core 
public health specialties (such as epidemiology, laboratory activities, 
and environmental health) and to facilitate the effective application 
of new knowledge, enable effective application of new knowledge about 
gene-environment interactions, and crosscutting family history 
information to chronic disease prevention opportunities.

    Note: The following statements are applicable for all 
Components: Measurable outcomes of the program will be in alignment 
with one or more of the following performance goals for the National 
Center for Disease Prevention and Health Promotion (NCCDPHP): Reduce 
cigarette smoking among youth; support prevention research to 
develop sustainable and transferable community-based behavioral 
interventions; increase the capacity of State arthritis programs to 
address the prevention of arthritis and its complications at the 
community level; help States monitor the prevalence of major 
behavioral risks associated with premature morbidity and mortality 
in adults to improve the planning, implementation, and evaluation of 
disease prevention and health promotion programs; support high-
priority State and local disease prevention and health promotion 
programs, and to help State use genetic information in their public 
health programs.
    Applicants are required to provide measures of effectiveness 
that will demonstrate the accomplishment of the various identified 
objectives of the grant or cooperative agreement. Measures of 
effectiveness must relate to the performance goal (or goals) as 
stated in section ``B. Purpose'' of this announcement. Measures must 
be objective and quantitative and must measure the intended outcome. 
These measures of effectiveness shall be submitted with the 
application and shall be an element of evaluation.

C. Eligible Applicants

Limited Competition
    Assistance will be provided only to the health departments of 
States or their bona fide agents, including the District of Columbia, 
the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth 
of the Northern Mariana Islands, American Samoa, Guam, the Federated 
States of Micronesia, the Republic of the Marshall Islands, the 
Republic of Palau, and Federally recognized Indian tribal governments. 
A bona fide agent is an agency/organization identified by the State as 
eligible to submit an application under the State eligibility in lieu 
of a state application.
    All applications received from current grant recipients under 
Program Announcements 99038, Component 1, (Comprehensive State-Based 
Tobacco Use Prevention and Control Programs); 00115 and 99135, 
Component 3 (Well Integrated Screening and Evaluation for Women Across 
the Nation WISEWOMAN) and 01098 (WISEWOMAN Enhanced); 01046, Component 
4 (Support for State Oral Disease Prevention Programs); 01097, 
Component 5 (Reducing the Impact of Arthritis and Other Rheumatic 
Conditions); 99044, Component 6, (Behavior Risk Factor Surveillance 
Systems) will be funded upon receipt and approval of a technically 
acceptable application. In addition to the eligible applicants above, 
potential applicants that are eligible for specific components 2, 3, 4, 
5, 6, and 7 are:
    Component 2--State Nutrition and Physical Activity Programs to 
Prevent Obesity and Other Chronic Diseases: Eligibility for this 
component is limited to States, Territories, and the District of 
Columbia. Applicants can apply for either or both programs, ``Capacity 
Building or Basic Implementation funding.'' Applicants awarded Basic 
Implementation funds will not be considered for Capacity funding. 
Applicants applying for both programs must submit two separate 
applications for this component.
    Component 3--WISEWOMAN: Assistance will be provided only to the 
health departments of certain States/Territories/Tribes or their bona 
fide agents who are currently receiving grants under Section 1501 of 
the Public Health Service Act. Applicants are eligible for one of two 
levels of funding for one of two types of projects, Standard or 
Enhanced (see Appendix A: Eligibility and Appendix B: Type of Program 
and Performance Requirements for more details).
    Component 4--State-Based Oral Disease Prevention Programs: The 13 
States currently receiving CDC funds for CORE Programs under Program 
Announcement 01046 are eligible to apply for Part 1 Capacity Building 
Program: Alaska, Arkansas, Colorado, Illinois, Michigan, New York, 
Nevada,

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North Dakota, Oregon, the Republic of Palau, Rhode Island, South 
Carolina, and Texas.
    Current CORE Program grantees that apply for Basic Implementation 
Program funding in year two and are not funded will continue to receive 
funding for the CORE (Capacity Building) Program. To make this 
possible, currently funded CORE (Capacity Building) Program grantees 
must provide a separate CORE (Capacity Building) Program Logic Model, 
Work Plan, budget, and budget justifications that addresses CORE 
(Capacity Building) Program activities to expedite the award process.
    Component 5--Arthritis: The only eligible applicants for Capacity 
Building Level B Funding during year one of this program announcement 
are the following 27 States which are currently funded under Program 
Announcement 01097, Reducing the Impact of Arthritis and Other 
Rheumatic Conditions: Alaska, Arizona, Arkansas, Colorado, Connecticut, 
Idaho, Indiana, Iowa, Kentucky, Maryland, Michigan, Nebraska, Nevada, 
New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, 
Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, 
Virginia, and Wisconsin. These States may not apply for Capacity 
Building Program Level A funding during year one of this announcement.
    Eligible applicants for Capacity Building Program Level A are those 
currently funded under Program Announcement 99074 and health 
departments other than those listed above who meet the requirements 
outlined in the ``Recipient Activities'' section of this Component for 
Capacity Building Program Level B and Capacity Program Level A.
    Component 6--Behavior Risk Factor Surveillance Systems (BRFSS): 
Assistance will be provided only to the existing 54 health departments 
funded under the Behavioral Risk Factor Surveillance, Program 
Announcement Number 99044.
    Component 7--Genomics: Assistance will be provided only to the 
health departments of States or their bona fide agents. A bona fide 
agent is an agency/organization identified by the state as eligible to 
submit an application under the State eligibility in lieu of a State 
application.

D. Availability of Funds

    Approximately $91,700,000 is available in FY 2003 to fund 
approximately 194 awards.
    It is expected that the awards will begin on or about June 30, 2003 
and will be made for a 12-month budget period within a project period 
of up to five years.
    Pending availability of funds, beginning in year two and each of 
the remaining years for this program announcement (June 30, 2004 
through June 30, 2008), there will be an open season for competitive 
applications. Specific guidance will be provided with exact due dates 
and funding levels each year.
    Applications from all new applicants as well as all currently 
funded programs, whose project period have ended or will end in FY 
2003, will be competitively reviewed by an independent Objective Review 
Panel.
    Continuation awards for year two and beyond will be made on the 
basis of satisfactory progress made toward the attainment of the goals, 
objectives, and corresponding performance measures as evidenced by 
required reports, and based on the availability of funds. Additional 
information is listed on a component-by-component basis.
Component 1: Comprehensive State-Based Basic Tobacco Prevention and 
Control Programs
D.1. Availability of Funds
    Approximately $57 million is available in FY 2003 to fund 59 
awards.
    In year one, States and Territories currently funded under program 
announcement 99038 should apply for the same base amount that is 
currently received on a non-competitive basis. Applicants should refer 
to ``Recipient Financial Participation'' for information on required 
matching funds. The remaining unfunded Territory is Marshall Island 
that is eligible to apply for funds in the amount of $100,000 to 
$125,000. If Marshall Island submits an application, it will be 
reviewed under a competitive review process.
    Continuation award amounts may be adjusted should a State receive 
lawsuit settlement funds, general funds, or excise tax funds for the 
State's comprehensive program.
Use of Funds
    CDC funds cannot be used to supplant existing State funding. 
Applicants may not use these funds to supplant funds from Federal or 
State sources, the Preventive Health and Health Service Block Grant or 
Center for Substance Abuse Prevention funding for youth access 
enforcement. Applicants must maintain current levels of support 
dedicated to tobacco use prevention and control from Federal, State 
sources, or the Preventive Health and Health Services Block Grant.
    Funds may not be used to conduct research. Surveillance and 
evaluation activities are for the purposes of monitoring program 
performance, and are not considered research.
    Cooperative agreement funds must be used for focused strategies to 
change systems, develop and implement policies, change the environment 
in which tobacco use occurs, and impact population groups rather than 
individuals. To this end, cooperative agreement funds may not be used 
to provide direct services such as individual and group cessation 
services, patient care, personal health services medications, patient 
rehabilitation, or other costs associated with the treatment of 
diseases caused by tobacco use. Funds may be used to support activities 
in line with CDC ``Guidelines for School Health Program to Prevent 
Tobacco Use and Addiction'' including curricula but may not be used for 
staff time to provide direct classroom instruction of students. 
Cooperative agreement funds may not be used to directly enforce tobacco 
control policies unless there are extenuating circumstances within the 
State. A justification must be provided and reviewed.
Recipient Financial Participation
    Federal sources as follows. During the first year of the award, 
States receiving funding from another source(s) that is equal to or 
greater than the CDC award will match one dollar of direct cash match 
from non-Federal sources for every dollar of Federal funds. All other 
States and Territories that do not receive funds from non-Federal 
sources that are equal to or greater than the CDC award will provide 
one dollar of cash or in-kind match from non-Federal sources for every 
ten dollars of Federal funds.
    Beginning in the second year and in each subsequent year of the 
award, all States and Territories will provide one dollar from non-
Federal sources for every four dollars of Federal funding. The match 
may be cash, in-kind, or a combination from State and/or public and 
private sources.
    Technical assistance will be available for potential applicants 
through the following means: a minimum of two conference calls to be 
held on or around December 12, 2002 and January 10, 2003.
E.1. Program Requirements
    In conducting activities to achieve the purpose of this program 
component, the recipient will be responsible for the activities under 
``1. Recipient Activities,'' and CDC will be responsible for the 
activities listed under ``2. CDC Activities.''

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    1. Recipient Activities. a. Program Management. Identify and hire 
staff with the appropriate competencies to manage a tobacco prevention 
and control program and provide information to demonstrate that 
management staff are at a level within the agency to affect the 
decision making process related to the tobacco program.
    A suggested minimum number of staff would be seven FTEs including 
one FTE Program Manager and one FTE for administrative support. Staff 
should have knowledge and skills in: Program development, coordination 
and management; fiscal management including management of funding to 
State and local partners; leadership development; tobacco control and 
prevention content; cultural competence; public health policy including 
analysis, development and implementation; community outreach and 
mobilization; training and technical assistance, health communications 
including counter-marketing; strategic use of media including media 
advocacy, earned and paid media; strategic planning; gathering and 
analyzing data (surveillance); and evaluation methods.
    Funding from other sources increases the scope of the program, 
requiring additional staff to administer and monitor the program. A 
suggested number of staff based on increased funding levels would be an 
additional one to eight FTEs for a total of eight to sixteen FTEs with 
program justification including description of activities funded 
through other sources. The Program Manager and the administrative 
support position should be FTEs within the State Health Department 
(SHD). Other positions may be SHD FTEs or may be contractual.
    Performance will be measured by evidence that the SHD has dedicated 
human resources to administer and manage the program effectively that 
is consistent with the competencies and staffing levels identified 
above in item (a) ``Program Management.''
    Evidence of the provision of ongoing training for staff can be 
demonstrated through staff participation in CDC sponsored training, 
meetings and conferences and other continuing education opportunities 
as identified by SHD program staff.
    Evidence of organizational impact could be demonstrated by 
providing evidence that management staff have organizational access to 
the State Health Officer and by providing information to support senior 
level management involvement in the tobacco program.
    b. Fiscal Management. 1. Describe how funding to support State and 
local programs that focus on population-based strategies, are science-
based and policy-focused, and reach diverse groups will be 
accomplished.
    2. Track and monitor the health and economic burden of tobacco use 
in the State through surveillance and evaluation activities, program 
activities supporting goals and objectives, tracking policy development 
and implementation.
    Performance will be measured by evidence that the SHD activities 
resulted in accomplishment of items (a) through (d) above.
    c. Strategic Planning. Develop a five-year strategic plan with 
active participation of State and local partners. The strategic plan 
should reflect all tobacco prevention and control activities in the 
State. It should be linked to and complement the SHD comprehensive 
cancer control plan, the cardiovascular health plan and other SHD plans 
to reduce tobacco-related chronic diseases. The five-year strategic 
plan should include: Description of evidence-based program and policy 
strategies tailored to data determined State needs; a logic model 
linking activities to outputs and short-term and intermediate outcomes 
using specific, measurable, achievable, relevant, and time bound 
program objectives; program evaluation activities including a summary 
and time-line for data collection activities; program components that 
address counter-marketing and strategic use of media advocacy and paid 
media when appropriate); strategies to address the four program goal 
areas.
    Performance will be measured by evidence that a five-year basic 
implementation, strategic State tobacco control plan has been developed 
and will be updated based on environmental changes. Evidence can be 
shown by a description of how the plan was developed and the submission 
of a plan that is consistent with the activities described above in 
item (a) ``Strategic Planning.''
    d. Surveillance and Evaluation. Develop and implement a basic 
implementation evaluation plan with stakeholder's involvement. The 
evaluation plan should include clear goal-based logic models, with 
outputs, short, intermediate, and long-term objectives; data collection 
on key tobacco-related indicators using valid methods that are 
comparable across States; data collection timetables, the production 
and dissemination of evaluation reports and establishment of a method 
to track the number and type of policy and systems changes that promote 
cessation. References U.S. HHS CDC ``Introduction to Program Evaluation 
for Comprehensive Tobacco Control Programs, November 2001'' and the 
upcoming report on key indicators that can be used to monitor and 
evaluate State level tobacco control programs (expected publication 
date: Spring 2003) for additional information.
    Performance will be measured by accomplishment of the activities 
described above in item (a) ``Surveillance and Evaluation'' and by 
providing the following evidence: A description of a comprehensive 
evaluation plan, including the involvement of stakeholders in the 
evaluation planning process; recommendations made and/or actions taken 
by an advisory group or task force composed of diverse State and local 
representation; a description of the data collection activities, 
including methodologies and data analysis; a description of process and 
outcome objectives and indicators to be used in program evaluation; a 
description of the SHD's role in coordinating surveillance and 
evaluation efforts and providing technical assistance and training on 
program monitoring, data collection, and evaluation; the production of 
useful evaluation reports, and the utilization of evaluation findings 
to improve, expand, or maintain the tobacco control program.
    e. Collaboration and Communication with Partners. Develop and 
maintain Statewide and local active partnerships that support the goal 
of reducing or eliminating the health and economic burden of tobacco 
use and an effective communication system with partners at the State 
and local level. Partnerships may include Statewide and local 
organizations, voluntary health organizations, universities, local 
health departments, organizations that represent diverse communities, 
community based organizations, Statewide and local coalition, and 
boards commissions, and advisory groups with responsibility for the 
State Tobacco Control Program. Working with partners includes capacity 
building with those organizations through technical assistance, 
training and educational activities.
    Performance will be measured by accomplishment of the activities 
described above in item (a) ``Collaboration and Communication with 
Partners'' and by providing the following evidence: Submission of 
letters of support that clearly define the level of commitment from the 
organization; description of grants, contacts, and memoranda of 
understanding; membership lists; active participation in meetings; 
clear role definitions for partners; active

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participation in Statewide and local planning including media 
campaigns, tobacco control plans, and conference. Evidence can be shown 
by: Description of stakeholder communication plan which employs 
multiple channels including Statewide list serve; Statewide conference, 
trainings, and information exchanges; electronic newsletters and 
updates; Statewide teleconferences; Web site postings; site visits; and 
videos.
    f. Local Grant Programs. Support local programs to establish 
grassroots networks at the community level. Support should be 
sufficient for designated staff at the local level to establish and 
participate in local coalitions, partnerships, and task forces for 
local policy development and implementation; local environmental scan; 
development and implementation of a written plan to work toward policy 
goals and participation in State participation in State evaluation and 
data collection efforts; access to tobacco control information through 
a variety of sources such as journals, Internet Web sites and list 
serves. Refer to U.S. HHS, CDC ``Best Practices for Comprehensive 
Tobacco Control Programs-August 1999,'' and American Journal of 
Preventive Medicine ``Community Prevention Services Guidelines for 
Tobacco Use, February 2001'' for information about local programs.
    Performance will be measured by accomplishment of the activities 
described above in item (a) ``Local grant program.''
    g. Training and Technical Assistance. Develop and implement a 
technical assistance and training process to address the needs of local 
health department staff, coalitions, and partners involved in tobacco 
prevention and control activities.
    Performance will be measured by evidence that training and 
technical assistance needs have been assessed and provided by the State 
Tobacco Control Program to local health department staff, coalitions, 
and partners. Evidence can be shown by: The number and description of 
trainings planned and/or provided that include the strategic purpose of 
the trainings and anticipated impacts as related to short-term and 
long-term outcomes, description of the process and strategy to provide 
technical assistance.
    h. Prevent Initiation of Tobacco Use Among Young People. Develop 
and implement science-based policy-focused strategies identified in the 
State strategic plan to prevent youth initiation of tobacco use.
    Performance will be measured by accomplishment of the activities 
described above in item ``(a) Prevent Initiation to Tobacco Use Among 
Young People.'' Evidence can be shown by describing: Multi-component 
community interventions to reduce youth initiation that are science-
based and policy focused such as price increase for tobacco products; 
educational activities that address the efficacy of policy initiatives 
such as restrictions on tobacco advertising, promotion and sponsorships 
and retailer licensing regulations; tobacco-free school policies school 
policies; identification of disparities related to youth initiation to 
tobacco use; partnerships with State and local education organizations 
to promote CDC ``Guidelines for School Health Programs to Prevent 
Tobacco Use and Addiction;'' Counter-marketing strategies that include 
media advocacy and paid advertising to disseminate messages regarding 
youth access; pro-health messages; State evaluation and data collection 
efforts to demonstrate local programs toward policies to reduce youth 
initiation.
    i. Eliminate Exposure to Second Hand Smoke. Develop and implement 
science-based policy-focused strategies to reduce exposure to second 
hand smoke.
    Performance will be measured by accomplishment of the activities 
described above in item (a) ``Eliminate Exposure to Secondhand Smoke.'' 
Evidence can be shown by describing: Local coalition objectives and 
evidence-based activities that are linked to a policy change leading to 
short-term and long-term outcomes as identified within the State plan; 
counter-marketing strategies that are supportive of local policy 
efforts, including both earned and paid media and the numbers of people 
reached through earned and paid media strategies; recommendations made 
and/or actions taken by an advisory group or task force composed of 
diverse State and local representation; a description of disparities 
related to exposure to secondhand smoke and strategies to reduce those 
disparities; actions taken to expand policy coverage to new communities 
and/or to strengthen policies in communities where they are already in 
place. Evidence can also be shown by a State-specific database that 
tracks local clean indoor air ordinances work, where pre-emption 
exists, voluntary policies and reporting of the number of policies 
implemented; State evaluation and data collection efforts to 
demonstrate local progress toward policies to eliminate exposure to 
secondhand smoke.
    j. Promote Cessation Among Adults and Youth. Implement science-
based policy-focused strategies as defined in the State strategic plan 
to promote cessation among adults and youth.
    Performance will be measured by accomplishment of the activities 
described above in item ``(a) Promote Cessation Among Adults and 
Youth.'' Evidence can be shown by describing: Strategies to promote 
guidelines published in ``U.S. DHHS Public Health Services Treating 
Tobacco Use and Dependence'' and ``Community Prevention Services 
Guidelines for Tobacco Use;'' strategies to reduce identified 
disparities; counter-marketing strategies that incorporate earned and 
paid media to provide information about and motivation for quitting and 
reach diverse populations and the number of people reached with paid 
media; Statewide activities, as detailed in the State strategic plan, 
to promote effective methods for quitting including support for and 
promotion of policy development and initiatives related to cessation 
services; links between the State program and other organizations to 
support and promote cessation.
    k. Identify and Eliminate Tobacco-related Disparities among 
Specific Population Groups. Identify and eliminate disparities in 
specific population groups related to (1) preventing initiation among 
young people; (2) eliminating exposure to secondhand smoke; and (3) 
promoting cessation among adults and youth.
    Performance will be measured by accomplishment of activities in 
item (a) ``Identify and eliminate tobacco-related disparities among 
specific population groups.'' Evidence can be shown by: Assessing 
national data sources and research related to at-risk populations; 
outlining demographics reflecting Statewide diversity; coordinating 
available State and national data with at-risk populations in the 
State; augmenting State data with qualitative data (i.e. population 
assessments of specific population groups); examining the potential 
limitations of data used; identifying and developing new quantitative 
and qualitative-based methodologies for data collection among specific 
population groups, developing strategies and initiatives to build 
capacity and infrastructure among disparately-affected population 
groups. If States have participated in the Office on Smoking and 
Health's Disparities Pilot Training, additional evidence can be shown 
by demonstrating the implementation of interventions based on strategic 
plan to identify and eliminate tobacco-related disparities

[[Page 3331]]

developed by a diverse and inclusive workgroup.
    1. Information Exchange. Develop and implement mechanisms to 
facilitate information exchange between the State Tobacco Control 
Program, the CDC, tobacco control program personnel in other States, 
and national partners.
    Performance will be measured by accomplishment of the activities 
described above in item (a) ``Information Exchange.''
    Evidence can be shown by: Establishing a communication loop with 
CDC for the exchange and dissemination of information about program 
effectiveness, progress toward short and long-term objectives as 
defined in the strategic plan; participation on CDC sponsored 
workgroups/task forces and the frequency of that participation, number 
of presentations at national meetings and conferences, number of 
publications of data and evaluation outcomes via ``Morbidity and 
Mortality Weekly Report'' (MMWR), peer-reviewed journals or as reports, 
number of reports on collaboration with programs and partners in 
neighboring States; posting information and resources on the CDC State 
forum; participation with Association of State Territorial Health 
Officers (ASTHO) regional networks and Tobacco Control Resource council 
and/or other tobacco-related projects sponsored by ASTHO.
    2. CDC Activities. a. Provide ongoing guidance, consultation, 
technical assistance, and training in tobacco use prevention and 
control as described under ``Recipient Activities.''
    b. Provide up-to-date information that includes diffusion of best 
practices for tobacco use prevention and control.
    c. Provide resources and technical assistance to develop and 
improve monitoring and surveillance systems. Provide guidance to States 
to identify indicators that can be used to monitor and evaluate State 
level tobacco control programs.
    d. Facilitate adoption of effective practices among grantees and 
other partners through workshops, conferences, training sessions, 
electronic and verbal communications.
    e. Identify, develop, and disseminate media campaign materials for 
use by programs; facilitate coordination of counter advertising 
materials between programs; provide technical assistance on design, 
development, and evaluation of media.
    f. Maintain an electronic center for State information sharing, 
State Forum, and the Chronicle, for progress reporting.
    g. Develop and maintain partnerships with Federal and non-Federal 
organizations to assist in tobacco control and create a national 
infrastructure to complement State infrastructure.
    h. Serve as a resource to States with regard to identifying and 
eliminating tobacco-related disparities among population groups.
    i. Maintain a Web site with access to a data warehouse that 
contains comparable measures of tobacco use prevention and control from 
different data sources.
F.1. Content
    The program announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. The narrative for this component, including the Executive 
Summary, should be no more than 45 double-spaced pages, printed on one 
side, with one-inch margins, and unreduced 12-point font. The annual 
action plan may be 20 pages, which will allow a total of 65 pages for 
the application (excluding budget and appendices). Appendices should 
total no more than 20 pages, excluding letters of support and the 
budget.
    Focus the application content ONLY on the planned ``Recipient 
Activities'' for which you seek CDC funding. However, the Background 
and Need content should describe accomplishments regardless of funding 
source. Include a description of why CDC funding is needed and how 
these funds will be used strategically to complement other funding 
sources.
    Provide supporting documentation such as resumes, job descriptions, 
and descriptions of coalitions and committees as appropriate. All 
materials must be suitable for photocopying.
    1. Executive Summary. Provide a narrative, not to exceed two pages 
and summarize: The environment in which tobacco control has been 
conducted, including barriers and supportive factors; accomplishments; 
anticipated needs; plans to address the Program Goals. Indicate major 
areas of future program focus.
    2. Program Narrative. Provide a narrative, not to exceed 43 pages, 
describing the burden of tobacco use, accomplishments to date, and 
areas of unmet needs. Provide specific reference to the following 
elements of State health department tobacco control program.
    a. Background and Need. Describe the burden of tobacco use 
including prevalence rates and the economic costs of tobacco use. 
Describe existing policies at the State and local level. Describe 
progress toward reducing the burden of tobacco use. Describe major 
tobacco control activities conducted in the State and how CDC funds 
will enhance these programs as well as other chronic disease and health 
promotion areas. Describe, if applicable, the impact of State budget 
cuts on program priorities and activities that will not be 
accomplished.
    b. State Health Department Infrastructure and Program Management. 
Describe current staff. Describe plans to develop a staffing pattern 
consisting of qualified technical, program, and administrative staff 
that are diverse and representative of the State population. Describe 
how program staff will have access to opportunities for professional 
training. Describe how the staffing pattern will enable sharing of 
information, resources, and materials with CDC and the national 
program. Describe how involvement of senior management and 
communication with the State Health Officer will be assured.
    3. Organization. Provide an organizational chart showing placement 
of the tobacco control program within the organization, indicating 
accountability and lines of communication.
    4. Fiscal Management. Describe plans to fill vacancies to minimize 
start-up delays, assure out-of-State travel, and administer funds to 
governmental and non-governmental entities at the State and local 
level. Describe accomplishments and barriers in providing funding to 
support State efforts. Describe accomplishments and barriers in 
providing funding to support State efforts. Describe accomplishments 
and barriers in filling staff vacancies, supporting out-of-State 
travel, and reducing start-up delays. Describe a plan for maintaining 
adequate staffing to administer the program should budget cuts, hiring 
freezes, etc. occur.
    5. Strategic Plan. Provide a copy of the five-year comprehensive 
strategy that meets the criteria in Recipient Activities (2) Strategic 
Planning and describe how the plan was developed based on the process 
in Recipient Activities (2). Demonstrate how the plan links to and 
complements the SHD's comprehensive cancer control plan, the 
cardiovascular health plan, and other SHD plans to reduce tobacco-
related chronic diseases. If a comprehensive strategic plan does not 
currently exist, describe how a plan will be developed and the expected 
completion date. Describe the process by which the strategic plan will 
be updated. Indicate

[[Page 3332]]

who will be responsible for maintaining the plan.
    6. Surveillance and Evaluation. Describe accomplishments. List the 
tracking systems used and/or needed at the State and local levels. 
Describe surveillance and evaluation activities currently being 
undertaken. Refer to U.S. HHS CDC ``Introduction to Program Evaluation 
for Comprehensive Tobacco Control Programs, November 2001.'' Describe 
involvement of stakeholders or advisory group in development of 
surveillance and evaluation approach. Describe barriers and identify 
methods to overcome them. Describe unmet needs and plans to address 
them.
    7. Collaboration and Partnerships. Describe plans to develop, 
strengthen and maintain partnerships and coalitions through linkages 
with other national, regional, State, and local level governmental, and 
non-governmental entities. Specify partner organizations and the 
purpose of those partnerships. Describe current State coalition members 
and plans to recruit new members. Describe plans to identify new 
partners including proposed partners and purpose of partnerships. 
Describe plans to maintain and strengthen participation by groups 
identified as experiencing tobacco related health disparities.
    Describe plans to collaborate with CDC and other Federal agencies, 
including participation in national or regional meetings and 
workgroups, and using the Internet to communicate and disseminate 
information.
    Describe how the State's and partners' roles will complement each 
other as part of the overall effort. Provide letters of support 
demonstrating collaborative activities, roles, responsibilities, and/or 
commitment of funds or other resources.
    Describe communication methods and channels used to inform and 
solicit information from stakeholders. Describe how the stakeholder 
communication plan was developed. Describe barriers in communicating 
with stakeholders. Describe plans to improve communication.
    8. Local Grant Programs. Describe existing local grants programs 
including funded organizations and level of funding, policy-focused 
activities, and collaboration with partners, and participation in 
coalitions. Describe the rationale for funding local organizations. 
Describe local environmental scans and how the scans inform a planning 
process. Describe progress toward policy goals and objectives. Describe 
how personnel access tobacco control information. Describe barriers and 
methods to address them. Describe unmet needs and plans to address 
them. If a local grants program does not currently exist, describe how 
such a program will be developed and implemented, including a timeline 
for implementation, a description of the grant process and eligible 
organizations.
    9. Training and Technical Assistance. Describe the audiences for 
whom training and technical assistance is provided. Describe how 
training and technical assistance needs will be determined. Describe 
activities and how they contribute to advancing the program goals and 
objectives. Describe barriers and methods used to overcome them. 
Identify unmet needs and plans to address them.
    10. Prevention Initiation of Tobacco Use Among Youth. Describe 
activities at the State and local level, including activities that are 
science-based and promote policy interventions. Describe activities to 
promote tobacco-free policy in schools. Describe surveillance and 
evaluation activities. Describe barriers and identify methods to 
overcome them. Describe unmet needs and plans to address them.
    11. Eliminate Exposure to Secondhand Smoke. Describe activities to 
move toward policy development at the local level, identify and 
eliminate disparities, collect and analyze data, conduct counter-
marketing. Describe activities undertaken by State and local 
coalitions/task forces and partnerships. Describe barriers and identify 
methods to overcome them. Describe unmet needs and plans to address 
them.
    12. Promote Cessation for Adults and Youth. Describe activities and 
strategies to promote science-based cessation services and policies. 
Applicants should refer to the ``Community Prevention Services 
Guidelines for Tobacco Use'' and ``U.S. DHHS Public Health Services 
Treating Tobacco Use and Dependence.'' Describe disparities and 
strategies to reduce them. Describe methods used to promote and 
encourage cessation, including counter-marketing, policy development, 
and implementation, and population-based and systems change strategies. 
Describe barriers and methods to overcome them. Describe unmet needs 
and plans to address them.
    13. Identify and Eliminate Tobacco-Related Disparities in Specific 
Populations. Describe the process for identifying and eliminating 
tobacco-related disparities. Include a description of: the national 
and/or State data sources used; the State population demographics; 
rationale for addressing tobacco-related disparities in specific 
population groups; specific strategies and initiatives to build 
capacity and infrastructure among disparately-affected population 
group. Describe the process for developing a strategic plan, if one 
exists, including who was involved and progress in implementation. 
Attach a copy of the plan.
    14. Information Exchange. Describe how State personnel communicate 
and exchange information with Federal, regional, State, and local 
tobacco control personnel in government and partner organizations. 
Describe participation in and collaboration with State and national 
organizations. Describe participation in local, State, regional, and 
national conferences and meetings and the benefits accrued. Describe 
barriers and identify methods to overcome them. Describe unmet needs 
and plans to address them.
    15. Annual Action Plan (no more than 20 pages). Submit an annual 
action plan detailing how the above requirements will be addressed. 
Include objectives with indicators and data sources. When writing long-
term, intermediate, short-term, and annual objectives, use specific, 
measurable, achievable, relevant, and time-bound (SMART) objectives. 
For each of the four program components in the Annual Action Plan, 
indicate key activities. For each activity, include the target group, 
lead role, timeline, and anticipated output. The Annual Action Plan: 
Program Goals form can be used to complete this requirement and will be 
provided at the pre-application workshop.
    16. Budget and Accompanying Justification (no page limit). Provide 
a line-item budget and justification consistent with the stated 
objectives, planned activities, and time frame of the project. Identify 
matching funds. Matching funds may be cash, in-kind or donated services 
or a combination of these made directly or through donations from 
public or private entities. All costs used to satisfy the matching 
requirements must be documented by the applicant. Commit a minimum of 
10 percent of award to surveillance and evaluation efforts. Program 
resources may be used for consultants; staff, survey design and 
implementation, data analysis, or other expenses associated with 
surveillance and evaluation efforts. These activities may fulfill the 
match requirement.
    A maximum of five percent of the award may be used to directly 
support a statewide telephone cessation counseling service with program 
justification.
    Include travel for a minimum of three staff members or selected 
representatives to attend each of two CDC-sponsored training meetings 
per

[[Page 3333]]

year, one staff person to attend a media training, a minimum of two 
staff people to attend one CDC-sponsored Program Management meeting, a 
minimum of two staff people to attend a training on the NTCP Chronicle, 
and a minimum of two staff people to attend the CDC-sponsored national 
tobacco control conference. For purposes of planning, these meetings/
conferences should be budgeted for travel to Atlanta, Boston, and 
Phoenix.

------------------------------------------------------------------------
                                    Number of
              Meeting                 staff             Location
------------------------------------------------------------------------
CDC sponsored training meeting              3  Atlanta, GA.
 (surveillance and evaluation).
CDC sponsored media training......          1  Atlanta, GA.
OSH Program managers meeting......          2  Atlanta, GA.
OSH NCTP Chronicle training.......          2  Atlanta GA.
CDC sponsored national training             3  Phoenix, AZ.
 program.
CDC sponsored national tobacco              2  Boston, MA.
 control conference.
------------------------------------------------------------------------

    States and Territories can request that CDC cover the travel costs 
of out-of-State trainings and meetings for one staff person per 
required meeting or conference. If a State program elects to have CDC 
cover travel costs, clearly state that the program is electing this 
option and provide an estimated expense for travel. Under this 
arrangement, the State award will be reduced by the amount estimated 
for travel plus an additional administrative cost.
G.1. Evaluation Criteria
    Application. Applications received from current grantees that are 
funded under Program Announcement 99038 will be reviewed utilizing the 
Technical Review process. Total possible points equal one hundred. 
Total points = 100.
    a. Background and Need (12 points). The extent to which the 
applicant describes Background and Need in Application Content, 2a.
    b. Annual Action Plan (11 points). The extent to which the annual 
action plan is based on the strategic plan and include activities in 
line with Recipient Activities and Application Content for tobacco 
control program.
    c. Program Management (7 points). The extent to which the applicant 
describes specific Recipient Activities in section 1a-d above and 
activities in Application Content, 2b.
    d. Strategic Plan (7 points). The extent to which the applicant has 
addressed specific Recipient Activities in Section (2); and Application 
Content, b 5.
    e. Surveillance and Evaluation (7 points). The extent to which the 
applicant clearly describes specific Recipient Activities in Section 
(3); and Application Content, b 6.
    f. Collaboration and Communication with Partners (7 points). The 
extent to which the applicant describes specific Recipient Activities 
in Section (4a); and Application Content, b 7.
    g. Local Grant Programs (7 points). The extent to which the 
applicant describes specific Recipient Activities, Section (5); and 
Application Content, b 8.
    h. Training and Technical Assistance (7 points). The extent to 
which the applicant demonstrates specific Recipient Activities in 
Section (6); and Application Content, b 9.
    i. Prevent Initiation to Tobacco Use Among Young People (7 points). 
The extent to which the applicant describes specific Recipient 
Activities in Section (7a); and Application Content, b 10.
    j. Eliminate Exposure to Secondhand Smoke (7 points). The extent to 
which the applicant describes specific Recipient Activities in Section 
(8a); and Application Content, b 11.
    k. Promote Cessation Among Adults and Young People (7 points). The 
extent to which the applicant describes specific Recipient Activities 
in Section (9a); and Application Content, b 12.
    l. Identify and Eliminate Tobacco-Related Disparities Among 
Specific Population Groups (7 points). The extent to which the 
applicant describes specific Recipient Activities in Section (10a); and 
Application Content, b 13.
    m. Information Exchange (7 points). The extent to which the 
applicant describes specific Recipient Activities in Section (11) and 
Application Content, b 14.
    n. Executive Summary (not scored). The extent to which an overview 
of the program is provided in a clear and concise manner.
Component 2: State Nutrition and Physical Activity Programs to Prevent 
Obesity and Other Chronic Diseases
D.2. Availability of Funds
    Approximately $7,000,000 is available in FY 2003 to fund 
approximately 16 State program awards for this component. Approximately 
$2,000,000 is available to fund one to two Basic Implementation 
Programs; approximately $5,000,000 is available to fund twelve to 
fourteen Capacity Building Programs. The average Capacity Building 
Program award will be $400,000 ranging from $350,000 to $450,000. The 
average Basic Implementation Program award will be $700,000 in year one 
ranging from $600,000 to $800,000.
Use of Funds
    Funds awarded under this component of this program announcement may 
not be used to supplant existing State or local funds. Cooperative 
agreement funds may be used to support personnel and to purchase 
equipment, supplies, and services directly related to program 
activities and consistent with the scope of the cooperative agreement. 
Cooperative agreement funds cannot be used to provide patient care, 
health screening, personal health services, medications, patient 
rehabilitation, or other costs associated with the treatment of obesity 
and chronic diseases. Population-based behavioral interventions are 
acceptable.
Recipient Financial Participation
    Recipient financial participation (matching funds) is required for 
only Basic Implementation programs in accordance with this Program 
Announcement. If applying for Basic Implementation programs, matching 
funds are required from non-Federal sources in an amount not less than 
one dollar for each four dollars. The matching funds may be cash or its 
equivalent in-kind or donated services, fairly evaluated. The 
contribution may be made directly or through donations from public or 
private entities.
    Matching funds may not be met through: (1) The payment of treatment 
services or the donation of treatment, or direct patient education 
services; (2) services assisted or subsidized by the Federal 
Government; or (3) the indirect or overhead of an organization. 
Matching funds must be consistent with the work plan activities that 
are submitted and approved.
E.2. Program Requirements
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities

[[Page 3334]]

under 1.a. (Recipient Activities for Capacity Building Program) or 1.b. 
(Recipient Activities for Basic Implementation Programs) and CDC will 
be responsible for the activities listed under 2. (CDC Activities).
    The focus of this program component is implementation of nutrition 
and physical activity strategies for health promotion for the entire 
population and for the prevention and control of obesity. Major program 
areas are: obesity prevention and control including balancing caloric 
intake and expenditure; improved nutrition including increased 
breastfeeding and increased consumption of fruits and vegetables, 
increased physical activity; and reduced television time. For all 
capacity building and basic implementation program recipient 
activities, efforts to address poor nutrition and physical inactivity 
should be coordinated with State Health Agency programs in 
cardiovascular health, cancer, diabetes, oral health, maternal and 
child health (including breastfeeding), arthritis, and WISEWOMAN, as 
well as with the State Agriculture Agency, and coordinated school 
health programs in the State Education Agency (see http://www.cdc.gov/nccdphp/dash/cshpdef.htm for a description of a coordinated school 
health program), and other relevant State Agencies.

1.a. Recipient Activities for Capacity Building Programs

    Note: As part of this program component, detailed descriptions 
of the program and additional information related to Capacity 
Building and Basic Implementation programs are located in 
``Technical Assistance Manual for State Nutrition and Physical 
Activity Programs to Prevent Obesity and Other Chronic Diseases'' at 
http://www.cdc.gov/nccdphp/dnpa/rfainformation.htm. The referenced 
Web site information will assist you in addressing the details of 
the recipient activities when completing your application.


    (1) Develop a Coordinated Nutrition and Physical Activity Program 
Infrastructure. Provide indicators of sound program infrastructure 
including program staff placed high in the organization to coordinate 
the program with other related programs, high level administrative 
commitment to sustain the program, access to resources such as physical 
space, funding, and training, access to scientific resources such as 
subject matter specialists and surveillance resources, and broad 
partnerships to institutionalize nutrition and physical activity. 
Examples of coordination include shared positions; joint planning, and 
combined strategy development and implementation. Organizational 
location of the program is recommended to be in the agency's chronic 
disease or health promotion section so that this program is aligned 
with chronic disease programs, such as cardiovascular health and 
diabetes, to allow for maximum collaboration. (See referenced Web site 
above).
    (a) Staffing. Identify, hire, or reassign, and supervise at least 
three dedicated full-time staff with appropriate competencies to plan 
and implement the program (major program areas: Obesity prevention and 
control including caloric intake and expenditure, improved nutrition 
including increased breastfeeding and increased consumption of fruits 
and vegetables, increased physical activity, and reduced television 
time). Staff includes a full-time high-level program coordinator to 
coordinate the crosscutting nutrition and physical activity functions 
for health department programs and other partners, a full-time physical 
activity coordinator, and a full-time nutrition coordinator. Staffing 
patterns are encouraged to include program skills and expertise 
necessary to carry out the program. Part of staff capacity building 
must be in 5 A Day fruit and vegetable promotion efforts.
    (b) Training. Participation in training, conferences, and frequent 
communication with national and State collaborators including other 
funded States.
    (2) Collaborate and coordinate with State and local government and 
private partners, including members of the population throughout the 
planning process. (See referenced Web site above).
    (a) Develop new linkages and maintain collaborations with State and 
local partners to coordinate nutrition and physical activity efforts, 
especially State Health Agency programs in cardiovascular health, 
cancer, diabetes, oral health, maternal and child health (including 
breastfeeding), arthritis, and WISEWOMAN, as well as the State 
Agriculture Agency, coordinated school health in the State Education 
Agency, and other relevant State Agencies. State programs should serve 
as a training and technical assistance resource for local health 
departments and others to conduct nutrition, physical activity, and 
obesity prevention interventions.
    (b) Collaborate with Prevention Research Centers, academic 
partners, and other relevant organizations in the State.
    (3) Conduct a planning process that leads to a comprehensive 
nutrition and physical activity plan to prevent and control obesity and 
other chronic diseases, and start to implement the plan. (See 
referenced Web site above.)
    (a) Describe the obesity epidemic and other chronic diseases in the 
State related to poor nutrition and physical inactivity.
    (b) Describe the nutrition and physical activity risk factors 
associated with obesity and other chronic diseases.
    (c) Describe the population subgroups affected by obesity that will 
be targeted for interventions.
    (d) Conduct inventories of strategies and programs currently used 
in the State to prevent or control obesity and other chronic diseases 
in one or more settings, such as worksite, faith-based organizations, 
health care services, or communities.
    (e) Establish priorities with and for the subgroups; identify the 
behaviors and influences of the population subgroups which are 
priorities for intervention.
    (f) Use the social-ecological theoretical model to guide State 
planning to address obesity and other chronic diseases in these 
populations; select and implement interventions from the list of proven 
strategies at http://www.cdc.gov/nccdphp/dnpa/rfainformation.htm so 
that multiple levels of influence in the social-ecological model are 
addressed. Consider using a social marketing approach in the 
intervention.
    (g) With key stakeholders, write the comprehensive State plan for 
nutrition and physical activity for the State, not just for the State 
Department of Public Health. One reference document to consider when 
developing the plan is the ``Guidelines for Comprehensive Programs to 
Promote Healthy Eating and Physical Activity'' at http://www.astphnd.org. Documents guiding coordinated school health programs 
are at http://www.cdc.gov/nccdphp/dash/.
    Design the plan to address nutrition and physical activity needs of 
the population including the pediatric population. The State plan 
should address at a minimum the following major program areas: Obesity 
prevention and control including caloric intake and expenditure, 
improved nutrition including increased breastfeeding and increased 
consumption of fruits and vegetables, increased physical activity, and 
reduced television time.
    Include descriptions of how the State Health Department will work 
with the State Education Agency to address nutrition and physical 
activity needs of the population through school programs.
    (h) Begin to implement components of the comprehensive State plan 
for

[[Page 3335]]

nutrition and physical activity by year two.
    (4) Identify and assess data sources to define and monitor the 
burden of obesity. Strengthen capacity to assess the burden of obesity 
and the impact of the program to change overweight and obesity related 
behaviors, particularly nutrition and physical activity. Data systems 
should monitor trends, disseminate data/information, and support 
evaluation efforts. Monitor at minimum, body mass index (BMI), BMI-for-
age, and dietary and physical activity behaviors. Data sources may 
include established surveillance systems (e.g., the Behavioral Risk 
Factor Surveillance System [BRFSS], Pediatric Nutrition Surveillance 
System, Pregnancy Nutrition Surveillance System, and Youth Risk 
Behavior Surveillance System) or alternative sources. Include a review 
process of considering potential changes needed in current surveillance 
systems and designate who is responsible for implementing and 
maintaining the surveillance system. (See referenced Web site above.)
    CDC will work with States to develop standard measures/indicators, 
and States will need to adopt these standardized measures. States are 
encouraged to retain flexible systems that can be modified as needed.
    (5) Implement and evaluate an intervention to prevent obesity and 
other chronic diseases. (Complete between years two to five.)
    Address one or more of the major program areas from the State plan 
in the intervention: Obesity prevention and control including caloric 
intake and expenditure, improved nutrition including increased 
breastfeeding and increased fruit and vegetable consumption, increased 
physical activity, and reduced television time. Provide a balance 
between nutrition and physical activity related interventions. Consider 
using a social marketing approach in the intervention. Specify clear, 
measurable process and impact objectives, and outcome objectives where 
feasible. Programs are encouraged to approach change at the State, 
community (towns, cities, counties, or regions), organizational (e.g., 
worksites), and group level (e.g., families). (See referenced Web site 
above.)
    (6) Evaluate progress and impact of the State plan and intervention 
projects.
    Develop an evaluation plan that includes baseline data and 
intermediate outcomes for the State plan's objectives. CDC has 
developed a plan for evaluating the State Nutrition and Physical 
Activity Programs to Prevent Obesity and Other Chronic Diseases based 
on a logic model framework. State evaluation plans should include 
issues addressed in the national evaluation plan as well as specific 
State program components.
    1.b. Recipient Activities for Basic Implementation Programs. Basic 
Implementation programs will expand their efforts to fully implement 
the State plan by enhancing surveillance activities, implementing 
Statewide interventions, funding communities to implement 
interventions, rigorously evaluating a new or existing intervention, 
and enhancing partnership efforts particularly with coordinated school 
health programs in the State Education Agency and with secondary 
prevention partners. In addition to providing evidence of and enhancing 
the Recipient Activities for Capacity Building Programs, Activities 1-
6, Basic Implementation programs will address the following activities.
    (1) Expand the existing coordinated nutrition and physical activity 
program infrastructure. (Year One) Expand staffing beyond the capacity 
building program to fully implement the State plan. Support and expand 
the program infrastructure at the local/regional level throughout the 
State.
    (2) Implement the State comprehensive plan for nutrition and 
physical activity and review and update the plan periodically. Develop 
and provide mini-grants and other assistance to support communities to 
adopt effective interventions. (Years One-Five) Assure that there is a 
continuing focus on strategic planning to reach objectives agreed upon 
within the State and to respond to new challenges and events. Review 
the written State plan annually. Adopt and diffuse effective 
interventions statewide or in communities and populations based on the 
State plan. Select and implement interventions from proven strategies 
so that multiple levels of influence in the social-ecological model are 
addressed, as guided by the State plan. Interventions can target the 
full State or local populations. Implement the ``Community Guide to 
Preventive Services'' physical activity recommended interventions in 
more depth or in more communities. Build community capacity to carry 
out and sustain an effective nutrition program. Provide intervention 
mini-grants to communities. Basic implementation programs located in 
States with CDC-funded coordinated school health programs must include 
a school-based intervention, working closely with the State Education 
Agency.
    (3) Expand partnerships with State Health Department units, the 
State Education Agency, other State agencies, local communities, and 
private partners to maximize impacts of the basic implementation 
program. (Years One-Five)
    Leverage resources for nutrition and physical activity working with 
the health department director, other health department units, the 
State Education Agency, other State agencies that share mutual goals, 
and other partners including local health partners and community 
groups. Identify environmental and policy issues; promote optimal 
standards and practices for nutrition and physical activity programs; 
and increase capacity through shared resources and expertise.
    (4) Develop a new or apply an existing intervention and evaluate 
its effectiveness to prevent or control obesity and other chronic 
diseases every five years. Provide a balance between nutrition and 
physical activity interventions. Basic implementation programs should 
design the intervention project to detect realistic changes in post-
intervention outcome measures when compared with pre-intervention 
measures. Sample sizes should provide adequate power to detect these 
changes. Specify clear, measurable evaluation objectives using process, 
impact, and outcome objectives. Intervention protocol development, 
project evaluation, and the preparation of publications and 
presentation of findings should be done in collaboration with community 
partners, Prevention Research Centers, university affiliates, relevant 
experts, and CDC, as appropriate.
    (5) Collaborate with partners on secondary prevention strategies. 
(Years One-Five).
    Describe activities supporting secondary prevention related to 
obesity. Integrate secondary prevention strategies and activities into 
the State plan, partnerships, policy and environmental changes, and 
training for health professionals to ensure that recognized national 
guidelines are followed. (See http://www.cdc.gov/nccdphp/dnpa/rfainformation.htm for additional information regarding this activity.)
    (6) Develop resources and training materials to help other State 
and local projects adopt successful programs. (Years Four-Five).
    Develop one or more training reports on at least one component of a 
program that works and train staff from other State or local programs. 
Assist in the dissemination and training of other State and local 
partners regarding the report findings. (See http://www.cdc.gov/
nccdphp/dnpa/

[[Page 3336]]

rfainformation.htm for additional information regarding this activity.)
    (7) Identify, assess, or develop data sources to further define and 
monitor the burden of obesity. See previous description of this 
activity under Capacity Building Recipient Activity 4.
    (8) Evaluate progress and impact of the State plan and intervention 
projects. See previous description of this activity under Capacity 
Building Recipient Activity 6.
    2. CDC Activities. a. Convene workshop and/or teleconferences of 
recipient programs for information sharing and problem-solving.
    b. Provide ongoing guidance, consultation, and technical assistance 
to plan, implement, and evaluate all aspects of nutrition and physical 
activity program activities. Activities include coordinating national 
surveillance activities, monitoring data quality of national 
surveillance systems, assisting with analyses and interpretation of 
findings from qualitative and quantitative research; assisting in the 
social marketing process, guiding program evaluation, and sharing 
community, environmental and policy strategies to promote physical 
activity and healthy eating. Disseminate to recipients relevant state-
of-the-art research findings and public health recommendations related 
to obesity and other chronic disease prevention and control through 
nutrition and physical activity interventions.
    c. On a consultant basis, assist in the development and review of 
the intervention protocols and program evaluation methods.
    d. Coordinate national level partnerships with relevant 
organizations and agencies involved in the promotion of physical 
activity and nutrition for the prevention and control of obesity and 
other chronic diseases.

    Note: Special Guidelines for Technical Assistance Telephone 
Conference Call. Technical assistance will be available for 
potential applicants on one conference call. Potential applicants 
are requested to call in using only one telephone line. The call 
will be on February 3, 2003 from 2 p.m. to 3:30 p.m. EST. This 
conference can be accessed by calling 1-800-713-1971 [Federal call 
(404) 639-4100] and entering access code 996903.


    The purpose of the telephone conference call is to help potential 
applicants:

--Understand the scope and intent of the Program Announcement for State 
Nutrition and Physical Activity Programs to Prevent Obesity and Other 
Chronic Diseases;
--Understand the role of nutrition and physical activity population-
based approaches, such as policy-level change and environmental 
support, in preventing and reducing obesity and other chronic diseases;
--Be familiar with the CDC funding policies and application and review 
procedures.
F.2. Content
    Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. The application will be evaluated based on the 
evaluation criteria listed, so it is important to follow them when 
writing the program plan. The narrative for this component, not 
including budget justification, should be no more than 30 double-spaced 
pages for Capacity Building program applications or 40 double-spaced 
pages for Basic Implementation program applications, printed on one 
side, with one-inch margins and 12-point font. Applicants may also 
submit appendices that include State nutrition and physical activity 
plan, resumes, job descriptions, organizational chart, facilities, and 
other supporting documentation not to exceed 100 total pages. Letters 
of support should include the specific roles and responsibilities of 
the collaborator/partner to the State plan or intervention. All 
materials must be suitable for photocopying (i.e., no audiovisual 
materials, posters, tapes, etc.).
    1. Background and Recent History. Provide information on the 
background and recent history of your State health agency's capacity 
for the prevention and control of obesity and other chronic diseases 
through nutrition and physical activity. Describe how the State has 
built nutrition and physical activity capacity with CDC funds or other 
funding and complete the following table describing the current 
nutrition and physical staff, including their education. Describe the 
kinds of staffing contract services/options if used to augment agency 
staffing.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                               Type of staffing
                                                               FTE for nutrition       FTE for physical       contract services/    Number of nutrition
              Program                  Dollar level and        dedicated to the      activity dedicated to     options used for    and physical activity
                                            source             program, include      the program, include   nutrition or physical    graduate students
                                                                  credentials             credentials              activity
--------------------------------------------------------------------------------------------------------------------------------------------------------
Nutrition/Physical Activity/
 Obesity (CDC funded)
Nutrition/Physical Activity/
 Obesity (non-CDC funded, not
 including WIC), please specify
Other:
Other:
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Describe how the State has fulfilled the capacity building 
recipient activities to date, including developing a comprehensive 
State nutrition and physical activity plan to prevent obesity and other 
chronic diseases, descriptions of the development, implementation, and 
evaluation of nutrition and physical activity interventions relevant to 
obesity and other chronic diseases, prevention activities, and what 
programs and partners were involved. If applying as a basic 
implementation program, include an appendix responding to the 
evaluation questions in Attachment 10 located at http://www.cdc.gov/nccdphp/dnpa/rfainformation.htm.
    2. Management Plan. a. Describe the management structure for the 
nutrition and physical activity program to prevent obesity and other 
chronic diseases. Describe plans with dates for hiring key staff. 
Include brief resumes of designated staff, the percentage of time they 
allocate to other health department programs, and job descriptions of 
existing and proposed staff.
    b. Identify organizational placement of the program. Submit an 
organizational chart identifying

[[Page 3337]]

relationships between programs such as cardiovascular disease, 
diabetes, cancer, health education and promotion. Identify clear and 
direct lines of authority, supervisory and fiscal controls, and the 
extent which the existing and proposed staff and organizational 
structure and systems demonstrate sufficient capacity and capability to 
efficiently and effectively conduct the proposed activities.
    c. Identify staffing and contracting barriers for the State health 
agency in the last year. Describe how work plans addressing nutrition, 
physical activity or obesity changed or were delayed because of the 
barriers. Also, identify strategies to carry out the proposed work plan 
considering current barriers. In particular, describe how the program 
will change if vacancies or hiring freezes occur.
    3. Program Past Performance. Provide documentation to support your 
previous accomplishments that addressed the prevention and control of 
obesity and other chronic diseases through nutrition and physical 
activity. Include the following:
    a. Evidence of State or community nutrition and physical activity 
policies, environmental supports, and/or legislative actions that are 
planned, initiated or modified for the prevention or control of obesity 
and other chronic diseases.
    b. Evidence that communities have implemented a nutrition and 
physical activity plan for the prevention and control of obesity and 
other chronic diseases.
    c. Evidence that an intervention for nutrition and physical 
activity was implemented and evaluated. If applying for Basic 
Implementation funds, submit the State nutrition and physical activity 
plan for the prevention and control of obesity and other chronic 
diseases as well as any intervention protocols and outcomes in the 
appendix. Capacity Building applicants submit if available.
    4. Burden (please limit to no more than three pages). Provide 
information such as estimated prevalence of obesity and overweight and 
other chronic disease, its geographic and demographic distribution 
within the State using existing epidemiological data. Cite the source 
for and time period covered by these data. Describe high-risk 
populations, at a minimum by racial/ethnic, gender, age, and 
socioeconomic factors. If available, describe profiles of potential or 
already selected populations regarding their knowledge, attitudes, 
beliefs, health practices, and consumer patterns and habits relative to 
nutrition and physical activity aspects of obesity and other chronic 
diseases.
    5. Program Work Plan--Provide a work plan that includes the 
following information:
    a. Key Goal(s) and Objectives. Five-year project period impact 
objectives and one-year budget period process objectives that are 
specific, measurable, achievable, relevant, and time-framed to help 
achieve the goal(s) of the program as outlined in the ``Recipient 
Activities'' of this program component. If applying as a Basic 
Implementation program, attach the State's program logic model and 
evaluation plan. Capacity Building applicants submit if available.
    b. Program Work Plan Methods. Provide a detailed description of the 
State's plan for conducting all program activities as outlined in the 
``Recipient Activities'' of this program announcement, including 
methods for achieving each of the proposed objectives, time-lines for 
all activities, responsible parties, and methods for monitoring 
progress. Describe the mechanism to regularly review, evaluate, and 
update the State plan to meet evolving needs.
    Chronic disease prevention programs, by their nature, must be 
integrated and well coordinated due to common risk factors. Resources 
are scarce; it is essential that efforts not be duplicated. Explain how 
the State will avoid duplication (but enhance coordination and 
integration) with other CDC-funded programs that address nutrition and 
physical activity. Basic Implementation funded nutrition, physical 
activity, and obesity programs will be the primary location for the 
leadership and delivery of population-based health promotion rather 
than those responsibilities falling to CVD, Diabetes or other chronic 
disease specific programs. If a comprehensive State nutrition and 
physical activity plan already exists, describe how the process used to 
develop the plan included and integrated the activities of other 
chronic disease programs. Include the plan in the appendix.
    6. Budget and Justification. Provide a detailed budget and line-
item justification that is consistent with the stated objectives, 
purpose, and planned activities of the project. Distinguish budget 
lines that are related to planning activities versus those that are 
related to data collection and intervention activities. Applicants are 
asked to include budget items for travel for two trips, one trip to 
Atlanta, Georgia for three staff to attend a three-day training and 
technical assistance workshop and another trip for three staff to the 
annual national conference on chronic disease prevention and control. 
If in-kind contributions are being provided by the applicant, these 
should be documented.
G.2. Evaluation Criteria (100 Points)
    Each set of the evaluation criteria is scored using a 100-point 
system. Evaluation criteria 1 through 5 are applicable for both 
programs. Specific Program Work Plan criteria are provided for each 
funding level. Applications will be evaluated individually against the 
following criteria by an independent review group appointed by CDC.
    1. Program Work Plan (Total 50 points). The extent to which the 
applicant addresses the items in Recipient Activities in E.2. and the 
Application Content in F.2. item 5.
    Point distribution for Capacity Building programs goals, 
objectives, and work plan methods by recipient activities:
    a. Develop a coordinated nutrition and physical activity program 
infrastructure. (10 points).
    b. Conduct a planning process that leads to a comprehensive 
nutrition and physical activity plan to prevent and control obesity and 
other chronic diseases and start to implement the plan. (10 points).
    c. Evaluate progress and impact of the State plan and intervention 
projects. (10 points).
    d. Implement and evaluate an intervention to prevent obesity and 
other chronic diseases. (10 points).
    e. Collaborate and coordinate with State and local government and 
private partners, including members of the population throughout the 
planning process. (5 points).
    f. Identify and assess data sources to define and monitor the 
burden of obesity. (5 points).
    2. Background and Recent History (15 points). The extent to which 
the applicant addresses the items in Recipient Activities in E.2. and 
Application Content in F.2. item 1.
    3. Management Plan (15 points). The extent to which the applicant 
addresses the items in Recipient Activities in E.2. and the Application 
Content in F.2. item 2.
    4. Program Past Performance (15 points). The extent to which the 
applicant addresses the items in Recipient Activities in E.2. and the 
Application Content in F.2. item 3.
    5. Burden (5 points). The extent to which the applicant addresses 
the items in Recipient Activities in E.2. and the Application Content 
in F.2. item 4.
    6. Point distribution for Basic Implementation programs goals, 
objectives, and work plan methods by recipient activities:
    a. Develop a new or apply an existing intervention and evaluate it 
to prevent

[[Page 3338]]

obesity and other chronic diseases. (10 points).
    b. Implement the State comprehensive plan for nutrition and 
physical activity and review and update the plan periodically. Develop 
mini-grants and other mechanisms to support communities to adopt 
effective interventions. (10 points).
    c. Evaluate progress and impact of the State plan and intervention 
projects. (10 points).
    d. Identify, assess, or develop data sources to further define and 
monitor the burden of obesity. (6 points).
    e. Expand the existing coordinated nutrition and physical activity 
program infrastructure. (5 points).
    f. Expand partnerships with State Health Department units, the 
State Education Agency, other State agencies, local communities, and 
private partners to maximize impacts of the comprehensive program (3 
points).
    g. Collaborate with partners on secondary prevention strategies. (3 
points).
    h. Develop resources and training materials to help other State and 
local projects to adopt successful programs. (3 points).
    6. Budget and Justification (Not weighted). The extent to which the 
line item budget justification is reasonable and consistent with the 
purpose and program goal(s) and objectives of the cooperative 
agreement. (Both programs).
    7. Human Subjects (Not weighted). Does the application adequately 
address the requirements of Title 45 CFR Part 46 for the protection of 
human subjects? (Both programs).
    The degree to which the applicant has met the CDC Policy 
requirements regarding the inclusion of women, ethnic, and racial 
groups in any proposed research. This includes:
    a. The proposed plan for the inclusion of both sexes and racial and 
ethnic minority populations for appropriate representation.
    b. The proposed justification when representation is limited or 
absent.
    c. A statement as to whether the design of the study is adequate to 
measure differences when warranted.
    d. A statement as to whether the plans for recruitment and outreach 
for study participants include the process of establishing partnerships 
with community(ies) and recognition of mutual benefits.
Program Performance Measures
    See Appendix C for the framework that will be used for measuring 
performance of the State Programs. Capacity Building Performance 
Measures for transitioning to basic implementation programs should 
include evidence that the applicant has significant capacity as 
specified in the Capacity Building Program Recipient Activities 1-6 and 
the program evaluation plan (See Attachment 10 located at http://www.cdc.gov/nccdphp/dnpa/rfainformation.htm) covering the following 
measurement areas:
    1. Evidence of States conducting strategic planning activities to 
develop a comprehensive State nutrition and physical activity plan to 
prevent and control obesity and other chronic diseases.
    2. Evidence that a quality comprehensive State nutrition and 
physical activity plan to prevent and control obesity and other chronic 
diseases promotes coordination of activities across all relevant State 
and community programs in which relevant partners are identified in 
substantive roles.
    3. Evidence of at least one community that implemented a nutrition 
and physical activity plan for the prevention and control of obesity 
and other chronic diseases.
    4. Evidence of outcomes/impacts of at least one intervention 
evaluating nutrition and physical activity strategies to prevent or 
control obesity and other chronic diseases.
    5. Evidence of State or community nutrition and physical activity 
policies, environmental supports, and/or legislative actions that were 
initiated, modified, or planned for the prevention or control of 
obesity and other chronic diseases.
    Five-Year Performance Measures for State Nutrition and Physical 
Activity Programs include:
    1. Evidence that communities have implemented a nutrition and 
physical activity plan for the prevention and control of obesity and 
other chronic diseases.
    2. Evidence of outcomes/impacts of interventions evaluating 
nutrition and physical activity strategies to prevent or control 
obesity and other chronic diseases.
    3. Evidence of State or community nutrition and physical activity 
policies, environmental supports, and/or legislative actions that were 
initiated, modified, or planned for the prevention or control of 
obesity and other chronic diseases.
    4. Evidence of increased physical activity and better dietary 
behaviors in communities reached through interventions.
    5. Evidence that the levels of obesity decrease or the rate of 
growth of obesity is reduced in communities reached through 
interventions.
Component 3--Well-Integrated Screening and Evaluation for Women Across 
the Nation (WISEWOMAN)
D.3. Availability of Funds
    Approximately $9,200,000 is available to fund approximately 12 
awards for grantees currently funded under program announcements 99135, 
00115, and 01098. These grantees are only eligible for the second 
funding level (See Appendix A). To determine eligibility for first or 
second funding level see Appendices A and B which is found at the 
bottom of this document and at the CDC Web site address at http://www.cdc.gov/od/pgo/funding/grantmain.htm. Scroll down the Web page to 
``Chronic Disease Prevention/Health Promotion Heading.'' Click on 
Program Announcement Number 03022. The attachments will be located at 
the bottom of the program announcement. The project period is five 
years. The average award for Standard Demonstration Projects will be 
approximately $500,000. Projects that screen substantially more women 
than 2,500 per year and exceed the performance expectations may qualify 
for higher awards. Information on performance expectations are found in 
Appendix B which is found at the bottom of this document and at the CDC 
Web site address http://www.cdc.gov/od/pgo/funding/grantmain.htm. 
Scroll down the Web page to ``Chronic Disease Prevention/Health 
Promotion Heading.'' Click on Program Announcement Number 03022. The 
attachments will be located at the bottom of the program announcement. 
The average award for Enhanced Projects will be approximately 
$1,000,000.
    In addition, approximately $750,000 is available in FY 2003 to fund 
up to three WISEWOMAN Projects at the first funding level. Requests for 
these funds will be competitive. The project period is five years. In 
the first year, Standard Demonstration Project funding will range from 
$50,000 to $250,000. If all performance measures (see Appendix B) are 
completed at the first funding level, applicants may apply for the 
second funding level through their continuation applications.
Use of Funds
    60/40 Requirements: Not less than 60 percent of cooperative 
agreement funds must be spent for screening, tracking, follow-up, 
lifestyle intervention, health education, and the provision of 
appropriate individually provided support services. Cooperative 
agreement funds supporting public education and outreach, professional 
education, quality assurance and improvement,

[[Page 3339]]

surveillance and program evaluation, partnerships, and management may 
not exceed 40 percent of the approved budget [WISEWOMAN follows the 
same legislative requirements as the NBCCEDP, Section 1503(a) (1) and 
(4) of the PHS Act, as amended; see http://www.cdc.gov/wisewoman/legislationhighlight.htm for more information on legislation]. Further 
information about the 60/40 distribution is provided in the WISEWOMAN 
Guidance Document: Interpretation of Legislative Language and Existing 
Documents. This can be accessed through the Internet at http://www.cdc.gov/wisewoman or by contacting the program technical assistant 
contact listed in Section ``J. Where to Obtain Additional 
Information.''
    a. Inpatient Hospital Services: Cooperative agreement funds must 
not be spent to provide inpatient hospital or treatment services 
[Section 1504g of the PHS Act, as amended].
    b. Administrative Expense: Not more than 10 percent of the total 
funds awarded may be spent annually for administrative expenses. These 
administrative expenses are in lieu of and replace indirect costs 
[Section 1504(f) of the PHS Act, as amended]. Administrative expenses 
comprise a portion of the 40 percent component of the budget.
    c. Limit of Use of Funds for Case Management: Use of Federal funds 
for case management of women without alert values is strongly 
discouraged. This policy and the definition of alert values are found 
on the WISEWOMAN Web site Guidance Document at http://www.cdc.gov/wisewoman.
Recipient Financial Participation--Matching Requirement
    a. Recipient financial participation is required for this program 
in accordance with the authorizing legislation. Section 1502(a) and (b) 
(1), (2), and (3) or the PHS Act, as amended, requires matching funds 
from non sources in an amount not less than one dollar for every three 
dollars of Federal funds awarded under this program. However, Title 48 
of the U.S. Code 1469a (d) requires DHHS to waive matching fund 
requirements for Guam, U.S. Virgin Islands, American Samoa and the 
Commonwealth of the Northern Mariana Islands up to $200,000.
    b. Matching funds may be cash, in-kind, or donated services, or 
equipment. Contributions may be made directly or through donations from 
public or private entities. Public Law 93-638 authorizes tribal 
organizations contracting under the authority of Title 1 to use funds 
received under the Indian Self-Determination Act as matching funds.
    c. All costs used to satisfy the matching requirements must be 
documented by the applicant and will be subject to audit. Specific 
rules and regulations governing the matching fund requirement are 
included in the PHS Grants Policy Statement, Section 6. Matching funds 
are not subject to the 60/40 requirements described above under ``Use 
of Funds.'' For further information about the matching fund 
requirement, see the WISEWOMAN Guidance Document.
Direct Assistance
    No direct assistance funds will be awarded in lieu of financial 
assistance to successful WISEWOMAN component recipients.
E.3. Program Requirements
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under ``1. 
Recipient Activities,'' and CDC will be responsible for the activities 
listed under ``2. CDC Activities.''
Standard Project
    Standard Demonstration Project (available for new applicants in FY 
2003 and FY 2004, not available for new applicants in FY 2005 or 
later).
    The major goal of a Standard Demonstration Project is to 
demonstrate the effectiveness of operational approaches to conducting 
the following activities for women aged 40-64 who participated in the 
NBCCEDP: Outreach, screenings for blood pressure, cholesterol, smoking, 
and other conditions (when appropriate); referral; lifestyle 
intervention (to include promotion of heart-healthy diet, increased 
physical activity, and tobacco cessation); tracking and follow-up; 
evaluation; professional and public education; and community 
engagement.
Enhanced Project
    One major goal of an Enhanced Project is to use scientifically 
rigorous methods to test the effectiveness and cost-effectiveness of a 
behavioral or lifestyle intervention that is grounded in the social and 
cultural context of the target population and aimed at preventing 
cardiovascular disease. The other major goal is to translate and 
transfer successful interventions and program strategies to other 
programs that serve financially disadvantaged women. Some important 
resources for understanding the scope of these translation and transfer 
activities can be found at http://www.replication.org/infores.html and 
http://www.replication.org/pdf/tool.pdf.
    1. Recipient Activities for Standard Demonstration Projects and 
Enhanced Projects: a. Develop a preventive health services program or a 
preventive health services research study/studies to include 
cardiovascular disease risk factor screening with mandatory cholesterol 
and blood pressure measurements built upon an extremely strong State, 
Territorial, or Tribal Breast and Cervical Cancer Early Detection 
Program with evidence provided of the strength of the BCCEDP Program.
    b. Staff with at least two professional staff members to work full-
time on WISEWOMAN (one of whom should be a full-time program 
coordinator and the other should have experience in nutrition, physical 
activity, or health education), or a plan for hiring such staff 
members. If staff must be hired, describe the staff that will manage 
the program until the hiring is completed. Describe the WISEWOMAN 
evaluation team and provide information on their experience and 
academic degrees.
    c. Work with health care systems that can effectively deliver 
WISEWOMAN services and that target the population in need of these 
services. This can best be accomplished by working with a health care 
system in which the State, Territory, or Tribal BCCEDP has previously 
been effective and that has successfully engaged the community to 
provide additional services/support to the population in need.
    d. Establish a cardiovascular disease prevention program as the 
primary focus, with culturally appropriate interventions addressing 
multiple risk factors that must include physical inactivity, poor 
nutrition (high intake of saturated fat and low intake of fruit and 
vegetables), and tobacco use. Other cardiovascular risk factors may be 
addressed such as overweight or obesity, and pre-diabetes or 
undiagnosed diabetes.
    Recipients may develop other preventive services to be delivered, 
such as intervention services aimed at prevention or relief of the 
following: Osteoporosis, arthritis, influenza or other diseases for 
which vaccines are readily available, or other significant conditions/
diseases which affect large numbers of older women.
    e. States, Territories, and Tribal Agencies should implement 
screening, referral, and follow-up according to the recommendations of 
the National Cholesterol Education Program (NCEP) of the National 
Heart, Lung, and Blood Institute for cholesterol screening using the 
Adult Treatment Panel III (ATP-III)

[[Page 3340]]

and the recommendations set forth for hypertension according to the 6th 
Joint National Report on the Detection, Evaluation and Treatment of 
High Blood Pressure published by the National Institutes of Health, 
National Heart, Lung, and Blood Institute. The guidelines can be 
obtained electronically at http://www.nhlbi.nih.gov/guidelines/index.htm. National guidelines for addressing other risk factors can be 
found at http://www.cdc.gov/wisewoman. Laboratories must be accredited 
under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and 
meet all applicable Federal and State quality assurance standards in 
the provision of any test performed. However, if a new, improved, or 
superior screening procedure becomes widely available and is 
recommended for use, this superior procedures will be utilized in the 
program. [Section 1503(b) of the PHS Act, as amended.]
    f. Recipients should design culturally appropriate lifestyle 
interventions aimed at lowering blood pressure or cholesterol, 
improving physical activity or nutrition, or achieving smoking 
cessation in a similar target population. A New Leaf Choices for 
Healthy Living is an example of an intervention that has been effective 
in improving nutrition (see http://www.hpdp.unc.edu/wisewoman/newleaf.htm).
    Alternatively, the intervention can be newly designed if it 
incorporates sound theoretical principles of behavioral change such as 
use of the socio-ecologic model to intervene at multiple levels, 
individual tailoring, self-efficacy, self-monitoring and reinforcement, 
readiness for change, small achievable steps, social support, 
collaborative goal setting, and strategies to overcome barriers (see 
monograph entitled Integrating Cardiovascular Disease Prevention into 
Existing Health Services: The Experience of the North Carolina 
WISEWOMAN Program at http://www.hpdp.unc.edu/wisewoman/manual.htm. If 
applying as a Standard Best Practices project (available in FY 2005 and 
later), interventions should be designed following WISEWOMAN 
recommended best practices (available in FY 2005).
    g. Recipients should propose methods aimed at sustaining behavioral 
change. Maintaining behavioral change should involve strategies to 
provide the participant with ongoing contact such as with health 
facility staff or community health workers (either in person or by 
mail) and to educate regarding relapse prevention. The use of computer-
tailored education can be especially useful (to view recommendations 
detailed in the monograph entitled Integrating Cardiovascular Disease 
Prevention into Existing Health Services: The Experience on the North 
Carolina WISEWOMAN Program see http://www.hpdp.unc.edu/wisewoman/manual.htm.
    Environmental supports aimed at sustaining behavioral change such 
as increased walking, healthier food choices, and smoking cessation 
should also be considered. These might include activities such as 
improving the safety of neighborhoods, advocating for walking groups at 
shopping malls, improving the quality of foods in local grocery stores 
and changing community norms around tobacco. Although WISEWOMAN 
applicants may not be able to completely fund these environmental 
strategies due to restrictions on the use of funds (see 60/40 
Requirement in under ``Use of Funds''), they may be able to establish 
strong partnerships with other CDC programs in their health department 
or agency that use community environmental and/or policy approaches 
(e.g., Nutrition/Physical Activity/Obesity, Tobacco Control, Diabetes, 
and Cardiovascular Health).
    h. Recipients should propose methods aimed at sustaining the 
program in future years. Methods include using the principles of 
community engagement (for more information, see CDC's monograph 
entitled ``Principles of Community Engagement'' at http://www.cdc.gov/phppo/pce/index.htm. Emphasis should be placed on developing 
traditional and non-traditional partnerships in the community through 
partnering with other CDC funded programs.
    i. Plan or conduct evaluation strategies to include reporting of 
suggested minimum data elements and cost information (see WISEWOMAN 
Guidance Document at http://www.cdc.gov/wisewoman for a list of the 
suggested minimum data elements). Other evaluations are strongly 
encouraged and might include measures of program feasibility and 
acceptability, mapping neighborhood assets to determine resources 
before and after program implementation, increases in partnerships as a 
result of the program, improvements in medical care, the usefulness of 
community health workers in the program, increases in knowledge of 
providers, improvements in participant's self-efficacy, and so forth;
    j. Formalize plans for Recipient Activities (a) to (i) through 
development of program protocols or conduct program operations 
according to previously developed and approved program protocols. Newly 
funded projects should conduct all program startup activities as 
detailed on page 18 of the monograph Integrating Cardiovascular Disease 
Prevention into Existing Health Services: The Experience of the North 
Carolina WISEWOMAN Program at http://www.cdc.gov/phppo/pce/index.htm 
and should be prepared to pilot test their methods.
    k. Work collaboratively with other State, Territorial, or Tribal 
WISEWOMAN program staff and partners (such as CDC contractors) to 
develop methods that have the potential to be implemented in other 
WISEWOMAN programs.
    2. CDC Activities: a. Convene workshops, trainings, and/or 
teleconferences of the funded projects for sharing of information and 
solving problems of mutual concern.
    b. Provide ongoing consultation and technical assistance to plan, 
implement, and evaluate program activities.
    c. Conduct site visits to assess program progress and mutually 
resolve problems, as needed, and/or coordinate reverse site visits to 
CDC in Atlanta, GA.
    d. Assist in the development of a research study protocol for IRB 
review by all cooperating institutions participating in the research 
project. If CDC IRB review is necessary, the CDC IRB will review and 
approve the protocol initially and on at least an annual basis until 
the research project is completed. For more detailed information on the 
CDC IRB see http://www.cdc.gov/od/ads/hsr2.htm.
    e. Collaborate with WISEWOMAN projects in the analysis of data and 
development of abstracts and publications that informs the program, 
public, scientific community, and Congress as to program progress and 
results.
    f. Copy and distribute materials developed by State, Territorial, 
or Tribal WISEWOMAN projects for the purpose of aiding other WISEWOMAN 
projects and public health partners.
F.3. Content
    Applications. The program announcement title and number must appear 
in the application. Use the information in the ``Program Requirements, 
Other Requirements, and Evaluation Criteria'' sections to develop the 
content. Your narrative should be no more than 30 double-spaced pages, 
printed on one side, with one-inch margins, and unreduced font.
    WISEWOMAN Application Outline: Please provide the following 
information and, as appropriate, a preliminary but realistic time-
phased

[[Page 3341]]

work plan that addresses all of the points below. Only existing 
WISEWOMAN projects are required to provide WISEWOMAN-specific 
information requested below. Applicants may apply for either the 
Standard Demonstration Project or the Enhanced Project, but not both.
    1. Background and Need. Provide a brief description of the extent 
of the disease burden and the need among the priority populations and 
the background of the health care system to include:
    a. The number of uninsured women living in the State/Territory/
Tribal area by race/ethnicity by two age categories if possible, i.e. 
40-49 years and 50-64 years.
    b. The current health care system in which State, Territorial, or 
Tribal BCCEDP and WISEWOMAN sites operate (e.g. are the sites county 
health department clinics, community health centers, private providers, 
managed care organizations, etc.) and the appropriateness of the health 
care system for implementing effective interventions, adhering to 
program protocols, tracking difficult to reach women, and providing 
timely information on women who have high values of cholesterol and 
blood pressure.
    c. Community involvement or engagement in the BCCEDP and/or 
WISEWOMAN project to include use of community health workers, use of 
community members, engagement in partnership activities with community 
agencies that serve financially disadvantaged women, use of referral 
systems to other community services, and so forth.
    2. Infrastructure. Document the current State, Territorial, or 
Tribal BCCEDP and WISEWOMAN (if applicable) infrastructure including:
    a. An organizational chart that shows the location of The WISEWOMAN 
Program in relationship to the agency's health promotion section, 
chronic disease section, minority, or women's health section, Breast 
and Cervical Cancer Early Detection Program, and to other programs that 
address chronic disease (e.g. cardiovascular health, tobacco, physical 
activity, nutrition, 5 A Day, diabetes, and obesity). Describe lines of 
communication between WISEWOMAN and the above-mentioned sections and 
programs.
    b. The number of BCCEDP and WISEWOMAN sites in operation as of the 
January preceding the date of this application.
    c. The total number of political subdivisions (e.g., counties) and 
the number of these subdivisions that had a BCCEDP site and the number 
that had a WISEWOMAN site as of January preceding the date of this 
application.
    d. During the most recent program year include:
    (1) The number of women served by BCCEDP and The WISEWOMAN Programs 
in the State, Territory, or Tribal area (provide data for each of the 
past 5 years, if available).
    (2) The racial/ethnic characteristics of the population served 
(include educational Characteristics, if available).
    (3) The percentage of women with a positive mammogram or pap test 
who did not go on for further diagnostics and reasons why women did not 
go on;
    (4) The percentage of women with a WISEWOMAN alert value who did 
not go on for further diagnostics and reasons why women did not go on.
    (5) The average length of time between a positive mammogram or Pap 
test and the receipt of a diagnostic test.
    (6) The average length of time between detection of a WISEWOMAN 
alert value and the receipt of diagnostic test (see WISEWOMAN Guidance 
Document at http://www.cdc.gov/od/ads/hsr2.htm for the definition for 
alert values).
    3. Program Planning for Upcoming Year. Describe how the program 
will decide or is currently conducting the following:
    a. Site selection, the approximate number of sites to receive 
WISEWOMAN services, the characteristics of the sites, the proportion of 
State or Territorial BCCEDP sites that will receive WISEWOMAN services, 
and estimated number of women who are expected to receive such services 
during the upcoming year.
    b. Screening and intervention services and start-up activities (if 
applying for Standard Demonstration Project funding level; see 
checklist of start-up activities in the WISEWOMAN Guidance Document at 
http://www.cdc.gov/wisewoman to be provided along with a time line for 
determining and implementing start-up activities, screening and 
intervention services [allowable screening and diagnostic procedures 
for the demonstration programs include resting pulse, blood pressure, 
serum total cholesterol, HDL-cholesterol, LDL-cholesterol, height and 
weight measurements, automated blood chemistry (to assess fasting blood 
glucose, potassium, calcium, creatinine, uric acid, triglyceride, or 
micronutrient levels), urine analysis (including urine cotinine), and 
paper and pencil tests, interviews, or computerized methods that 
measure level of physical activity, dietary intake, smoking, 
osteoporosis risk status, immunization status, or other chronic disease 
risk factors or preventable health problems. The use of program funds 
for other tests will require substantial justification by the program. 
The schedule of fees/charges should not exceed the maximum allowable 
charges established by the Medicare Program for the same or similar 
laboratory tests. (Fees/charges for services covered by Medicare may 
vary by location, thus, States or Territories should determine the 
appropriate reimbursement rates for their areas.)
    c. A pilot study to test proposed methods.
    d. Inclusion of letters of support for WISEWOMAN from a substantial 
number of State/Territorial BCCEDP site directors and medical staff.
    e. Methods for tracking women through the system and after they 
leave the system [(for the purpose of bringing them back for further 
screening and intervention)(Standard Projects should ensure that at 
least 60 percent of new women receive the complete intervention)], for 
flagging, tracking, and managing women who need immediate referral 
because of extremely high blood pressure (=180 systolic 
blood pressure or 110 diastolic blood pressure), cholesterol 
(400 mg/dL), or glucose levels (375 mg/dL).
    f. Program tracking to determine which women receive which 
interventions; routine reporting on the progress of the program (see 
suggested quarterly report format in WISEWOMAN Guidance Document at 
http://www.cdc.gov/wisewoman and reporting of minimum data elements. 
These minimum data elements will yield the performance measures that 
will determine whether a project qualifies for additional funding. The 
complete set of performance measures are detailed in Appendix B.
    4. Screening and Intervention. Document the ability of the program 
to screen and intervene upon women enrolled in the WISEWOMAN program 
including implementation of WISEWOMAN screening activities, the 
rationale and guidelines for implementing WISEWOMAN intervention 
activities, methods for reaching women from the State or Territorial 
BCCEDP for the purpose of WISEWOMAN screening and intervention and the 
use of outreach and community health workers to address barriers to 
program involvement, barriers to behavioral change, and barriers to 
maintaining contact for future health screenings and interventions.
    5. Evaluation--(Standard Program):

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    a. Describe the current evaluation team or propose a plan to 
establish the evaluation team using criteria such as prior work 
experience, professional training, and academic degrees.
    b. Describe the current evaluation plan or propose an evaluation 
plan that includes clearly stated evaluation objectives with a time 
line for the collection of data throughout the project.
    c. Describe the current database or propose a database that details 
data elements, methods for data management, the creation of unique 
identifiers, methods for identifying women who need immediate 
treatment, and other important data procedures.
    6. Evaluation--(Enhanced Program): Submit an evaluation design to: 
(1) Examine the impact of chronic disease risk factor intervention(s) 
on lowering blood pressure, improving cholesterol levels (lowering 
total cholesterol levels and raising HDL cholesterol levels), and 
improving other risk factors such as poor nutrition and inadequate 
physical activity at six and twelve months after intervention and 
program strategies. The plan for effectiveness should include:
    a. The extent to which a university or Prevention Research Center 
will be involved in the evaluation design.
    b. The preliminary evaluation questions to be answered.
    c. The type of evaluation design (e.g. randomized controlled 
design) and rationale for using this type of design.
    d. Length of follow-up and measurement intervals.
    e. Protocol used to ensure that the maximum number of women will 
return for each evaluation.
    f. Statistical techniques that will be used to analyze the data 
with preliminary estimates of the sample size needed to achieve 
adequate statistical power. To obtain the statistical power to evaluate 
the intervention, the program should add cholesterol and blood pressure 
screenings (and other optional screenings, if desired) to a 
sufficiently large number of State or Territorial BCCEDP sites to 
provide adequate statistical power for evaluating program 
effectiveness. States or Territories may want to consider including a 
total of at least 20 sites. The study design for this type of 
evaluation might include women from a number of sites assigned to 
intervention (i.e., the special intervention group) compared to women 
from a number of sites assigned to usual standard practice (i.e., the 
usual care group or comparison group). Other study designs may be 
proposed including randomizing women to each of arm of the study. A 
method of collecting information for the purpose of program evaluation 
should be developed and implemented. Voluntary reporting of Minimum 
Data Elements is recommended as part of the program evaluation. The 
plan for translation and transferring successful strategies should 
include:
    (1) The extent to which the evaluation team includes staff with 
expertise in translation and transfer activities;
    (2) Clear objectives regarding translating strategies into products 
using lay language, compiling information in clear, user-friendly 
format, testing of the translation package for usability;
    (3) Methods for providing technical assistance, orientation and 
training on implementing and ensuring fidelity with regard to 
implementing the translation package;
    (4) Methods for evaluating and refining the translation package and 
plans for dissemination of the final package;
    (5) A timeline with regard to translation and transfer activities. 
Some important resources for understanding the scope of these 
translation and transfer activities are found at http://www.replication.org/infores.html and http://www.replication.org/pdf/tool.pdf.
    7. Collaborative Efforts. Provide a concise collaboration plan that 
addresses program methods and analyzing and publishing data with CDC 
and others. The following areas should be addressed:
    a. Meeting and teleconferences attendance for the purpose of 
developing forms, tracking systems, measurements, policy, etc.
    b. Analyzing data and co-authoring abstracts and publications; 
sharing information with CDC and its contractors (stripped of 
identifying information) on a twice-yearly basis.
    c. Plans to collaborate with other health promotion experts in the 
health agency including nutritionists, physical activity experts, 
tobacco control experts, and others who promote a healthy lifestyle 
through better eating, weight management, physical activity, and 
smoking cessation.
    d. For Enhanced projects, plans for developing a monograph and/or 
training on methods to help other projects adopt successful program 
practices (See example ``Integrating Cardiovascular Disease Prevention 
into Existing Health Services: The Experience of the North Carolina 
WISEWOMAN Program'' at http://www.hpdp.unc.edu/wisewoman/manual.htm.
    8. Budget and Justification: Provide a detailed budget and line-
item justification that is consistent with the stated objectives, 
purpose, and planned activities of the project. Applicants should note 
the following budget-related issues:
    a. Budget for the following travel:
    (1) Up to two persons to attend the Nutrition and Public Health 
Course that is sponsored by the University of North Carolina Prevention 
Research Center and the Centers for Disease Control and Prevention. 
This is a five-day course. For more information see http://www.hpdp.unc.edu/nph. Future topics and place to be determined. This is 
a mandatory training course that provides training with regard to 
WISEWOMAN Best Practices.
    (2) Up to two persons to participate in the annual WISEWOMAN 
Project Directors Meeting that is held in conjunction with NCCDPHP 
Annual Chronic Disease Conference (four days) or other CDC Conferences. 
Details are provided at http://www.cdc.gov/nccdphp/conference/index.htm. This is a mandatory meeting for the purpose of sharing 
projects successes and challenges.
    (3) One person to attend the Physical Activity and Public Health 
Course that is sponsored by the University of South Carolina Prevention 
Research Center and the Centers for Disease Control and Prevention. 
This is an eight-day Postgraduate Course on Research Directions and 
Strategies and a six-day Practitioner's Course on Community 
Interventions. See http://prevention.sph.sc.edu/seapines/index.htm. Or 
one person to participate in a non-CDC sponsored professional meeting 
directly relevant to the program. (A tobacco cessation training course 
is highly recommended.)
    (4) Cost Data and Minimum Data Elements: Budget for collecting and 
reporting cost data and minimum data elements. (See WISEWOMAN Guidance 
Document at http://www.cdc.gov/wisewoman for list of minimum data 
elements.) Section 1505 [42 U.S.C. 300n-1] requires that applicants 
provide assurance that the grant funds be used in the most cost-
effective manner.
G.3. Evaluation Criteria
    Applications received from current grantees that are funded under 
program announcements 00115, 99135, and 01098 will be reviewed 
utilizing the Technical Review process. For applicants that apply 
competitively as Standard Demonstration Projects or Enhanced Projects, 
an independent objective review group appointed by CDC will evaluate 
each application individually using the following criteria:
    1. Program Plan (35 points). The extent to which the applicant has 
addressed Recipient Activities 1.a

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through 1.j and items 3.a through 3.g in the Application Content 
sections.
    2. Screening and Intervention (Standard Projects: 25 points and 
Enhanced program: 15 points). The extent to which the applicant has 
addressed Recipient Activities 1.b through 1.f and items 4 in the 
Application Content sections.
    3. Evaluation Plan--(Standard Program: 15 points). The extent to 
which the applicant has addressed Recipient Activities 1.h and items 5 
in the Application Content sections.
    Evaluation Plan--(Enhanced Program--25 points). The extent to which 
the applicant has addressed Recipient Activities 1.h and items 6 in the 
Application Content sections.
    4. Background, Need, and Potential for Community Involvement (10 
points). The extent to which the applicant has addressed Recipient 
Activities 1.a and items 1.a through 1.c in the Application Content 
sections.
    5. Infrastructure (10 points). The extent to which the applicant 
has addressed Recipient Activities 1.b and 1.d and items 2.a through 
2.c in the Application Content sections.
    6. Collaborative Efforts (5 points). The extent to which the 
applicant has addressed Recipient Activities 1.a and items 7 in the 
Application Content sections.
    7. Human Subjects (not scored). Does the application adequately 
address the requirements of Title 45 CFR Part 46 for the protection of 
human subjects? Not scored; however, an application can be disapproved 
if the research risks are sufficiently serious and protection against 
risks is so inadequate as to make the entire application unacceptable. 
Does the application adequately address the CDC Policy requirements 
regarding the inclusion of women, ethnic, and racial groups in the 
proposed research? This includes:
    1.1 The proposed plan for the inclusion of both sexes and racial 
and ethnic minority populations for appropriate representation.
    1.2 The proposed justification when representation is limited or 
absent.
    1.3 A statement as to whether the design of the study is adequate 
to measure differences when warranted.
    1.4 A statement as to whether the plans for recruitment and 
outreach for study participants includes the process recognition of 
mutual benefits.
Component 4:--State-Based Oral Disease Prevention Program D.4. 
Availability of Funds
    Approximately $2,600,000 is available in FY 2003 to fund 
approximately 13 Part 1 Capacity Building Program awards. It is 
expected that the Capacity Building Program average award will be 
$200,000, ranging from $65,000 to $400,000. Funding estimates may vary 
and are subject to change.
    No funding is available in FY 2003 for Part 2 Basic Implementation 
Program awards. Pending available funding resources, applications will 
be accepted in years two through five.
Use of Funds
    Applicants may not use these funds to supplant oral health program 
funds from local, State, or Federal sources. Applicants must maintain 
current levels of support dedicated to oral health from other funding 
sources. Funding received under this program announcement cannot be 
used for the purchase of dental services, dental sealant equipment, or 
materials.
Recipient Financial Participation
    Applicants requesting funding for community water fluoridation 
equipment will be required to provide matching funds. Matching funds 
are required from State and/or local sources in an amount of not less 
than one dollar for each four dollars of Federal funds awarded for 
community water fluoridation equipment under this program announcement.
    Matching funds are required from State and/or local sources in an 
amount of not less than one dollar for each four dollars of Federal 
funds awarded for a Basic Implementation Program.
    Matching funds may be in cash or its equivalent, including donated 
or in-kind appropriate equipment, supplies, and or services. Do not 
include funds from other Federal sources including the Preventive 
Health and Health Services Block Grant.
    CDC funding covers some of the costs of oral health core capacity, 
infrastructure, and community-based prevention interventions, but it is 
not intended to fully support all aspects of the oral health program.
Direct Assistance
    You may request Federal personnel as direct assistance in years two 
through five, in lieu of a portion of financial assistance.
    To request new direct-assistance assignees, include:
    a. Number of assignees requested.
    b. Description of the position and proposed duties.
    c. Ability or inability to hire locally with financial Assistance.
    d. Justification for request.
    e. Organizational chart and name of intended supervisor 
opportunities for training, education, and work.
    f. Opportunities for training, education, and work experience for 
assignees.
    g. Description of assignee's access to computer equipment for 
communication with CDC (e.g., personal computer at home, personal 
computer at workstation, shared computer at workstation on site, shared 
computer at a central office).
E.4. Program Requirements
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1.a and 1.b 
(Recipient Activities), and CDC will be responsible for the activities 
listed under 2. CDC Activities.
    1.a. Part 1 Capacity Building Program Recipient Activities and 
Performance Measures:
    (1) Develop oral health program leadership capacity. Develop a 
State oral health team. Leadership capacity should include: (a) full-
time dental director (oral health professional with public health 
training); (b) .25 time epidemiologic support at a minimum; (c) 
demonstrated access to at least .50 time of a water fluoridation 
engineer/specialist or coordinator, and (d) demonstrated access to 
appropriate program support, .50 to one time dental sealant 
coordinator, .25 time capacity for health education, health 
communication, and .25 time support staff, through leveraging of 
dollars, shared dedicated resources and letters of support.
    Performance will be measured by evidence of established leadership 
capacity. Evidence of leadership capacity can be shown by: The 
composition of an oral health program team consistent with (1) above.
    (2) Describe the oral disease burden, health disparities, and unmet 
needs in the State. Describe the oral disease burden within the State 
and document unmet oral health needs of target populations and existing 
oral health assets (e.g., professional dental/dental hygiene schools, 
prevention interventions undertaken within the State).
    Performance will be measured by evidence that State oral disease 
burden has been accurately described. Evidence can be shown by: (a) a 
publicly available disease burden document describing oral disease 
burden and oral health disparities, issued in the past five years using 
the most recent data, preferably data no more than five years old; and 
(b) document includes oral health status with indicators consistent 
with the National Oral Health System (NOHSS), the Water Fluoridation 
Reporting

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System (WFRS), and the ASTDD State Synopsis.
    (3) Develop or update a comprehensive State Oral Health Plan. 
Develop or update a comprehensive State Oral Health Plan for oral 
health promotion, disease prevention, and control that includes 
specific objectives for future reductions in oral disease and related 
risk factors and objectives for the promotion of oral health. The plan 
should provide specific, measurable, and time-phased objectives to 
accomplish each goal related to the logic model (see http://www.cdc.gov/OralHealth/index.htm for additional information). In 
addition, develop a comprehensive State Oral Health Plan (suggest five-
year plan) that is available to the public, periodically updated, and 
developed in collaboration with the assistance of stakeholders. The 
Plan should address the following oral health areas: (a) Oral health 
infrastructure including current resources, gaps in resources and 
recommendations for their elimination; (b) Healthy People 2010 
objectives; (c) caries; (d) water fluoridation and school-based or 
school-linked sealant programs; (e) description of priority populations 
and burden of disease; (f) strategies to address oral health promotion 
across the lifespan; (g) strategies to identify best practices that can 
be replicated; (h) evaluation strategies and recommendations for 
monitoring the outcomes and impacts of plan implementation; (i) 
implementation strategies, leveraging of resources, partnerships, and 
plan maintenance including roles and responsibilities of State and 
local agencies; and (j) oral cancer, periodontal diseases, and 
infection control.
    Performance will be measured by evidence that a comprehensive State 
Oral Health Plan has been completed. Evidence can be shown by 
development of a plan consistent with the process described and with 
elements (a) through (j) above.
    (4) Establish and sustain a diverse Statewide oral health 
coalition. Establish a coalition to assist in the formulation of plans, 
guide project activities, and identify additional financial resources 
for this project. Coalition membership should be representative of 
stakeholder organizations within the State health department, within 
the State government and groups external to State government, for 
examples see http://www.cdc.gov/OralHealth/index.htm.
    Performance will be measured by evidence of a sustained, diverse 
statewide oral health coalition. Evidence can be shown by: (a) Extent 
of progress towards coalition sustainability, such as written by-laws, 
goals and objectives, plans and procedures for operation, past 
accomplishments, clerical staff support, and evidence of leveraging of 
resources; (b) membership entities representing each, but not limited 
to, categories in the coalition framework at Web site; (c) clear 
responsibility; (d) coalition activity in infrastructure, community 
water fluoridation, and sealants. Coalition activities must address all 
of the following activities: Infrastructure development, community 
water fluoridation, school-based/school-linked dental sealant programs, 
unless the grantee can document how current activities in the State 
have already met or exceeded Health People 2010 objectives for these 
activities.
    (5) Develop or enhance oral disease surveillance system. Develop 
key resources, data sources, and capabilities to promote the State's 
surveillance needs. See http://www.cdc.gov/OralHealth/index.htm for 
detailed outline of data sources to consider. Activities should 
include: (a) Establish plan for how data collection, analysis, and 
dissemination will support program activity, including a surveillance 
plan logic model consistent with the CDC Surveillance Logic model (see 
http://www.cdc.gov/OralHealth/index.htm); (b) conduct surveillance so 
that key oral health indicators have been collected in a valid and 
timely manner using standard approaches with attention to comparability 
across States and consistent with annual data submission to the ASTDD's 
State Synopsis and data submissions to NOHSS, and updated at least 
every five years; and (c) monitor water fluoridation on a monthly basis 
comparable and consistent with WFRS.
    Performance will be measured by evidence of a developed or enhanced 
oral disease surveillance system. Evidence can be shown by: 
Documentation that key resources, data sources, capabilities and 
surveillance plan are in place to provide an adequate surveillance 
system via activities consistent with (a) through (c) above.
    (6) Identify prevention opportunities for systemic, socio-political 
and/or policy change to improve oral health. Conduct a periodic 
assessment of policy and systems level strategies with potential to 
reduce oral diseases. The assessment should include identification of 
opportunities to make changes in policy and health systems to overcome 
barriers, capitalize on assets, increase capacity, and coordinate 
prevention interventions.
    Performance will be measured by evidence of identification of 
socio-political and policy changes. Evidence can be shown by periodic 
assessments consistent with the activities above.
    (7) Develop and coordinate partnerships to increase State-level and 
community capacity to address specific oral disease prevention 
interventions. Identify, consult with and involve appropriate partners 
to assess areas critical to the development of State-level and 
community-based oral health promotion and disease prevention programs, 
avoid duplication of efforts, ensure synergy of resources, and enhance 
the overall leadership within the State. Partnerships should augment 
the oral health coalition.
    Performance will be measured by evidence of the development and 
coordination of partnerships. Evidence can be shown by: (a) 
Collaborative partnerships with Statewide and local entities (e.g., 
Memorandum of Understanding (MOU) with other State agencies, joint 
dedication of resources); (b) broad range of partnerships inside and 
outside of the State Health Department, encouraging the focus on 
prevention interventions.
    (8) Coordinate and implement limited community water fluoridation 
program management. Provide coordination and management of a 
fluoridation program, provide/develop fluoridation training materials 
for engineers and water plant operators, and evaluate community water 
fluoridation accomplishments and new and/or replacement water 
fluoridation equipment.
    Performance will be measured by the development, implementation, 
and coordination of a water fluoridation program. Evidence can be shown 
by: (a) Extent the water fluoridation program incorporates and makes 
progress towards the 1995 Engineering and Administrative 
Recommendations for Water Fluoridation (EARWF), including: (1) Daily 
testing; (2) access to .50 fluoridation engineer; (3) targeted 
inspection activity; (4) basic fluoridation training; (b) monthly 
monitoring consistent with the Water Fluoridation Reporting System 
(WFRS); (c) percent of fluoridated water systems consistently 
maintaining optimal levels of fluoride as defined by State and 
consistent with EARWF; (d) document communities and populations 
receiving new or replacement fluoridation equipment.
    (9) Evaluate, document, and share State program accomplishments, 
best practices, lessons learned, and use of evaluation results. 
Evaluation activities should: (a) Be consistent with the CDC oral 
health global logic model, work plan: (see http://www.cdc.gov/OralHealth/index.htm) the CDC Evaluation Framework for Evaluating

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Public Health Programs (http://www.cdc.gov/mmwr), the CDC Guide to 
Evaluating Surveillance Systems (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013al.htm), and consider assessments of changes in oral 
health outcomes, as well as process evaluations consistent with the 
Association of State and Territorial Dental Directors' Best Practices 
evaluation criteria (see http://www.cdc.gov/OralHealth/index.htm); (b) 
document outcome evaluation measures including but not limited to 
percentage of population receiving fluoridated water and dental 
sealants; (c) include evaluation efforts consistent with indicators 
developed for ``supported States evaluation plan'' (see http://www.cdc.gov/OralHealth/index.htm); (d) be used to improve recipient 
activities above; and (e) be institutionalized as an on-going activity. 
Sharing of State program accomplishments, best practices, and lessons 
learned may include participation in forums for exchanging ideas and 
identification of methods and avenue for dissemination such as the CDC 
Chronic Disease Conference, and the National Oral Health Conference as 
well as local and State supported forums (e.g., State Summits, State 
dental and dental hygiene association meetings).
    Performance will be measured by evidence that evaluation has been 
completed, State evaluation capacity and activities have become 
institutionalized; State program accomplishments have been collected, 
evaluated, and shared with stakeholders; and evaluation results are 
used to improve program performance. Evidence can be shown by: (1) 
Documentation of evaluation activities consistent with (a) through (e) 
above; and (2) documentation of participation in scientific forums 
consistent with the activities above.
    (10) Capacity Building Prevention Intervention (To be undertaken 
after Part 1 Capacity Building Program 1-9 from above have been met).
    a. Develop and Implement a water fluoridation program. Provide or 
develop fluoridation educational materials, as appropriate, to promote 
water fluoridation. Implement a program to support new replacement 
water fluoridation equipment. Evaluate the accomplishments of the water 
fluoridation program.
    Performance will be measured by the development, implementation, 
and coordination of a water fluoridation program. Evidence can be shown 
by: (1) Documentation of appropriate education and promotion efforts; 
(2) documentation of communities and populations receiving replacement 
fluoridation equipment by funding source; (3) extent of progress 
towards reaching or exceeding Health People 2010 objective of 75 
percent of population on public water supplies receiving fluoridated 
water.
    b. Develop, coordinate and implement limited school-based or 
school-linked dental sealant programs. Describe and document the number 
of eligible public elementary or secondary schools, and existing 
related oral health assets. Document infrastructure is in place for the 
coordination and management of school-based or school-linked dental 
sealant program and show collaborative working relationships and formal 
agreements (e.g., MOA, MOU, or other written agreement between the 
State Health Department and the State educational agency).
    Develop school-based or school-linked dental sealant programs 
targeting public elementary or secondary schools located in: (a) Urban 
areas, and in which more than 50 percent of the student population of 
that school or school entity is participating in Federal or State free 
and reduced meal programs; or (b) rural school districts having a 
median income that is at or below 235 percent of the poverty line, as 
defined in section 673(2) of the Community Services Block Grant Act [42 
U.S.C. 9902(2)].
    Performance will be measured by the development, implementation, 
and coordination of school-based/school-linked dental sealant programs. 
Evidence can be shown by: (1) Extent that priority populations have 
been identified; (2) extent that implementation strategies appropriate 
to State setting have been developed; percent and number of children in 
funded programs receiving at least one permanent molar sealant; 
proportion of eligible schools participating in program; and proportion 
of children participating in free and reduced cost lunch program 
receiving at least one sealant.
    Optional Cost Analysis Recipient Activities and Performance 
Measures: Measures include the collection, tracking, and completion of 
cost analysis for school-based/school-linked dental sealant program. 
Evaluate the accomplishments, efficiency, and effectiveness of the 
implemented school-based/school-linked dental sealant programs. 
Proposals may include requests for technical assistance for the 
following optional performance measures:
    Performance will be measured by the collection, tracking, and 
accomplishment of a cost-analysis for school-based or school-linked 
dental sealant programs. Evidence can be shown by: (a) Documentation of 
baseline mean pit and fissure caries severity (i.e., pit and fissure 
DMFS) in targeted permanent molars among children three years older 
than target population; (b) cost-analysis report published and 
submission made to the ASTDD Best Practices Project.
    1.b. Part 2 BASIC IMPLEMENTATION Program Recipient Activities and 
Performance Measures: Basic Implementation Recipient Activities and 
Performance Measures include evidence that applicant continues to meet 
CAPACITY BUILDING program and CAPACITY BUILDING-PREVENTION INTERVENTION 
program activities and performance measures in section 1.a. above.
    (1) Develop a Statewide community water fluoridation program or 
maintain Statewide fluoridation program that has reached the Healthy 
People 2010 objective. Enhance or expand existing community water 
fluoridation demonstration or pilot project into a statewide program 
showing annual progress.
    Performance will be measured by evidence that water fluoridation 
efforts result in significant progress towards meeting, maintaining or 
exceeding Healthy People 2010 goals. Evidence can be shown by: (a) 
Extent that Statewide water fluoridation program incorporates and makes 
progress in meeting the Engineering and Administrative Recommendations 
for Water Fluoridation (EARWF, 1995), including: (1) Monthly monitoring 
and participation; (2) additional fluoridation engineers and/or 
specialist if appropriate; (3) all fluoridation engineers and/or 
specialists attend CDC fluoridation engineers and/or specialists attend 
CDC fluoridation training or equivalent; (4) all water plant operators 
receive basic fluoridation training; (5) all adjusted fluoridated water 
systems have annual inspections to insure that all the technical 
recommendations, including the (a) safety requirements of EARWF are 
followed; (b) all split sampling reference labs should participate in 
the CDC Lab Proficiency Testing Program; (c) document progress in 
increasing percent of fluoridated water systems consistently 
maintaining optimal levels of fluoride as defined by State and 
consistent with recommendations outlined in EARWF; (d) document 
progress toward reaching or exceeding Healthy People 2010 objective; 
(e) document communities and populations receiving new or replacement 
fluoridation equipment.
    (2) Develop Statewide school-based or school-linked dental sealant 
program or

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maintain school-based or school-linked dental sealant program if the 
Healthy People 2010 objective has been met. Enhance or expand existing 
school-based or school-linked dental sealant demonstration or pilot 
project into a Statewide program showing annual progress. School 
eligibility criteria as stated in (10)(b) above will be used.
    Performance will be measured by evidence that grantee is 
implementing and expanding school-based or school-linked dental sealant 
programs Statewide. Evidence can be shown by: (a) Documentation of 
progress towards reaching or exceeding goal of school-based or school-
linked sealant programs in at least 50 percent of eligible schools; (b) 
significant progress towards increasing: The percent and number of 
children in Statewide funded programs receiving at least one permanent 
molar sealant; proportion of eligible schools participating in program; 
and proportion of eligible schools participating in program; and 
proportion of children in funded programs participating in free and 
reduced cost lunch program receiving at least one sealant; (c) 
demonstrated participation in ASTDD Best Practices project; (d) 
demonstrated leadership capacity in dissemination and technical 
assistance to other State sealant programs; (e) progress towards 
sustainability and institutionalization of sealant program through 
leveraging of dollars, partnership participation, billing Medicaid and/
or SCHIP or other sources of support.
    (3) Develop other evidence-based, population-based, intervention 
strategies consistent with the State Oral Health Plan. Strategies 
should include policy and systems level approaches. Interventions 
should be population based, with objectives that specify the population 
wide changes sought and may address use of dental sealants, water 
fluoridation efforts, tobacco use, diabetes, poor nutrition, oral 
health education and, secondary prevention.
    Performance will be measured by demonstration of implementation of 
evidence-based, population-based strategies. Evidence will be shown by: 
(a) Documentation of evidence-based for intervention initiative; (b) 
extent that population-based interventions meet the established 
objectives specifying the population-wide changes sought; and (c) 
submission to the ASTDD Best Practices Project.
    (4) Evaluate intervention components. Design and implement a public 
health practice evaluation system that collects and analyzes 
information to be used to measure program progress, community capacity 
changes, short-term and distal outcomes. Evaluation results and related 
findings should be used to add to and/or enhance program 
implementation.
    Performance will be measured by evidence that State evaluation 
capacity and activities have become an on-going normative activity and 
that State program accomplishments have been collected, evaluated and 
shared with stakeholders. Evidence can be shown by: (a) Demonstration 
that the recipient is taking a leadership role in providing technical 
assistance and transfer of practice knowledge to other States; and b) 
quantification (in terms of dollars) of resources used and returns on 
those resources.
    (5) Expand oral health program leadership capacity. Expand State 
oral health team beyond CAPACITY BUILDING level. Provide National 
leadership by sharing results, with one another, best practices, and 
other lessons learned to help shape the national agenda and improving 
the oral health of the public. Capacity should include: (a) 
Epidemiologic support .50 time at a minimum; (b) demonstrated access to 
1.0 time fluoridation engineer/specialist or coordinator (may be less 
for States with small number of water systems or more for States with a 
large number of water systems); and (c) demonstrated access to 
appropriate program support at a minimum: 1.0 time program coordinator, 
1.0 time dental sealant coordinator, .50 time capacity for health 
education, .50 time health communication, .50 time data manager, .25 
time grant writer, 1.0 time support staff, and regional consultants, 
through leveraging of dollars, shared dedicated resources, and letters 
of support.
    Performance will be measured by evidence of expanded leadership and 
access to needed functions through personnel, leveraging of dollars, 
shared dedicated resources and/or letters of support, sharing through 
publications and presentations at national and regional meetings. 
Evidence can be shown by: (a) The minimum composition of the oral 
health program is consistent with the activities outlined above; (b) 
demonstrated with the activities outlined above; and (c) demonstrated 
evidence of sharing best practices and other lessons learned inside and 
outside of the State borders through publications and meeting 
presentations.
    (6) Develop and maintain expanded surveillance capacity. The 
surveillance system is maintained and sustainable, and able to compare 
State or smaller area data to those from national data sources. 
Surveillance system should be able to conduct original analyses or 
forge good working relationships with in-State agencies that will 
conduct the original analyses. Refer to surveillance logic model at Web 
site for more information.
    Activities should include: (a) Development of regional or county 
level indicators; (b) development of surveillance system quality 
checks, establishment of data cleaning protocol, and document data 
linkages and security procedures; (c) utilization of original analytic 
analyses and comparisons to national data in dissemination activities 
and reports; (d) documentation of regional or county level indicators; 
and (e) collaboration with other programs in the health department to 
answer key epidemiological questions of mutual interest, e.g., 
diabetes, tobacco, cancer, MCH.
    Performance will be measured by evidence that surveillance is on-
going, sustainable activity within the State, is expanded beyond the 
basic requirements of a core system, and uses data to direct program 
planning and oral health promotion. Evidence can be shown by: 
Documentation of activities (a) through (e) above.
    (7) Expand the diverse statewide oral health coalition. Expand 
statewide oral health coalition and address institutionalization and 
sustainability.
    Performance will be measured by evidence of a sustained, diverse 
statewide oral health coalition with established plans for membership 
and recruitment of diverse stakeholders. Evidence can be shown by: (a) 
Extent that coalition has been significantly expanded in both numbers 
and types of members and documentation of expanded coalition 
activities; (b) documentation of dedicated support staff; (c) 
documentation of established communication measures and outreach to 
community, policy makers and stakeholders; (d) extent of progress 
towards coalition sustainability such as meeting minutes, schedule of 
meeting dates and locations; and (e) documentation of active support 
from stakeholders including funding sources and in-kind contributions.
    (8) Address program sustainability by broadening resources. Address 
the institutionalization of the oral health unit, oral health 
surveillance system, statewide coalition, and the State's best practice 
programs.
    Performance will be measured by demonstration of condition 
supportive of the sustainability of State oral health infrastructure 
and programs. Evidence can be shown by measures including: (a) Non-
award funding and measures that activities are institutionalized; (b) 
demonstration of environment

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conducive to the growth of promotion of oral health in three major 
support areas: Infrastructure and processes, resources and culture/
context in the State, and local health department(s); (c) demonstration 
of shared dedicated resources, leveraging of dollars, and supportive 
partnerships; (d) demonstrated legislative and other State government 
support.
    (9) Collect, track and complete cost analysis for school-based or 
school-linked dental sealant program. Evaluate the accomplishments, 
efficiency, and effectiveness of the implemented school-based or 
school-linked dental sealant programs. Performance will be measured by 
the completion of a cost-analysis for school-based or school-linked 
dental sealant programs. Evidence can be shown by: (a) Documentation of 
baseline mean pit and fissure caries severity (i.e., pit and fissure 
DMFS) in targeted permanent molars among children three years older 
than target population; and (b) cost-analysis report published and 
submission made to the ASTDD Best Practices Project.
    2. CDC Activities. a. Update and provide information related to the 
purposes and/or objectives of the program announcement related to 
recipient activities. b. Provide programmatic and technical assistance 
for recipients and their stakeholders and partners through programmatic 
and technical consultation, workshops, information exchanges and other 
forms of guidance, assistance and information sharing to assist the 
recipient in: (a) The assessment of oral health status and behaviors of 
target sub-populations; (b) the design and implementation of strategies 
for prevention interventions based on best available scientific 
evidence; (c) the design, evaluation and monitoring of interventions 
effectiveness; (d) the distribution of information documenting lessons 
learned, best practices and program costs; and (e) the evaluation of 
State oral health programs.
    c. Communicate and share information, evaluations, data, and 
programmatic activities with other recipients and partners, as 
appropriate.
    d. Coordinate conference calls, workshops, and other information 
sharing opportunities, as appropriate.
F.4. Content
    The program announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan.
    This section will outline the requirements for each program and 
will note additional requirements for each specific Part.
    The narrative for Part 1 CAPACITY BUILDING Program should be no 
more than 36 pages, double-spaced, printed on one side, with one-inch 
margins, and 12-point Universal unreduced font.

(Part 1) CAPACITY BUILDING Program

    1. Executive Summary (not to exceed two pages). Provide a clear, 
concise two-page written summary to include: (a) Synthesis of need for 
oral health programs; (b) changes in infrastructure required to support 
proposed programs; (c) major proposed objectives for implementation of 
Work Plan (see section (4) below and http://www.cdc.gov/OralHealth/index.htm); (d) amount of Federal funding requested under Part 1 of 
this cooperative agreement.
    2. Statement of Need (not to exceed seven pages) (a) Describe oral 
disease burden within the State, indicate specific sub-populations and 
source(s) of data provided; (b) describe current assets and capacity of 
the State to reduce identified burdens. Current grantees under Program 
Announcement 01046, should not include CDC funding from Program 
Announcement 01046 under existing resources; (c) identify barriers and 
facilitators likely to affect the reduction of oral disease burden; and 
(d) describe gaps in Statewide infrastructure affecting the capability 
of the applicant to perform recipient activities and operate prevention 
programs.
    3. Five-year Plan (Goals) (not to exceed five pages). (a) Design a 
logic model for State oral health program. See Web site for the CDC 
Logic Model Template. Incorporate planned Capacity Building Prevention 
Interventions if appropriate, into State oral health logic model; (b) 
Goals: List feasible, realistic goals related to logic model to 
achieved in five years.
    4. One-year Plan, Activities and Timeline (not to exceed nine 
pages) Objectives: Provide specific, measurable, and time-phased 
objectives to accomplish each goal related to the logic model and the 
performance measures outlined in Section E above. (a) State how 
achievement of objectives will contribute to meeting the goal; (b) 
describe the one-year work plan for achieving each objective in Section 
(3) above. See Web site for the CDC Work Plan Template; (c) the one-
year work plan should describe activities planned to complete each 
objective. Applicants must link each time-phased objective and 
performance measure from Section E above, with the activities intended 
to support that objective; (d) one-year work plan should establish a 
time line for completion of each component or major activity; (e) 
identify specific individual (person) responsible for each objective or 
activity in the one-year work plan.
    5. Evaluation Plan (not to exceed seven pages). a. Describe plan 
for monitoring progress toward achieving objectives stated in Section 
(4) above;
    b. For each objective, specify how achievement will be documented 
including measures, data collection protocols, and data quality 
required to obtain needed information;
    c. Using the logic model as a framework, specify: (1) Indicators 
for process and outcome objectives; (2) expected increase in capacity 
of the State oral health program, delivery systems, and communities; 
(3) changes in oral health outcomes;
    d. Plans for analysis, interpretation and reporting of findings;
    e. Plans for use of findings; and
    f. Provide a time-line for the completion of the evaluation.
    6. Program Management (not to exceed six pages). (a) Describe 
employing agencies or institutions, as well as professional backgrounds 
of existing or proposed staff who will be responsible for each 
functional project aspect, including in-kind staff resources and 
percent of time commitment (including in-kind staff resources and 
percent of time commitment (Include Curriculum Vitae as appropriate); 
(b) provide evidence of State support for proposed project; (c) 
describe coalitions involvement in planning, implementation, and 
evaluation; (d) describe management, coordination team and 
responsibility for different program aspects; and (e) identify staff 
that will direct evaluation efforts including additional team members 
assigned to evaluation tasks. Provide a detailed description of 
expertise, experience, and delineation of staff, and responsibilities 
for program evaluation.
    7. Budget and Accompanying Justification (no page limitation). 
Submit a detailed budget and line item justification that is consistent 
with the purpose of the program and the proposed project objectives and 
activities, using the format of the sample budget provided at http://www.cdc.gov/OralHealth/index.htm.
    To the extent necessary, applicants are encouraged to include 
travel for: (a) Up to four persons associated with this project to each 
annually attend up to two technical assistance workshops. For

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the purpose of the initial funding period, budget for the workshops, 
training courses, and technical assistance meetings to be held in 
Atlanta, Georgia; and (b) two staff to annually participate in the 
National Oral Health Conference. For the purpose of the initial funding 
period, applicant should budget for the 2004 National Oral Health 
Conference.
    The narrative for Part 2 BASIC IMPLEMENTATION Program should be no 
more than 45 pages, double-spaced, printed on one side, with one-inch 
margins, and 12 point Universal unreduced font.

(Part 2) BASIC IMPLEMENTATION Program

    Use the application guidance from Part 1 Capacity Building Program 
with the exception of the page limits and the additional section as 
outlined below.
    1. Executive Summary (not to exceed four pages)
    2. Statement of Need (not to exceed seven pages)
    3. Eligibility (not to exceed seven pages)
    (a) Outline how State oral health program has accomplished 
activities and performance measures under the Capacity Building 
Program; (b) outline how your demonstration/pilot CAPACITY BUILDING 
PREVENTION INTERVENTIONS have been successful. Include a description of 
activities and performance measures under Section E.1.a as appropriate.
    4. Five-year plan (Goals) (not to exceed five pages)
    5. One-year Plan, Activities and Timeline (not to exceed nine 
pages)
    6. Evaluation Plan (not to exceed seven pages)
    7. Program management (not to exceed six pages)
    8. Budget and Accompanying Justification (no page limit)
G.4. Evaluation Criteria
    Applicants received from current grantees that are funded under 
Program Announcement 01046, will be reviewed utilizing the Technical 
Review process. Applications received from unfunded applicants (new), 
will be evaluated individually against the following criteria by an 
independent review group appointed by CDC.
    Applications received from grantees funded under Program 
Announcement 01046 will be reviewed by independent reviewers utilizing 
the Technical Acceptability Review (TAR) process.

CAPACITY BUILDING Program Criteria

    a. One Year Plan (30 points). The extent to which the applicant has 
addressed Recipient Activities 3 and item 4.a in the Application 
Content section of Component 4.
    b. Five Year Plan (20 points). The extent to which the applicant 
has addressed Recipient Activities 3 and item 3 in the Application 
Content section of Component 4.
    c. Program Management (20 points). The extent to which the 
applicant has addressed Recipient Activities 1, 7, 8, and 10 and item 6 
in the Application Content section of Component 4.
    d. Statement of Need (15 points). The extent to which the applicant 
has addressed Recipient Activities 1 and 2 and item 2 in the 
Application Content section of Component 4.
    e. Evaluation Plan (15 points). The extent to which the applicant 
has addressed Recipient Activities 5, 6, and 9 and item 5 in the 
Application Content section of Component 4.
    f. Budget (not scored). The extent to which the applicant has 
addressed item 7 in the Application Content section of Component 4.
BASIC IMPLEMENTATION Program Criteria
    a. One Year Plan (30 points). The extent to which the applicant has 
addressed Recipient Activities 3 and item 4.a in the Application 
Content section of Component 4.
    b. Five Year Plan (20 points). The extent to which the applicant 
has addressed Recipient Activities 3 and item 3 in the Application 
Content section of Component 4.
    c. Evaluation Plan (20 points). The extent to which the applicant 
has addressed Recipient Activities 5, 6, and 9 and item 5 in the 
Application Content section of Component 4.
    d. Program Management (20 points). The extent to which the 
applicant has addressed Recipient Activities 1, 7, 8, and 10 and item 6 
in the Application Content section of Component 4.
    e. Statement of Need (10 points). The extent to which the applicant 
has addressed Recipient Activities 1 and 2 and item 2 in the 
Application Content section of Component 4.
    f. Budget (not scored). The extent to which the applicant has 
addressed item 7 in the Application Content section of Component 4.
Component 5--Arthritis
D.5. Availability of Funds
    Approximately $6,000,000 is available in FY 2003 to fund up to 36 
awards. Approximately $3,640,000 is available to fund 28 existing 
Capacity Building Program Level A grantees under Program Announcement 
01097. Capacity Building Program Level A grantees will undergo a 
technical review of their application and will be funded pending 
receipt and approval of a technically acceptable application. It is 
expected that the average award will be $135,000 ranging from $120,000 
to $150,000.
    Approximately $2,360,000 is available to fund six to eight Capacity 
Building Program Level B programs. Requests for these funds will be 
competitive and will be reviewed by an independent objective review 
panel. It is expected that the average award will be $275,000 ranging 
from $250,000 to $300,000.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds. The interim progress report will be used 
as evidence of Capacity Building Program Level A attainment of their 
respective goals and objectives and readiness to compete for the next 
level of funding should funds be available. Capacity Building Program 
Level A grantees wishing to compete for the next level of funding 
should submit an application that is responsive to the Capacity Level B 
Program Performance Measures, Application Content and Recipient 
Activities section of this program announcement including a line-item 
budget and budget justification. Applications for advancement from a 
Level A to Level B program will be reviewed by CDC staff utilizing the 
Technical Acceptability Review (TAR) process. Applications can be 
submitted in fiscal year 2004, 2005, or 2006. Funding decisions will be 
made on the basis of satisfactory progress on the appropriate 
Performance Measures as evidenced by required reports and the 
availability of funds. Capacity Building Program Level A programs that 
unsuccessfully compete for Capacity Building Program Level B funding 
will be funded for a Capacity Building Program Level A.
Use of Funds
    Cooperative Agreement Funds may not be used to supplant State or 
Local funds. In addition, funds may not be used to support primary 
prevention activities.
Recipient Financial Participation
    Matching funds are not required for this program.
E.5. Program Requirements
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1a. 
(Recipient Activities for Capacity Building Program Level A) and

[[Page 3349]]

1b. (Recipient Activities for Capacity Building Program Level B 
Programs) and CDC will be responsible for the activities listed under 
2. CDC Activities.

1a. Recipient Activities for Capacity Building Program Level A

    1. Staffing: Establish a full-time arthritis program manager to 
oversee arthritis program activities and to promote an arthritis 
program within the State. All arthritis program managers are strongly 
encouraged to take the training ``The Arthritis Challenge'' and 
``Arthritis: The Public Health Approach'' located at http://www.astdhpphe.org. Performance will be measured by the extent to which 
the program is appropriately staffed in a timely manner as evidenced by 
the submission of the name of the program manager, the date of hire, 
and their completion of the training, ``Arthritis: The Public Health 
Approach'' as documented by a course completion certificate.
    2. Partnerships: Establish an advisory group or coalition to guide, 
review, and provide direction for the State in all activities directed 
at reducing the burden of arthritis. The advisory group, at a minimum, 
should include the local chapter(s) of the Arthritis Foundation. In 
addition, the State should consider the following as members of the 
advisory board or coalition:
    a. Individuals with expertise in arthritis;
    b. Agencies/organizations with activities relevant to arthritis, 
resources for arthritis activities, and access to target populations 
(e.g., Area Agencies on Aging, Medicaid/Medicare, managed care 
organizations, American Association of Retired Persons, senior centers, 
and faith communities); and
    c. Persons with arthritis or family members of persons with 
arthritis.
    As appropriate, States should establish internal workgroups with 
other components of State government that are directly or indirectly 
involved in some aspect of arthritis control and prevention.
    Performance will be measured by the extent to which there is 
evidence of diverse, active, and viable partnerships. Documentation 
should include minutes of meetings, lists of members, copies of by-laws 
or written operating procedures.
    3. Surveillance:
    a. Define and monitor the prevalence and impact of arthritis using 
the Behavioral Risk Factor Surveillance System (BRFSS). It is 
recommended that funded States collect data using the Arthritis 
Optional Module of the BRFSS in odd years (i.e., 2003, 2005, 2007)
    b. Issue a State of Arthritis Report using, at a minimum, 2001 
BRFSS arthritis data. (Arthritis data was collected by all States in 
calendar year 2001 through the BRFSS). This activity should be 
completed within the first two years of the cooperative agreement.
    c. For years two and beyond surveillance activities should be 
expanded to include the measuring of intervention reach and effects. 
Measuring reach includes, but is not limited to, establishing 
mechanisms to determine annual availability and delivery of evidenced-
based self-management programs such as ASHC, PACE, and Arthritis 
Foundation Aquatics programs. Availability measures the number of 
programs offered and their geographic dispersion; delivery measures 
both the number of programs given and the number of persons with 
arthritis attending. Measuring effects includes, but is not limited to, 
measuring changes in health impacts, improvement in quality of life, or 
functioning among those attending the above programs.
    Performance will be measured by:
    a. The extent to which there is evidence that the burden of 
arthritis has been defined using BRFSS data that identifies 
demographics, prevalence, and related risk behaviors (i.e., physical 
activity and obesity). A State of Arthritis Report has been published 
and disseminated.
    b. The extent to which the grantee is able to demonstrate the 
ability to define and monitor the number of evidenced-based self 
management courses available within the State and the number of 
individuals impacted by these programs.
    4. State Plan: Develop or update a State Plan for Arthritis that 
outlines a proposed framework for activities to reduce the burden of 
arthritis. This document should be planned with partners and include 
activities to be implemented by the partners. The plan should not 
address health department activities only and should be completed 
within the first eighteen months of the cooperative agreement.
    Performance will be measured by the extent to which documentation 
is provided that a written State plan for arthritis is completed. The 
plan should contain a description of the State burden of arthritis, and 
assessment of resources and resource gaps, strategies to decrease the 
burden of arthritis, priorities, and time-line for implementation of 
interventions. The plan should be endorsed and supported by partner 
organizations.
    5. Interventions: Implement one or more strategies from the State 
Arthritis Plan that is consistent with the Public Health Framework for 
Arthritis (see http://www.cdc.gov/nccdphp/arthritis) with a focus on 
the immediate effects and/or short term goals as outlined in this 
framework. Activities should be data driven. Applicant should develop 
implementation plans and evaluation strategies for the proposed 
intervention(s). Activities should be implemented with a focus on one 
or more of the following areas:
    a. Evidence-based Self Management Education and Physical Activity 
Interventions: Broaden the reach of evidence-based self management 
programs, e.g., the Arthritis Self Help Course (ASHC), the promotion of 
physical activity in individuals with arthritis using land-based 
exercise programs such as People with Arthritis Can Exercise (PACE) or 
water-based such as the Arthritis Foundation Aquatics Program.
    b. Health Communications Campaigns: Develop or utilizing health 
communications interventions that will increase/enhance knowledge and 
beliefs necessary for appropriate management of arthritis. 
Communications strategies should be designed to increase self-
management beliefs and behaviors and to increase the belief that self-
management is an important part of arthritis management. The 
communications activity can be targeted to people with arthritis, and 
their families, the general public, or non-physician health 
professionals. CDC developed health communication campaign Physical 
Activity. ``The Arthritis Pain Reliever,'' may be used. A summary of 
this material will be posted at http://www.cdc.gov/nccdphp/arthritis. 
Physician education efforts, while worthy, will not be considered as 
part of this activity.
    Performance will be measured by the extent that the grantee can 
provide documentation that one or more evidenced-base intervention was 
implemented including: the process used for selecting the intervention, 
the target audience, the location of the intervention, and data used to 
support the decision to implement.

1b. Recipient Activities for Capacity Level B Programs

    In addition to continuing and enhancing the Recipient Activities 
for Capacity Building Program Level A, Capacity Building Program Level 
B Program will include:
    1. Surveillance: Examine the availability and applicability of 
other State-based data sources including but not limited to data from 
outpatient/ambulatory care settings, managed care

[[Page 3350]]

organizations, and follow back surveys of BRFSS respondents. Pharmacy 
data may also prove useful to better define the burden of arthritis 
within the State. All surveillance activities outside of BRFSS should 
be directly linked to programmatic activities.
    Performance will be measured by the extent to which non-BRFSS data 
have been examined and have informed program decisions or enhanced 
existing activities.
    2. Interventions: Implement two or more strategies from the State 
Arthritis Plan that is consistent with the Public Health Framework for 
Arthritis with a focus on Evidenced-Based Arthritis Education Programs 
and/or Health Communications. Capacity Building Level B programs may 
choose to implement and evaluate physical activity or self-management 
interventions other than ASHC, aquatics and PACE, that may be 
beneficial and effective in reducing arthritis related pain and 
disability and improving the quality of life among persons with 
arthritis. For these interventions, States must propose an 
implementation and evaluation plan. This plan should include a 
description of the program, expected program outcomes, implementation 
strategies, the role of partners and consultants in implementing and 
evaluating the program, and the evaluation plan. The evaluation should 
describe how impact will be measured, domains of interest, proposed 
data collection tools, and how data will be collected and analyzed. A 
time-line should be included.
    Performance will be measured by:
    a. The extent to which grantee can provide documentation that two 
or more evidenced-base interventions were implemented including: the 
process used for selecting the intervention, the target audience, the 
location of the intervention, the role of partners, and data used to 
support the decision to implement.
    b. The extent to which non-evidence based programs have been 
implemented and evaluated.

    Notes: All funded States are expected to adhere to the most 
current surveillance, intervention, and health communication 
recommendations that will be posted at http://www.cdc.gov/nccdphp/arthritis/index.htm.

2. CDC Activities

    a. Provide consultation and technical assistance to plan, 
implement, and evaluate each component of the program.
    b. Provide current information on the status of
    c. National efforts as they relate to the implementation of 
recipient activities.
    d. As needed, provide technical assistance in the coordination of 
surveillance efforts and the use of other data systems to measure and 
characterize the burden of arthritis, provide standard analyses of 
BRFSS data for States, and provide data for national level comparisons.
    e. Facilitate communication among arthritis programs, other 
government agencies, and others involved in arthritis control and 
prevention efforts.
F.5. Content
    The program announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. Applications for Capacity Building Program Level A should be no 
more than 30 pages and Capacity Building Program Level B Programs no 
more than 40 pages excluding Federal forms, budget, justification, 
abstract, and appendixes. All applications should be double-spaced, 
printed on one side, with one-inch margins, and 12-point font. All 
applicants should also submit as appendices, resumes, job descriptions, 
organizational charts, and any other supporting documentation as 
appropriate. All graphics, maps, overlays, etc., should be in black and 
white and meet the above criteria. All submitted materials must be 
suitable for photocopying. Your application must be submitted unstapled 
and unbound.
    1. Abstract (All Applicants). A one-page, single-spaced, typed 
abstract must be submitted with the application. The heading should 
include the title of the program, organization, name and address of the 
project director, telephone number, facsimile number, and e-mail 
address. The abstract should clearly state which level of activities 
the applicant is applying for: Capacity Building Program Level A, or 
Capacity Building Level B Program. The abstract should briefly list 
major program elements and activities. A table of contents that 
provides page numbers for each section should follow the abstract.
    2. Background/Current Status. Capacity Building Program Level A 
Programs: Describe the burden of arthritis in the State. Identify what 
data sources are being used, the barriers the State currently faces in 
developing and implementing a program for arthritis, and identify the 
specific needs and resources available for arthritis activities.
    Capacity Building Level B Programs: a. Applicants for Capacity 
Building Programs Level B should provide evidence that they have 
significantly met the requirements specified in the Recipient 
Activities for Capacity Building Programs Level A (see Program 
Recipient Activities Section).
    b. In addition, the applicant should adequately describe the burden 
of arthritis within the State including how the program defines 
arthritis using BRFSS and other data.
    c. Include a description of the barriers the State currently faces 
in further developing and implementing programs for the control of 
arthritis.
    3. Work-Plan. Provide a work plan that includes objective, methods, 
evaluation plans, and a time-line for each for the required elements 
cited in Recipient Activities above. Objectives should describe what is 
to happen, by when, by whom, and to what degree. Methods should 
describe the plan for achieving each of the objectives including a 
description of how partners will be involved. Also included should be a 
description of how progress toward attainment of the objectives will be 
monitored.
    a. Staffing (All Applicants). Describe how proposed or existing 
staff has the relevant background, qualifications, and experience to 
manage a public health program. Include a description of their role in 
promoting an arthritis program within the State, their specific 
responsibilities, their role in coordinating activities between 
relevant programs within the State, how the organizational structure 
will support the staff's ability to conduct proposed activities, and 
the level of effort and time to be devoted to the arthritis program. 
Job descriptions, resumes if available, and an organizational chart 
should be included.
    b. Partnerships (All Applicants). Include plans for developing 
partnerships with the local chapter(s) of the Arthritis Foundation, 
State and local agencies, Federal agencies, and others with an interest 
in arthritis. If partnerships have already been developed, the 
applicant should describe the process used, and the role of advisory 
groups, partnerships, or coalitions in the development and 
implementation of activities in the State Plan for Arthritis. 
Partnerships are expected to have been ongoing and viable. Applicants 
should include copies of agendas for all partnership meetings within 
the past two calendar years. Letters of support should be submitted and 
should describe the nature and extent of involvement by outside 
partners.

[[Page 3351]]

c. Surveillance

Capacity Building Program Level B
    1. Describe plans to monitor the burden of arthritis within the 
State using BRFSS data and include plans for the development and 
dissemination of a State of Arthritis Report.
    2. Applicant should also describe the method to be used to develop 
mechanisms to measure programmatic reach and effects of evidenced-based 
arthritis self-management programs as defined in the ``Recipient 
Activities'' section of this announcement.
Capacity Building Level B
    3. In addition to criteria under Capacity Building Program Level A, 
applicants for Capacity Building Level B Programs should present plans 
to examine the availability and applicability of other State-based data 
sources as described in the ``Recipient Activities'' section.

d. State Plan

Capacity Building Program Level A
    Applicants should describe the process to be used for engaging 
relevant partners and developing a State arthritis plan. If a State 
plan has been developed, describe the process used for its development, 
provide agendas for planning meetings, and provide the executive 
summary of the State plan.

e. Interventions

    1. Applicants should describe the process to be used to select the 
intervention to be implemented.
    2. If an already existing State plan or partnership has provided 
guidance for the selection of the intervention, describe the 
relationship between the intervention and strategies identified within 
the State plan and the Public Health Framework for Arthritis. Provide a 
description of implementation plans, the proposed intervention(s) 
activity(ies), the target population, geographic location, the actual 
methods of implementation, a time-line, evaluation strategy, and the 
role of partners in this process.
Capacity Building Program Level B
    a. Address the elements 1 and 2 under Capacity Building Program 
Level A.
    b. If proposing the implementation of non evidenced-based 
intervention(s), provide an implementation plan that includes a 
description of the program and expected outcomes. In addition, the 
evaluation plan should describe how impact will be measured, domains of 
interest, proposed data collection tools, and how data will be 
analyzed.
    f. Evaluation (All Applicants). Applicant should provide a plan 
that is capable of monitoring progress toward meeting specified project 
objectives.
    g. Budget (All Applicants). Provide a detailed line-item budget and 
justifications consistent with the purpose and proposed objectives. 
Budgets should include travel for one to two program staff to attend a 
two-day meeting in Atlanta. Proposed sub-contracts should identify the 
name of the contractor, if known; describe the services to be 
performed; provide an itemized budget and justification for the 
estimated costs of the contract; specify the period of performance; and 
describe the method of selection. If indirect costs are requested, a 
copy of the Indirect Cost Rate Agreement should be included.
G.5. Evaluation Criteria (100 Points)
    Applications received from current grantees that are funded under 
Program announcement 01097, will be reviewed utilizing the Technical 
Review process. Applications received from States funded under program 
announcement 99074 and all other applicants will be evaluated 
individually against the following criteria by an independent review 
group appointed by CDC.

A. Capacity Building Program Level A (100 points)

    1. Need/Current Status. Capacity Building Program Level A (15 
points) Capacity Level B (25 points). The extent to which the applicant 
addresses the requirements identified in Section F.5. (Application 
Content) item 3. Point distribution is listed below.
    2. Staffing. Capacity Building Program Level A (20 points) Capacity 
Building Program Level B (10 points). The extent to which the applicant 
addresses the requirements identified in section E5 (Recipient 
Activities) section 1a. item 1 and section F.5 (Application Content) 
item 3a.
    3. Partnerships. Capacity Building Program Level A (15 points) 
Capacity Building Program Level B (15 points). The extent to which the 
applicant addresses the requirements identified in Section E.5 
(Recipient Activities) section 1a. item 2 and section F.5 (Application 
Content) item 3b.
    4. Surveillance. Capacity Building Program Level A (15 points) 
Capacity Building Program Level B (20 points). The extent to which the 
applicant addresses the requirements identified in Section E.5 
(Recipient Activities) section 1a. item 3; section 1b item 1 and 
section F.5 (Application content) item 3c.
    5. State Plan. Capacity Building Program Level A (15 points) 
Capacity Building Program Level B (0 points). The extent to which the 
applicant addresses the requirements identified in Section E.5 
(Recipient Activities) section 1a. item 4 and section F.5 (Application 
Content) item 3d.
    6. Interventions. Capacity Building Program Level A (15 points) 
Capacity Building Program Level B (25 points). The extent to which the 
applicant addresses the requirements identified in Section E.5 
``Recipient Activities'' section 1a. item 5; section 1b item 2 and 
section F.5 ``Application Content'' item 3e.
    7. Evaluation. Capacity Building Program Level A (5 points) 
Capacity Building Program Level B (5 points). The extent to which the 
applicant addresses the requirements identified in Section F.5 
(Application content) item 3f.
    8. Budget (not scored). The extent to which the applicant addresses 
the requirements identified in Section F.5 (Application content) item 
3g.
    9. Human Subjects (not scored). Does the application adequately 
address the requirements of title 45 CFR Part 46 for the protection of 
human subjects? Not scored; however, an application can be disapproved 
if the research risks are sufficiently serious and protection against 
risks is so inadequate as to make the entire application unacceptable.
Component 6--Behavior Risk Factor Surveillance Systems (BRFSS)
D.6. Availability of Funds
    Approximately $5,000,000 is available in FY 2003 to fund 
approximately 54 existing grants under program announcement 99044. It 
is expected that the average award will be $75,000, ranging from 
$50,000 to $100,000. It is expected that the awards will begin on or 
about June 30, 2003 and will be made for a 12-month budget period 
within a project period of up to five years. Funding estimates may 
change.
Use of Funds
    Funds provided under this program announcement cannot be used to 
conduct community-based pilot or demonstration projects. Cooperative 
agreement funds may not be used to supplant State or local funds. 
Cooperative agreement funds may not be used to provide patient care, 
personal health services, medications, patient rehabilitation, or other 
cost associated with treatment. Funds awarded under this program 
announcement may be obligated and expended only for those BRFSS 
surveillance, data collection, and

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related activities identified in the Notice of Grant Award.
E.6. Program Requirements
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1. Recipient 
Activities, and CDC will be responsible for the activities listed under 
2. CDC Activities.
    1. Recipient Activities. a. At a minimum, identify a program 
director and BRFSS data coordinator dedicated to overall coordination 
and operations of BRFSS.
    b. Adopt the standard BRFSS written protocol that has been 
developed and formulate a plan for developing and conducting BRFSS data 
collection activities in conformance with protocols used by other 
participating States and delineated in the ``BRFSS User's Guide'' and 
numbered memorandums (The ``BRFSS User's Guide'' is available at http://www.cdc.gov/brfss).
    c. Develop and implement plans and written procedures for ongoing 
analysis of behavioral risk factor data Statewide and for selected 
local areas.
    d. Develop and implement plans and written procedures to ensure the 
routine use of BRFSS data for directing program planning, evaluating 
programs, establishing program priorities, developing specific 
interventions and policies, assessing trends, and targeting relevant 
population groups.
    e. Develop and implement plans for the use of BRFSS data to address 
emerging Public Health chronic disease and injury issues within the 
State.
    f. Develop and implement procedures to increase collaboration with 
and among State, local, and, as appropriate, national, public, private, 
voluntary, for-profit and nonprofit agencies, organizations, and 
universities that analyze data or seek to reduce chronic disease and 
injury morbidity and mortality.
    g. Assure active cooperation and collaboration with recipients of 
funding from other CDC supported programs (cancer, tobacco use, 
diabetes, alcohol use, women's health, etc.) and identify opportunities 
to link program and BRFSS efforts where appropriate and reinforcing, 
including co-funding of BRFSS activities.
    h. Ensure adequate and, as required, periodic training of State 
BRFSS interviewers. Interviewers must follow the standard BRFSS 
questionnaire script developed in collaboration with BRFSS member 
States and should be trained with appropriate standards for telephone 
interviewing. (The BRFSS Interviewer Training is located in the 
training section of the BRFSS Web site referenced above in 1.b.)
    i. Develop, maintain, and make available to CDC monthly, electronic 
BRFSS data sets for data management (i.e., editing, cleaning, and 
weighting).
    j. Conduct monthly, monitoring data quality and data management 
(i.e., through verification and validation efforts).
    k. Develop and implement an analysis plan.
    l. Participate with others in individual and multi-State analyses 
comparing data across BRFSS States.
    m. Disseminate BRFSS findings through presentations and 
publications to health departments, professional societies, voluntary 
agencies, universities, other BRFSS States, and other interested 
individuals and organizations.
    n. Make data and BRFSS findings available for training workshops 
and meetings at least once a year (i.e., BRFSS Conference).
    o. Assure that CDC receives final end-of-year BRFSS data sets on or 
before February 15 of the following year.
    2. CDC Activities. a. Assist BRFSS member States to develop an 
annual survey instrument to be used by States with States and CDC 
programs.
    b. Assist BRFSS member States to establish standard survey 
protocols to be followed by States and disseminate them in the ``BRFSS 
User's Guide'' and in numbered memorandums; and, as appropriate, assist 
in the development of State-specific protocols.
    c. Assist BRFSS member States with designing and obtaining 
appropriate telephone samples.
    d. Assist BRFSS member States in the development of data processing 
procedures to be used by States and CDC to produce edited data files 
with standard, uniform formats. Provide program software, training, and 
on-going technical assistance for operations management, questionnaire 
data entry, and development of the BRFSS analysis database.
    e. Develop and provide to States semi-annual and annual summary 
reports on selected risk factors related to the leading causes of State 
morbidity and mortality in a standardized and uniform manner.
    f. Assist in training State staff related to data collection, data 
analysis, interpretation, and use.
    g. Conduct or assist with the specification of cleaning, weighting, 
data editing, variable and format layouts of all data files.
    h. Provide technical assistance to resolve problems regarding data 
collection procedures, response rates, sampling procedures (unbiased 
sampling and estimate omissions), and database file completeness.
    i. Collaborate with State, Federal, and other programs on joint 
analysis of BRFSS data.
    j. Coordinate and facilitate the interchange of technical 
information among cooperative agreement recipients.
    k. Provide BRFSS States with programmatic, epidemiological, and 
statistical technical assistance.
    l. In collaboration with State(s) conduct multi-State and single-
State analyses and facilitate dissemination and translation of 
findings.
    m. Participate with States in workshops, training, and meeting to 
exchange information.
    n. Conduct site visits to monitor program operations and to provide 
technical assistance as needed.
    Performance will be measured based on accomplishment of the 
activities listed above. Evidence can be demonstrated through the 
quality of data, adherence to survey recommendations, utilization of 
BRFSS data for program planning and evaluation.
F.6. Content
    The program announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Applications will be evaluated on the criteria 
listed, so it is important to follow them in laying out program plans. 
The narrative should be no more than 30 double-spaced pages, printed on 
one side, with one-inch margins, and unreduced font.
    Available funds will be allocated first for the costs of an 
estimated base of 2,000 completed 100-question surveys in each State.

1. Program Management

    a. Identify the percentage of the project coordinator's time and 
related costs for project activities and describe procedures or process 
(i.e., contractors or in-house) for the management of data collection. 
Provide job descriptions, resumes, and organizational charts.
    b. Include written procedures or describe plans to develop and 
implement the following:
    c. BRFSS data analysis Statewide and for local areas.
    d. Use of BRFSS data for directing program planning, program 
evaluation, setting program priorities, developing interventions, 
assessing trends, and targeting relevant population groups.
    e. To address emerging public health issues.

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    f. To increase collaboration among State, local, and other 
agencies, organizations, and universities that analyze data or seek to 
reduce chronic disease and injury morbidity and mortality.
    g. Provide a list of training taken by key BRFSS staff, to include 
data collection/interviewer staff, within the previous 12 months. 
Training list should include course title, a brief description of 
course content, dates of training, and names and titles of staff 
attending the training.
    h. Provide a copy of projected staff training with the course 
title, course description, dates of training, and names and titles of 
staff who will be attending training.

2. Operational Plan

    a. Provide an estimate of the number of interviews to be completed 
in addition to the base number of 2000 completed interviews per State 
per year.
    b. Provide a list of the survey questions to be asked in addition 
to the base-length questionnaire.
    c. Identify the percentage of an analyst's time and related costs 
for analyzing data collected.
    d. Provide the title and author(s) of publications produced and/or 
distributed using BRFSS data.
    e. Upgrading computer-assisted telephone interviewing systems and 
computer systems for analysis and Internet activities.
    f. Describe the nature and extent of collaboration and coordination 
with and support (i.e., financial, shared resources, etc.) from other 
State programs.

3. Evaluation

    Describe the procedures currently used or planned to monitor the 
performance of the data collection system, adherence to prescribed data 
collection protocols, and the extent of the use and dissemination of 
the data.

4. Budget

    Provide a detailed budget and line-item justification for all 
operating expenses. The budget should be consistent with the State's 
objectives and planned activities of the project. Budget requests 
should include the cost of two two-day trips to Atlanta for two 
individuals and the cost of one five-day trip (including travel days) 
for up to two individuals to attend the annual BRFSS conference. The 
budget should address funds requested, as well as the applicant's in-
kind or direct support.
G.6. Evaluation Criteria (100 points)
    Applications received from current grantee that are funded under 
program announcement 99044, will be reviewed utilizing the Technical 
Review process.
    1. Operational Plan (50 points). The extent to which the applicant 
has addressed Recipient Activities 1.b, 1.c, 1.d, 1.e, 1.k, 1.m, and 
items 1 through 6 in the Application Content section.
    2. Program Management (25 points). The extent to which the 
applicant has addressed Recipient Activities 1.a, 1.g, 1.h, 1.i, and 
items 1 through 5 in the Application Content section.
    3. Evaluation (25 points). The extent to which the applicant has 
addressed Recipient Activities 1.i, 1.j, and 1.o, and item 3 in the 
Application Content section.
    4. Budget (Not Weighted). The extent to which the applicant has 
addressed item 4 in the Application Content section.
Component 7--Genomics and Chronic Disease Prevention
D.7. Availability of Funds
    Approximately $1,000,000 is available in FY 2003 to fund 
approximately three to five States' program awards. It is expected that 
the average award will be $200,000 ranging from $150,000 to $250,000.
Use of Funds
    Funds awarded under this component may not be used to conduct 
genomic research or pay for patient services such as genetic testing or 
counseling. Cooperative agreement funds may be used to develop or 
enhance the State Health Department's capacity for planning with other 
agency programs and outside partners, and implementing the use of 
genomic information (e.g. genetic testing and family history data) in 
public health policy and programs. Funds may also be used to enhance 
data collection through disease registries and other surveillance 
systems and to develop public health work-force competency in the use 
of genomics for disease prevention. Developing genomic leadership 
capacity will enhance comprehensive chronic disease prevention and 
health promotion by establishing cross-cutting activities with one or 
more disease-specific programs and increasing collaboration across the 
agency in epidemiology, environmental health, infectious disease, 
maternal and child health, and related programs that increase the 
effectiveness of chronic disease prevention.
E.7. Program Requirements
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1. Recipient 
Activities, and CDC will be responsible for the activities listed under 
2. CDC Activities.

1. Recipient Activities

    Note: In this announcement, integrating genomic and the use of 
family history into chronic disease program planning, policy 
development, and intervention design includes, but is not limited 
to, (a) Establishing or expanding leadership capacity in the field 
of genomics, (b) developing and implementing population-based 
assessments and incorporating genomic information into disease-
specific data collection through surveillance and registries, (c) 
developing expanded uses of genomics in programmatic activities 
including BRFSS and the analysis of vital records and other sources 
important in population-based analysis, (d) educating the health 
workforce, policy makers, and the public about the importance of 
understanding the role of family history and genetic risk factors in 
disease etiology and prevention, and (e) specifically preparing the 
chronic disease workforce for using genomic tools to reduce the 
burden of specific diseases and understanding the benefits and 
limitations of available genetic tests.


    a. Develop or strengthen the health agency organizational 
capacities for assessing and utilizing existing genomics and public 
health program experience and expertise in planning the integration of 
genomics into existing chronic disease prevention and health promotion 
programs.
    b. Acquire or enhance the leadership capacity required to integrate 
genomics into existing or planned chronic disease prevention and health 
promotion programs. In this effort, coordination of the core public 
specialties (such as epidemiology, laboratory services, policy 
development, and infectious disease prevention) to integrate genomics 
and family history, as appropriate, is required. The use of genomics 
within public health requires collaboration with academic and health 
care organizations that can provide technical assistance and expertise 
in expanding program and policy development. Leadership capacity may 
include: (a) Designating a State agency-wide, or chronic disease 
genomics coordinator or team, expanding existing leadership roles to 
include chronic disease and other disease-specific responsibilities, 
and/or coordinating a team representing all or selected public health 
disease programs; (b) the availability of adequate epidemiologic, 
genomics, laboratory, health education, communications expertise and 
program support; and (c) a mechanism for assessing and increasing the 
genomic and public health competency of the chronic disease work-force 
through technical assistance and specific

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training activities. Information of work force competency is available 
at: http://www.cdc.gov/genomics/training/competencies/comps.htm.
    c. Utilizes national, regional and State training and technical 
assistance resources for program development, and expands collaborative 
relationships with key academic institutions such as the Centers for 
Genomics and Public Health (Link to: http://www.cdc.gov/genomics/training/competencies/comps.htm).
    Ensures that State professional organizations, industry, community 
representatives or key partners and community are key partners 
throughout the planning process.
    d. Develop and implement a plan for integrating genomics and 
related risk assessment tools such as family history into core public 
health activities and priorities for one or more chronic infectious, 
environmental, Maternal and Child Health or other public health 
programs during the first year.
    e. Plan and coordinate the assessment and use of various types of 
targeted risk assessment strategies related to enhanced disease 
prevention based on genomics and family history tools. Collaborate with 
professional, industrial, and academic resources and partners in the 
testing, assessment, and usage of risk assessment tools that help 
organize knowledge about inheritable factors into a process for early 
recognition of increased disease susceptibility and strategies for 
disease prevention.
    f. Plan and coordinate the assessment and use of various types of 
targeted risk assessment strategies related to enhanced disease 
prevention based on genomics and family history tools. Collaborate with 
CDC and the Centers for Genomics and Public Health in the testing, 
assessment, and usage of family history tools that help organize 
knowledge about heritable factors into a process for early recognition 
of increased disease susceptibility and strategies for disease 
prevention.

2. CDC Activities

    a. Convene workshop and/or teleconference of recipient Programs for 
information-sharing and problem solving.
    b. Provide ongoing guidance, consultation, and technical assistance 
to plan, implement, and evaluate all aspects of program activities. 
Activities include assisting with analyses and interpretation of the 
rapidly expanding knowledge base on public health genomics and findings 
from qualitative and quantitative research; guiding program evaluation, 
and sharing community, environmental and policy strategies to promote 
the integration of genomics across health agency programs associated 
with chronic disease program activities. Disseminate relevant state-of-
the-art research findings and public health recommendations related to 
genomics and disease-specific prevention and control.
    c. On a consultative basis, assist in the development and review of 
intervention protocols and program evaluation methods.
    d. Coordinate national level partnerships with relevant 
organizations and agencies involved in the translation of genomics and 
family history into relevant guidelines and recommendations for public 
health policy development and program action.
F.7. Content
    The program announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. Applications should be no more than 20 pages excluding Federal 
forms, budget, justifications, abstract, and appendices. All 
applications should be double spaced, printed on one side, with one-
inch margins, and 12-point font. All applicants should also submit as 
appendices, resumes, job descriptions, organizational charts, and any 
other supporting documentation as appropriate. All graphics maps, 
overlays, etc., should be in black and white and meet the above 
criteria. All submitted materials must be suitable for photocopying. 
Your application must be submitted UNSTAPLED and UNBOUND.
    1. Abstract. A one-page, single-spaced, typed abstract must be 
submitted with the application. The heading should include the title of 
the program, organization, name and address of the project director, 
telephone number, facsimile number, and e-mail address. The abstract 
should briefly list major program elements and activities. A table of 
contents that provides page numbers for each section should follow the 
abstract.
    2. Background, Need, and Understanding. Describe the status of 
health agency activities and capacity for establishing coordinated 
leadership in genomics to guide crosscutting health policy and program 
development. Provide status and level of involvement of chronic 
disease, infectious disease, environmental health, epidemiology, 
maternal and child health, and laboratory within this agency leadership 
capacity. Describe the extent to which genomics is integrated into 
chronic disease programs function and the proposed or actual placement 
of a focus for genomic activities within that structure. Discuss any 
agency actions implemented or planned that facilitate the integration 
of genomics and/or the use of family history in developing risk factor 
assessments and targeting disease prevention efforts. Provide evidence 
of the readiness of the agency and its program to integrate genomics 
and family history into chronic disease prevention and health promotion 
planning, policy development, and intervention activities. Identify the 
specific components of this, or other chronic disease program 
announcements, or the crosscutting issues, to be addressed.
    3. Work-plan. Provide a work plan that addresses each of the 
required elements cited in the Recipient Activities above. The work 
plan should include:
    a. Program Objectives for each of the Recipient Activities. 
Objectives should describe what is to happen, by when, by whom, and to 
what degree.
    b. The proposed method of achieving each of the objectives.
    c. The proposed plan for evaluating progress toward attainment of 
the objectives.
    d. A milestone, time line, and completion chart for all objectives 
for the project period.
    4. Budget. Provide a detailed line-item budget with justifications 
consistent with the purpose and proposed objectives. Clearly 
differentiate budget amounts and activities requested through this 
component from the resources or activities of other components or 
programs. Budgets should include travel for one to two persons to 
attend a two-day meeting in Atlanta. Proposed sub-contracts should 
identify the name of the contractor, if known; describe the services to 
be performed; provide an itemized budget and justification for the 
estimated costs of the contract; specify the period of performance; and 
describe the method of selection. If indirect costs are requested, a 
copy of the Indirect Cost Rate Agreement should be included.
G.7. Evaluation Criteria
    Applications for this component will be objectively reviewed 
against the following criteria by an independent review group appointed 
by CDC.
    1. Background, Need, and Understanding (25 points). The extent to 
which the applicant describes

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Background, Need as presented in the application content section 
(F.8.4), and demonstrates an Understanding of the intent and focus of 
the program as presented in the Recipient Requirements (E.8.1).

2. Work Plan

    a. Program Objectives (25 points). The extent to which the 
applicant presents specific, measurable, and time phased objectives for 
each Recipient Requirement (E.8.1.a-e).
    b. Methods of Achieving the Objectives (25 points). The extent to 
which the applicant's plan for each Recipient Requirement (E.8.1 a-e) 
will accurately monitor, and permit re-direction of activities.
    c. Plan for Evaluating Progress (15 points). The extent to which 
the evaluation plan for each Recipient Requirement (E.8.1 a-e) will 
accurately monitor, and permit re-direction of activities.
    d. Milestone, Timeline, and Completion Chart (10 points). The 
extent to which the chart(s) provided represents an effective tool for 
monitoring program progress.

3. Abstract (Not scored). The extent to which an overview of the 
program is provided in a clear and concise manner.

    4. Budget and Justification (Not scored). The extent to which the 
line item budget justification is reasonable and consistent with 
purpose of this component and program goal(s) and objectives of the 
cooperative agreement.
Program Performance Measures
    Performance measures for the first year: 1. Evidence that States 
have performed a review of organizational and operational capacities 
for integrating genomics into public health practices and policies.
    2. Evidence that States have identified and defined the nature and 
scope of population-based data, genomics information, and leadership 
capacity necessary to integrate genomics into chronic disease and other 
public health program activities.
    3. Evidence that States have developed and initiated a plan for 
integrating genomics and risk assessment tools such as family history 
into one or more chronic, infectious, environmental, maternal and child 
health, or other public health programs.
    4. Evidence that the States have formed partnerships with academic 
institutions, professional organizations, community and industry groups 
and involved them in the planning of genomic integration activities.

Five Year Performance Measures

    1. Evidence that the States have integrated genomics and related 
risk assessment tools, such as family history, as a routine component 
of disease investigations and analysis.
    2. Evidence that the States have used population-based data and the 
expanding genomics knowledge base to develop or revise chronic, 
environmental, and infectious disease programmatic activities, 
interventions, and policies.
    3. Evidence that the States have conducted preliminary evaluations 
of the impact of genomics in case identification, disease prevention, 
economic, and disease specific health outcome.

    Note: This section applies to all components.

H. Submission and Deadline

    Submit the original and two copies of CDC form 0.1246. Forms are 
available in the application kit and at the following Internet address: 
http://www.cdc.gov/od/pgo/forminfo.htm.

    Note: Your application should be submitted as one application 
but should consist of specific Categorical Components to allow each 
categorical program to remove their section of the application to 
assist with the preparation of the application.


    The application must be received by 4:00 p.m. Eastern Time March 
28, 2003. Submit the application to: Technical Information Management 
Section--Program Announcement 03022, Procurement and Grants Office, 
Center For Disease Control and Prevention, 2920 Brandywine Road, Room 
3000, Atlanta, Georgia 30341-4146.
    Deadline Applications will be considered as meeting the deadline if 
they are received before 4:00 p.m. Eastern Time on the deadline date. 
Applicants sending applications by the United States Postal Service or 
commercial delivery services must ensure that the carrier will be able 
to guarantee delivery of the application by the closing date and time. 
If an application is received after closing due to carrier error, when 
the carrier accepted the package with a guarantee for delivery by the 
closing date and time, or if significant weather delays or natural 
disasters, CDC will upon receipt of proper documentation, consider the 
application as having been received by the deadline.
    Applications which do not meet the above criteria will not be 
eligible for competition and will be discarded. Applicants will be 
notified of their failure to meet the submission requirements.

I. Other Requirements

Technical Reporting Requirements
    Provide CDC with original plus two copies of:
    1. Interim progress report, the interim progress report will be due 
February 15, 2004, and subsequent interim progress reports will be due 
on the 15th of February each year through February 15, 2008, except for 
Component 6. The second report (annual progress report) is due 90 days 
after the end of the budget period (30th of September). The progress 
report, due in February, will serve as your non-competing continuation 
application and must include the following elements:
    a. A succinct description the program accomplishments/narrative and 
progress made in meeting each Current Budget Period Activities 
Objectives during the first six months of the budget period (June 30th 
through December 31st).
    b. A succinct description of the program accomplishments/narrative 
and progress made in meeting each Current Budget Period Activities 
Objectives during the first six months of the budget period (June 30th 
through December 31st).
    c. The reason(s) for not meeting established program objectives and 
strategies to be implemented to achieve unmet objectives.
    d. Current Budget Period Financial Progress.
    e. New Budget Period Proposed Activities and Objectives.
    f. Detailed Line-Item Budget and Justification.
    g. For all proposed contracts, provide the name of contractor, 
method of selection, period of performance, scope of work, and itemized 
budget and budget justification. If the information is not available, 
please indicate ``To Be Determined'' until the information becomes 
available; it should be submitted to CDC Procurement and Grants 
Management Office contact identified in this program announcement.
Applicable for Program Components 2 (Nutrition, Physical Activity and 
Obesity), 3 (WISEWOMAN), 4 (State-Based Oral Disease Prevention), and 5 
(Arthritis), only:
    The interim progress report that is due on the 15th of February 
will also be used as evidence of a program's readiness to move from 
level to the next higher level based on attainment of goals and 
objectives when funding is available. Applicants wishing to

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compete for the next funding level should submit items a, b, d, e, f, 
and g above and the information requested in the next funding level 
Recipient Activities and Application Content identified in this program 
announcement including a line item budget and budget justification.
    Applicants can be submitted in fiscal years 2004, 2005, 2006, and 
2007 but be received by February 15th of the specific submission year. 
Funding decisions will be made on the basis of attainment of current 
goals and objectives as evidenced by the require reports, application 
score, and the availability of funds.
    2. Financial status report, no more than 90 days after the end of 
the budget period. The financial status report should include an 
attachment that identifies unspent balances for each program component.
    3. Final financial and performance reports, no more than 90 days 
after the end of the project period.
    Send all reports to the Grants Management Specialist identified in 
the ``Where to Obtain Additional Information'' section of this 
announcement.
    The following additional requirements are applicable to this 
program.

AR-1 Human Subjects Requirements (Component 2 & 3)
AR-2 Requirements for Inclusion of Women and Racial and Ethnic 
Minorities in Research (Component 2 & 3)
AR-7 Executive Order 12372 Review
AR-8 Public Health System Reporting Requirements
AR-9 Paperwork Reduction Act Requirements
AR-10 Smoke Free Workplace Requirements
AR-11 Health People 2010
AR-12 Lobbying Restrictions

J. Where To Obtain Additional Information

    For this and other CDC announcements, the necessary applications, 
and associated forms can be found on the CDC home page Internet 
address--http://www.cdc.gov. Click on ``Funding'' then ``Grants and 
Cooperative Agreements.''
    Business management and technical assistance may be obtained from: 
Lucy Picciolo, Grants Management Specialist, Procurement and Grants 
Office, Centers for Disease Control and Prevention, 2920 Brandywine 
Road, Room 3000, Atlanta, GA 30341-4146, Telephone number: 770-488-
2683, E-mail address: [email protected].
    Business management technical assistance for the U.S. Territories 
may be obtained from: Charlotte Flitcraft, Contract Specialist, 
Procurement and Grants Office, Centers for Disease Control and 
Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 30341-4146, 
Telephone number: 770-488-2632, E-mail address: [email protected].
    Business Management technical assistance for Territories may be 
obtained from: Charlotte Flitcraft, Contract Specialist, Procurement 
and Grants Office, Centers for Disease Control and Prevention, 2920 
Brandywine Road, Room 3000, Atlanta, GA 30341-4146, Telephone number: 
770-488-2632, E-mail address: [email protected].
    For program technical assistance, contact: Component 1--
Comprehensive State-Based Tobacco Use Prevention and Control Programs: 
Dianne May, Program Services Branch, Office on Smoking and Health, 
National Center for Chronic Disease Prevention and Health Promotion, 
Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS 
K50, Atlanta, GA 30341, Telephone number: (770) 488-1104, E-mail 
address: [email protected].
    Component 2--State Nutrition and Physical Activity Programs to 
Prevent Obesity and Other Chronic Diseases: Robin Hamre, Obesity 
Prevention Programs Team Leader, Division of Nutrition and Physical 
Activity, National Center for Chronic Disease Prevention and Health 
Promotion, Centers for Disease Control and Prevention, 4770 Buford 
Hwy., NE, MS K24, Atlanta, GA 30341, Telephone number: (770) 488-6050, 
E-mail address: [email protected].
    Component 3--WISEWOMAN: Julie C. Will, PhD, MPH, WISEWOMAN Team 
Leader, Division of Nutrition and Physical Activity, National Center 
for Chronic Disease Prevention and Health Promotion, Centers for 
Disease Control and Prevention, 4770 Buford Hwy., NE, MS K26, Atlanta, 
GA 30341, Telephone number: (770) 488-6024, E-mail address: 
[email protected].
    For WISEWOMAN Definitions see WISEWOMAN Guidance Document: 
Interpretation of Legislative Language and Existing Documents at http://www.cdc.gov/wisewoman.
    Component 4--State Based Oral Disease Prevention Programs: Kathleen 
Heiden, RDH, MSPH, Division of Oral Health, National Center for Chronic 
Disease Prevention and Health Promotion, Centers for Disease Control 
and Prevention, 4770 Buford Hwy., NE, MS F10, Atlanta, GA. 30341, 
Telephone number: (770) 488-6056, E-mail address: 
[email protected].
    Component 5--Arthritis: Sakeena Smith, Division of Adult and 
Community Health, National Center for Chronic Disease Prevention and 
Health Promotion, Centers for Disease Control and Prevention, 4770 
Buford Hwy., NE, MS K66, Atlanta, GA 30341-3717, Telephone (770) 488-
5440, E-mail address: [email protected].
    Component 6--BRFSS: Ruth Jiles, Division of Adult and Community 
Health, National Center for Chronic Disease Prevention and Health 
Promotion, Centers for Disease Control and Prevention, 4770 Buford 
Hwy., NE, MS K66, Atlanta, GA 30341-3717, Telephone (770) 488-2542, E-
mail address: [email protected].
    Component 7--Chronic Disease Genomics: Ann Malarcher, Division of 
Adult and Community Health, National Center for Chronic Disease 
Prevention and Health Promotion, Centers for Disease Control and 
Prevention, 4770 Buford Hwy., NE, MS K47, Atlanta, GA 30341, Telephone: 
(770) 488-8006, E-mail address: [email protected].

    Dated: January 13, 2003.
Sandra R. Manning,
CGFM, Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention (CDC).

K. Appendices

    Relevant to WISEWOMAN Component:

                                                                Appendix A.--Eligibility
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                              Competitive                Funding level              Type of program
                              Applicant                              -----------------------------------------------------------------------------------
                                                                           Yes           No            1st           2nd        Standard      Enhanced
--------------------------------------------------------------------------------------------------------------------------------------------------------
States:
    Alabama.........................................................            X   ............            X   ............            X             X

[[Page 3357]]

 
    Alaska..........................................................            X   ............            X   ............            X             X
    Arizona.........................................................            X   ............            X   ............            X             X
    Arkansas........................................................            X   ............            X   ............            X             X
    California......................................................  ............            X   ............            X   ............            X
    Colorado........................................................            X   ............            X   ............            X             X
    Connecticut.....................................................  ............            X   ............            X             X   ............
    Delaware........................................................            X   ............            X   ............            X             X
    Florida.........................................................            X   ............            X   ............            X             X
    Georgia.........................................................            X   ............            X   ............            X             X
    Hawaii..........................................................            X   ............            X   ............            X             X
    Idaho...........................................................            X   ............            X   ............            X             X
    Illinois........................................................  ............            X   ............            X   ............            X
    Indiana.........................................................            X   ............            X   ............            X             X
    Iowa............................................................  ............            X   ............            X   ............            X
    Kansas..........................................................            X   ............            X   ............            X             X
    Kentucky........................................................            X   ............            X   ............            X             X
    Louisiana.......................................................            X   ............            X   ............            X             X
    Maine...........................................................            X   ............            X   ............            X             X
    Maryland........................................................            X   ............            X   ............            X             X
    Massachusetts...................................................  ............            X   ............            X             X   ............
    Michigan........................................................  ............            X   ............            X             X   ............
    Minnesota.......................................................            X   ............            X   ............            X             X
    Mississippi.....................................................            X   ............            X   ............            X             X
    Missouri........................................................            X   ............            X   ............            X             X
    Montana.........................................................            X   ............            X   ............            X             X
    Nebraska........................................................  ............            X   ............            X             X   ............
    Nevada..........................................................            X   ............            X   ............            X             X
    New Hampshire...................................................            X   ............            X   ............            X             X
    New Jersey......................................................            X   ............            X   ............            X             X
    New Mexico......................................................            X   ............            X   ............            X             X
    New York........................................................            X   ............            X   ............            X             X
    North Carolina..................................................  ............            X   ............            X   ............            X
    North Dakota....................................................            X   ............            X   ............            X             X
    Ohio............................................................            X   ............            X   ............            X             X
    Oklahoma........................................................            X   ............            X   ............            X             X
    Oregon..........................................................            X   ............            X   ............            X             X
    Pennsylvania....................................................            X   ............            X   ............            X             X
    Rhode Island....................................................            X   ............            X   ............            X             X
    South Carolina..................................................            X   ............            X   ............            X             X
    South Dakota....................................................  ............            X   ............            X             X   ............
    Tennessee.......................................................            X   ............            X   ............            X             X
    Texas...........................................................            X   ............            X   ............            X             X
    Utah............................................................            X   ............            X   ............            X             X
    Vermont.........................................................  ............            X   ............            X             X   ............
    Virginia........................................................            X   ............            X   ............            X             X
    Washington......................................................            X   ............            X   ............            X             X
    Washington, D.C.................................................            X   ............            X   ............            X             X
    West Virginia...................................................            X   ............            X   ............            X             X
    Wisconsin.......................................................            X   ............            X   ............            X             X
    Wyoming.........................................................            X   ............            X   ............            X             X
Territories:
    American Samoa..................................................            X   ............            X   ............            X             X
    Guam............................................................            X   ............            X   ............            X             X
    N. Mariana Islands..............................................            X   ............            X   ............            X             X
    Puerto Rico.....................................................            X   ............            X   ............            X             X
    Republic of Palau...............................................            X   ............            X   ............            X             X
    Virgin Islands..................................................            X   ............            X   ............            X             X
Tribes:
    Arctic Slope....................................................            X   ............            X   ............            X             X
    Cherokee Nation.................................................            X   ............            X   ............            X             X
    Cheyenne River..................................................            X   ............            X   ............            X             X
    Consolidated Tribal Health......................................            X   ............            X   ............            X             X
    Hopi............................................................            X   ............            X   ............            X             X
    Indian Community Health.........................................            X   ............            X   ............            X             X
    KAW Nation......................................................            X   ............            X   ............            X             X
    NARA............................................................            X   ............            X   ............            X             X
    Navajo..........................................................            X   ............            X   ............            X             X
    Poach Band......................................................            X   ............            X   ............            X             X
    South Puget.....................................................            X   ............            X   ............            X             X
    South-central...................................................  ............            X   ............            X   ............            X

[[Page 3358]]

 
    Southeast Alaska................................................  ............            X   ............            X             X
    Yukon-Kuskokwim.................................................            X   ............            X   ............            X             X
All other programs funded by NBCCEDP................................            X   ............            X   ............            X             X
All other programs not funded by NBCCEDP............................          Not   ............  ............  ............  ............  ............
                                                                         eligible
--------------------------------------------------------------------------------------------------------------------------------------------------------


                            Appendix B.--Type of Program and Performance Requirements
[Depending on type of program and level of funding, a project is expected to complete the performance activities
                                        detailed in the appropriate cell]
----------------------------------------------------------------------------------------------------------------
                                                     Type of program and performance requirements
                                    ----------------------------------------------------------------------------
                                         Standard Demonstration Project
           Funding level              (Available for  applicants applying
                                       in FY 2003 and FY 2004)  Standard     Enhanced (Available for applicants
                                      Best Practices Project (Available in     applying in FY 2003 and later)
                                               FY 2005 and later)
----------------------------------------------------------------------------------------------------------------
First Annual Funding:                (1) Complete Program Startup           (1) Complete Program Startup
$50,000 to $250,000 (Standard);       Activities found in checklist *.       Activities found in checklist
 $250,000 to $500,000 (Enhanced)     (2) Test activities using pilot study   including IRB protocols *.
                                      methods.                              (2) Receive IRB approval.
                                     (3) Screen 500 women annually for      (3) Test methods in pilot study that
                                      blood pressure and cholesterol and     includes screening and intervention
                                      provide all with health education.     activities.
                                     (4) Ensure at least 60 percent of      ....................................
                                      newly screened women receive          (4) Demonstrate adequate power to
                                      complete lifestyle intervention        test effectiveness of lifestyle
                                      program.                               interventions in a full-scale
                                     (5) If applying in FY 2005 or later,    study.
                                      programs must implement WISEWOMAN-    ....................................
                                      recommended best practices            (5) Prepare publishable manuscript
                                      (recommendations available in FY
                                      2005).
Second Annual Funding:               (1) Screen at least 2500 women each    (1) Screen and intervene with enough
$250,000 to $750,000 (Standard);      year for blood pressure and            women to achieve statistical power
 $750,000 to $1,250,000 (Enhanced);   cholesterol and provide all with       as determined during 1st level
 Funding level for Standard and       health education * *.                 (2) Ensure 75 percent of eligible
 Enhanced Programs depends on        (2) Ensure at least 60 percent of new   women in intervention group receive
 success in meeting or exceeding      women receive complete lifestyle       complete intervention
 performance requirements             intervention.                         (3) Demonstrate that intervention
                                     (3) Demonstrate that newly enrolled     group adopts a healthier lifestyle
                                      participants adopt a healthier         during the year following
                                      lifestyle during the year following    enrollment * *
                                      enrollment * *.                       (4) Demonstrate statistically
                                     (4) Demonstrate that at least one       significant difference on one key
                                      quarter of women screened are newly    outcome.
                                      detected with high blood pressure or  (5) Develop monograph and/or
                                      high cholesterol * *.                  training on methods to help other
                                     (5) Demonstrate a reduction in          projects adopt successful program
                                      expected coronary heart disease       (6) Submit at least one manuscript
                                      deaths per 1000 women expected in 10   on methods and results to a peer-
                                      years * * *.                           reviewed journal
----------------------------------------------------------------------------------------------------------------
* Program Start-Up Checklist developed by the North Carolina WISEWOMAN program is found on page 18 of the
  monograph ``Integrating Cardiovascular Disease Prevention into Existing Health Services: The Experience of the
  North Carolina WISEWOMAN Program'' at http://www.hpdp.unc.edu/wisewoman/manual.htm.
* * See GPRA measures developed May 17, 2002 found in WISEWOMAN Guidance Document: Interpretation of Legislative
  Language and Existing Documents at http://ww.cdc.gov/wisewoman.
* * * Use Framingham risk formulation that includes smoking, systolic blood pressure, total cholesterol, and
  age. This is calculated from minimum data elements.


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Appendix D --Eligibility for Program Announcement 03022 Chronic Disease 
Prevention and Health Promotion Programs

Component 1: State-Based Basic Implementation Tobacco Prevention 
and Control Programs

    Applications received from current grant recipients under: 
Program Announcement 99038, Comprehensive State-Based Tobacco Use 
Prevention, and Control Programs, will be funded upon receipt and 
approval of a technically acceptable application.

Component 3: Well-Integrated Screening and Evaluation for Women 
Across the Nation

    Applications received from current grant recipients under Well 
Integrated Screening and Evaluation for Woman Across the nation 
(WISEWOMAN):

Program announcement 00115 WISEWOMAN
Program Announcement 99135 WISEWOMAN
Program Announcement 01098 WISEWOMAN Enhanced, will be funded upon 
receipt and approval of a technically acceptable application.

Component 4: State-Based Oral Disease Prevention Program

    Applications received from current grant recipients under: 
Program Announcement 01046 Support State Oral Disease Prevention 
Programs, will be funded upon receipt and approval of a technically 
acceptable application.

Component 5: Arthritis

    Applications received from current grant recipients under: 
Program Announcement 01097 Reducing the Impact of Arthritis and 
Other Rheumatic Conditions, will be funded upon receipt and approval 
of a technically acceptable application.

Component 6: Behavioral Risk Factor Surveillance Systems (BRFSS)

    Applications received from current grant recipients under: 
Program Announcement 99044 Behavioral Risk Factor Surveillance 
System (BRFSS), will be funded upon receipt and approval of a 
technically acceptable application.

[FR Doc. 03-1065 Filed 1-22-03; 8:45 am]
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