[Federal Register Volume 68, Number 102 (Wednesday, May 28, 2003)]
[Notices]
[Pages 31707-31720]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-13222]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 03032]


Addressing Asthma From a Public Health Perspective; Notice of 
Availability of Funds

    Application Deadline: July 14, 2003.

A. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under section 301 and 317 of the Public 
Health Service Act [42 U.S.C. section 241 and 247b], as amended. The 
Catalog of Federal Domestic Assistance number is 93.283.

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 ``Addressing Asthma from a Public Health Perspective.'' 
This program addresses the ``Healthy People 2010'' focus areas 
Environmental Health, Occupational Safety and Health, and Respiratory 
Diseases.
    The purpose of the program is to provide the impetus to begin 
development of program capacity to address asthma from a public health 
perspective in order to bring about: (1) A focus of asthma-related 
activity within the agency; (2) an increased understanding of asthma-
related data and its application to program planning through 
development of an ongoing surveillance system; (3) an increased 
recognition within the public health structure of the state or 
territory of the potential to use a public health approach to reduce 
the burden of asthma; (4) linkages of the agency to the many agencies 
and organizations addressing asthma in the population; and (5) 
participation in intervention program activities. Epidemiological 
surveillance is ``the ongoing systematic collection, analysis, and 
interpretation of health data essential to the planning, 
implementation, and evaluation of public health practice, closely 
integrated with the timely dissemination of these data to those who 
need to know. The final link in the surveillance chain is the 
application of these data to prevention and control. A surveillance 
system includes a functional capacity for data collection, analysis, 
and dissemination linked to public health programs.'' Refer to Boss, 
L.; Kreutzer, R.; Luttinger, D.; Leighton, J.; Wilcox, K.; and Redd, S. 
The Public Health Surveillance of Asthma, Journal of Asthma, 38(1), 83-
89, 2001.
    This program announcement has three parts: (1) Part A: Developing 
State Capacity to Address Asthma, (2) Part A Enhanced: Enhancing State 
Capacity to Address Asthma, and (3) Part B: Implementation of State 
Asthma Plans.
    Measurable outcomes of the program will be in alignment with the 
following performance goal for the National Center for Environmental 
Health (NCEH): Reduce the burden of asthma.

C. Eligible Applicants

    Applications may be submitted by:
    [sbull] Federally recognized Indian tribal governments.
    [sbull] Indian tribes.
    [sbull] Indian tribal organizations.
    [sbull] State public health departments or their bona fide agents 
(this includes the District of Columbia, the Commonwealth of Puerto 
Rico, the Virgin Islands, the Commonwealth of the Northern Marianna 
Islands, American Samoa, Guam, the Federated States of Micronesia, the 
Republic of the Marshall Islands, and the Republic of Palau).
    Part A: Developing State Capacity to Control Asthma. Eligible 
applicants are those entities listed above that do not have a final, 
approved, comprehensive, asthma plan or a well-developed asthma 
surveillance system. Grantees currently funded by CDC Announcement 
99109, 01106, or 02085 are not eligible to 
apply because they have already received funds to conduct activities in 
Part A: Developing State Capacity to Control Asthma. See Attachment II 
for a list of states funded by these announcements. All attachments 
referenced in this announcement are posted with the announcement on the 
CDC Web site, Internet address: http://www.cdc.gov, click on 
``Funding'', then click on ``Grants and Cooperative Agreements.''
    Part A Enhanced: Enhancing State Capacity to Address Asthma. 
Eligible applicants are those entities that are currently funded by CDC 
Announcement 99109, are in the latter stages of finishing the 
capacity building process, and are preparing to begin implementing 
interventions. These states are Colorado, Iowa, Maine, New Jersey, New 
Mexico, Rhode Island, and Vermont.
    Applicants for Part A Enhanced: Enhancing State Capacity to Address 
Asthma must:
    1. Submit a copy of the final, approved, comprehensive State Asthma 
Plan. Approval can be documented with a letter from the Agency's Health 
or Medical Director and letters from key partners or by appropriate 
sign-offs on the asthma plan. Plans that are pending final approval may 
be accepted if the draft plan is accompanied by letters from the 
Agency's Health or Medical Director and key partners stating their 
commitment to and approval of the plan, a time frame for final 
approval, as well as a description of the plan's approval process 
status.
    2. Have an operational surveillance system for asthma. This may be 
demonstrated through submission of your most recent and comprehensive 
published surveillance report that describes asthma within the 
jurisdiction, including, if available, a report on asthma in the 
Medicaid population.
    Applications for Part A Enhanced: Enhancing State Capacity to 
Address Asthma that fail to submit evidence requested will be 
considered non-responsive and returned without review.

[[Page 31708]]

    Part B: Implementation of State Asthma Plans. Eligible applicants 
are those entities that have a final, approved, comprehensive, State 
Asthma Plan and an operational surveillance system for asthma. The 
states of California, Illinois, Michigan, Minnesota, New York, and 
Oregon are not eligible to apply for any parts: Part A: Developing 
State Capacity to Address Asthma; Part A Enhanced: Enhancing State 
Capacity to Address Asthma; or Part B: Implementation of State Asthma 
Plans, because they are currently funded by CDC Program Announcement 
01106 (Part B) or 02085 to implement State asthma 
activities. See Attachment II for a list of states funded by these 
announcements.
    Applicants for Part B: Implementation of State Asthma Plans must:
    1. Submit a copy of the final, approved, comprehensive State Asthma 
Plan. Approval may be documented with a letter from the Agency's Health 
or Medical Director and letters from key partners or by appropriate 
sign-offs on the asthma plan. Plans that are pending final approval may 
be accepted if the draft plan is accompanied by letters from the 
Agency's Health or Medical Director and key partners stating their 
commitment to and approval of the plan. Include a description of the 
plan's approval process status.
    2. Have an operational surveillance system for asthma. This may be 
demonstrated through submission of your most recent, comprehensive 
published surveillance report that describes asthma within the State, 
territory, tribe, or jurisdiction, including, if available, a report on 
asthma in the Medicaid population.
    Applications for Part B: Implementation of State Asthma Plans that 
fail to submit evidence requested will be considered non-responsive and 
returned without review.
    Based on eligibility requirements described in Section C Eligible 
Applicants, an applicant may apply for:
    [sbull] Part A: Developing State Capacity to Address Asthma,
    * Part A Enhanced: Enhancing State Capacity to Address Asthma,
    * Part B: Implementation of State Asthma Plans, or
    [sbull] Any combination

However, only one award per applicant will be made. Applicants must 
submit a separate application for each part they are applying for.

    Note: Title 2 of the United States Code section 1611 states that 
an organization described in section 501 (c)(4) of the Internal 
Revenue Code that engages in lobbying activities is not eligible to 
receive Federal funds constituting an award, grant or loan.

D. Funding

Availability of Funds

    Approximately $4,450,000 is available in FY 2003 to fund 
approximately 9-12 awards.
    Part A: Developing State Capacity to Address Asthma. Approximately 
$600,000 is available to fund approximately one to three awards. It is 
expected that the average award will be $200,000.

Part A Enhanced: Enhancing State Capacity to Address Asthma

    Approximately $2,450,000 is available to fund approximately seven 
awards. It is expected that the average award will be $350,000.

Part B: Implementation of State Asthma Plans.

    Approximately $1,400,000 is available to fund approximately one to 
two awards. It is expected that the average award will be $700,000.
    It is expected that awards under this program announcement will 
begin on or about August 1, 2003 and will be made for a 12-month budget 
period for the first year that will end on August 31, 2004. The project 
period for Part A: Developing State Capacity to Address Asthma will be 
up to three years, Part A Enhanced: Enhancing State Capacity to Address 
Asthma for up to three years, and Part B: Implementation of State 
Asthma Plans for up to five years. Funding estimates may change.
    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.

Use of Funds

    Cooperative agreement funds may be used to support costs directly 
related to the program activities and consistent with the scope of the 
cooperative agreement. Funds under this program announcement may not be 
used to conduct research projects. Surveillance and evaluation 
activities that are for the purposes of monitoring program performance 
are not considered research. Funds under this program announcement may 
not be used for screening or registry activities. Federal funds awarded 
under this program announcement may not be used to supplant State or 
local funds.

Recipient Financial Participation

    Matching funds are not required for this program.

Funding Preferences

    Funding preferences may include (1) geographic distribution, and 
(2) racial and ethnic populations with a disproportionate asthma 
burden.

E. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities listed in 1. 
Recipient Activities, and CDC will be responsible for the activities 
listed in 2. CDC Activities.

Part A: Developing State Capacity To Address Asthma

1. Recipient Activities
    a. Implement a new (or enhance an existing) asthma surveillance 
system in order to gather and interpret data that will quantify the 
burden of asthma within the State, and upon which to base the 
development of the State Asthma Plan. Include asthma morbidity, 
mortality and work-related asthma.
    b. Develop a comprehensive State Asthma Plan.
    c. Develop and implement an evaluation plan that measures the 
effectiveness of the program as a whole as well as each intervention. 
Systematically document lessons learned.
    d. Develop and organize collaborative linkages with appropriate 
agencies and organizations statewide to together (1) systematically 
describe the asthma problem in the State; (2) identify available 
resources; and (3) in conjunction with partners, develop a 
comprehensive State Asthma Plan.
    e. Establish a strong agency commitment within the State Health 
Department to support the asthma program.
    f. Participate in CDC convened meetings and periodic conference 
calls for grantees to share experiences, data, and materials.

Part A Enhanced: Enhancing State Capacity To Address Asthma

1. Recipient Activities
    a. Enhance the existing asthma surveillance system to include 
asthma hospitalizations. Conduct analysis and interpretation of 
surveillance data and disseminate these data through reports to local, 
State, and Federal partners and agencies.
    b. If not already completed, obtain final approval for a 
comprehensive State Asthma Plan. This activity should be completed 
within three months of the year one budget period.
    c. Implement a subset of interventions described in the State 
Asthma Plan.
    d. Develop and implement an evaluation plan that measures the 
effectiveness of your program as a whole as well as each intervention.

[[Page 31709]]

Systematically document lessons learned.
    e. Maintain existing or expand (as appropriate) statewide coalition 
and partnership activities; including a workgroup to address work-
related asthma if one does not exist. Include as members of this 
workgroup representatives from State governmental agencies (e.g. state 
department of labor), Federal agencies, public health agencies, and 
professional care organizations conducting or interested in 
occupational health activities.
    f. Maintain a strong agency commitment within the State Health 
Department to support continued efforts of the asthma program.
    g. Participate in CDC convened meetings and periodic conference 
calls for grantees to share experiences, data, and materials.

Part B: Implementation of State Asthma Plans

1. Recipient Activities
    a. Expand existing surveillance efforts for, but not limited to, 
asthma prevalence, severity, management, mortality, hospitalizations, 
emergency care, costs of asthma and other indicators in order to 
monitor the effectiveness of the intervention activities. Include 
surveillance of work-related asthma.
    b. Conduct analysis and interpretation of surveillance data and 
disseminate these data through appropriate surveillance reports to 
local, state, and federal partners and agencies.
    c. Develop and implement an evaluation plan that measures the 
effectiveness of your program as a whole and each intervention. 
Systematically document lessons learned.
    d. Maintain existing statewide coalition and partnership activities 
to oversee implementation and evaluation of the State Asthma Plan. 
Expand partnership activities as appropriate.
    e. Implement defined aspects of the final, approved, comprehensive 
State Asthma Plan. Maintain existing asthma-related activities 
currently underway in the health agency and expand as appropriate. 
Assure institutionalization of asthma intervention activities.
    f. Maintain a strong agency commitment within the State Health 
Department to support continued efforts of the asthma program.
    g. Participate in CDC convened meetings and periodic conference 
calls for grantees to share experiences, data, and materials.
2. CDC Activities for Part A: Developing State Capacity to Address 
Asthma, Part A Enhanced: Enhancing State Capacity to Address Asthma, 
and Part B: Implementation of State Asthma Plans
    a. Participate with recipients in further development and 
enhancement of existing surveillance activities, including data 
collection methods and data analysis.
    b. Collaborate with recipients on data analysis and interpretation 
of individual state surveillance data and release of surveillance 
reports.
    c. Provide technical and scientific assistance and consultation on 
program development, implementation of the State Asthma Plan, 
intervention activities and operational issues.
    d. Serve as a facilitator for communication between states to share 
expertise regarding various topics, including the expansion and 
development of partnerships, implementation of State Asthma Plans, and 
surveillance activities.
    e. Facilitate working group conference calls with recipients.
    f. Collaborate on the development of an appropriate evaluation plan 
that measures the effectiveness of the program as a whole and each 
intervention.
    g. Convene meetings and periodic conference calls for grantees to 
share experiences, data, and materials.

F. Content

Letter of Intent (LOI)

    A LOI is optional for this program. The Program Announcement title 
and number must appear in the LOI. The narrative should be no more than 
one page, double-spaced, printed on one side, with one-inch margins, 
and unreduced 12-point font. Your letter will be used to ascertain the 
level of interest in this announcement and to assist in determining the 
size and composition of the independent review panel. It should include 
the following information:
    1. Name and address of organization.
    2. Name, address, telephone number, fax number, and e-mail address 
of the organization's primary contact for writing and submitting the 
application.
    3. A clear description of which part of the program announcement 
(Part A: Developing State Capacity To Address Asthma, Part A Enhanced: 
Enhancing State Capacity to Address Asthma, Part B: Implementation of 
State Asthma Plans, or any combination) you are applying for.

Applications

    The Program Announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, Evaluation Criteria, and this section 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 should be no more than 30 pages for Part A: 
Developing State Capacity to Address Asthma, 35 pages for Part A 
Enhanced: Enhancing State Capacity to Address Asthma, or 40 pages for 
Part B: Implementation of State Asthma Plans, double-spaced, printed on 
one side, with one-inch margins, and unreduced 12-point font. The 
application must be submitted unstapled and unbound. Appendices are 
limited to a maximum of 100 pages and must be submitted unstapled and 
unbound.
Part A: Developing State Capacity To Address Asthma
    Include each of the following sections:
1. Description of the Problem
    Describe what is known about the asthma burden in the State, 
territory, tribe, or jurisdiction and efforts to begin to 
systematically address the problem. Identify existing initiatives, 
capacity, and infrastructure of the agency within which asthma programs 
will occur. Describe the barriers that need to be addressed to develop 
a comprehensive asthma program in the State.
2. Workplan
    Provide specific goals, objectives, and activities that describe 
what the agency intends to accomplish by the end of the three-year 
project period. These goals, objectives and activities should be 
measurable, realistic, related to Recipient Activities, and reflect 
activities in year one, two, and three of the project. Include a 
project time-line that indicates when the proposed goals, objectives, 
and activities will be met. Document how progress made toward meeting 
the objectives will be evaluated. Provide measures for evaluating 
process, impact, and outcome for each goal and objective. Refer to 
``Framework for Program Evaluation in Public Health,'' Morbidity and 
Mortality Weekly Report, September 17, 1999/48(RR-11); 1-40 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm or other evaluation 
resources on the CDC website at http://www.cdc.gov/eval/index).
    In addition, describe how lessons learned will be systematically 
gathered, documented, and included as an integral part of the program 
evaluation process.

[[Page 31710]]

3. Surveillance Plan
    Describe the current operational asthma surveillance system within 
the health agency (if one exists). Provide a surveillance plan 
containing the following information: (a) A description of data 
currently available to the program; (b) additional data the agency will 
obtain and methods for obtaining it; (c) plans for identifying specific 
populations at-risk for poorly controlled asthma (e.g. gender, age 
groups, racial/ethnic groups, socio-economic groups, and/or geographic 
areas); (d) how the agency will use data to develop (or enhance) an 
ongoing surveillance system; and (e) how the surveillance data will be 
used to support policy, program development, implementation, and 
evaluation activities. At a minimum, the surveillance system should 
include measures to track asthma morbidity, asthma mortality, and work-
related asthma. For more information about work-related asthma, refer 
to:
    ``Surveillance of Work-Related Asthma in Selected U.S. States Using 
Surveillance Guidelines for State Health Departments--California, 
Massachusetts, Michigan and New Jersey, 1993-1995,'' Morbidity and 
Mortality Weekly Report, June 25, 1999/48 (SS03); 1-20 at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4803a1.htm.
    Workgroup Report ``The Role of States in a Nationwide Comprehensive 
Surveillance System for Work-related Diseases, Injuries and Hazards'' 
at http://www.cste.org/occupationalhealth.htm.
    ``Minimum and Comprehensive State-Based Activities in Occupational 
Safety and Health,'' June 1995--DHHS (NIOSH) Publication No. 95-107 at 
http://www.cdc.gov/niosh/95-107.html.
    Applicants funded by this announcement will be expected to use the 
Behavioral Risk Factor Surveillance System (BRFSS) supplemental asthma 
module within the first year of the project.
    Describe a strategy to conduct analysis, interpret surveillance 
data, and disseminate data through published reports to local, state, 
and federal partners and agencies.
    Present a detailed plan for evaluating whether the asthma 
surveillance system is useful for monitoring trends over time. Refer to 
``Updated Guidelines for Evaluating Surveillance Systems, 
Recommendations from the Guidelines Working Group,'' Morbidity and 
Mortality Weekly Report, July 27, 2001/(50)RR-13; 1-35 or http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm
4. State Asthma Plan
    Describe the process by which a comprehensive State Asthma Plan 
will be developed. The plan must address all persons with asthma in the 
State regardless of age, race/ethnicity, gender or geographic area. 
Include key environments in which persons with asthma spend significant 
time (e.g. home, school, and workplace). If a specific population in 
the State is not affected by asthma, clearly identify and describe this 
population.
    Include information about the agencies and organizations that will 
participate in developing the State Asthma Plan. Describe each 
partner's roles and responsibilities. Explain how the collaborative 
relationships will be used after the plan is in place and the agency is 
ready to implement interventions.
    Describe how data collected in the asthma surveillance system will 
be used to identify priority areas and guide the development of program 
goals and objectives. Explain how the State Asthma Plan will evolve and 
change based on surveillance data, evaluation of interventions, and 
other outside factors that affect the overall climate in the State.
5. Collaboration Plan
    Describe experiences with collaborative relationships around asthma 
or with other chronic or environmentally-related or occupationally-
related disease requiring extensive collaborative relationships both 
within and outside the agency. Specifically define the approach to be 
used to establish or further develop these relationships.
    Document partnerships with the clinical community; local health 
agencies; physician organizations; community health centers; local, 
State, or regional asthma or respiratory health organizations (such as 
the American Lung Association); local education authorities; and groups 
or organizations that serve minority or other populations experiencing 
a disproportionate burden of asthma. If one or more of these partners 
will not be included, the applicant should explain why.
    Describe how the collaboration will (1) establish leadership, (2) 
develop consensus regarding goals, (3) identify roles and 
responsibilities of members, (4) develop procedures and patterns of 
communications, and (5) sustain the participation of members over time.
    Provide letters of commitment from each specific organization, 
including a statement of how they intend to collaborate, as well as 
their expertise, and capacity to carry out assigned responsibilities.
    Grant funds may be used to leverage asthma program development in 
the State, territory, tribe or jurisdiction along with resources from 
other agencies and organizations.
    Present a plan to determine the effectiveness of collaborations.
6. Management and Staffing Plan
    Demonstrate the applicant's organizational commitment to the asthma 
program by describing how the agency as a whole will focus its efforts 
on asthma. Provide a plan to maintain a strong commitment within the 
State Health Department to support continued efforts of the asthma 
program.
    Describe the organizational location of the proposed staff, their 
relation to the State's asthma contact (the position in the agency 
currently responsible for contact with CDC on asthma issues), and the 
support within the organizational structure for the activities defined 
for the project staff. Attach an organizational chart for the unit 
where asthma activities will be located and, at a minimum, the next two 
levels above it.
    Describe the qualifications and roles of trained public health 
professionals to serve as a full-time asthma coordinator for the agency 
to manage the planning process and conduct other programmatic 
activities; a full-time epidemiologist to develop and implement 
surveillance activities for the asthma project; and a supervisor who 
will assure support for the project staff. Other program positions may 
also be proposed. Attach position descriptions, qualifications, and 
curricula vitae for all staff positions.
    For each position, describe the primary roles and responsibilities 
for the project staff over the three-year grant period. Also, include 
the specific staff activities that will contribute to meeting each 
objective.
    Provide a plan to expedite filling of the staff position(s) and 
assure that they have been or will be approved by the applicant's 
personnel system. Include a letter of support from the agency 
guaranteeing hiring of personnel and support for the asthma program. 
Also, describe positions in the asthma program that are currently 
filled, but will not be funded by resources under this cooperative 
agreement.
    Document assurance of the ability of key project staff to 
participate in conferences or grantee meetings convened by CDC and 
willingness to share innovations, information, data, and materials.

[[Page 31711]]

7. Budget
    Include a detailed first-year budget and narrative justifications 
as well as annual budget projections for years two and three. The 
applicant should describe the program purpose for each budget item. For 
each contract contained within the budget, provide (1) the name the 
contractor(s); (2) method of selection; (3) period of performance; (4) 
description of activities; and (5) an itemized budget with narrative 
justifications. If this information is not available when the 
application is submitted, and the contract(s) is approved by the CDC, 
then the funds for the contract(s) will be restricted for expenditure 
on the award.
    The budget should include travel funds for project staff to attend 
a yearly conference or grantee meeting convened by CDC. In addition, 
the applicant should include costs for one person to travel to Atlanta, 
GA, to attend the 6th National Environmental Health Conference on 
December 3-5, 2003. Review the CDC/NCEH web site for additional 
information concerning this conference: http://www.cdc.gov/nceh/default.htm.
    List other funds, outside this cooperative agreement, that will be 
used to support this program.
Part A Enhanced: Enhancing State Capacity To Address Asthma
1. Description of the Problem
    Describe what is known about the asthma burden in the State, 
territory, tribe or jurisdiction and efforts to systematically address 
the problem. Include a description of populations at increased risk of 
poorly controlled asthma (e.g. gender, age groups, racial/ethnic 
groups, socio-economic groups, and geographic areas).
    Identify existing initiatives, capacity, and infrastructure of the 
agency within which the asthma programs will occur.
    Describe how barriers, identified when developing the State Asthma 
Plan, were addressed.
2. Workplan
    Provide specific goals, objectives, and activities that describe 
what the agency intends to accomplish by the end of the three-year 
project period. These goals, objectives and activities should be 
measurable, realistic, related to Recipient Activities, and reflect 
activities in year one, two, and three of the project. Include a 
project time-line that indicates when the proposed goals, objectives, 
and activities will be met.
    Document how progress made toward meeting the objectives will be 
evaluated. Provide measures for evaluating process, impact, and outcome 
for each goal and objective. Refer to ``Framework for Program 
Evaluation in Public Health,'' MMWR, September 17, 1999/48 RR-11; 1-40 
at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm or other 
evaluation resources on the CDC website at http://www.cdc.gov/eval/index).
    In addition, describe how lessons learned will be systematically 
gathered, documented, and included as an integral part of the 
evaluation process.
3. Surveillance Plan
    Describe the current operational asthma surveillance system within 
the health agency. Submit copies of the most recent and comprehensive 
published surveillance report that describes asthma within the State, 
territory, tribe or jurisdiction, including if available, a report of 
asthma in the Medicaid population and for enrollees of the State 
Children's Health Insurance Program (SCHIP).
    Provide a surveillance plan containing the following information: 
(a) A description of data currently available to the program; (b) 
additional data the agency will obtain and methods for obtaining it; 
(c) plans for identifying specific populations at risk for poorly 
controlled asthma (e.g. gender, age groups, racial/ethnic groups, 
socio-economic groups, or geographic areas); (d) how the agency will 
use data to develop or enhance an ongoing surveillance system; and (e) 
how the surveillance data will be used to support policy, program 
development, implementation, and evaluation activities.
    At a minimum, the surveillance system should include measures to 
track asthma morbidity, asthma mortality, work-related asthma, and 
asthma hospitalizations. For more information about work-related 
asthma, refer to the following references:
    ``Surveillance of Work-Related Asthma in Selected U.S. States Using 
Surveillance Guidelines for State Health Departments--California, 
Massachusetts, Michigan and New Jersey, 1993-1995,'' Morbidity and 
Mortality Weekly Report, June 25, 1999/48 (SS03); 1-20 at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4803a1.htm.
    Workgroup Report ``The Role of States in a Nationwide Comprehensive 
Surveillance System for Work-related Diseases, Injuries and Hazards'' 
at http://www.cste.org/occupationalhealth.htm.
    ``Minimum and Comprehensive State-Based Activities in Occupational 
Safety and Health,'' June 1995--DHHS (NIOSH) Publication No. 95-107 at 
http://www.cdc.gov/niosh/95-107.html.
    Applicants funded by this announcement will be expected to use the 
Behavioral Risk Factor Surveillance System (BRFSS) supplemental asthma 
module within the first year of the project.
    Describe the methods that will be used to conduct analysis, 
interpret surveillance data, and a strategy for disseminating data 
through published reports to local, State, and Federal partners and 
agencies.
    Present a detailed plan to determine whether the asthma 
surveillance system is useful for monitoring asthma trends over time, 
determining the effectiveness of interventions, and modifying the State 
Asthma Plans. Refer to ``Updated Guidelines for Evaluating Surveillance 
Systems, Morbidity and Mortality Weekly Report, July 27, 2001/(50)RR13; 
1-35 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm.
4. State Asthma Plan
    Submit a copy of the final, approved, comprehensive State Asthma 
Plan. Approval may be documented with a letter from the agency's Health 
or Medical Director and letters from key partners or by appropriate 
sign-offs on the plan. State Asthma Plans that are pending final 
approval may be accepted if the draft plan is accompanied by letters 
from the agency's Health or Medical Director and key partners stating 
their commitment to and approval of the plan, a time frame for final 
approval, as well as a description of the approval process status. The 
letters should assure that the State Asthma Plan would be completed 
within the first three months of the year one budget period.
    Describe the process by which the comprehensive State Asthma Plan 
was developed and how it addresses all persons with asthma in the State 
regardless of age, race/ethnicity, gender, or geographic area and 
includes key environments in which persons with asthma spend 
significant time (e.g. home, school, workplace). If a specific 
population in the State is not affected by asthma, clearly identify and 
describe this population.
    Include information about the agencies and organizations that are 
participating in the planning process and describe their roles and 
responsibilities.
    Explain how the collaborative relationships will be used after the 
plan is in place and the agency is ready to implement interventions.
    Describe how data collected in the asthma surveillance system is 
used to

[[Page 31712]]

identify priority areas and guide the development of program goals and 
objectives. If a State Asthma Plan already exists, describe the subset 
of interventions to be implemented with these grant funds. Note that a 
statewide approach is encouraged. If focusing on one part of the 
state's population, explain and justify the rationale for this 
approach.
    Proposed activities to meet the plan's objectives may include, but 
are not limited to, efforts to (1) expand surveillance for asthma; (2) 
improve provider compliance with the National Asthma Education and 
Prevention Program's (NAEPP) ``Guidelines for the Diagnosis and 
Management of Asthma,'' (Clinical Practice Guidelines, Guidelines for 
the Diagnosis and Management of Asthma. National Institutes of Health 
(NIH), National Heart, Lung and Blood Institute. NIH publication No. 
97-4051, April 1997); (3) improve the skills of patients and families 
affected by asthma to manage the disease; (4) review legislation and 
policies impacting people with asthma; (5) identify environmental 
factors that contribute to asthma prevalence and morbidity, and reduce 
or eliminate exposure to these factors; and (6) communicate between 
those implementing and those affected by planned activities.
    Explain how the State Asthma Plan will evolve and change based on 
analysis of surveillance data, evaluation of interventions, and other 
outside factors that affect the overall climate in the State.
5. Collaboration Plan
    Describe experiences with collaborative relationships around asthma 
or with other chronic or environmentally-related or occupationally-
related disease requiring extensive collaborative relationships both 
within and outside the agency. Specifically define the approach to be 
used to establish or further develop these relationships.
    Document partnerships with the clinical community; local health 
agencies; physician organizations; community health centers; local, 
State, or regional asthma or respiratory health organizations (e.g. 
American Lung Association); local education authorities, and groups or 
organizations that serve minority or other populations experiencing a 
disproportionate burden of asthma. If one or more of these partners is 
not listed, the applicant should explain why.
    Describe how the collaboration (1) established leadership, (2) 
developed consensus regarding goals, (3) identified roles and 
responsibilities, (4) developed procedures and patterns for 
communication, (5) and sustained the participation of members over 
time.
    Provide letters of commitment from each specific organization, 
including a statement of how they are or intend to collaborate, as well 
as their expertise, and capacity to carry out assigned 
responsibilities.
    Describe how the partners who developed the State Asthma Plan will 
continue to work together to implement and monitor the intervention 
strategies and modify the plan over time. Expand partnership activities 
as appropriate.
    Grant funds may be used to leverage asthma program development in 
the State, territory, tribe or jurisdiction along with resources from 
other collaborative agencies and organizations.
6. Implementation Plan
    Provide specific, realistic, measurable, and time-phased objectives 
for each of the interventions to be implemented over the three-year 
project period using resources of this announcement. If objectives and 
interventions from the plan are addressed using other resources, 
explain how they are related. While the overall State Asthma Plan must 
address all populations, interventions should be prioritized based on 
surveillance data, focusing on high priority and disparate populations 
first.
    Interventions that change systems and individuals to provide 
improved disease management or education are preferred. This discussion 
might include the guidelines that the applicant will use for work-
related asthma (e.g., adapted from generic Minimum and Comprehensive 
State-Based Activities in Occupational Safety Health, June 1995--DHHS 
(NIOSH) Publication No. 95-107) at http:/www.cdc.gov/niosh/95-107.html; 
or from the Workgroup Report ``The Role of States in a Nationwide 
Comprehensive Surveillance System for Work-related Diseases, Injuries 
and Hazards'' (refer to http://www.cste.org/occupationalhealth.htm). 
Include an assessment of existing and needed resources to implement 
these strategies.
    Describe how the State Asthma Plan implementation activities were 
developed and how members of the statewide partnership group determined 
that these particular objectives and strategies would be addressed 
first. Demonstrate the extent to which the intervention plan is 
supported in the community by the inclusion of letters of support from 
key members of the community. Describe how the partners who developed 
the asthma plan will continue to work together to implement and monitor 
the intervention strategies and modify the plan over time. Expand 
partnership activities as appropriate.
    Demonstrate the scientific basis for proposed interventions. If 
proposed interventions include case management programs, assure that 
patients enrolled are those with moderate to severe persistent asthma 
and are receiving care consistent with the National Asthma Education 
and Prevention Program (NAEPP) Guidelines for the Diagnosis and 
Management of Asthma. Refer to ``Guidelines for the Diagnosis and 
Management of Asthma,'' (Clinical Practice Guidelines, Guidelines for 
the Diagnosis and Management of Asthma. National Institutes of Health 
(NIH), National Heart, Lung and Blood Institute. NIH publication No.97-
4051, April 1997) or link to http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.
    Provide the methodology and specific measures for monitoring 
progress in meeting all objectives related to implementation of 
activities in the asthma plan.
    Describe how process, impact, and outcome objectives will be 
evaluated. (Refer to ``Framework for Program Evaluation in Public 
Health,'' Morbidity and Mortality Weekly Report, September 17, 1999/48 
RR-11; 1-40 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm or 
other evaluation resources on the CDC Web site at http://www.cdc.gov/eval/index).
7. Management and Staffing
    Demonstrate the applicant's organizational commitment to the asthma 
program by describing how the agency as a whole will focus its efforts 
on asthma. Provide a plan to maintain a strong agency commitment within 
the State Health Department to support continued efforts of the asthma 
program.
    Describe the organizational location of the proposed staff, their 
relation to the State's asthma contact (the position in the agency 
currently responsible for contact with CDC on asthma issues), and the 
support within the organizational structure for the activities defined 
for the project staff. Attach an organizational chart for the unit 
where asthma activities will be located and, at a minimum, the next two 
levels above it.
    Describe the qualifications and roles of trained public health 
professionals to serve as a full-time asthma coordinator for the agency 
to manage the planning process and conduct other programmatic 
activities; a full-time epidemiologist to develop and implement 
surveillance activities for the

[[Page 31713]]

asthma project; and a supervisor who will assure support for the 
project staff. Other program positions may also be proposed. Attach 
position descriptions, qualifications and curricula vitae for all staff 
positions.
    For each position, describe the primary roles and responsibilities 
for the project staff over the three-year grant period. Also, include 
the specific staff activities that will contribute to meeting each 
objective.
    Provide a plan to expedite filling of the staff position(s) and 
assure that they have been or will be approved by the applicant's 
personnel system. Include a letter of support from the agency 
guaranteeing hiring of personnel and support for the asthma program. 
Also, describe positions in the asthma program that are currently 
filled, but will not be funded by resources under this cooperative 
agreement.
    Document assurance of the ability of key project staff to 
participate in the conferences or grantee meetings convened by CDC and 
willingness to share innovations, information, data, and materials.
8. Budget
    Include a detailed first-year budget, narrative justifications, as 
well as annual budget projections for years two and three. The 
applicant should describe the program purpose for each budget item. For 
each contract contained within the budget, provide (1) the name the 
contractor(s); (2) method of selection; (3) period of performance; (4) 
description of activities; and (5) an itemized budget with narrative 
justifications. If this information is not available when the 
application is submitted, and CDC approves the contract(s), then the 
funds for the contract(s) will be restricted for expenditure on the 
award.
    The budget should include travel funds for project staff to attend 
a yearly conference or grantee meeting convened by CDC. In addition, 
the applicant should include costs for one person to travel to Atlanta, 
GA, to attend the 6th National Environmental Health Conference on 
December 3-5, 2003. Review the CDC/NCEH web site for additional 
information concerning this conference: http://www.cdc.gov/nceh/default.htm.
    If applicable, list other funds outside of this cooperative 
agreement that will be used to support this program.
Part B: Implementation of State Asthma Plans
    Include each of the following sections:
1. Description of Problem
    Describe what is known of the asthma problem in the State, 
territory, tribe, or jurisdiction and efforts to systematically address 
the problem. Include a description of populations at increased risk of 
poorly controlled asthma (e.g. gender, age groups, racial/ethnic 
groups, socio-economic groups, or geographic areas).
    Describe existing asthma initiatives, capacity, and infrastructure 
of the agency within which the asthma programs occur.
2. Workplan
    Provide specific goals, objectives and activities that describe 
what the agency intends to accomplish by the end of the five-year 
project period. These goals, objectives and activities should be 
measurable, realistic, related to the Recipient Activities, and reflect 
plans in year one through five of the project. Include a project time-
line that indicates when the proposed goals, objectives, and activities 
will be met.
    Document how progress made toward meeting the objectives will be 
evaluated. Provide measures for evaluating process, impact, and outcome 
for each goal and objective. Refer to ``Framework for Program 
Evaluation in Public Health,'' MMWR, September 17, 1999/48 RR-11; 1-40 
at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm or other 
evaluation resources on the CDC website at http://www.cdc.gov/eval/index).
    In addition, describe how lessons learned will be systematically 
gathered, documented, and included as an integral part of the 
evaluation process.
3. Surveillance Plan
    Describe the current operational asthma surveillance system within 
the health agency. Submit copies of the most recent, comprehensive 
published surveillance report that describes asthma within the State, 
territory, tribe, or jurisdiction, including if available, a report of 
asthma in the Medicaid population and for enrollees of the State 
Children's Health Insurance Program (SCHIP).
    Provide a surveillance plan containing the following information: 
(a) A description of data currently available to the program; (b) 
additional data the agency will obtain and methods for obtaining it; 
(c) plans for identifying specific populations at risk for poorly 
controlled asthma (e.g. gender, age groups, racial/ethnic groups, 
socio-economic groups, or geographic areas); (d) how the agency will 
use data to develop or enhance an ongoing surveillance system; and (e) 
how the surveillance data will be used to support policy, program 
development, implementation, and evaluation activities.
    Describe all asthma indicators to be assessed over time including, 
but not limited to, prevalence, severity, management, mortality, 
hospitalization, emergency care, and costs of asthma. Refer to Boss, 
L.; Kreutzer, R.; Luttinger, D.; Leighton, J.; Wilcox, K.; and Redd, S. 
``The Public Health Surveillance of Asthma,'' Journal of Asthma, 38(1), 
83-89, 2001.
    Discuss the use of the Behavioral Risk Factor Surveillance System 
(BRFSS) asthma module(s) and the frequency of its use.
    Include surveillance and public health intervention of work-related 
asthma. Provide the applicant's definition of work-related asthma. 
(Refer to ``Surveillance of Work-Related Asthma in Selected U.S. States 
Using Surveillance Guidelines for State Health Departments--California, 
Massachusetts, Michigan and New Jersey, 1993-1995,'' Morbidity and 
Mortality Weekly Report, June 25, 1999/48 (SS03); 1-20) at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4803a1.htm.
    Describe the methods that will be used to conduct analysis, 
interpret surveillance data, and a strategy for disseminating this data 
(e.g. published reports) to local, State, and Federal partner and 
agencies.
    Present a detailed plan to determine whether the asthma 
surveillance system is useful for monitoring asthma trends over time, 
determining the effectiveness of asthma interventions, and modifying 
the State Asthma Plan. (Refer to ``Updated Guidelines for Evaluating 
Surveillance Systems,'' Morbidity and Mortality Weekly Report, July 27, 
2001/(50)RR13; 1-35) at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm.
4. Approved State Asthma Plan
    Submit a copy of the final, approved, comprehensive State Asthma 
Plan. Approval may be documented with a letter from the agency's Health 
or Medical Director and letters from key partners, or by appropriate 
sign-offs on the plan. State Asthma Plans that are pending final 
approval may be accepted if the draft plan is accompanied by letters 
from the agency's Health or Medical Director and key partners stating 
their commitment to and approval of the plan. Also include a 
description of the plan's approval process and a time-line for final 
approval.

[[Page 31714]]

    The approved plan (or attachments to the plan) must include:
    a. Background information that defines the current condition and 
describes why asthma should be a public health priority, and an 
assessment of the asthma burden in the State, territory, tribe, or 
jurisdiction using population-based data. The plan must address all 
persons with asthma in the State regardless of age, race/ethnicity, or 
gender and include key environments in which persons with asthma spend 
significant time (e.g. home, school, or workplace). If a specific 
population in the State is not affected by asthma, the plan should 
clearly identify and describe this population.
    b. A description of the process by which the plan was developed, a 
list of partners that participated in the development of the plan, and 
how they contributed to the process.
    c. A description of the established asthma priorities within the 
State, territory, tribe, or jurisdiction based on the results of 
surveillance activities. These objectives should be time-phased and 
organized in accordance with the priorities identified in the State 
Asthma Plan. Highlight issues unique to your region and note how your 
priorities may differ or coincide with national asthma control 
priorities.
    d. Proposed activities to meet the plan's objectives including, but 
not limited to, efforts to (1) expand surveillance for asthma; (2) 
improve provider compliance with the National Asthma Education and 
Prevention Program's (NAEPP) ``Guidelines for the Diagnosis and 
Management of Asthma,'' (Clinical Practice Guidelines, Guidelines for 
the Diagnosis and Management of Asthma. National Institutes of Health 
(NIH), National Heart, Lung and Blood Institute. NIH publication No. 
97-4051, April 1997); (3) improve the skills of patients and families 
affected by asthma to manage the disease; (4) review legislation and 
policies impacting people with asthma; (5) identify environmental 
factors that contribute to asthma prevalence and morbidity, and reduce 
or eliminate exposure to these factors; and (6) communicate between 
those implementing and those affected by planned activities.
5. Collaboration Plan
    Describe experiences with collaborative relationships around asthma 
or with other chronic or environmentally related or occupationally 
related disease requiring extensive collaborative relationships both 
within and outside the agency. Specifically define the approach to be 
used to establish or further develop these relationships.
    Document partnerships with the clinical community; local health 
agencies; physician organizations; community health centers; local, 
State, or regional asthma or respiratory health organizations (e.g. 
American Lung Association); local education authorities; and groups or 
organizations that serve minority or other populations experiencing a 
disproportionate burden of asthma. If one or more of these partners 
will not be included, the applicant should explain why.
    Describe how the collaboration will (1) establish leadership, (2) 
develop consensus regarding goals, (3) identify roles and 
responsibilities of members, (4) develop procedures and patterns of 
communications, and (5) sustain the participation of members over time.
    Provide letters of commitment from each specific organization, 
including a statement of how they intend to collaborate, as well as 
their expertise, and capacity to carry out assigned responsibilities.
    Describe how partners who developed the State Asthma Plan will 
continue to work together to implement and monitor intervention 
strategies and modify the plan over time. Expand partnership activities 
as appropriate.
    Note that grant funds may be used to leverage asthma program 
development in the State, territory, tribe or jurisdiction along with 
resources from other agencies and organizations.
    Present a plan to determine the effectiveness of collaborations.
6. Implementation Plan
    Provide specific, realistic, measurable, and time-phased objectives 
for each of the interventions to be implemented over the five-year 
project period using resources of this announcement. If objectives and 
interventions from the plan are addressed using other resources, 
explain how they are related. While the overall State Asthma Plan must 
address all populations, implementation strategies should be 
prioritized based on surveillance data, focusing on high priority and 
disparate populations first. Interventions that change systems and 
individuals to provide improved disease management or education are 
preferred.
    Discuss guidelines the applicant will use for work-related asthma 
(e.g., adapted from generic Minimum and Comprehensive State-Based 
Activities in Occupational Safety Health, June 1995--DHHS (NIOSH) 
Publication No. 95-107) at http:/www.cdc.gov/niosh/95-107.html; or from 
the Workgroup Report ``The Role of States in a Nationwide Comprehensive 
Surveillance System for Work-related Diseases, Injuries and Hazards'' 
at http://www.cste.org/occupationalhealth.htm).
    Include an assessment of existing and needed resources to implement 
these strategies.
    Describe how the State Asthma Plan implementation activities were 
developed and how members of the statewide partnership group determined 
that these particular objectives and strategies would be addressed. 
Demonstrate the extent to which the intervention plan is supported in 
the community by including letters of support from key members of the 
community.
    Demonstrate the scientific basis for proposed interventions. If 
proposed interventions include case management programs, assure that 
patients enrolled are those with moderate to severe persistent asthma 
and are receiving care consistent with the National Asthma Education 
and Prevention Program (NAEPP) Guidelines for the Diagnosis and 
Management of Asthma. Refer to ``Guidelines for the Diagnosis and 
Management of Asthma,'' (Clinical Practice Guidelines, Guidelines for 
the Diagnosis and Management of Asthma. National Institutes of Health 
(NIH), National Heart, Lung and Blood Institute. NIH publication No. 
97-4051, April 1997) at http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.
    Provide the methodology and specific measures for monitoring 
progress in meeting all objectives related to implementation of 
activities in the asthma plan. Discuss how process, impact and outcome 
objectives will be evaluated. Refer to ``Framework for Program 
Evaluation in Public Health,'' Morbidity and Mortality Weekly Report, 
September 17, 1999/48 RR-11; 1-40 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4811a1.htm or other evaluation resources on the CDC Web site 
at http://www.cdc.gov/eval/index).
7. Management and Staffing Plan
    Demonstrate the applicant's organizational commitment to the asthma 
program by describing how the agency as a whole will focus its efforts 
on asthma. Explain how the overall asthma program will be 
institutionalized and sustained upon completion of funding from this 
cooperative agreement.
    Describe the organizational location of proposed staff, their 
relation to the State's asthma contact (the position in the agency 
currently responsible for contact with the CDC on asthma issues), and 
the support within the

[[Page 31715]]

organizational structure for the activities defined for the project 
staff. Attach an organizational chart for the unit where the asthma 
activities will be located and, at a minimum, the next two levels above 
it.
    Describe the qualifications and roles of trained public health 
professionals who will serve as a full-time asthma coordinator for the 
agency to manage programmatic activities; 2 full-time epidemiologists 
to develop and implement surveillance activities for the asthma 
project; and a supervisor who will assure support for the project 
staff. Other program positions may also be proposed. Attach position 
descriptions, qualifications, and curricula vitae for all staff 
positions.
    Include a description of existing asthma program staff within the 
health department, the current function of these staff members, their 
role in developing this project plan, and management structure of the 
asthma program. Describe asthma surveillance staff and their role 
within the project activities.
    For each position, describe the primary roles and responsibilities 
for the program staff over the five-year project period. Include 
specific activities that will contribute to meeting stated program 
goals/objectives.
    Document assurance of ability to access and utilize funds, if 
awarded, for the purposes of this announcement.
    If intervention activities will be implemented through contracts, 
define the process by which these contracts will be awarded and 
monitored.
    Discuss the role of the statewide partnership group and oversight 
of intervention activities.
    Document assurance of ability of key project staff to participate 
in the conferences or grantee meetings convened by CDC and willingness 
to share innovations, information, data, and materials.
8. Budget
    Include a detailed first-year budget, narrative justifications, as 
well as annual budget projections for years two through five. The 
applicant should describe the program purpose for each budget item. For 
each contract contained within the budget, applicants should provide 
(1) the name the contractor(s); (2) method of selection; (3) period of 
performance; (4) description of activities; and (5) an itemized budget 
with narrative justifications. If this information is not available 
when the application is submitted, and CDC approves the contract(s), 
then the funds for the contract(s) will be restricted for expenditure 
on the award.
    The budget should include travel for key project staff to attend a 
yearly conference or grantee meeting convened by CDC. In addition, the 
applicant should include costs for one person to travel to Atlanta, GA, 
to attend the 6th National Environmental Health Conference on December 
3-5, 2003. Review the CDC/NCEH web site for additional information 
concerning this conference: http://www.cdc.gov/nceh/default.htm.
    If applicable, list other funds outside this cooperative agreement 
that will be used to support this program.

G. Submission and Deadline

Letter of Intent (LOI) Submission

    On or before June 27, 2003, submit the LOI to the Grants Management 
Officer identified in the ``Where to Obtain Additional Information'' 
section of this announcement.

Application Forms

    Submit the signed original and two copies of PHS 5161-1 (OMB Number 
0920-0428). Forms are available at the following Internet address: 
http://www.cdc.gov/od/pgo/forminfo.htm.
    If you do not have access to the Internet, or if you have 
difficulty accessing the forms on-line, you may contact the CDC 
Procurement and Grants Office Technical Information Management Section 
(PGO-TIMS) at: (770) 488-2700. Application forms can be mailed to you.

Submission Date, Time, and Address

    The application must be received by 4 p.m. Eastern Time on July 14, 
2003. Submit the application to: Technical Information Management--
PA03032, Procurement and Grants Office, 2920 Brandywine Road, 
Atlanta, GA 30341-4146.
    Applications may not be submitted electronically.

CDC Acknowledgement of Application Receipt

    A postcard will be mailed by PGO-TIM, notifying you that CDC has 
received your application.

Deadline

    Letters of intent and applications shall be considered as meeting 
the deadline if they are received before 4 p.m. Eastern Time on the 
deadline date. Any applicant who sends their application 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 (1) carrier error, when the carrier accepted the package with a 
guarantee for delivery by the closing date and time, or (2) significant 
weather delays or natural disasters, CDC will upon receipt of proper 
documentation, consider the application as having been received by the 
deadline.
    Any application that does not meet the above criteria will not be 
eligible for competition, and will be discarded. The applicant will be 
notified of their failure to meet the submission requirements.

H. Evaluation Criteria

Application

    Applicants are required to provide measures of effectiveness that 
will demonstrate the accomplishment of the various identified 
objectives of the cooperative agreement. Measures of effectiveness must 
relate to the performance goal as stated in purpose section of this 
announcement. Measures must be objective and quantitative and must 
measure the intended outcome. These measures of effectiveness must be 
submitted with the application and will be an element of evaluation.
    An independent review group appointed by CDC will evaluate each 
application against the following criteria:
Part A: Developing State Capacity To Address Asthma
1. Workplan (25 points)
    The extent to which:
    a. The applicant identifies goals, objectives, and activities that 
are consistent with the Recipient Activities; are specific, measurable 
and realistic; and reflect activities in year one, two, and three of 
the project period.
    b. Objectives will contribute to accomplishment of the goals.
    c. Activities are likely to achieve objectives.
    d. The time-line for accomplishing proposed goals, objectives, and 
activities is reasonable.
    e. Measures for monitoring and evaluating the process, impact, and 
outcome of each goal and objective are specific and appropriate.
    f. The plan to systematically gather and document lessons learned 
is incorporated into the program evaluation process.
2. Management and Staffing Plan (20 points)
    The extent to which:
    a. The agency demonstrates a high level of commitment and 
organizational support for the asthma program. Organizational charts 
show where the asthma program is located.

[[Page 31716]]

    b. The roles of proposed staff members are defined and appropriate 
for carrying out stated responsibilities.
    c. The staffing plan identifies at least a full-time asthma 
coordinator, at least a full-time epidemiologist, and a supervisor.
    d. Job descriptions, qualifications, and curricula vitae indicate 
that each proposed staff member has the credentials, knowledge, 
training, and experience to perform assigned tasks.
    e. The plan to expedite filling of the staff position(s), assuring 
that they will be approved by the applicant's personnel system, is 
realistic.
    f. The applicant plans to attend CDC conferences/meetings and is 
willing to share innovations, information, data, and materials.
3. Surveillance Plan (20 points)
    The extent to which the plan:
    a. Provides a comprehensive description of data currently available 
to the program, additional data the agency will obtain, and methods for 
obtaining it.
    b. Identifies populations at risk for poorly controlled asthma, 
such as specific age groups, ethnic groups, socio-economic groups, or 
geographic areas.
    c. The applicant provides a reasonable approach for how the agency 
will develop or enhance an ongoing surveillance system and how the data 
will be used to support policy, program development, implementation, 
and evaluation.
    d. Uses appropriate measures to track asthma morbidity, asthma 
mortality, and work-related asthma over time.
    e. Includes the Behavioral Risk Factor Surveillance System 
supplemental asthma module within the first year of the project period.
    f. Uses appropriate strategies for conducting analysis, 
interpreting surveillance data, and disseminating data through 
published reports.
    g. Includes reasonable strategies for evaluating whether the asthma 
surveillance system is useful for monitoring trends over time.
4. State Asthma Plan (15 points)
    The extent to which:
    a. The applicant describes how the comprehensive State Asthma Plan 
will be developed.
    b. The plan addresses all persons with asthma regardless of age, 
race/ethnicity, gender, or geographic area and includes key 
environments in which persons with asthma spend significant time (e.g. 
home, school, workplace).
    c. The number and type of agencies and organizations proposed to 
participate in developing the State Asthma Plan are appropriate. 
Partner's roles and responsibilities are fully described and 
reasonable.
    d. Collaborative relationships will be used appropriately when 
implementing interventions.
    e. Data collected in the asthma surveillance system will be used to 
identify priority areas and guide the development of program goals and 
objectives.
    f. The process of making changes to the State Asthma Plan is 
reasonable.
5. Collaboration Plan (10 points)
    The extent to which:
    a. The applicant demonstrates prior successful collaborations that 
address asthma or other chronic or environmentally-related or 
occupationally-related problems.
    b. Collaborating organizations and agencies include a wide variety 
of appropriate partners in the clinical community; local health 
agencies; physician organizations; community health centers; local, 
state or regional asthma or respiratory health organizations (such as 
the American Lung Association), local education authorities; and groups 
or organizations that serve populations experiencing a disproportionate 
burden of asthma. If one or more of these partners are not included, 
the applicant explains why.
    c. Partners will work together to: (1) Establish leadership, (2) 
develop a consensus regarding goals, (3) identify roles and 
responsibilities through a negotiated process, (4) develop routine and 
consistent patterns of communications, and (5) sustain the 
participation of members over time.
    d. Letters of commitment from key organizations demonstrate their 
willingness, expertise, and capacity to carry out assigned 
responsibilities.
    e. The plan for determining the effectiveness of collaborations is 
reasonable.
6. Description of the Problem (10 points)
    The extent to which:
    a. The applicant fully describes what is known about the asthma 
burden in the State, tribe, territory or jurisdiction; identifies 
populations at increased risk of poorly controlled asthma (regardless 
of gender, age, race/ethnicity, or geographic area); and explains 
efforts to systematically address the problem.
    b. The applicant identifies existing initiatives, capacity, and 
infrastructure of the agency within which asthma programs will occur.
    c. The applicant identifies barriers that need to be resolved in 
order to develop comprehensive asthma program in the State.
    d. The applicant demonstrates the agency's commitment to addressing 
asthma by accomplishments to date and understanding of the problem.
7. Budget (reviewed, but not scored)
    The extent to which:
    a. The budget is comprehensive and includes details for year one 
projections and details for year two and three of the budget period.
    b. The budget contains justifications that are consistent with 
stated goals, objectives, activities, and the intended use of 
cooperative agreement funds.
    c. The budget is reasonable and includes funds for project staff to 
attend a yearly conference or grantee meeting convened by CDC. In 
addition, the applicant should include costs for one person to travel 
to Atlanta, GA, to attend the 6th National Environmental Health 
Conference on December 3-5, 2003. Review the CDC/NCEH web site for 
additional information concerning this conference: http://www.cdc.gov/nceh/default.htm.
8. Performance Goals (reviewed, but not scored)
    The extent to which the applicant will reduce the burden of asthma 
in the State, territory, tribe or jurisdiction.
Part A Enhanced: Enhancing State Capacity To Address Asthma
1. Workplan (25 points)
    The extent to which:
    a. The applicant identifies goals, objectives, and activities that 
are consistent with the Recipient Activities, are specific, measurable 
and realistic, and reflect activities in year one, two, and three of 
the project period.
    b. Objectives will contribute to accomplishment of the goals.
    c. Activities are likely to achieve objectives.
    d. The time-line for accomplishing proposed goals, objectives, and 
activities is reasonable.
    e. Measures for monitoring and evaluating the process, impact, and 
outcome of each goal and objective are specific and appropriate.
    f. The plan to systematically gather and document lessons learned 
is incorporated into the program evaluation process.
2. Management and Staffing Plan (20 points)
    The extent to which:
    a. The agency demonstrates a high level of commitment and 
organizational support for the asthma program. Organizational charts 
show where the asthma program is located.

[[Page 31717]]

    b. The roles of proposed staff members are defined and appropriate 
for carrying out stated responsibilities.
    c. The staffing plan includes at least a full-time asthma 
coordinator, at least a full time epidemiologist, and a supervisor.
    d. Job descriptions, qualifications, and curricula vitae indicate 
that each proposed staff member has the credentials, knowledge, 
training, and experience to perform assigned tasks.
    e. The plan to expedite filling of the staff position(s), assuring 
that they will be approved by the applicant's personnel system, is 
realistic.
    f. The applicant plans to attend CDC conferences and meetings and 
is willing to share innovations, information, data, and materials.
3. State Asthma Plan (15 points)
    The extent to which:
    a. The State Asthma Plan is comprehensive and approved by the state 
health agency. If not already approved, the applicant provides 
assurance that the State Asthma Plan will be completed within 3 months 
of the first budget year.
    b. The plan addresses all persons with asthma regardless of gender, 
age, race/ethnicity, or geographic area and includes key environments 
in which persons with asthma spend significant time (e.g. home, school, 
workplace).
    c. The number and type of agencies and organizations that 
participated in developing the State Asthma Plan are appropriate. 
Partner's roles and responsibilities are fully described and 
reasonable.
    d. The applicant describes the collaboration's progress in (1) 
establishing leadership, (2) developing a consensus regarding goals, 
(3) identifying roles and responsibilities through a negotiated 
process, (4) developing routine and consistent patterns of 
communications, and (5) sustaining the participation of members over 
time.
    e. Collaborative relationships are used after the plan is in place 
and the agency begins to implement selected interventions.
    f. Proposed activities to meet the plan's objectives include, but 
are not limited to, efforts to (1) expand surveillance for asthma; (2) 
improve provider compliance with the National Asthma Education and 
Prevention Program's (NAEPP) ``Guidelines for the Diagnosis and 
Management of Asthma,'' (Clinical Practice Guidelines, Guidelines for 
the Diagnosis and Management of Asthma. National Institutes of Health 
(NIH), National Heart, Lung and Blood Institute. NIH publication No. 
97-4051, April 1997); (3) improve the skills of patients and families 
affected by asthma to manage the disease; (4) review legislation and 
policies impacting people with asthma; (5) identify environmental 
factors that contribute to asthma prevalence and morbidity, and reduce 
or eliminate exposure to these factors; and (6) communicate between 
those implementing and those affected by planned activities.
    g. Data collected in the asthma surveillance system was (and will 
be) used to identify priority areas and guide the development of 
program goals and objectives.
    h. The applicant describes how the State Asthma Plan will evolves 
over time and the process by which changes are made.
4. Surveillance Plan (15 points)
    The extent to which:
    a. The applicant has an operational surveillance system for asthma.
    b. Attached surveillance reports are of high quality and fully 
describe the burden of asthma within State, territory, tribe, or 
jurisdiction, including, if available a report on asthma in the 
Medicaid population.
    c. The applicant describes data currently available, additional 
data the agency will obtain, and methods for obtaining it.
    d. The applicant clearly identifies populations at risk for poorly 
controlled asthma such as specific age groups, ethnic/racial groups, 
socio-economic groups, or geographic areas.
    e. The applicant explains how the agency will enhance an ongoing 
surveillance system and how data will be used to support policy, 
program development, implementation, and evaluation activities.
    f. The plan uses appropriate measures to track asthma morbidity, 
asthma mortality, work-related asthma, and asthma hospitalizations over 
time.
    g. The applicant plans to use the Behavioral Risk Factor 
Surveillance System supplemental asthma module within the first year of 
the project period.
    h. The surveillance plan describes appropriate strategies to 
conduct analysis, interpret surveillance data, and disseminate data 
through published reports.
    i. Includes reasonable strategies for evaluating whether the asthma 
surveillance system is useful for monitoring trends over time.
5. Collaboration Plan (10 points)
    The extent to which:
    a. The applicant has had previous experience collaborating with 
other chronic or environmentally related or occupationally related 
agencies.
    b. Collaborating organizations and agencies include a wide variety 
of appropriate partners in the clinical community; local health 
agencies; physician organizations; community health centers; local, 
state or regional asthma or respiratory health organizations (such as 
the American Lung Association), local education authorities; and groups 
or organizations that serve populations experiencing a disproportionate 
burden of asthma. If one or more of these partners are not included, 
the applicant explains why.
    c. The applicant describes how the collaboration's progress in: (1) 
Establishing leadership, (2) developing a consensus regarding goals, 
(3) identifying roles and responsibilities through a negotiated 
process, (4) developing routine and consistent procedures and patterns 
of communications, and (5) sustaining the participation of members over 
time will be documented and monitored.
    d. Letters of commitment from key organizations demonstrate their 
willingness, expertise, and capacity to carry out assigned 
responsibilities.
    e. The applicant fully describes how partners who developed the 
State Asthma Plan will continue to work together to monitor the 
intervention strategies over time.
    f. The plan for determining the effectiveness of collaborations is 
reasonable.
6. Implementation Plan (10 points)
    The extent to which:
    a. The applicant presents specific, realistic, measurable and time-
phased objectives for each intervention proposed.
    b. Interventions focus on high priority and disparate populations. 
Priorities are based on surveillance data.
    c. Interventions will change systems and individuals to provide 
improved disease management or education.
    d. The community supports the intervention plan.
    e. The applicant demonstrates a scientific basis for each 
intervention.
    f. The methods and measures for monitoring progress of 
interventions are appropriate.
7. Description of the Problem (5 points)
    The extent to which:
    a. The applicant provides a comprehensive description of what is 
known about the asthma burden in the State, tribe, territory or 
jurisdiction including all ages, race/ethnic groups, and geographic 
areas.
    b. The applicant fully identifies existing initiatives, capacity, 
and

[[Page 31718]]

infrastructure of the agency within which the asthma programs will 
occur.
    c. The barriers identified when developing the State Asthma Plan 
were addressed.
    d. The agency's commitment to addressing asthma is demonstrated by 
accomplishments to date and understanding of the problem.
8. Budget (reviewed, but not scored)
    The extent to which:
    a. The budget is comprehensive and includes details for year one 
and projections for year two and three of the project period.
    b. The budget contains justifications that are consistent with 
stated goals, objectives, activities, and the intended use of 
cooperative agreement funds.
    c. The budget is reasonable and includes funds for project staff to 
attend a yearly conference or grantee meeting convened by CDC. In 
addition, the applicant included costs for one person to travel to 
Atlanta, GA, to attend the 6th National Environmental Health Conference 
on December 3-5, 2003.
    9. Performance Goals (reviewed, but not scored)
    The extent to which the applicant will reduce the burden of asthma 
in the State, tribe, territory, tribe or jurisdiction.
Part B: Implementation of State Asthma Plan
1. Implementation Plan (25 Points)
    The extent to which:
    a. Implementation objectives are specific, realistic, measurable 
and time-phased for each of the interventions.
    b. High priority interventions are based on surveillance data and 
focus on disparate populations first. Strategies that change systems 
and individuals to provide improved disease management are included.
    c. There is a clear link between the State Asthma Plan and the 
proposed interventions, including an assessment of existing and needed 
resources to implement these strategies.
    d. The intervention plan is supported in the community and this is 
demonstrated by the inclusion of letters of support from key members of 
the community.
    e. Statewide partners are involved in implementing and monitoring 
the plan over time.
    f. Proposed intervention strategies are appropriate and have a 
scientific basis. Asthma management activities are consistent with the 
National Asthma Education and Prevention Program (NAEPP) ``Guidelines 
for the Diagnosis and Management of Asthma.''
    g. Methods and measures for monitoring intervention activities are 
specific, reasonable, and likely to assess the effectiveness of 
activities in reaching program goals and objectives. Process, impact, 
and outcome objectives are included.
2. Management and Staffing Plan (20 Points)
    The extent to which:
    a. The applicant demonstrates a high level of commitment and 
organizational support for the asthma program. Organizational charts 
demonstrate clear lines of authority and coordination with related 
programs at the State health department such as tobacco control, 
environmental health, or maternal and child health. The plan for 
institutionalizing and sustaining the asthma program beyond the 5-year 
project period is achievable.
    b. Job descriptions and curricula vitae indicate that each proposed 
staff member has the credentials, knowledge, training and experience to 
perform assigned tasks.
    c. The roles of proposed staff members are defined and appropriate 
for carrying out stated responsibilities.
    d. The staffing plan includes at least a full-time asthma 
coordinator, at least 2 full-time epidemiologists, and a supervisor. 
Other staff position(s) are also included.
    e. The plan to expedite filling of the staff position(s), assuring 
that they will be approved by the applicant's personnel system, is 
realistic.
    f. The role of the statewide partnership group is appropriate for 
the oversight of intervention activities.
    g. The applicant documents assurance that key personnel will attend 
scheduled grantee meetings and CDC-sponsored national asthma 
conferences, and that the applicant agrees to share innovations, 
information, data and materials.
3. Workplan (15 Points)
    The extent to which:
    a. The applicant identifies goals, objectives and activities that 
are specific, measurable, realistic, related to the Recipient 
Activities, and reflect plans in year one through five of the project.
    b. Objectives will contribute to the accomplishment of the stated 
goals.
    c. Activities are likely to achieve related objectives.
    d. Project time-line is realistic and indicates when each goal, 
objective, and activity will be met.
    e. Measures for monitoring and evaluating the process, impact, and 
outcome of each goal and objective are appropriate and specific.
4. Surveillance System (15 Points)
    The extent to which:
    a. The applicant has an operational surveillance system for asthma 
within the health agency.
    b. Attached surveillance reports are of high quality and 
comprehensively describe the asthma burden within the State, territory, 
tribe, or jurisdiction, including, if available, a report on asthma in 
the Medicaid population and the State Children's Health Insurance 
Program (SCHIP).
    c. The applicant identifies all data currently available to the 
program as well as additional data the agency will obtain and methods 
for obtaining it. Plan includes use of the Behavioral Risk Factor 
Surveillance System (BRFSS) asthma module(s).
    d. The plan identifies populations at risk for poorly controlled 
asthma such as specific racial/ethnic groups, socio-economic groups, 
and/or geographic areas.
    e. The applicant presents a reasonable approach for how the agency 
will enhance an ongoing surveillance system and how the data will be 
used to support policy, program development, implementation, and 
evaluation activities.
    f. The plan describes appropriate measures for asthma prevalence, 
severity, management, mortality, hospitalization, emergency care, and 
costs of asthma.
    g. The plan includes surveillance and public health interventions 
for work-related asthma.
    h. The approach for conducting analysis, interpreting surveillance 
data, and disseminating data through published reports is appropriate.
    i. The plan for evaluating the asthma surveillance system addresses 
all program goals and objectives, will be effective in monitoring 
asthma trends over time, will determine the effectiveness of asthma 
interventions, and will support modifications to the State Asthma Plan.
5. Approved State Asthma Plan (15 Points)
    The extent to which:
    a. A commitment by the Agency to implement this plan is 
demonstrated by the inclusion of a letter of support from the Secretary 
of Health or the Agency's Medical Director. If the State Asthma Plan is 
not already approved, the applicant provides assurance that it will be 
completed within 3 months of the first budget year.
    b. The State Asthma plan is comprehensive, addressing all persons 
with asthma regardless of age, race/

[[Page 31719]]

ethnicity, gender, or geographic area. It also includes key 
environments in which persons with asthma spend significant time such 
as the home, school, and workplace.
    c. The Plan defines the current status of asthma, why asthma should 
be a public health priority, and an assessment of the asthma burden in 
the State, territory, tribe, or jurisdiction. Applicant also lists 
asthma priorities and provides evidence that these priorities are 
directly related to analysis of population-based surveillance data. 
Objectives are time-phased and organized in accordance with the 
priorities identified in the State Asthma Plan.
    d. The applicant fully describes how the Plan was developed and how 
partners participated in the process. The number and type of agencies 
that participated and their contributions in developing the State 
Asthma Plan are appropriate.
    e. Proposed activities to meet the plan's objectives include, but 
are not limited to, efforts to: (1) Expand surveillance for asthma; (2) 
improve provider compliance with the National Asthma Education and 
Prevention Program's (NAEPP) ``Guidelines for the Diagnosis and 
Management of Asthma,'' (Clinical Practice Guidelines, Guidelines for 
the Diagnosis and Management of Asthma. National Institutes of Health 
(NIH), National Heart, Lung and Blood Institute. NIH publication No. 
97-4051, April 1997); (3) improve the skills of patients and families 
affected by asthma to manage the disease; (4) review legislation and 
policies impacting people with asthma; (5) identify environmental 
factors that contribute to asthma prevalence and morbidity, and reduce 
or eliminate exposure to these factors; and (6) communicate between 
those implementing and those affected by planned activities.

6. Collaboration Plan (5 Points)

    The extent to which:
    a. The applicant has experience collaborating with partners around 
asthma or other chronic or environmental related or occupationally 
related diseases both within and outside the agency.
    b. Collaborating organizations and agencies include a wide variety 
of appropriate partners in the clinical community; local health 
agencies; physician organizations; community health centers; local, 
state or regional asthma or respiratory health organizations (such as 
the American Lung Association), local education authorities; and groups 
or organizations that serve populations experiencing a disproportionate 
burden of asthma. If one or more of these partners are not included, 
the applicant explains why.
    c. The applicant includes a description of the collaboration's 
progress in: (1) Establishing leadership, (2) developing a consensus 
regarding goals, (3) identifying roles and responsibilities through a 
negotiated process, (4) developing routine and consistent patterns of 
communications, and (5) sustaining the participation of members over 
time.
    d. Letters of commitment from key organizations demonstrate their 
willingness, expertise, and capacity to carry out assigned 
responsibilities.
    e. The applicant presents a sound plan to determine the 
effectiveness of collaborations.
7. Description of the Problem (5 Points)
    The extent to which:
    a. The applicant provides a comprehensive description on what is 
known about the asthma burden in the State, tribe, territory, or 
jurisdiction, and a description of populations at increased risk of 
poorly controlled asthma within the jurisdiction (e.g., ethnic groups, 
socio-economic groups, and geographic areas).
    b. The applicant identifies existing initiatives, capacity, and 
infrastructure of the agency within which the asthma programs will 
occur.
    c. The agency's commitment to addressing asthma is demonstrated by 
accomplishments to date and understanding of the problem.
8. Budget (reviewed, but not scored)
    The extent to which:
    a. The budget is comprehensive and includes details for year one 
and projections for year two and three of the project period.
    b. The budget contains justifications that are consistent with 
stated goals, objectives, activities, and the intended use of 
cooperative agreement funds.
    c. The budget is reasonable and includes funds for project staff to 
attend a yearly conference or grantee meeting convened by CDC. In 
addition, the applicant included costs for one person to travel to 
Atlanta, GA, to attend the 6th National Environmental Health Conference 
on December 3-5, 2003.
9. Performance Goals (reviewed, but not scored)
    The extent to which the applicant will reduce the burden of asthma 
in the State, territory, tribe or jurisdiction.

I. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
    1. Interim progress report, no less than 90 days before the end of 
the budget period. The progress report will serve as your non-competing 
continuation application, and must contain the following elements:
    a. Current Budget Period Activities Objectives.
    b. Current Budget Period Financial Progress.
    c. New Budget Period Program Proposed Activity Objectives.
    d. Detailed Line-Item Budget and Justification.
    e. Additional Requested Information.
    2. Financial status report, no more than 90 days after the end of 
the budget period.
    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.

Additional Requirements

    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment I of the 
program announcement as posted on the CDC web site.

AR-7 Executive Order 12372
AR-9 Paperwork Reduction Act Requirements
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2010
AR-12 Lobbying Restrictions
AR-21 Small, Minority and Women-owned Business

J. Where To Obtain Additional Information

    This and other CDC announcements, the necessary applications, and 
associated forms can be found on the CDC web site, Internet address: 
http://www.cdc.gov. Click on ``Funding'' then ``Grants and Cooperative 
Agreements''.
    For general questions about this announcement, contact: Technical 
Information Management, CDC Procurement and Grants Office, 2920 
Brandywine Road, Atlanta, GA 30341-4146, Telephone: (770) 488-2700.
    For business management and budget assistance, contact: Mildred 
Garner, Grants Management Officer, Procurement and Grants Office, 
Centers for Disease Control and Prevention, 2920 Brandywine Road, 
Atlanta, GA

[[Page 31720]]

30341-4146, Telephone: (770) 488-2745, e-mail address: [email protected].
    For business management and budget assistance in the territories, 
contact: Charlotte Flitcraft, Grants Management Officer, Procurement 
and Grants Office, Centers for Disease Control and Prevention, 2020 
Brandywine Rd., Atlanta, GA 30319, Telephone: (770) 488-2632, e-mail 
address: [email protected].
    For program technical assistance, contact: Kathie Sunnarborg, MPH, 
CHES, Public Health Advisor, Air Pollution and Respiratory Health 
Branch, National Center for Environmental Health, Centers for Disease 
Control and Prevention, 1600 Clifton Rd., NE, Mailstop E-17, Atlanta, 
GA 30333, Telephone number: (404) 498-1451, e-mail address: 
[email protected].

    Dated: May 21, 2003.
Sandra R. Manning,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention.
[FR Doc. 03-13222 Filed 5-27-03; 8:45 am]
BILLING CODE 4163-18-P