[Federal Register Volume 70, Number 75 (Wednesday, April 20, 2005)]
[Notices]
[Pages 20555-20563]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-7889]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Addressing Asthma From a Public Health Perspective: Part A; 
Enhanced; Notice of Availability of Funds

    Announcement Type: New.
    Funding Opportunity Number: RFA 05044.
    Catalog of Federal Domestic Assistance Number: 93.283.
    Key Dates: Application Deadline: June 6, 2005.

I. Funding Opportunity Description

    Authority: This program is authorized under Sections 301 and 317 
of the Public Health Service Act, (42 U.S.C. 241 and 247b), as 
amended.

    Purpose: The purpose of the program is to provide the impetus to 
further develop program capacity to address asthma from a public health 
perspective to bring about: (1) A focus of asthma-related activity 
within the state; (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 a state, of the potential to use a public 
health approach to reduce the burden of asthma; (4) linkages of the 
state to many agencies and organizations addressing asthma in the 
population; and (5) participation in intervention program activities.
    This program addresses the ``Healthy People 2010'' focus areas of 
Environmental Health, Occupational Safety and Health, and Respiratory 
Diseases.
    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 citation 
in Attachment I, ``The Public Health Surveillance of Asthma,'' for more 
information. (All attachments will be posted with this program 
announcement on the CDC Web site.)
    Measurable outcomes of the program will be in alignment with the 
following performance goal for the National Center for Environmental 
Health (NCEH): Reduce the number of deaths, hospitalizations, emergency 
department visits, school or work days missed, and limitations on 
activity due to asthma.
    This announcement is only for non-research activities supported by 
CDC. If research is proposed, the application will not be reviewed. For 
the definition of research, please see the CDC Web site at the 
following Internet address: http://www.cdc.gov/od/ads/opspoll1.htm.
    Activities: Awardee Activities for this program are as follows:
     Enhance the existing asthma surveillance system to include 
(at a minimum) asthma hospitalizations, morbidity (measures from the 
Behavioral Risk Factor Surveillance System (BRFSS) or equivalent), 
mortality, and work-related asthma. Conduct analysis of and interpret 
surveillance data; and disseminate these data through reports to local, 
state, and federal partners and agencies.
     Implement a defined subset of interventions described in 
the State Asthma Plan.

--Improve provider compliance with the National Asthma Education and 
Prevention Program's (NAEPP) ``Guidelines for the Diagnosis and 
Management of Asthma'' (refer to citation in Attachment I for more 
information).
--Improve the skills of patients and families affected by asthma to 
manage the disease.
--Review legislation and policies impacting people with asthma.
--Identify environmental factors that contribute to asthma prevalence 
and morbidity, and reduce or eliminate exposure to these factors.
--Facilitate communication between those implementing and those 
affected by planned activities.

     Develop and implement an evaluation plan that measures the 
effectiveness of your program as a whole, as well as each intervention. 
Systematically document lessons learned.
     Maintain existing, and expand, as appropriate, statewide 
coalition and partnership activities; include a workgroup to address 
work-related asthma, if one does not exist; and evaluate effectiveness 
of collaboration.
     Maintain a strong commitment within the state to support 
continued efforts of the asthma program.
     Participate in CDC convened meetings and periodic 
conference calls for grantees to share experiences, data, and 
materials.
    In a cooperative agreement, CDC staff is substantially involved in 
the program activities, above and beyond routine grant monitoring. CDC 
Activities for this program are as follows:
     Provide consultation and guidance to awardees to enhance 
and expand existing asthma surveillance activities, including data 
collection methods and data analysis.
     Collaborate with awardees on analysis of asthma data, 
interpretation

[[Page 20556]]

of individual state surveillance data, and release of surveillance 
reports.
     Provide technical and scientific assistance and 
consultation on program development, implementation of the State Asthma 
Plan, intervention activities, and operational issues.
     Serve as a facilitator for communication between states to 
share expertise regarding various topics, such as the expansion and 
development of partnerships, implementation of the State Asthma Plan, 
and surveillance activities.
     Collaborate on the development of an appropriate 
evaluation plan that measures the effectiveness of the program as a 
whole and each intervention. Review and provide feedback on evaluation 
plans, and link awardees to additional expertise from CDC or its 
contractors.
     Plan and implement conferences and meetings to provide a 
forum through which awardees can increase their knowledge and skills, 
learn from each other, share resources, and work collaboratively to 
address issues related to reducing the burden of asthma.

II. Award Information

    Type of Award: Cooperative Agreement. CDC involvement in this 
program is listed in the Activities Section above.
    Fiscal Year Funds: 2005.
    Approximate Total Funding: $1,750,000. (This amount is an estimate, 
and is subject to availability of funds.)
    Approximate Number of Awards: 2-5.
    Approximate Average Award: $350,000. (This amount is for the first 
12-month budget period, and includes both direct and indirect costs.)
    Floor of Award Range: None.
    Ceiling of Award Range: $350,000. (This ceiling is for the first 
12-month budget period.)
    Anticipated Award Date: August 31, 2005.
    Budget Period Length: 12 months.
    Project Period Length: 3 years.
    Throughout the project period, CDC's commitment to continuation of 
awards will be conditioned on the availability of funds, and evidence 
of satisfactory progress by the recipient (as documented in required 
reports), and the determination that federal funding is in the best 
interest of the Federal Government.

III. Eligibility Information

III.1. Eligible Applicants

    Entities eligible to receive this funding are those states 
currently or previously funded under CDC Program Announcement (PA) 
01106, ``Addressing Asthma from a Public Health Perspective, Part A 
Planning''. Those states currently funded under Part A Enhanced or Part 
B Implementation are excluded.
    Eligible applicants are the states of Hawaii, Indiana, Nebraska, 
Oklahoma, and Washington.
    These states may designate their Bona Fide Agents to submit 
applications. 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. If you are applying as a 
bona fide agent of a state government, you must provide a letter from 
the state government as documentation of your status. Place this 
documentation behind the first page of your application form. Only one 
application from each state may be submitted.
    During the initial phase of Addressing Asthma from a Public Health 
Perspective (PA 01106 Part A Planning), states were required to 
complete a planning process that entailed developing an asthma 
surveillance system, establishing partnerships, and collaboratively 
writing a State Asthma Plan. Successfully completing this process is a 
prerequisite for states to move into the next phase, Part A Enhanced, 
where they will begin implementing a limited number of interventions 
from their state asthma plan. Only those states originally selected via 
a competitive award process for Part A Planning, and showing evidence 
of satisfactory progress in achieving Part A objectives, will be 
eligible.

III.2. Cost Sharing or Matching

    Matching funds are not required for this program.

III.3. Other

    If you request a funding amount greater than the ceiling of the 
award range, your application will be considered non-responsive, and 
will not be entered into the review process. You will be notified that 
your application did not meet the submission requirements.
    Special Requirements: If your application is incomplete or non-
responsive to the special requirements listed in this section, it will 
not be entered into the review process. You will be notified that your 
application did not meet submission requirements. Late applications 
will be considered non-responsive. See section ``IV.3. Submission Dates 
and Times'' for more information on deadlines.
    As previously stated, eligible applicants are those entities 
currently or previously funded by CDC Program Announcement 01106 
``Addressing Asthma from a Public Health Perspective, Part A 
Planning.'' States currently funded for Part A Enhanced or Part B 
Implementation are excluded. Eligible states are Hawaii, Indiana, 
Nebraska, Oklahoma, and Washington.
    Applicants must document eligibility with the following:
    1. Submit a copy of the final, approved, comprehensive State Asthma 
Plan. Approval can be documented with a letter from the State's Health 
or Medical Director and a letter from key partners indicating their 
commitment to and approval of the asthma plan. These letters may be 
contained within the plan itself. If so, this should be indicated by 
the applicant. Plans that are pending final approval may be accepted if 
the entire draft plan is submitted and accompanied by letters from the 
State Health or Medical Director and key partners stating their 
commitment to and approval of the plan, a time frame for final 
approval, and a description of the plan's approval process status. The 
letters should assure that the State Asthma Plan will be completed 
within the first month of the year one budget period.
    2. Have an operational surveillance system for asthma. This may be 
documented through submission of the most recent, comprehensive 
published surveillance report that describes asthma within the state, 
including, if available, a report on asthma in the Medicaid population 
and for enrollees of the State Children's Health Insurance Program 
(SCHIP).

    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.

IV. Application and Submission Information

IV.1. Address To Request Application Package

    To apply for this funding opportunity, use application form PHS 
5161-1.
    CDC strongly encourages you to submit your application 
electronically by utilizing the forms and instructions posted for this 
announcement at http://www.grants.gov.
    Application forms and instructions are available on the CDC Web 
site, 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

[[Page 20557]]

Grants Office, Technical Information Management Section (PGO-TIM) staff 
at: 770-488-2700. Application forms can be mailed to you.

IV.2. Content and Form of Submission

    Application: You must submit a project narrative with your 
application forms. The narrative must be submitted in the following 
format:
     Maximum number of pages: 45. If your narrative exceeds the 
page limit, only the first pages, which are within the page limit, will 
be reviewed. Budget Justification, State Asthma Plan, and asthma burden 
reports will not count against the narrative page limit.
     Font size: 12 point unreduced
     Spacing: Double-spaced; single-spaced tables in the 
narrative are acceptable.
     Paper size: 8.5 by 11 inches
     Page margin size: One inch
     Printed only on one side of page
     Held together only by rubber bands or metal clips; not 
bound in any other way.
     Written in plain language, avoid jargon.
    Your narrative should address activities to be conducted over the 
entire project period, and must include the following items in the 
order listed:
1. Description of the Problem
    Describe what is known about the asthma burden in the state 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 
those located in particular 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. Surveillance Plan
    Describe the current operational asthma surveillance system within 
the state. Include a description of each data set that contains asthma 
specific items, and that is currently available to, and used by, the 
asthma program. Discuss the limitations of each data set, and specify 
the most recent year of data available for analysis. At a minimum, the 
surveillance system should include measures to track asthma morbidity 
(asthma prevalence measures from the BRFSS or equivalent), asthma 
mortality, work-related asthma, and asthma hospitalizations. Medicaid 
and SCHIP data should be discussed, if available.
    Provide a surveillance plan containing the following information:
     Future plans for the data that are currently available to 
the asthma program (e.g., frequency of analysis and distribution, 
frequency of publication of comprehensive reports, methods of 
distribution).
     Additional data the program will obtain and methods for 
obtaining it.
     Plans for identifying specific populations at risk for 
poorly controlled asthma (e.g., gender, age groups, racial/ethnic 
groups, socio-economic groups, or by geographic area).
     How the state will use existing and new data to develop or 
enhance an ongoing surveillance system.
     How the surveillance data will be used to support policy, 
program development, implementation, and evaluation activities.
    Describe the methods that will be used to analyze, interpret, and 
disseminate surveillance data through published reports to local, 
state, and federal partners and agencies.
    In addition to cross-sectional analysis, include in the 
surveillance plan a discussion of how the asthma surveillance system 
will be used to monitor trends over time.
    Applicants funded by this announcement will be expected to use the 
BRFSS optional ten question adult asthma history module, the BRFSS 
optional six-question child selection module and the BRFSS optional two 
question child prevalence module within the first year of the project 
period, as well as in subsequent years. Applicants should plan to fund 
their state BRFSS for the ten adult questions and the two child 
prevalence questions. Since the six questions in the child selection 
module will be used by other programs, use of this module should be 
coordinated with those programs, and costs for this module should be 
shared with those other programs, if possible.
    A letter of support from the BRFSS coordinator, which acknowledges 
the intent to use these modules, must be included in the application. A 
letter of support from other programs using the child selection module 
must be included in the application, and should specify intent to share 
costs.
    In place of the ten-question adult asthma history module, the 
applicant can choose to use the BRFSS Asthma Call-Back Survey. This 
asthma-only call-back survey will provide extensive additional 
information on asthma. It will be available to all states for data 
collection year 2006, with funding provided through the BRFSS funding 
mechanism. The state asthma program will still need to fund the use of 
the six question child selection module and the two question child 
prevalence module to identify children with asthma for the call-back 
survey. Adults with asthma are identified by the BRFSS core questions. 
If this call-back survey is used in place of the adult history module, 
a letter of support from the BRFSS coordinator, which acknowledges 
agreement with the intent to use the asthma call-back survey, must be 
included in the application.
    If the state asthma program has another method (such as the State 
and Local Area Integrated Telephone Survey--National Survey of 
Children's Health) to acquire the same or similar information as that 
acquired from BRFSS, applicant should provide a detailed justification 
and description of alternate information and methodology.
    Submit copies of the most recent, comprehensive, published 
surveillance report that describes asthma within the state, including 
data of all available types (mortality, prevalence, hospitalization, 
emergency department visits, Medicaid and SCHIP enrollee data, and 
BRFSS adult history and child prevalence data). The report should 
include an analysis of the most recent year of data available from each 
data source mentioned above.
    For more information, refer to the following citations in 
Attachment 1:
     ``Updated Guidelines for Evaluating Surveillance Systems, 
Recommendations from the Guidelines Working Group''
     ``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''
     ``The Role of States in a Nationwide Comprehensive 
Surveillance System for Work-related Diseases, Injuries and Hazards''
     ``Minimum and Comprehensive State-Based Activities in 
Occupational Safety and Health''
     ``American Thoracic Society Statement: Occupational 
Contribution to the Burden of Airway Disease''
    For more information on the BRFSS Asthma Call-Back Survey, see 
Attachment II.
3. State Asthma Plan
    Submit a copy of the final, approved, comprehensive State Asthma 
Plan. Approval can be documented with a letter from the State's Health 
or Medical Director and a letter from key partners indicating their 
commitment to and approval of the asthma plan. These letters may be 
contained within the plan itself. If so, this should be indicated by 
applicant. Plans that are pending final approval may be accepted if the 
entire

[[Page 20558]]

draft plan is submitted and accompanied by letters from the State 
Health or Medical Director and key partners stating their commitment to 
and approval of the plan, a time frame for final approval, and a 
description of the plan's approval process status. The letters should 
assure that the State Asthma Plan will be completed within the first 
month of the year one budget period.
    Describe the collaborative process by which the comprehensive State 
Asthma Plan was developed. Describe how the plan addresses all persons 
with asthma regardless of age, race/ethnicity (including Native 
Americans), gender, or geographic locale, and includes key environments 
in which persons with asthma spend significant time (e.g., home, 
school, or workplace). If a specific population is not affected by 
asthma, clearly identify and describe this population.
    Include information about the agencies and organizations that have 
participated in the planning process and describe their roles and 
responsibilities, and how they will be involved in implementing 
interventions.
    Describe how data collected in the asthma surveillance system is 
used to identify priority areas and guide the development of program 
goals and objectives.
    Describe a subset of interventions from the State Asthma Plan to be 
implemented with these grant funds. Also, briefly explain the remaining 
interventions in the State Asthma Plan that will not be conducted under 
this announcement due to limited funding.
    Note that a statewide approach is encouraged. If focusing on one 
segment of the 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:
     Expand surveillance for asthma.
     Improve provider compliance with the National Asthma 
Education and Prevention Program's (NAEPP) ``Guidelines for the 
Diagnosis and Management of Asthma'' (refer to citation in Attachment I 
for more information).
     Improve the skills of patients and families affected by 
asthma to manage the disease.
     Review legislation and policies impacting people with 
asthma.
     Identify environmental factors that contribute to asthma 
prevalence and morbidity, and reduce or eliminate exposure to these 
factors.
     Facilitate communication 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 state support for asthma.
4. Collaboration Plan
    Describe experiences with partnerships requiring extensive 
collaboration to address asthma, 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); state or local education authorities; and 
groups or organizations that serve minority or other populations 
experiencing a disproportionate burden of asthma. Also, include 
representatives from state governmental agencies (e.g., Department of 
Labor); federal agencies; public health agencies; and professional care 
organizations conducting or interested in work-related asthma 
activities. If one or more of these partners is not listed, the 
applicant should explain why.
    Describe how the collaboration:
     Established leadership.
     Developed consensus regarding goals.
     Identified roles and responsibilities.
     Developed procedures and patterns for communication.
     Sustained the participation of members over time.
    Provide letters of commitment from each specific organization, 
including a statement of how they do, 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.
5. 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. Disparate populations include those communities that are 
experiencing worse than average health, or are medically underserved.
    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, such as ``Minimum and Comprehensive State-Based 
Activities in Occupational Safety Health,'' and/or ``The Role of States 
in a Nationwide Comprehensive Surveillance System for Work-related 
Diseases, Injuries and Hazards.'' Refer to citations in Attachment I 
for more information.
    Include an assessment of existing and needed resources to implement 
these strategies.
    Describe how implementation activities from the State Asthma Plan 
were selected by members of the statewide partnership group, and how 
they 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. Letters should describe 
their willingness to work together to implement and monitor the 
intervention strategies, and modify the plan over time.
    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 NAEPP ``Guidelines for the 
Diagnosis and Management of Asthma.'' Refer to citation in Attachment I 
for more information.
    Provide the methodology and specific measures for monitoring 
progress in meeting all objectives related to implementation of 
activities in the asthma plan.
    Provide measures for evaluating process, impact, and outcomes for 
each goal and objective. For more information, refer to the citation in 
Attachment I, ``Framework for Program Evaluation in Public Health,'' or 
other evaluation resources on the CDC Web site at http://www.cdc.gov/eval/framework.htm.
6. Workplan
    Provide specific goals, objectives, and activities that describe 
what the state intends to accomplish by the end of the three-year 
project period. These goals, objectives and activities should be 
measurable, realistic, related to

[[Page 20559]]

Awardee Activities described in Section I of this funding opportunity 
announcement, and reflect activities in years one, two, and three of 
the project. Include a project time-line that indicates when the 
proposed goals, objectives, and activities will be completed. A single-
spaced table format may be used for this.
    Document how progress made toward meeting the objectives will be 
evaluated. Provide measures for evaluating process, impact, and outcome 
for each goal and objective. For more information, refer to the 
citation in Attachment I, ``Framework for Program Evaluation in Public 
Health,'' or other evaluation resources on the CDC Web site at http://www.cdc.gov/eval/framework.htm.
    In addition, describe how lessons learned will be systematically 
gathered, documented, and included as an integral part of the 
evaluation process.
7. Management and Staffing
    Demonstrate the applicant's organizational commitment to the asthma 
program by describing how the state as a whole will focus its efforts 
on asthma. Provide a plan to maintain a strong commitment within the 
state to support continued efforts of the asthma program.
    Describe the organizational location of the proposed staff, their 
relation to the state asthma contact (the position 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: at least the equivalent of one full-time 
asthma coordinator to manage the planning process and conduct other 
programmatic activities; at least the equivalent of one full-time 
epidemiologist to develop and implement surveillance activities for the 
asthma project; and a supervisor (paid with grant funds or in-kind 
contributions) who will assure support for the project staff. Other 
program positions may also be proposed. Attach an official position 
description, qualifications and curricula vitae for all proposed staff 
positions.
    For each position, describe the primary roles and responsibilities 
for the project staff over the three-year project period. Also, include 
specific staff activities that will contribute to meeting each 
objective. Describe the level of involvement of the principal 
investigator.
    Provide a plan to expedite filling of the staff position(s) within 
the first budget year and assure that they have been, or will be, 
approved by the applicant's personnel system. Include a letter of 
support from the state 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.
    Assure that at least two key project staff will attend and 
participate in the conferences or grantee meetings convened by CDC, and 
their willingness to share innovations, information, data, and 
materials. This should be reflected in the budget.
8. Budget and Justification
    Include a detailed first-year budget with narrative justifications, 
as well as annual budget projections for years two and three (budget 
and justification will not be counted toward the narrative page limit). 
The applicant should describe the program purpose for each budget item. 
For each contract contained within the budget, provide: (a) The name(s) 
of the contractor(s); (b) method of selection; (c) period of 
performance; (d) description of activities; (e) method of 
accountability; and (f) an itemized budget with narrative 
justifications.
    The budget should include travel funds for at least two project 
staff to attend a yearly conference or grantee meeting convened by CDC.
    If applicable, list other funds outside this cooperative agreement 
(i.e., in-kind contributions) that will be used to support this 
program.
    Additional information may be included in the application 
appendices. The appendices will not be counted toward the narrative 
page limit. This additional information includes: Curriculum Vitaes, 
Resumes, Organizational Charts, Position Descriptions, Letters of 
Support, the State Asthma Plan and supporting documentation, 
Surveillance Reports, etc.
    You are required to have a Dun and Bradstreet Data Universal 
Numbering System (DUNS) number to apply for a grant or cooperative 
agreement from the Federal government. The DUNS number is a nine-digit 
identification number, which uniquely identifies business entities. 
Obtaining a DUNS number is easy and there is no charge. To obtain a 
DUNS number, access www.dunandbradstreet.com or call 1-866-705-5711.
    For more information, see the CDC Web site at: http://www.cdc.gov/od/pgo/funding/pubcommt.htm. If your application form does not have a 
DUNS number field, please write your DUNS number at the top of the 
first page of your application, and/or include your DUNS number in your 
application cover letter.
    Additional requirements that may require you to submit additional 
documentation with your application are listed in section ``VI.2. 
Administrative and National Policy Requirements.''

IV.3. Submission Dates and Times

    Application Deadline Date: June 6, 2005.
    Explanation of Deadlines: Applications must be received in the CDC 
Procurement and Grants Office by 4 p.m. Eastern Time on the deadline 
date.
    You may submit your application electronically at http://www.grants.gov. Applications completed online through Grants.gov are 
considered formally submitted when the applicant organization's 
Authorizing Official electronically submits the application to http://www.grants.gov. Electronic applications will be considered as having 
met the deadline if the application has been submitted electronically 
by the applicant organization's Authorizing Official to Grants.gov on 
or before the deadline date and time.
    If you submit your application electronically with Grants.gov, your 
application will be electronically time/date stamped, which will serve 
as receipt of submission. You will receive an e-mail notice of receipt 
when CDC receives the application.
    If you submit your application by the United States Postal Service 
or commercial delivery service, you must ensure that the carrier will 
be able to guarantee delivery of the application by the closing date 
and time. If CDC receives your application 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, you will be given the opportunity to 
submit documentation of the carrier's guarantee. If the documentation 
verifies a carrier problem, CDC will consider the application as having 
been received by the deadline.
    If you submit a hard copy application, CDC will not notify you upon 
receipt of your submission. If you have a question about the receipt of 
your LOI or application, first contact your courier. If

[[Page 20560]]

you still have a question, contact the PGO-TIM staff at 770-488-2700. 
Before calling, please wait two to three days after the application 
deadline. This will allow time for applications to be processed and 
logged.
    This announcement is the definitive guide on application content, 
submission address, and deadline. It supersedes information provided in 
the application instructions. If your submission does not meet the 
deadline above, it will not be eligible for review, and will be 
discarded. You will be notified that you did not meet the submission 
requirements.

IV.4. Intergovernmental Review of Applications

    Your application is subject to Intergovernmental Review of Federal 
Programs, as governed by Executive Order (EO) 12372. This order sets up 
a system for state and local governmental review of proposed federal 
assistance applications. You should contact your state single point of 
contact (SPOC) as early as possible to alert the SPOC to prospective 
applications, and to receive instructions on your state's process. 
Click on the following link to get the current SPOC list: http://www.whitehouse.gov/omb/grants/spoc.html.

IV.5. Funding Restrictions

    Restrictions, which must be taken into account while writing your 
budget, are as follows:
     Funds may not be used to conduct research. Surveillance 
and evaluation activities that are for the purposes of monitoring 
program performance are not considered research. However, any 
identifiable information collected must be kept confidential.
     Cooperative agreement funds may be used to support costs 
that are directly related to the program activities, and are consistent 
with the scope of the cooperative agreement.
     Awards will allow reimbursement of pre-award costs.
     Funds awarded 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.
     Grant funds may be used to leverage asthma program 
development in the state, along with resources from other collaborative 
agencies and organizations.
    If you are requesting indirect costs in your budget, you must 
include a copy of your indirect cost rate agreement.
    If your indirect cost rate is a provisional rate, the agreement 
must be less than 12 months old.
    Guidance for completing your budget can be found on the CDC Web 
site, at the following Internet address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm.

IV.6. Other Submission Requirements

    Application Submission Address: CDC strongly encourages applicants 
to submit electronically at: http://www.grants.gov. You will be able to 
download a copy of the application package from http://www.grants.gov, 
complete it offline, and then upload and submit the application via the 
Grants.gov site. E-mail submissions will not be accepted. If you are 
having technical difficulties in Grants.gov, they can be reached by e-
mail at http://[email protected] or by phone at 1-800-518-4726 (1-
800-GRANTS). The Customer Support Center is open from 7 a.m. to 9 p.m., 
Monday through Friday.
    CDC recommends that you submit your application to Grants.gov early 
enough to resolve any unanticipated difficulties prior to deadline. You 
may also submit a back-up paper submission of your application. Any 
such paper submission must be received in accordance with the 
requirements for timely submission detailed in Section IV.3. of the 
grant announcement. The paper submission must be clearly marked: 
``BACK-UP FOR ELECTRONIC SUBMISSION.''
    The paper submission must conform to all requirements for 
electronic submissions. If both electronic and back-up paper 
submissions are received by the deadline, the electronic version will 
be considered the official submission.
    It is strongly recommended that you submit your grant application 
using Microsoft Office products (i.e., Microsoft Word, Microsoft Excel, 
etc.). If you do not have access to Microsoft Office products, you may 
submit a PDF file. Directions for creating PDF files can be found on 
the Grants.gov web site. Use of file formats other than Microsoft 
Office or PDF may result in your file being unreadable by our staff. Or
    Submit the original and two hard copies of your application by mail 
or delivery service to: Technical Information Management-PA  
05044, CDC Procurement and Grants Office, 2920 Brandywine Road, 
Atlanta, GA 30341.

V. Application Review Information

V.1. Criteria

    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 goals stated in the ``Purpose'' section of 
this program 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.
    Your application will be evaluated by the extent to which you 
demonstrate evidence for the following criteria. Criteria are listed 
according to their point value; you do not have to address them in this 
order. Points in parentheses reflect the number of possible points for 
that section. The total number of points for the entire application is 
100.
1. Workplan (20 Points)
    Does applicant identify goals, objectives, and activities that:
     Are consistent with surveillance findings and the Awardee 
Activities described in Section I of this Program Announcement?
     Are specific, measurable, and realistic?
     Reflect activities in years one, two, and three of the 
project period?
    Are the activities likely to achieve objectives, and are the 
objectives likely to contribute to accomplishment of identified goals?
    Is the time-line for accomplishing proposed goals, objectives, and 
activities reasonable?
    Are measures for monitoring and evaluating the process, impact, and 
outcome of each goal and objective specific and appropriate?
    Is the plan to systematically gather and document lessons learned 
incorporated into the program evaluation process?
2. Surveillance Plan (20 Points)
    Does the applicant demonstrate an operational surveillance system 
for asthma as evidenced by a description of existing data sources, the 
timeliness of the data available and any limitations? Does the plan use 
appropriate measures to track the following over time:
     Asthma hospitalizations?
     Asthma morbidity (measures from the BRFSS or equivalent)?
     Asthma mortality?
     Work-related asthma?
    Are Medicaid and SCHIP data included, if available?

[[Page 20561]]

    Does the applicant explain how the state will enhance an on-going 
surveillance system by describing:
     Future plans for analyzing the data currently available?
     Additional data the state will obtain and the methods for 
obtaining it?
     Plans for the identification of demographic groups at high 
risk for poor asthma health outcomes?
     How the existing surveillance system will be enhanced by 
additional data sets and/or additional analyses of existing data?
     How the data will be used to support policy and program 
development, implementation and evaluation?
    Are surveillance data analyses, interpretation and dissemination 
methods described and are they appropriate? Is the utility of existing 
data for time trends analysis discussed and is it reasonable?
    Does the plan clearly state applicant's intent, within the first 
year of the project period and in subsequent years, to implement:
     The BRFSS optional six-question child selection module?
     The BRFSS optional two-question child asthma module?
     The BRFSS optional ten question adult module; or
    The BRFSS Asthma call-back survey?
    Are letters of support from the BRFSS coordinator and other 
programs using the child selection module (if any) included? If another 
method (other than BRFSS) will be used, or if the applicant is unable 
to implement the recommended BRFSS modules, is a detailed and 
reasonable justification provided?
    Are the attached surveillance reports comprehensive and timely 
(data from the most recently available year are used)? Is the burden of 
asthma within the state fully described, including: mortality; BRFSS 
prevalence; BRFSS adult history and child prevalence data; and, if 
available, hospitalization, emergency department, Medicaid and SCHIP 
enrollee data?
    Does the surveillance report clearly identify segments of the 
population, such as specific age groups, ethnic/racial groups, socio-
economic groups, or those residing in particular geographic regions, at 
disparate risk for asthma and asthma outcomes in each data source?
3. State Asthma Plan (15 Points)
    Is the State Asthma Plan comprehensive? Has it been approved by the 
state and key partners? If not already approved, has the applicant 
provided assurance that the State Asthma Plan will be completed within 
one month of the first budget year?
    Does the plan address all persons with asthma, regardless of 
gender, age, race/ethnicity, or geographic location? Are key 
environments in which persons with asthma spend significant time (e.g., 
home, school, or workplace) addressed?
    Are the number and type of agencies and organizations that 
participated in developing the State Asthma Plan appropriate? Are 
partner's roles and responsibilities fully described and reasonable?
    Does the applicant describe the collaboration's progress towards:
     Establishing leadership?
     Developing a consensus regarding goals?
     Identifying roles and responsibilities through a 
negotiated process?
     Developing routine and consistent patterns of 
communications?
     Sustaining the participation of members over time?
    Will collaborative relationships be used after the plan is in place 
and the state begins to implement selected interventions?
    Are a subset of the interventions to be implemented from the State 
Asthma Plan with grant funds described? Do proposed activities to meet 
the plan's objectives include, at a minimum, efforts to:
     Expand surveillance for asthma?
     Improve provider compliance with the NAEPP ``Guidelines 
for the Diagnosis and Management of Asthma?
     Improve the skills of patients and families affected by 
asthma to manage the disease?
     Review legislation and policies impacting people with 
asthma?
     Identify environmental factors that contribute to asthma 
prevalence and morbidity, and reduce or eliminate exposure to these 
factors?
     Facilitate communication between those implementing and 
those affected by planned activities?
    Was asthma data collected by the surveillance system used to 
identify priority areas and guide the development of program goals and 
objectives? Are future plans to do this described?
    Does applicant describe how the State Asthma Plan will evolve over 
time, and the process by which changes will be made?
4. Collaboration Plan (15 Points)
    Does applicant demonstrate previous successful experiences 
collaborating with internal and external partners to address asthma?
    Do collaborating organizations and agencies represent 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 or state education authorities; 
and groups or organizations that serve populations experiencing a 
disproportionate burden of asthma? Are representatives from state 
governmental agencies (e.g., Department of Labor), federal agencies, 
public health agencies, and professional care organizations conducting 
or interested in work-related asthma activities included? If one or 
more of these partners is not included, does the applicant explain why?
    Does the applicant describe satisfactory progress by the 
collaboration around:
     Establishing leadership?
     Developing a consensus regarding goals?
     Identifying roles and responsibilities through a 
negotiated process?
     Developing routine and consistent procedures and patterns 
of communications?
     Sustaining the participation of members over time?
    Does applicant describe how progress is monitored?
    Do letters of commitment from key organizations demonstrate their 
willingness, expertise, and specific capacity to carry out assigned 
responsibilities?
    Does applicant realistically describe how partners who developed 
the State Asthma Plan will continue to work together to monitor the 
intervention strategies over time?
    How likely is it that the plan for evaluating the effectiveness of 
collaborations will be implemented, and that measures to assess 
effectiveness will be reasonable and identify areas for improvement?
5. Management and Staffing Plan (15 Points)
    Does the state demonstrate a high level of commitment and 
organizational support for the asthma program? Are organizational 
charts included, showing where the asthma program is located?
    Are roles of proposed staff members adequately defined and 
appropriate for carrying out stated responsibilities? Is the proposed 
level of involvement of the principal investigator adequate?
    Does the staffing plan include at least the equivalent of one full-
time asthma coordinator, at least the equivalent of one full-time 
epidemiologist, and a supervisor?

[[Page 20562]]

    Do job descriptions, qualifications, and curricula vitae indicate 
that each proposed staff member has the credentials, knowledge, 
training, and experience to perform assigned duties?
    Is the plan to expedite filling of the staff position(s) and assure 
that they will be approved by the applicant's personnel system, 
realistic?
    Does the applicant commit to having at least two key project staff 
attend CDC conferences and meetings, to share innovations, information, 
data, and materials?
6. Implementation Plan (10 Points)
    Does the applicant present specific, realistic, measurable and 
time-phased objectives for each intervention proposed, along with 
appropriate measures to evaluate process, impact and outcomes?
    Do proposed interventions focus on high priority and disparate 
populations, with priorities based on surveillance data?
    Are interventions focused on bringing about change at both the 
systems level and the individual level to provide improved disease 
management and education?
    Is the intervention plan supported in the community, as 
demonstrated by the inclusion of letters of support from key members of 
the community?
    Does the applicant demonstrate a scientific basis for each proposed 
intervention?
    Does the applicant demonstrate the availability of sufficient 
resources to implement the proposed subset of interventions?
    Are the methods and measures for monitoring progress towards 
meeting intervention goals and objectives appropriate?
7. Description of the Problem (5 Points)
    Does the applicant provide a comprehensive description of what is 
known about the asthma burden in the state, including all ages, race/
ethnic groups, and geographic areas?
    Does the applicant fully identify existing initiatives, capacity, 
and infrastructure of the state within which the asthma programs will 
occur?
    Were barriers identified when developing the State Asthma Plan 
appropriately addressed?
    Is the state's commitment to addressing asthma demonstrated by 
accomplishments to date and understanding of the problem?
8. Budget (Reviewed, But Not Scored)
    The budget is comprehensive and includes details for year one, and 
projections for years two and three, of the project period.
    The budget contains justifications that are consistent with stated 
goals, objectives, activities, and the intended use of cooperative 
agreement funds.
    The budget is reasonable and includes funds for at least two 
project staff to attend a yearly conference or grantee meeting convened 
by CDC.
9. Performance Goals (Reviewed, But Not Scored)
    The extent to which the applicant will reduce the number of deaths, 
hospitalizations, emergency department visits, school or work days 
missed, and limitations on activity due to asthma in the state.

V.2. Review and Selection Process

    Applications will be reviewed for completeness by the Procurement 
and Grants Office (PGO) staff, and for responsiveness by National 
Center of Environmental Health (NCEH). Incomplete applications and 
applications that are non-responsive to the eligibility criteria will 
not advance through the review process. Applicants will be notified 
that their application did not meet submission requirements.
    An objective review panel will evaluate your application according 
to the criteria listed in the ``V.1. Criteria'' section above. All 
members of the panel will be CDC employees from outside of the funding 
center (NCEH).
    In addition, the following factors may affect the funding decision: 
(1) Geographic distribution; and (2) racial and ethnic populations with 
a disproportionate asthma burden. CDC will provide justification for 
any decision to fund out of rank order.

V.3. Anticipated Announcement Award Dates

    August 31, 2005.

VI. Award Administration Information

VI.1. Award Notices

    Successful applicants will receive a Notice of Award (NoA) from the 
CDC Procurement and Grants Office. The NoA shall be the only binding, 
authorizing document between the recipient and CDC. The NoA will be 
signed by an authorized Grants Management Officer, and mailed to the 
recipient fiscal officer identified in the application.
    Unsuccessful applicants will receive notification of the results of 
the application review by mail.

VI.2. Administrative and National Policy Requirements

45 CFR Part 74 or Part 92
    For more information on the Code of Federal Regulations, see the 
National Archives and Records Administration at the following Internet 
address: http://www.access.gpo.gov/nara/cfr/cfr-table-search.html.
    The following additional requirements apply to this project:
     AR-7 Executive Order 12372
     AR-8 Public Health System Reporting Requirements
     AR-10 Smoke-Free Workplace Requirements
     AR-11 Healthy People 2010
     AR-12 Lobbying Restrictions
     AR-21 Small, Minority, and Women-Owned Business
    Additional information on these requirements can be found on the 
CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/ARs.htm.
    An additional Certifications form from the PHS5161-1 applications 
needs to be included in your Grants.gov electronic submission only. 
Refer to http://www.cdc.gov/od/pgo/funding/PHS5161-1Certificates.pdf. 
Once the form is filled out, attach it to your Grants.gov submission as 
Other Attachment Forms.

VI.3. Reporting Requirements

    You must provide CDC with an original, plus two hard copies of the 
following reports:
    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.
    f. Measures of Effectiveness.
    2. Financial status report and annual progress 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.
    These reports must be sent to the Grants Management Officer listed 
in the ``Agency Contacts'' section of this announcement.

VII. Agency Contacts

    For general questions about this announcement, contact: Technical 
Information Management Section, CDC Procurement and Grants Office, 2920 
Brandywine Road, Atlanta, GA 30341, Telephone: 770-488-2700.
    For program technical assistance, contact: Michele Mercier, Project

[[Page 20563]]

Officer, Air Pollution and Respiratory Health Branch, Division of 
Environmental Hazards and Health Effects, National Center for 
Environmental Health, Centers for Disease Control and Prevention, 1600 
Clifton Road, NE, Mailstop E-17, Atlanta, GA 30333, Telephone: 404-498-
1033, E-mail: [email protected].
    For financial, grants management, or budget assistance, contact: 
Gary Teague, Grants Management Specialist, CDC Procurement and Grants 
Office, 2920 Brandywine Road, Atlanta, GA 30341, Telephone: 770-488-
1981, E-mail: [email protected].

VIII. Other Information

    This and other CDC funding opportunity announcements can be found 
on the CDC Web site, Internet address: http://www.cdc.gov. Click on 
``Funding'' then ``Grants and Cooperative Agreements.''
    For additional reference materials, please see Attachments I and 
II.

    Dated: April 14, 2005.
William P. Nichols,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention.

Attachment I--References

``National Asthma Training Curriculum'' CD-ROM educational resource, 
CDC National Center for Environmental Health and the Academy of 
Allergy, Asthma and Immunology, August 2004.
``Potentially Effective Interventions for Asthma'' http://www.cdc.gov/asthma/interventions.htm.
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.
``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 http://www.cdc.gov/eval/framework.htm.
``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.
``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.
``American Thoracic Society: Occupational Contribution to the Burden 
of Airway Disease,'' American Journal of Respiratory and Critical 
Care Medicine, 167:787-797, 2003.
``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 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm.
Madden, J; Boss, L; Kownaski, M; Lambright, L; Lee, C; Luttinger, D; 
Recer, G; Wedemeyer, C. ``Guide for State Health Agencies in the 
Development of Asthma Programs.'' Atlanta, Georgia: U.S. Centers for 
Disease Control and Prevention, 2003.
``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.
``Key Clinical Activities for Quality Asthma Care: Recommendations 
of the National Asthma Education and Prevention Program.'' MMWR 
March 28, 2003; 52(RR06):1-84.
Strategies for addressing asthma in school settings: http://www.cdc.gov/HealthyYouth/asthma/.

Attachment II--BRFSS Asthma Call-Back Survey

    The National Asthma Survey (NAS) is a comprehensive state/city 
level detailed asthma survey. It is administered by phone and 
includes respondents of all ages. Previously the NAS was linked to 
the National Immunization Survey (NIS) through the State and Local 
Area Integrated Telephone Survey (SLAITS) mechanism. SLAITS is a 
function of the National Center for Health Statistics. A full 
questionnaire for that survey can be viewed on the SLAITS Web site. 
http://www.cdc.gov/nchs/about/major/slaits/nsa.htm.
    The initial NAS field test occurred in 2002 in Alabama, 
California, Illinois and Texas. This first field test did not 
achieve an adequate response rate level. Consequently additional 
field tests were implemented to determine whether procedural changes 
could improve the response rate. In 2003, the NAS was conducted as a 
field test in the same four states and also in a national sample.
    There were four arms in the 2003 field test. The national sample 
and the state sample were the two main arms. The national sample 
obtains demographic information about respondents who do not have 
asthma in order to estimate prevalence rates. The four-state sample 
only solicited information from households that had a member with 
asthma and, consequently, prevalence rates cannot be determined. 
Results from comparing the four state results with the first field 
test will determine if obtaining prevalence rates resulted in a 
significantly lower response rate. Comparing the national sample 
with the first field test in the four states will determine if the 
four selected states were particularly difficult with respect to 
response rates as was suggested from the results from other surveys.
    Each of the two main arms was also divided into a NIS-connected 
sample and a sample independent of the NIS procedures. Comparisons 
between these two secondary arms within each primary arm will 
determine if restrictions related to the NIS survey procedures were 
detrimental to the NAS response rate. In addition, several other 
modifications were made to simplify the selection of a single 
respondent from the household members.
    During 2004 the data obtained were weighted and scrutinized to 
determine the best combination of methodological changes to ensure 
that quality data result from further implementation of the National 
Asthma Survey.
    In 2005 the NAS will be implemented as a call-back survey in 
conjunction with the Behavioral Risk Factor Surveillance System 
(BRFSS) in three test states (Michigan, Minnesota and Oregon). The 
child selection module and the child prevalence module must be 
conducted at the time of the BRFSS interview. Adults and children 
who are identified with lifetime asthma will be called back 
approximately 2 weeks after the initial BRFSS telephone interview. 
At the time of the call-back the NAS interview will be conducted. 
Draft questionnaires can be obtained by contacting the Air Pollution 
and Respiratory Health Branch (404-498-1000). Prevalence figures for 
adults in all BRFSS areas (50 states, DC and 3 territories) can be 
obtained from the core BRFSS survey. However, the child selection 
module and child prevalence modules are needed for state level child 
prevalence estimates from BRFSS.
    In 2006 funding to implement the BRFSS asthma call-back survey 
will be provided to BRFSS states, DC, or territories who 
successfully apply for that funding in conjunction with their BRFSS 
funding. Asthma program staff must work jointly with their state's 
BRFSS program coordinator when submitting request for asthma call-
back funding to the National Center for Chronic Disease Prevention 
and Health Promotion (NCCDPHP).

[FR Doc. 05-7889 Filed 4-19-05; 8:45 am]
BILLING CODE 4163-18-P