[Federal Register Volume 70, Number 101 (Thursday, May 26, 2005)]
[Notices]
[Pages 30451-30466]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-10537]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Public Health Emergency Preparedness

    Announcement Type: New.
    Funding Opportunity Number: AA154.
    Catalog of Federal Domestic Assistance Number: 93.283.
    Application Deadline: July 13, 2005.
    Notice of Award: August 31, 2005.

I. Funding Opportunity Description

    Authority: This program is authorized under 42 U.S.C. 247d-3.

    Purpose: The purpose of this program is to upgrade and integrate 
State and local public health jurisdictions' preparedness for and 
response to terrorism and other public health emergencies with Federal, 
State, local, and tribal governments, the private sector, and Non-
Governmental Organizations (NGOs). These emergency preparedness and 
response efforts are intended to support the National Response Plan 
(NRP)\1\ and the National Incident Management System (NIMS) \2\.
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    \1\ Emergency Support Function Annexes. National Response Plan. 
Available at: http://www.dhs.gov/dhspublic/interapp.editorial/editorial_0566.xml.
    \2\ National Incident Management System http://www.fema.gov/nims/.
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    In addition, the activities described in this cooperative agreement 
guidance are designed to develop emergency-ready public health 
departments in accord with the Interim National Preparedness Goal (NPG) 
\3\, the Interim Public Health and Healthcare Supplement to the NPG 
\4\, and the Centers for Disease Control and Prevention (CDC) 
Preparedness Goals (see below). Associated with the Interim NPG are two 
broad-gauged resources to help guide preparedness planning and 
implementation: A set of scenarios and the Target Capabilities List 
\5\. The Department of Homeland Security (DHS) developed the Interim 
NPG and the associated resources in concert with the Department of 
Health and Human Services and other agencies of the Federal Government 
as well as with representatives of State and local public health 
departments and other stakeholders. All of these documents will be 
refined and extended from time to time to capture lessons learned and 
to introduce new concepts as appropriate.
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    \3\ Interim National Preparedness Goal: http://www.ojp.usdoj.gov/odp/docs/InterimNationalPreparednessGoal_03-31-05_1.pdf.
    \4\ Interim Public Health and Healthcare Supplement to the 
National Preparedness Goal: http://www.hhs.gov/ophep/index.html.
    \5\ Target Capabilities List: Version 1.0; January 31, 2005. 
U.S. Department of Homeland Security Office of State and Local 
Government Coordination and Preparedness (ATTN: Office for Policy, 
Initiatives, and Analysis) 810 7th Street, NW. Washington, DC 20531. 
Version 1.0 of the Target Capabilities List will be made available 
on the ODP Secure Portal (https://odp.esportals.com) and the Lessons 
Learned and Information Sharing network (http://www.llis.gov).
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    This announcement is only for non-research activities supported by 
the Centers for Disease Control and Prevention/Agency for Toxic 
Substances and Disease Registry (CDC/ATSDR). 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/opspoll1.htm.
    This program addresses the ``Healthy People 2010'' focus area(s) of 
public health infrastructure.
    Recipient Activities: CDC has developed Preparedness Goals designed 
to measure urgent public health system response performance parameters 
that are directly linked to health protection of the public. The 
Preparedness Goals are intended to measure urgent public health system 
response performance for terrorism and non-terrorism events including 
infectious disease, environmental and occupational related emergencies. 
For the purposes of this announcement urgent response is intended to 
indicate non-routine public health system reaction to limit possible 
mortality, morbidity, loss of quality of life, or economic damage. The 
primary intent of this cooperative agreement is to fund the active 
participation of awardees in the immediate establishment, use, and 
continuous improvement of a national system using the CDC Preparedness 
Goals to measure public health system response performance. The CDC 
Preparedness Goals are below:
    Prevent: (1) Increase the use and development of interventions 
known to prevent human illness from chemical, biological, radiological 
agents, and naturally occurring health threats.
    (2) Decrease the time needed to classify health events as terrorism 
or naturally occurring in partnership with other agencies.
    Detect/ Report: (3) Decrease the time needed to detect and report 
chemical, biological, radiological agents in tissue, food or 
environmental samples that cause threats to the public's health.
    (4) Improve the timeliness and accuracy of information regarding 
threats to the public's health as reported by clinicians and through 
electronic early event detection, in real time, to those who need to 
know.
    Investigate: (5) Decrease the time to identify causes, risk 
factors, and appropriate interventions for those affected by threats to 
the public's health.
    Control: (6) Decrease the time needed to provide countermeasures 
and health guidance to those affected by threats to the public's 
health.
    Recover: (7) Decrease the time needed to restore health services 
and environmental safety to pre-event levels. (8) Increase the long-
term follow-up provided to those affected by threats to the public's 
health.
    Improve: (9) Decrease the time needed to implement recommendations 
from after-action reports following threats to the public's health.
    The activities in this cooperative agreement guidance will be based 
on the synchronization of the Department of Homeland Security Target 
Capabilities List (TCL) with the CDC Preparedness Goals in order to 
create a preparedness framework that identifies the key needs for the 
public health community.
    The TCL was developed under the auspices of Homeland Security 
Presidential Directive 8: National Preparedness (HSPD-8). It is a 
functional, performance-focused compendium of response activities 
designed to provide State and local jurisdictions with nationally 
accepted preparedness levels of first responder capabilities. The TCL 
was developed in close consultation with Federal, State, local, and 
tribal entities and national associations, including CDC and many of 
the agency's key response partners.
    Additional Requirements: The activities outlined in the guidance 
and required for the application for funds are as follows:
    1. The existence of or current efforts to establish or participate 
in a senior advisory committee during Fiscal Year 2005 (FY05) to 
coordinate funding with the U.S. Department of Health and Human 
Services' (HHS) Centers for Disease Control and Prevention; U.S. 
Department of Health and Human Services' (HHS) Health Resource and 
Services Administration (HRSA) hospital preparedness cooperative 
agreement; and FY05 Homeland Security Grant Program Department of

[[Page 30452]]

Homeland Security, Office for Domestic Preparedness.
    2. During the award year, awardees ability to respond to events 
will be evaluated through assessments, site visits, drills, exercises, 
and responses to real events. In year one of this cooperative 
agreement, CDC will initiate a series of drills to test components of a 
comprehensive response system. In years 2-5 of this cooperative 
agreement, CDC will require the demonstration of a broader set of 
measures that are consistent with the TCLs through full-scale exercises 
at the State and local level. Further guidance on the development and 
evaluation of exercises and drills will be forthcoming from CDC. To the 
extent possible, public health exercises should use standards set by 
the DHS Homeland Security Exercise Evaluation Program (HSEEP) as well 
as other recognized exercise programs including those used by the 
Federal Emergency Management Agency (FEMA) Emergency Management 
Institute. These exercises should test both horizontal and vertical 
integration with response partners at the local, tribal, State, and 
federal level.
    3. Awardees must ensure that funds are available to establish and 
maintain systems to collect and report on the performance measures 
described in this program announcement, including reporting on the 
achievement of performance measures by local public health entities.
    4. Awardees are expected to address the activities and outcomes 
described in this announcement through the use of cooperative agreement 
funds and coordination with other funding sources such as the Urban 
Areas Security Initiative (UASI) and the Metropolitan Medical Response 
System (MMRS) through the Department of Homeland Security. Achievement 
of these outcomes will be evaluated through drills, exercises, and 
responses to real events whenever possible.
    5. While this guidance contains instructions for CDC awardees, it 
also includes recipient activities that need to be integrated with 
those funded by the hospital preparedness cooperative agreement 
administered by HRSA. Further, CDC encourages applicants to coordinate 
activities with current relevant efforts in their jurisdictions or 
proposed under the various goals of this cooperative agreement.
    Applicants should also coordinate activities within their 
jurisdictions (i.e., at the State level), between State and local 
jurisdictions, tribes, and military installations; among local 
agencies; and with hospitals and major health care entities, including 
tribal and Public Health Service health facilities; among 
jurisdictional MMRSs, and adjacent States. If applicable, awardees 
should coordinate with neighboring provinces, tribal/First Nations 
indigenous jurisdictions and States across international borders.
    6. Public health agencies must support public health response 
functions in the context of NIMS. In accordance with HSPD-5, NIMS 
provides a consistent approach for Federal, State, and local 
governments to work effectively and efficiently together to prepare 
for, prevent, respond to, and recover from domestic incidents, 
regardless of cause, size, or complexity. As a condition of receiving 
Public Health Emergency Preparedness cooperative agreement funds, 
awardees agree to adopt and implement NIMS. In accordance with the 
eligibility and allowable uses of the cooperative agreement, awardees 
are encouraged to direct FY05 funding towards activities necessary to 
implement NIMS.
    On September 8, 2004, the former Secretary of Homeland Security, 
Tom Ridge, wrote a letter to the Governors outlining the important 
steps that State, territorial, tribal and local entities should take 
during FY05 to become compliant with NIMS.\6\
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    \6\ Available at http://www.fema.gov/doc/nims/letter_to_governors_09082004.doc, accessed April 7, 2005.
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    In order to receive Fiscal Year 2006 (FY06) preparedness funding, 
the minimum FY05 compliance requirements described in the Secretary's 
letter must be met. Applicants will be required to certify as part of 
their FY06 cooperative agreement applications that they have met the 
FY05 NIMS requirements.
    NIMS compliance activities to be accomplished during FY05 are as 
follows:

States and Territories

     Incorporate NIMS into existing training programs and 
exercises;
     Ensure that federal preparedness funding (including the 
National Bioterrorism Hospital Preparedness cooperative agreement) 
supports State, local and tribal NIMS implementation;
     Incorporate NIMS into Emergency Operations Plans (EOP);
     Promote intraState mutual aid agreements;
     Coordinate and provide NIMS technical assistance to local 
and tribal entities; and
     Incorporate Incident Command Systems (ICS) into public 
health department, hospital, and supporting health care systems.

State, Territorial, Local and Tribal Jurisdictions

     Complete the NIMS Awareness Course: ``National Incident 
Management System (NIMS), An Introduction'' IS 700.
    This independent study course developed by the Emergency Management 
Institute (EMI) explains the purpose, principles, key components and 
benefits of NIMS. The course is available on the EMI Web page at: 
http://training.fema.gov/EMIWeb/IS/is700.asp.
     Formally recognize the NIMS and adopt NIMS principles and 
policies.
    States, territories, tribes and local entities should establish 
legislation, executive orders, resolutions, or ordinances to formally 
adopt the NIMS. Go to http://www.fema.gov/nims and see NIMS Resources 
for examples.
     Determine which NIMS requirements have already been met.
    State, territorial, tribal, and local entities have already 
implemented many of the concepts and protocols identified in the NIMS. 
However, as gaps in compliance with the NIMS are identified, States, 
territories, tribes and local entities should use existing awards to 
develop strategies for addressing those gaps.
     Develop a strategy and timeframe for full NIMS 
implementation.
    States, territories, tribes, and local entities are encouraged to 
achieve full NIMS implementation during FY05. To the extent that full 
implementation is not possible during FY05, federal preparedness 
assistance must be leveraged to complete NIMS implementation by FY06. 
By Fiscal Year 2007 (FY07), federal preparedness assistance will be 
conditioned by full compliance with the NIMS. States should work with 
tribal and local governments to develop a strategy for Statewide 
compliance with the NIMS.
     Incorporate Incident Command Systems (ICS) into public 
health department, hospital, and supporting health care systems.
    All Federal, State, territory, tribal and local jurisdictions are 
required to adopt ICS in order to be compliant with the NIMS. See NIMS 
and the Incident Command System at http://www.fema.gov/nims under NIMS 
Resources.
    During the FY 2005 budget period the Department of Health and Human 
Services will continue to work closely with the NIMS Integration Center 
to clarify NIMS requirements for public health and medical communities. 
Both HRSA and CDC will continue to provide technical assistance 
throughout this

[[Page 30453]]

process to assist to awardees in meeting 2005 requirements.
    7. Competency-based education of public health workers, clinicians, 
and others critical to emergency response should be planned and 
implemented based on needs identified through assessments and/or 
evaluations of performance. Awardees are expected to continue to 
support preparedness education and training activities needed to 
successfully achieve targeted outcomes and preparedness goals. 
Development, delivery, and evaluation of competency-based preparedness 
education should be done in conjunction with Centers for Public Health 
Preparedness (CPHP), and academic experts in other schools of public 
health, medicine, nursing, and academic health science centers.
    Prior to planning development of new preparedness education courses 
or training programs to meet identified needs, efforts should be taken 
to identify and utilize existing education programs that have been 
evaluated for learning effectiveness (e.g. as evidenced by measured 
knowledge gained through pre- and post-tests, self-assessed learner 
competence, and/or skill demonstrations.) Resources such as learning 
management systems ((e.g. TrainingFinder Real-time Affiliate Integrated 
Network (TRAIN)) and other preparedness educational inventories ((e.g. 
Centers for Public Health Preparedness (CPHP) Resource Center)) can 
help facilitate the identification of existing preparedness educational 
programs that can be accessed, adopted, and adapted for local use, 
which will result in less duplication and more efficient use of 
available funds.
    8. During the award year, awardees are expected to implement 
capable, interoperable information systems that support public health 
preparedness. PHIN Preparedness defines functional requirements in the 
areas of Early Event Detection, Outbreak Management, Countermeasure and 
Response Administration, Partner Communications and Alerting, and 
Connecting Laboratory Systems. All awardees are expected to develop 
information technology systems that are compliant with PHIN and begin 
to initiate the PHIN Preparedness certification process (further 
guidance on this process can be found at http://www.cdc.gov/phin/certification) during this cooperative agreement cycle. PHIN 
certification will ensure that systems have the capabilities necessary 
(``functional requirements'') to share data and work together (``Key 
Performance Measures--KPM's'') in order to implement a national network 
of capable public health preparedness systems. Certification is based 
upon the system requirements and specification guides found at http://www.cdc.gov/phin. Self-assessment tools are available for all 
functional areas and the alerting KPMs at http://www.cdc.gov/phin/certification.
    Awardees may choose to meet the system requirements and 
specifications by: building or enhancing their own systems, purchasing 
commercial solutions, or using CDC developed systems and services. The 
requirements documents and specification guides include the details of 
what needs to be implemented in grantee systems to meet these needs. 
Some awardees may choose to use CDC developed software and services 
either as their final solutions or as bridge solutions until their own 
systems meet the requirements and specifications and are certified. The 
CDC has software and services available to cover all of the PHIN 
Preparedness functional areas, but the CDC is committed to working with 
awardees to help support solutions from any viable software solutions 
providers. The implementation of the PHIN Preparedness functional 
requirements will usually require several software systems to cover all 
of the functional areas, but in some circumstances, awardees may 
implement a single system that covers more than one functional area. 
Each PHIN Preparedness functional area can be certified separately. 
While CDC systems will undergo certification themselves, if CDC 
software and services are used in the awardee environment some 
components will require certification in the environment they are 
implemented.
    9. CDC requires documentation with the cooperative agreement 
application that describes the process used by the State health 
department to engage local health departments to reach consensus, 
approval, or concurrence for the proposed use of non-earmarked 
cooperative agreement funds. Non-earmarked cooperative agreement funds 
are those funds not designated for urban areas (e.g. Cities Readiness 
Initiative (CRI)), Early Warning Infectious Disease Surveillance 
(EWIDS), currently established Level 1 Chemical laboratories, or other 
specialty activities as defined in the guidance. The description should 
bear evidence that local health department officials have been engaged 
in the cooperative agreement application process and at least a 
majority, if not the total, approves or concur with the application 
itself. This evidence may be demonstrated by:
    a. The consensus of a majority of local health officials whose 
collective jurisdictions encompass a majority of the State's 
population;
    b. The recommendation of the President of the State Association of 
County and City Health Officials (SACCHO) if a majority of local health 
officials whose collective jurisdictions encompass a majority of the 
State's population agree with the SACCHO's decision; or
    c. Any other alternative method agreed to by the State Health 
Official and a majority of local health officials whose collective 
jurisdictions encompass a majority of the State's population.
    State applicants will be required to submit a list of concurring 
local health departments and a brief description of the process used to 
engage local health departments to reach consensus, approval, or 
concurrence for the proposed use of funds. In addition, State 
applicants will be required to provide signed letters of concurrence 
upon request.
    10. CDC requires documentation with the cooperative agreement 
application that describes the process used by the State health 
department to engage the following entities in preparedness and 
response activities: American Indian tribal governments, Tribal 
organizations representing those governments, tribal epidemiologic 
centers, or Alaska Native Villages and Corporations located within 
their boundaries.
    11. State awardees are expected to ensure the preparedness of major 
population centers within each State either through the provision of 
funding to the population centers to ensure their capability to perform 
the outcomes and activities described and/or (for those States with a 
centralized public health system that does not fund local health 
agencies) by directly achieving the performance outcomes and completing 
the required activities described in this cooperative agreement 
announcement in those population centers. State awardees are expected 
to report on the relevant performance measures (see Appendix 4) for the 
following population centers. Some of the performance measures will be 
reported on by each local public health agency (through the State) in 
the jurisdiction; others will require the local agencies to work 
collaboratively to develop an integrated response. In those cases, 
reporting will be done through the State for the region as a whole (see 
Appendix 4).

[[Page 30454]]



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                                    Biowatch\*\ or UASI
              State                     (05) cities                           Associated MSA
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Arizona..........................  Phoenix.............  Phoenix-Mesa-Scottsdale, AZ
California.......................  Anaheim.............  Los Angeles-Long Beach-Santa Ana, CA
                                   Long Beach..........  Los Angeles-Long Beach-Santa Ana, CA
                                   Los Angeles.........  Los Angeles-Long Beach-Santa Ana, CA
                                   Oakland.............  San Francisco-Oakland-Fremont, CA
                                   Sacramento..........  Sacramento Arden-Arcade Roseville, CA
                                   San Diego...........  San Diego-Carlsbad-San Marcos, CA
                                   San Francisco.......  San Francisco-Oakland-Fremont, CA
                                   San Jose............  San Jose-Sunnyvale-Santa Clara, CA
                                   Santa Ana...........  Los Angeles-Long Beach-Santa Ana, CA
Colorado.........................  Denver..............  Denver-Aurora, CO
Delaware.........................  Philadelphia........  Philadelphia-Camden-Wilmington, PA-NJ-DE
District of Columbia.............  Washington/NCR......  Washington-Arlington-Alexandria, DC-VA-MD
Florida..........................  Jacksonville........  Jacksonville, FL
                                   Miami...............  Miami-Fort Lauderdale-Miami Beach, FL
                                   Tampa...............  Tampa-St. Petersburg-Clearwater, FL
Georgia..........................  Atlanta.............  Atlanta-Sandy Springs-Marietta, GA
Hawaii...........................  Honolulu............  Honolulu, HI
Illinois.........................  Chicago.............  Chicago-Naperville-Joliet, IL-IN-WI
                                   St. Louis...........  St. Louis, MO-IL
Indiana..........................  Indianapolis........  Indianapolis, IN
                                   Chicago.............  Chicago-Naperville-Joliet, IL-IN-WI
                                   Cincinnati..........  Cincinnati-Middletown, OH-KY-IN
                                   Louisville..........  Louisville, KY-IN
Iowa.............................  Omaha...............  Omaha-Council Bluffs, NE-IA
Kansas...........................  Kansas City.........  Kansas City, MO-KS
Kentucky.........................  Louisville..........  Louisville, KY-IN
                                   Cincinnati..........  Cincinnati-Middletown, OH-KY-IN
Louisiana........................  Baton Rouge.........  Baton Rouge, LA
                                   New Orleans.........  New Orleans-Metairie-Kenner, LA
Massachusetts....................  Boston..............  Boston-Cambridge-Quincy, MA-NH
Maryland.........................  Baltimore...........  Baltimore-Towson, MD
                                   Washington DC.......  Washington-Arlington-Alexandria, DC-VA-MD
Michigan.........................  Detroit.............  Detroit-Warren-Livonia, MI
Minnesota........................  Minneapolis.........  Minneapolis-St. Paul-Bloomington, MN-WI
Missouri.........................  Kansas City.........  Kansas City, MO-KS
                                   St. Louis...........  St. Louis, MO-IL
Nebraska.........................  Omaha...............  Omaha-Council Bluffs, NE-IA
North Carolina...................  Charlotte...........  Charlotte-Gastonia-Concord, NC-SC
New Hampshire....................  Boston..............  Boston-Cambridge-Quincy, MA-NH
New Jersey.......................  Jersey City.........  New York-Northern New Jersey-Long Island, NY-NJ-PA
                                   Newark..............  New York-Northern New Jersey-Long Island, NY-NJ-PA
                                   Philadelphia........  Philadelphia-Camden-Wilmington, PA-NJ-DE
Nevada...........................  Las Vegas...........  Las Vegas-Paradise, NV
New York.........................  Buffalo.............  Buffalo-Niagara Falls, NY
                                   New York............  New York-Northern New Jersey-Long Island, NY-NJ-PA
Ohio.............................  Cincinnati..........  Cincinnati-Middletown, OH-KY-IN
                                   Cleveland...........  Cleveland-Elyria-Mentor, OH
                                   Columbus............  Columbus, OH
                                   Toledo..............  Toledo, OH
Oklahoma.........................  Oklahoma City.......  Oklahoma City, OK
Oregon...........................  Portland............  Portland-Vancouver-Beaverton, OR-WA
Pennsylvania.....................  Philadelphia........  Philadelphia-Camden-Wilmington, PA-NJ-DE
                                   Pittsburgh..........  Pittsburgh, PA
                                   New York............  New York-Northern New Jersey-Long Island, NY-NJ-PA
South Carolina...................  Charlotte...........  Charlotte-Gastonia-Concord, NC-SC
Texas............................  Austin\*\...........  Austin-Round Rock, TX
                                   Arlington...........  Dallas-Fort Worth-Arlington, TX
                                   Dallas..............  Dallas-Fort Worth-Arlington, TX
                                   Fort Worth..........  Dallas-Fort Worth-Arlington, TX
                                   El Paso\*\..........  El Paso, TX
                                   Houston.............  Houston-Baytown-Sugar Land, TX
                                   San Antonio.........  San Antonio, TX

[[Page 30455]]

 
Virginia.........................  Washington DC.......  Washington-Arlington-Alexandria, DC-VA-MD
Washington.......................  Seattle.............  Seattle-Tacoma-Bellevue, WA
                                   Portland............  Portland-Vancouver-Beaverton, OR-WA
Wisconsin........................  Chicago.............  Chicago-Naperville-Joliet, IL-IN-WI
                                   Milwaukee...........  Milwaukee-Waukesha-West Allis, WI
                                   Minneapolis.........  Minneapolis-St. Paul-Bloomington, MN-WI
----------------------------------------------------------------------------------------------------------------
\*\ Biowatch only.

    12. CDC will work with awardees and partner agencies ((including 
National Association of County and City Health Officials (NACCHO), 
Association of State and Territorial Health Officials (ASTHO), Council 
of State and Territorial Epidemiologists (CSTE), Association of Public 
Health Laboratories (APHL), DHS, and FEMA)) to build on these initial 
activities and develop performance-based metrics within the next six 
months that will measure all aspects of preparedness as outlined in the 
CDC Preparedness Goals and the TCLs. They will be developed with the 
understanding that wherever possible these activities can be 
demonstrated through performance in drills, exercises, or real events. 
Additional activities will include gap analysis, economic modeling, 
continuous improvement and data collection/evaluation from exercises 
and real events as well as piloting the developed metrics. Required 
critical tasks and performance measures will be updated in each project 
year as public health learns more about measuring preparedness. In 
addition, CDC will be developing targets for those measures that do not 
currently have them based on research over the coming year.
    13. As Stated in the FY04 guidance, awardees should provide a copy 
of the complete pandemic influenza plan for the jurisdiction to HHS 
Office of Public Health Emergency Preparedness (OPHEP) via CDC Division 
of State and Local Readiness' Management Information System (DSLR-MIS). 
Awardees of this cooperative agreement should collaborate with 
influenza programs to maximize the impact of funds and efforts, reduce 
duplication, and coordinate activities including drills and exercises. 
Detailed information concerning the development of influenza pandemic 
preparedness plans is available in the document Pandemic Influenza: A 
Planning Guide for State and Local Officials, version 2.1 available at 
http://www.hhs.gov/nvpo/pubs/pandemicflu.htm.

Local Caches of Antiviral Drugs

    Certain antiviral drugs are efficacious in countering influenza 
virus and could be the sole initial medical countermeasure against a 
pandemic strain until an effective vaccine is available. The H5N1 avian 
strain currently circulating widely in Asia has been shown to infect 
humans and cause significant mortality and morbidity; and the virus 
could trigger an influenza pandemic if it were to undergo genetic 
changes that enhance its transmissibility from person to person. One 
commonly available drug, Oseltamivir, has been shown to be effective 
against the current H5N1 strain. Because worldwide production capacity 
for antiviral drugs faces significant limitations, the Department of 
Health and Human Services is working to create a mechanism whereby it 
and its State and local public health partners might acquire and pre-
deploy predictable quantities of antiviral drugs during the next 
several years.
    The Hospital Bioterrorism Cooperative Agreement of the Health 
Resources and Services Administration (HRSA) includes a Critical 
Benchmark for hospital-based pharmaceutical caches. This provision 
provides a means for jurisdictions to amass appropriate quantities of 
antiviral drugs as a first line of protection for the staff of 
hospitals and other healthcare entities as well as their most 
critically ill patients. Such action could be one of the most important 
steps toward maintaining an effective healthcare infrastructure during 
an influenza pandemic.
    Hospital-based pharmaceutical caches also could house antiviral 
drugs to protect public health professionals, another critical part of 
the human resources needed to combat an influenza pandemic. Funds 
allocated through the CDC bioterrorism cooperative agreement could be 
used to acquire appropriate quantities of antiviral drugs for storage 
within the hospital-based caches funded by the HRSA cooperative 
agreement. When and as needed, the drugs could be released to the 
public health department for it to dispense to its staff. This 
arrangement would be analogous to the way some jurisdictions have 
implemented the CHEMPAK program (containerized sets of nerve-agent 
antidotes)--i.e., using CDC funds to acquire materiel, using HRSA funds 
to offset costs of storing it, and planning to release the materiel 
when and as needed to those authorized to use it in accord with an 
established Concept of Operations.
    Awardees requesting to use cooperative agreement funds for the 
purchase of antiviral drugs for these caches must specify the quantity 
and cost as part of the budget application.
    14. Awardees participating in the FY04 CRI will continue to do so 
in FY05 (the second year of the pilot initiative). The guidelines for 
CRI can be found in Appendix 3.
    Application Content: What follows is the outline to be used to 
develop the application for funds. It was derived from a combination of 
many resources: past guidance, input from State and local public health 
partners, subject matter expertise within technical program areas of 
CDC, priorities from HHS, CDC priorities, documentation from DHS's TCL, 
DHS's Universal Task List (UTL), and HSPD-8.
    The outline is arranged in the following manner:
    CDC Goals--Draft CDC Preparedness Goals that form a framework for 
public health activities surrounding preparedness. This cooperative 
agreement is one activity among many that will contribute to meeting 
the Preparedness Goals.
    Outcomes--The outcomes are Statements that were developed with 
State and local input from public health and homeland security. They 
were created in relation with HSPD-8 and are a comprehensive 
description of the major roles and capabilities needed to respond to an 
event of significance. Version 1 of the TCL contained 36 capabilities. 
For year one of this guidance, we singled out those capabilities that 
had a significant public health component. In some cases, we added 
language to the capabilities to

[[Page 30456]]

create a public health focused outcome. A comprehensive budget where 
each allocation is linked to an outcome should be submitted with the 
application through the DSLR MIS.
    Required Critical Tasks--The critical tasks were obtained from the 
TCL. In most cases, the public health specific critical tasks 
associated with an outcome were listed. Language was added or modified 
to make the required critical task more specific to public health. In 
addition, program requirements specific to CDC and this cooperative 
agreement were added as sub-bullets under the required critical tasks 
to assure that each applicant addressed plans to continue 
implementation of the activities in the next cooperative agreement 
cycle.
    Performance Measures--The performance measures are defined as 
leading indicators that will allow a national ``snapshot'' to show how 
the preparedness and response activities, and the associated resources, 
aid in making a public health system that responds more quickly and 
comprehensively in a public health emergency.
    Applicants will be required to address each critical task (using 
the DSLR-MIS) by providing an explanation of their current capability 
to perform this task and proposing activities for this budget year to 
enhance performance on each critical task. In addition, applicants will 
be asked how they currently evaluate or plan to evaluate their ability 
to perform each of the critical tasks.
    After award, CDC Project Officers and technical experts will 
monitor the progress of each awardee in accomplishing the activities 
set forth and approved in the plan submitted.

CDC Preparedness Goal 1: Prevent

    Increase the use and development of interventions known to prevent 
human illness from chemical, biological, radiological agents, and 
naturally occurring health threats.
Outcome 1A: All Hazards Planning
    Emergency response plans, policies, and procedures that identify, 
prioritize, and address all hazards (using the 15 National Planning 
Scenarios 7 8 9 10 as a guide to identify or recognize the 
roles and responsibilities for each jurisdiction/agency) across all 
functions. All plans are coordinated at all levels of government and 
address the mitigation of secondary and cascading emergencies.
---------------------------------------------------------------------------

    \7\ Frequently Asked Questions: HSPD 8/National Planning 
Scenarios/Targeted Capabilities List. Available at: http://www.ojp.usdoj.gov/odp/assessments/hspd8.htm.
    \8\ Homeland Security Presidential Directive 8 http://www.whitehouse.gov/news/releases/2003/12/print/20031217-6.html.
    \9\ Homeland Security Presidential Directive 5 http://www.fas.org/irp/offdocs/nspd/hspd-5.html.
    \10\ Homeland Security Grant Program--FY 2005. Available at: 
http://www.ojp.usdoj.gov/odp/docs/fy05hsgp.pdf.
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    Required Critical Tasks: (1) Support incident response operations 
according to all-hazards plan
    (2) Improve regional, jurisdictional, and State all-hazard plans 
(including those related to pandemic influenza) to support response 
operations in accordance with NIMS and the National Response Plan.\11\
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    \11\ Guide for All-Hazard Emergency Operations Planning: State 
and Local Guide 101. Federal Emergency Management Agency. April 
2001. http://www.fema.gov/pdf/rrr/slg101.pdf.
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    (a) Increase participation in jurisdiction-wide self-assessment 
using the National Incident Management System Compliance Assessment 
Support Tool \12\ (NIMCAST).
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    \12\ National Incident Management System Compliance Assessment 
Support Tool (NIMCAST). http://www.fema.gov/nimcast/index.jsp.
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    (b) Agency's Emergency Operations Center meets NIMS incident 
command structure requirements to perform core functions: coordination, 
communications, resource dispatch and tracking and information 
collection, analysis and dissemination.
    (3) Increase the number of public health responders who are 
protected through Personal Protective Equipment (PPE), vaccination or 
prophylaxis
    (a) Have or have access to a system that maintains and tracks 
vaccination or prophylaxis status of public health responders in 
compliance with Public Health Information Network (PHIN) Preparedness 
Functional Area Countermeasure and Response Administration \13\
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    \13\ Public Health Information Network (PHIN) Preparedness 
Requirements http://www.cdc.gov/phin/.
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    (4) Increase and improve mutual aid agreements, as needed, to 
support NIMS-compliant public health response.
    (5) Increase all-hazard incident management capability by 
conducting regional, jurisdictional and State training to:
    (a) Include the Emergency Management Independent Study Program, IS 
700, ``National Incident Management System: An Introduction \14\'' in 
the training plan for all staff expected to report for duty following 
activation of the public health emergency response plan and/or staff 
who have emergency response roles documented in their job descriptions.
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    \14\ Emergency Management Independent Study Program , IS 700, 
National Incident Management System, An Introduction. http://www.training.fema.gov/EMIWeb/IS/IS700.asp.
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    (6) Provide support for continuity of public health operations at 
regional, State, tribal, local government, and agency level.
    Measures: (1) Percent of public health employees who have emergency 
response roles documented in their job descriptions that are trained in 
Incident Management.
    (2) Time to organize a NIMS-compliant medical and public health 
operations functional area \15\ with hospitals that supports:
---------------------------------------------------------------------------

    \15\ The CNACorporation. Medical Surge Capacity and Capability: 
A Management System for Integrating Medical and Health Resources 
During Large-Scale Emergencies. Prepared under Contract Number 233-
03-0028 for the Department of Health and Human Services. Alexandria, 
Virginia: August 2004. Available at: http://www.cna.org/documents/mscc_aug2004.pdf.
---------------------------------------------------------------------------

     incident epidemiological profiling
     pre-hospital care
     medical care
     mental health
     hazard threat/disease containment
     mass casualty care
     (Target: 3 hours from plan activation)
    (3) Time from request for mutual aid to acknowledgement that 
request has been approved.
    (4) Time to complete the notification/alerting of the initial wave 
of personnel to staff emergency operations (Target: 60 minutes).
    (5) Time to have initial wave of personnel physically present to 
staff emergency operations (Target: 90 minutes from notification).

CDC Preparedness Goal 2: Prevent

    Decrease the time needed to classify health events as terrorism or 
naturally occurring in partnership with other agencies.
Outcome 2A: Information Collection and Threat Recognition
    Locally generated public health threat and other terrorism-related 
information is collected, identified, provided to appropriate analysis 
centers, and acted upon as appropriate.
    Required Critical Tasks: (1) Increase the use of disease 
surveillance and early event detection systems.
    (a) Select conditions that require immediate reporting to the 
public health agency (at a minimum, Category A agents).
    (b) Develop and maintain systems to receive disease reports 24/7/
365.
    (c) Have or have access to electronic applications in compliance 
with PHIN Preparedness Functional Area Early Event Detection to 
support:

[[Page 30457]]

     Receipt of case or suspect case disease reports 24/7/365.
     Reportable diseases surveillance.
     Call triage of urgent reports to knowledgeable public 
health professionals.
     Receipt of secondary use health-related data and 
monitoring of aberrations to normal data patterns.
    (d) Develop and maintain protocols for the utilization of early 
event detection devices located in your community (e.g., BioWatch).
    (e) Assess timeliness and completeness of disease surveillance 
systems annually.
    (2) Increase sharing of health and intelligence information within 
and between regions and States with Federal, local and tribal agencies.
    (a) Improve information sharing on suspected or confirmed cases of 
immediately notifiable conditions, including foodborne illness, among 
public health epidemiologists, clinicians, laboratory personnel, 
environmental health specialists, public health nurses, and staff of 
food safety programs.
    (b) Maintain secret and/or top secret security clearance for the 
State health official, local health officials, preparedness directors, 
and preparedness coordinators to ensure access to sensitive information 
about the nature of health threats and intelligence information \16\.
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    \16\ HHS Guidance: http://198.102.218.46/doc/Security%20Class%20Guide.doc.
---------------------------------------------------------------------------

    (3) Decrease the time needed to disseminate timely and accurate 
national strategic and health threat intelligence.
    (a) Maintain continuous participation in CDC's Epidemic Information 
Exchange Program (Epi-X)\17\.
---------------------------------------------------------------------------

    \17\ Epidemic Information Exchange Program (Epi ``X) http://www.cdc.gov/epix/.
---------------------------------------------------------------------------

    (b) Participate in the Electronic Foodborne Outbreak Reporting 
System (EFORS) by entering reports of foodborne outbreak investigations 
and monitor the quality, completeness or reports and time from onset of 
illnesses to report entry \18\.
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    \18\ Electronic Foodborne Outbreak Reporting System (EFORS) 
http://www.cdc.gov/foodborneoutbreaks/info_healthprofessional.htm.
---------------------------------------------------------------------------

    (c) Perform real-time subtyping of PulseNet \19\ tracked foodborne 
disease agents. Submit the subtyping data and associated critical 
information (isolate identification, source of isolate, phenotype 
characteristics of the isolate, serotype, etc) electronically to the 
national PulseNet database within 72 to 96 hours of receiving the 
isolate in the laboratory.
---------------------------------------------------------------------------

    \19\ PulseNet http://www.cdc.gov/pulsenet/.
---------------------------------------------------------------------------

    (d) Have or have access to a system for 24/7/365 notification/
alerting of the public health emergency response system that can reach 
at least 90% of key stakeholders and is compliant with PHIN 
Preparedness Functional Area Partner Communications and Alerting.
    Measures: (1) Time to receive confirmed case reports of immediately 
notifiable conditions by public health agency (includes Biowatch and 
Biohazard Detection Systems (BDS)).
    (2) Time for State to notify local/tribal or local/tribal to notify 
State of receipt of a suspicious or confirmed case report of an 
immediately notifiable condition (Target: one hour from receipt).
    (3) Time to have a knowledgeable public health professional answer 
a disease report call and begin taking the report 24/7/365 (Target: 15 
minutes or less).
    (4) Percent of sub-typing data submitted to PulseNet within 72-96 
hours of receiving isolate in the laboratory.
Outcome 2B: Hazard and Vulnerability Analysis
    Jurisdiction-specific Hazards are identified and assessed to enable 
appropriate protection, prevention, and mitigation strategies so that 
the consequences of an incident are minimized.
    Required Critical Tasks: (1) Prioritize the hazards identified in 
the jurisdiction hazard/vulnerability assessment for potential impact 
on human health with special consideration for lethality of agents and 
large population exposures within 60 days of cooperative agreement 
award.
    (2) Decrease the time to intervention by the identification and 
determination of potential hazards and threats, including quality of 
mapping, modeling, and forecasting.
    (3) Decrease human health threats associated with identified 
community risks and vulnerabilities (i.e., chemical plants, hazardous 
waste plants, retail establishments with chemical/pesticide supplies).
    (4) Through partners increase the capability to monitor movement of 
releases and formulate public health response and interventions based 
on dispersion and characteristics over time.
    Measures: (1) Time to recommend public health courses of action to 
minimize human health threats identified in the jurisdiction's hazard 
and vulnerability analysis (Target: 60 days from identification of risk 
or hazard).

CDC Preparedness Goal 3: Detect/Report

    Decrease the time needed to detect and report chemical, biological, 
radiological agents in tissue, food, or environmental samples that 
cause threats to the public's health.
Outcome 3A: Laboratory Testing
    Potential exposure and disease will be identified rapidly, reported 
to multiple locations immediately, and accurately confirmed to ensure 
appropriate preventive or curative countermeasures are implemented. 
Additionally, public health laboratory testing is coordinated with law 
enforcement and other appropriate agencies.
    Required Critical Tasks: (1) Increase and maintain relevant 
laboratory support for identification of biological, chemical, 
radiological and nuclear agents in clinical (human and animal), 
environmental, and food specimens 20, 21, 22
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    \20\ CDC: Emergency Preparedness and Response--Lab Issues. 
http://www.bt.cdc.gov/labissues/.
    \21\ National Lab Training Network http://www.phppo.cdc.gov/nltn/default.aspx.
    \22\ Sentinel (Level A) lab protocols http://www.asm.org/Policy/index.asp?bid=6342.
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    (a) Develop and maintain a database of all sentinel (biological)/
Level Three (chemical) labs in the jurisdiction using the CDC-endorsed 
definition that includes:
     Name.
     Contact information.
     BioSafety Level.
     Whether they are a health alert network partner.
     Certification status.
     Capability to rule-out Category A and B bioterrorism 
agents per State-developed proficiency testing or College of American 
Pathologists (CAP) \23\ bioterrorism module proficiency testing.
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    \23\ College of American Pathologists (CAP) http://www.cap.org/apps.cap.portal?_nfpb=rue&_pageLabel=home_page.
---------------------------------------------------------------------------

     Names and contact information for in-State and out-of-
State reference labs used by each of the jurisdiction's sentinel/Level 
Three labs.
    (b) Test the competency of a chemical terrorism laboratory 
coordinator and bioterrorism laboratory coordinator to advise on proper 
collection, packaging, labeling, shipping, and chain of custody of 
blood, urine and other clinical specimens.
    (c) Test the ability of sentinel/Level Three labs to send specimens 
to a confirmatory Laboratory Response Network (LRN) laboratory on 
nights, weekends, and holidays.
    (d) Package, label, ship, coordinate routing, and maintain chain-
of-custody of clinical, environmental, and food specimens/samples to 
laboratories that

[[Page 30458]]

can test for agents used in biological, chemical, and radiological 
terrorism.
    (e) Continue to develop or enhance operational plans and protocols 
that include:
     Specimen/samples transport and handling.
     Worker safety.
     Appropriate Biosafety Level (BSL) working conditions for 
each threat agent.
     Staffing and training of personnel.
     Quality control and assurance.
     Adherence to laboratory methods and protocols.
     Proficiency testing to include routine practicing of LRN 
validated assays as well as participation in the LRN's proficiency 
testing program electronically through the LRN Web site.
     Threat assessment in collaboration with local law 
enforcement and Federal Bureau of Investigations (FBI) to include 
screening for radiological, explosive and chemical risk of samples.
     Intake and testing prioritization.
     Secure storage of critical agents.
     Appropriate levels of supplies and equipment needed to 
respond to bioterrorism events with a strong emphasis on surge 
capacities needed to effectively respond to a bioterrorism incident.
    (f) Ensure the availability of at least one operational Biosafety 
Level Three (BSL-3) facility in your jurisdiction for testing for 
biological agents. If not immediately possible, BSL-3 practices, as 
outlined in the CDC-NIH publication ``Biosafety in Microbiological and 
Biomedical Laboratories, 4th Edition'' (BMBL), should be used (see 
MACROBUTTON HtmlResAnchor www.cdc.gov/od/ohs) or formal arrangements 
(i.e., Memorandum of Understanding (MOU)) should be established with a 
neighboring jurisdiction to provide this capacity.
    (g) Ensure that laboratory registration, operations, safety, and 
security are consistent with both the minimum requirements set forth in 
Select Agent Regulation (42 CFR part 73) and the U.S. Patriot Act of 
2001 (Pub. L. 107-56) and subsequent updates.
    (h) Ensure at least one public health laboratory in your 
jurisdiction has the appropriate instrumentation and appropriately 
trained staff to perform CDC-developed and validated real-time rapid 
assays for nucleic acid amplification (Polymerase Chain Reaction, PCR) 
and antigen detection (Time-Resolved Fluorescence, TRF).
    (i) Ensure the capacity for LRN-validated testing and reporting of 
Variola major, Vaccinia and Varicella viruses in human and 
environmental samples either in the public health laboratory or through 
agreements with other LRN laboratories.
    (2) Increase the exchange of laboratory testing orders and results.
    (a) Monitor compliance with public health agency (or public health 
agency lab) policy on timeliness of reporting results from confirmatory 
LRN lab back to sending sentinel/Level Three lab (i.e., feedback and 
linking of results to relevant public health data) with a copy to CDC 
as appropriate.
    (b) Comply with PHIN Preparedness Functional Areas Connecting 
Laboratory Systems and Outbreak Management to enable: (a) the linkage 
of laboratory orders and results from sentinel/Level Three and 
confirmatory LRN labs to relevant public health (epi) data and (b) 
maintenance of chain of custody.
    Measures: (1) Percentage of LRN biologic and chemical laboratories 
that demonstrate proficiency in:
     Confirming Category A agents in human clinical specimens 
(proficiency in accordance with CDC's Laboratory Response Network (LRN) 
proficiency testing program)
     Confirming Category A agents in food samples.
     Confirming the identity of and further characterizing 
(e.g., assessment of toxin production, serotyping, phage typing, and 
DNA ``fingerprinting'') Salmonella (including Salmonella Typhi), 
Shigella species, Shiga toxin-producing E. coli and pathogenic vibrios 
isolated from FOOD samples.
     Confirming Category A agents in environmental samples.
     Confirming chemical agents in human clinical specimens.
    (2) Time following initiation of an epidemiological investigation 
to begin obtaining or directing the acquisition of samples/specimens 
for laboratory analysis to support epidemiological investigation, as 
needed (Target: 60 minutes).
    (3) For clinical specimens, environmental samples and samples of 
potentially contaminated food collected by public health personnel in 
an emergency, time to:
     Send clinical specimens to a reference laboratory within 
the LRN when an incident may involve an infectious biological agent 
(Target: within 60 minutes of collection).
     Send clinical specimens to the CDC or CDC-designated State 
laboratory when an incident may involve a hazardous chemical agent 
(Target: within 180 minutes of collection).
     Send environmental samples to a reference laboratory 
within the LRN when the incident requires biological or chemical 
characterization of an incident scene (Target: within 60 minutes of 
collection).
     Send potentially contaminated food samples to a reference 
laboratory within the LRN or coordinate with Food Emergency Response 
Network (FERN), as appropriate, when the incident might involve food 
contaminated with a biological or chemical agent \24\ (Target: within 
60 minutes of collection).
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    \24\ Abrin, Acids and bases, Aconites, actinomycin type protein 
synthesis inhibitors, Adamsite, Aflatoxin, amanitin toxin (Amanita 
phalloides), Anatoxin B, Any potent carcinogens or teratogens (e.g. 
benzo[a]pyrene, accutane), Arsenic compounds, Azides, Barium salts, 
Cancer chemotherapeutic agents, Carbamates, cardioactive glycosides, 
Colchicine, Copper and arseno-copper compounds, Corrosives 
(permanganate, chromate, etc), Cyanides, Cycloheximide, Digoxin, 
Dioxin, Ergot alkaloids, Ethylene glycol, Fluoroacetate salts, 
Hallucinogens (PCP, LSD, myristosin, others), Ipecac/emetine, Lead 
compounds, Mercury compounds, Methanol, Microcystins, Nicotine, 
Organochlorine pesticides, Organophosphate pesticides, Paraquat, 
Pentachlorophenol and dinitrophenols, Ricin, Rotenone, Sodium 
nitrite, Strychnine, Superwarfarins, Tetramine, Tetrodotoxin, 
Thallium salts.
---------------------------------------------------------------------------

CDC Preparedness Goal 4: Detect/Report

    Improve the timeliness and accuracy of information regarding 
threats to the public's health as reported by clinicians and through 
electronic early event detection in real time to those who need to 
know.
Outcome 4A: Health Intelligence Integration and Analysis
    To produce timely, accurate, and actionable health intelligence or 
information in support of prevention, awareness, deterrence, response, 
and continuity planning operations.
    Required Critical Tasks: (1) Increase source and scope of health 
information.
    (2) Increase speed of evaluating, integrating, analyzing for, and 
interpreting health data to detect aberrations in normal data patterns.
    (3) Improve integration of existing health information systems, 
analysis, and distribution of information consistent with PHIN 
Preparedness Functional Area Early Event Detection, including those 
systems used for identification and tracking of zoonotic diseases.
    (4) Improve effectiveness of health intelligence and surveillance 
activities \25\.
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    \25\ Updated Guidelines for Evaluating Public Health 
Surveillance Systems http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013A1.htm.
---------------------------------------------------------------------------

    (5) Improve reporting of suspicious symptoms, illnesses, or 
circumstances to the public health agency.
    (a) Maintain a system for 24/7/365 reporting cases, suspect cases, 
or unusual events consistent with PHIN Preparedness Functional Area 
Early Event Detection.

[[Page 30459]]

    (6) Increase number of local sites using BioSense for early event 
detection.
    Measures: (1) Percent of local public health agencies using 
BioSense or other integrated early event detection systems.
    (2) Percent of desired non-traditional public health data sources 
that are currently part of early event detection system (e.g., HMO 
encounter data, over-the-counter pharmaceutical sales).

CDC Preparedness Goal 5: Investigate

    Decrease the time to identify causes, risk factors, and appropriate 
interventions for those affected by threats to the public's health.
Outcome 5A: Public Health Epidemiological Investigation
    Potential exposure and disease will be identified rapidly, reported 
to multiple locations immediately, investigated promptly, and 
accurately confirmed to ensure appropriate preventive or curative 
countermeasures are implemented. Additionally, public health 
epidemiological investigation is coordinated with law enforcement and 
other appropriate agencies including tribal and federal agencies.
    Required Critical Tasks:
    (1) Increase the use of efficient surveillance and information 
systems to facilitate early detection and mitigation of disease.
    (2) Conduct epidemiological investigations and surveys as 
surveillance reports warrant.
    (3) Coordinate and direct public health surveillance and testing, 
immunizations, prophylaxis, isolation or quarantine for biological, 
chemical, nuclear, radiological, agricultural, and food threats.
    (4) Have or have access to a system for an outbreak management 
system that captures data related to cases, contacts, investigation, 
exposures, relationships and other relevant parameters compliant with 
PHIN preparedness functional area Outbreak Management.
    Measures: (1) Time to initiate epidemiologic investigation after 
initial detection of a deviation from normal disease/condition patterns 
or a positive ``hit'' from an early detection device (Target: 3 hours 
from initial detection).
    (2) Time from initial detection of a deviation from normal disease/
condition patterns, initial report, or positive ``hit'' from an early 
detection device to initiation of intervention (e.g., dissemination of 
protective action guidance, treatment)

CDC Preparedness Goal 6: Control

    Decrease the time needed to provide countermeasures and health 
guidance to those affected by threats to the public's health.
Outcome 6A: Emergency Response Communications
    A continuous flow of critical information is maintained among 
emergency responders, command posts, agencies, and government officials 
for the duration of the emergency response operation.
    Required Critical Tasks: (1) Decrease the time needed to 
communicate internal incident response information.
    (a) Develop and maintain a system to collect, manage, and 
coordinate information about the event and response activities 
including assignment of tasks, resource allocation, status of task 
performance, and barriers to task completion.
    (2) Establish and maintain response communications network.
    (3) Implement communications interoperability plans and protocols.
    (4) Ensure communications capability using a redundant system that 
does not rely on the same communications infrastructure as the primary 
system.
    (5) Increase the number of public health experts to support 
Incident Command (IC) or Unified Command (UC).
    (6) Increase the use of tools to provide telecommunication and 
information technology to support public health response.
    (a) Ensure that the public health agency has ``essential service'' 
designation from their telephone provider and cellular telephone 
provider.\26\
---------------------------------------------------------------------------

    \26\ Government Emergency Telecommunications Service. Accessed 
March 8, 2005 http://gets.ncs.gov/.
---------------------------------------------------------------------------

    (b) Ensure that the public health agency has priority restoration 
designation from their telephone provider.
    (7) Have or have access to a system for 24/7/365 notification/
alerting of the public health emergency response system that can reach 
at least 90% of key stakeholders and is compliant with PHIN 
Preparedness Functional Area Partner Communications and Alerting.
    Measures: (1) Percent of key stakeholders that are notified/alerted 
using the public health emergency communication system (Target: 90%).
    (2) Time to obtain message approval and authorization for 
distribution of public health and medical information to clinicians and 
other responders (Target: 60 minutes from confirmation of health 
threat).
    (3) Percent of key stakeholders that are notified/alerted when 
electricity, telephones, cellular telephone service, and Internet 
service are unavailable.
    (4) Percent of Level Three/Sentinel labs that can reach a 
designated contact at an LRN laboratory 24/7/365 by phone within 15 
minutes OR radio/satellite phone within 5 minutes.
Outcome 6B: Emergency Public Information
    The public is informed quickly and accurately, and updated 
consistently, about threats to their health, safety, and property and 
what protective measures they should take.
    Required Critical Tasks: (1) Decrease time needed to provide 
specific incident information to the affected public, including 
populations with special needs such as non-English speaking persons, 
migrant workers, as well as those with disabilities, medical 
conditions, or other special health care needs, requiring 
attention.27 28
---------------------------------------------------------------------------

    \27\ CDC Crisis and Emergency Risk Communication Manual http://www.orau.gov/cdcynergy/erc/content/activeinformation/resources/CERC_course_materials.htm.
    \28\ Emergency Preparedness Initiative Guide on the Special 
Needs of People with Disabilities for Emergency Managers, Planners, 
and First Responders http://www.nod.org/resources/pdfs/epiguide2005.pdf.
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    (a) Advise public to be alert for clinical symptoms consistent with 
attack agent.
    (b) Disseminate health and safety information to the public.
    (c) Ensure that the Agency's public information line can 
simultaneously handle calls from at least 1% of the jurisdiction's 
population.
    (2) Improve the coordination, management and dissemination of 
public information.
    (3) Decrease the time and increase the coordination between 
responders in issuing messages to those that are experiencing 
psychosocial consequences to an event.
    (4) Increase the frequency of emergency media briefings in 
conjunction with response partners via the jurisdiction's Joint 
Information Center (JIC), if applicable.
    (5) Decrease time needed to issue public warnings, instructions, 
and information updates in conjunction with response partners.
    (6) Decrease time needed to disseminate domestic and international 
travel advisories.
    (7) Decrease the time needed to provide accurate and relevant 
public health and medical information to clinicians and other 
responders.
    Measures: (1) Time to issue information to the public that 
emphatically acknowledges the event;

[[Page 30460]]

explains and informs the public about risk; provides emergency courses 
of action; commits to continued communication (Target: 60 minutes from 
activation of the response plan).
Outcome 6C: Worker Health Safety
    No further harm to any first responder, hospital staff member, or 
other relief provider due to preventable exposure to secondary trauma, 
chemical release, infectious disease, radiation, or physical and 
emotional stress after the initial event or during decontamination and 
event follow-up.
    Required Critical Tasks: (1) Increase the availability of worker 
crisis counseling and mental health and substance abuse behavioral 
health support.
    (2) Increase compliance with public health personnel health and 
safety requirements.
    (a) Provide Personal Protection Equipment (PPE) based upon hazard 
analysis and risk assessment.
    (b) Develop management guidelines and incident health and safety 
plans for public health responders (e.g.; heat stress, rest cycles, 
PPE).
    (c) Provide technical advice on worker health and safety for IC and 
UC.
    (3) Increase the number of public health responders that receive 
hazardous material training.
    Measures: (1) Percent of public health responders that have been 
trained and cleared to use PPE appropriate for their response roles
Outcome 6D: Isolation and Quarantine
    Successful separation, restriction of movement, and health 
monitoring of individuals and groups who are ill, exposed, or likely to 
be exposed, in order to stop the spread of a contagious disease 
outbreak. Legal authority for these measures is clearly defined and 
communicated to the public. Logistical support is provided to maintain 
measures until danger of contagion has elapsed.
    Required Critical Tasks: (1) Assure legal authority to isolate and/
or quarantine individuals, groups, facilities, animals and food 
products 29 30 31 32
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    \29\ The Model State Emergency Health Powers Act. The Center for 
Law and the Public's Health at Georgetown and Johns Hopkins 
Universities. December 21, 2001. http://www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf.
    \30\ Public Health Emergency Legal Preparedness Checklist: 
Interjurisdictional Legal Coordination for Public Health Emergency 
Preparedness. The Center for Law and the Public's Health at 
Georgetown and Johns Hopkins Universities. December 2004. http://www.publichealthlaw.net/Resources/ResourcesPDFs/Checklist%201.pdf.
    \31\ Public Health Emergency Legal Preparedness Checklist: Local 
Government Public Health Emergency Legal Preparedness and Response. 
The Center for Law and the Public's Health at Georgetown and Johns 
Hopkins Universities. December 2004. Accessed January 14, 2005. 
http://www.publichealthlaw.net/Resources/ResourcesPDFs/Checklist%202.pdf.
    \32\ Public Health Emergency Legal Preparedness Checklist: Civil 
Legal Liability and Public Health Emergencies. The Center for Law 
and the Public's Health at Georgetown and Johns Hopkins 
Universities. December 2004. Accessed January 14, 2005. http://www.publichealthlaw.net/Resources/ResourcesPDFs/Checklist%203.pdf.
---------------------------------------------------------------------------

    (2) Coordinate quarantine activation and enforcement with public 
safety and law enforcement.
    (3) Improve monitoring of adverse treatment reactions among those 
who have received medical countermeasures and have been isolated or 
quarantined.
    (4) Coordinate public health and medical services among those who 
have been isolated or quarantined.
    (5) Improve comprehensive stress management strategies, programs, 
and crisis response teams among those who have been isolated or 
quarantined.
    (6) Direct and control public information releases about those who 
have been isolated or quarantined.
    (7) Decrease time needed to disseminate health and safety 
information to the public regarding risk and protective actions.
    (8) Have or have access to a system to collect, manage, and 
coordinate information about isolation and quarantine, compliant with 
PHIN Preparedness Functional Area Countermeasure and Response 
Administration.
    Measures: (1) Percentage of isolation orders that are violated.
    (2) Percentage of quarantine orders that are violated.
Outcome 6E: Mass Prophylaxis and Vaccination
    Appropriate prophylaxis and vaccination strategies are implemented 
in a timely manner upon the onset of an event, with an emphasis on the 
prevention, treatment, and containment of the disease. Prophylaxis and 
vaccination campaigns are integrated with corresponding public 
information strategies.
    Required Critical Tasks: (1) Decrease the time needed to dispense 
mass therapeutics and/or vaccines.
    (a) Implement local, (tribal, where appropriate), regional and 
State prophylaxis protocols and plans.
    (b) Achieve and maintain the Strategic National Stockpile (SNS) 
preparedness functions described in the current version of the 
Strategic National Stockpile guide for planners.
    (c) Ensure that smallpox vaccination can be administered to all 
known or suspected contacts of cases within 3 days and, if indicated, 
to the entire jurisdiction within 10 days.\33\
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    \33\ Smallpox Response Planning http://www.bt.cdc.gov/agent/smallpox/response-plan/index.asp.
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    (d) Have or have access to a system to collect, manage, and 
coordinate information about the administration of countermeasures, 
including isolation and quarantine, compliant with PHIN Preparedness 
Functional Area Countermeasure and Response Administration.
    (2) Decrease time to provide prophylactic protection and/or 
immunizations to all responders, including non-governmental personnel 
supporting relief efforts.
    (3) Decrease the time needed to release information to the public 
regarding dispensing of medical countermeasures via the jurisdiction's 
JIC (if JIC activation is needed).
    Measures: (1) Current rating on the SNS (or CRI for participating 
cities) preparedness functions based on the CDC SNS assessment tool.
    (2) Time to provide prophylactic protection and/or immunizations to 
all responders, including non-governmental personnel supporting relief 
efforts.
Outcome 6F: Medical and Public Health Surge
    Cases are investigated by public health to reasonably minimize 
morbidity and mortality rates, even when the numbers of casualties 
exceed the limits of the normal medical infrastructure for an affected 
community.
    Required Critical Tasks: (1) Improve tracking of cases, exposures, 
adverse events, and patient disposition.
    (a) Have or have access to a system that provides these 
capabilities consistent with PHIN Preparedness Functional Area Outbreak 
Management.
    (2) Decrease the time needed to execute medical and public health 
mutual aid agreements.
    (3) Improve coordination public health and medical services.
    (a) Ensure epidemiology response capacity consistent with hospital 
preparedness guidelines for surge capacity.
    (b) Participate in the development of plans, procedures, and 
protocols to identify and manage local, tribal, and regional public 
health and hospital surge capacity.
    (4) Increase the proficiency of volunteers and staff performing 
collateral duties in performing epidemiology investigation and mass 
prophylaxis support tasks.

[[Page 30461]]

    (5) Increase the number of physicians and other providers with 
experience and/or skills in the diagnosis and treatment of infectious, 
chemical, or radiological diseases or conditions possibly resulting 
from a terrorism-associated event who may serve as consultants during a 
public health emergency.
    Measures: (1) Percent of volunteers needed to support epidemiologic 
investigation that have been trained.
    (2) Percent of volunteers needed to support mass prophylaxis that 
have been trained.

CDC Preparedness Goal 7: Recover

    Decrease the time needed to restore health services and 
environmental safety to pre-event levels.
Outcome 7A: Economic and Community Recovery
    Recovery and relief plans are implemented and coordinated with the 
nonprofit sector and nongovernmental relief organizations and with all 
levels of government. Economic impact is estimated. Priorities are set 
for recovery activities. Business disruption is minimized. Individuals 
and families are provided with appropriate levels and types of relief 
with minimal delay.
    Required Critical Tasks: (1) Conduct post-event planning and 
operations to restore general public health services.
    (2) Decrease the time needed to issue interim guidance on risk and 
protective actions by monitoring air, water, food, and soil quality, 
vector control, and environmental decontamination, in conjunction with 
response partners.
    Measures: (1) Time needed to issue interim guidance on risk and 
protective actions during recovery.

CDC Preparedness Goal 8: Recover

    Increase the long-term follow-up provided to those affected by 
threats to the public's health.
    Required Critical Tasks: (1) Develop and coordinate plans for long-
term tracking of those affected by the event.
    (2) Improve systems to track cases, exposures, and adverse event 
reports.
    (3) Increase the availability of information resources and messages 
to foster community's return to self-sufficiency.
    Measures: (1) Percent of cases and exposed successfully tracked 
from identification through disposition to enable short- and long-term 
follow-up.

CDC Preparedness Goal 9: Improve

    Decrease the time needed to implement recommendations from after-
action reports following threats to the public's health.
    Required Critical Tasks: (1) Exercise plans to test horizontal and 
vertical integration with response partners at the federal, State, 
tribal, and local level.
    (2) Decrease the time needed to identify deficiencies in personnel, 
training, equipment, and organizational structure, for areas requiring 
corrective actions.
    (3) Decrease the time needed to implement corrective actions.
    (4) Decrease the time needed to re-test areas requiring corrective 
action.
    Measures: (1) Time needed to identify deficiencies in personnel, 
training, equipment, and organizational structure, for areas requiring 
corrective actions (Target: 72 hours after a real event or exercise).
    (2) Time needed to implement corrective actions and integrate 
changes into plans (Target: 60 days after identification of 
deficiency).
    (3) Time needed to re-test areas requiring corrective action 
(Target: 90 days after identification of deficiency).
    International Cross-Border Early Warning Infectious Disease 
Surveillance (EWIDS) Project (Selected awardees): As in the previous 
two years, the Office of Public Health Emergency Preparedness within 
the Office of the Secretary (HHS) is continuing to provide funds for 
early detection, identification, reporting and investigation of 
infectious disease outbreaks (both bioterrorist-triggered and naturally 
occurring) at our borders with Canada and Mexico.
    This year, in recognition of the fact that States sharing a common 
border with a neighboring Canadian province or a Mexican State have 
some natural affinities and common challenges with respect to planning 
and implementing cross-border surveillance and epidemiological 
activities, the Early Warning Infectious Disease Surveillance (EWIDS) 
program is offering the opportunity for any two or more neighboring 
States to submit a joint proposal. This approach, which is strictly 
voluntary, may be most appealing to States that have already undertaken 
joint planning activities either because they share a common border 
with a Canadian province or Mexican State or because they wish to 
leverage their capabilities and resources as well as EWIDS funding. 
Although EWIDS funds would still be allocated on a State-by-State 
basis, this approach will capitalize on the synergies created by 
activities that a number of Border States have initiated.
    States interested in this opportunity must jointly develop a common 
EWIDS proposal that would be broader in scope than what each State 
could submit on its own. Within the proposal, each of the participating 
States must clearly identify the specific activities for which it would 
be individually responsible and accountable. For example, a coalition 
of four States could each submit the same proposal that they had 
jointly prepared. In this common proposal, each State would clearly 
identify a set of activities for which it would assume lead 
responsibility. There would be minimal duplication of effort among the 
States and, as a result of the synergy and resource leveraging; all 
four States would be able to benefit from each other's efforts. States 
that wish to take advantage of this opportunity must each submit a copy 
of the common proposal that was jointly developed. However, each State 
should submit its own budget reflecting not only the specific 
activities for which it would be responsible but also the amount of its 
EWIDS funds.
    In accordance with their authorizing legislation, EWIDS funds are 
intended strictly for the support of surveillance and epidemiology-
related activities to address bioterrorism and other outbreaks of 
infectious diseases. EWIDS funds are not to be used to support non-
infectious disease surveillance or broader border activities in 
terrorism preparedness. Consequently, these funds may not be used to 
finance any chemical, radiological, nuclear or other emergency 
preparedness activities. Moreover, EWIDS funds cannot be used to 
supplant surveillance and/or epidemiological activities already 
supported by other funding sources. Proposed EWIDS activities must be 
consistent with the laws and regulations of the United States and in 
harmony with existing binational agreements and guidelines.
    The EWIDS guidance can be found in Appendix 2. In substance, this 
guidance is consistent with the guidance issued last year. However, the 
structure has been modified to conform to the format that has been 
established for the broader CDC public health emergency preparedness 
cooperative agreement. The DSLR MIS template provides space for 
responses to the EWIDS guidance for eligible applicants. These 
activities will be updated in the MIS as part of regular progress 
reports.
    Collaboration across State, Tribal, Military, and International 
Borders: Applicants may use cooperative agreement funds to conduct 
necessary activities in support of cross jurisdictional planning, 
coordination, communications, program development, and exercises to 
enhance health security in the United States. In a jurisdiction that 
shares State, tribal, military installation or international borders, 
the

[[Page 30462]]

public health agency may use cooperative funds to jointly participate 
in disaster planning meetings (e.g., city-State-tribal collaboration or 
city-State-province/State collaboration, etc.); exchange health alert 
messages; exchange epidemiological data; provide mutual aid; conduct 
collaborative drills, exercises, and evaluate disaster scenarios. 
Applicants may propose relevant activities related to meeting the 
goals, outcomes, tasks or measures as listed above. Proposed activities 
must be consistent with national laws and regulations of the United 
States and in harmony with any pre-existing agreements and guidelines.
    CDC Responsibilities: 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:
    -- Technical Assistance

--Integration/Coordination of federal funding for preparedness.
--Subject matter expertise on preparedness activities (e.g., laboratory 
testing, epidemiology and surveillance).
--Identification of promising practices.
--Development of performance goals and standards.
--Guidance on, and in some cases, conduct, of drills and exercises.

     Monitoring of performance.
     Monitoring adherence to all relevant PHS, HHS, CDC rules, 
regulations and policies regarding cooperative agreements.
     Facilitate tribal, military, international, DHS and other 
federal agency efforts into national public health preparedness efforts 
and coordinate the public health preparedness responsibilities of the 
NRP where CDC is the designated lead agency.

II. Award Information

    Type of Award: Cooperative Agreement. CDC involvement in this 
program is listed in the Activities Section above.
    Approximate Total Funding: Approximately $862 million of fiscal 
year (FY) 2005 funds are available to fund budget year one of this 
agreement (August 31, 2005-August 30, 2006) as follows:

$809,956,000: Base funds available for all awardees.
$40,181,000: Urban Area focused funding (to include maintenance of CRI 
activities in previous 21 awardees) as described in Appendix 3.
$5,440,000: Early Warning Infectious Disease Surveillance (EWIDS) funds 
available to select awardees (see Appendix 2).
$7,200,000: Chemical Laboratories funds available to select awardees 
(see Appendix 1).

    Each State awardee and Puerto Rico will receive a base amount of 
$3.91 million, plus an amount equal to its proportional share of the 
national population as reflected in the U.S. Census estimates for July 
1, 2003. The District of Columbia will receive a base amount of $10 
million and New York City, Los Angles County, and Chicago will continue 
to receive a base amount of $5 million. Due to their demographic 
characteristics and unique programmatic needs, American Samoa, the U.S. 
Virgin Islands, Guam, the Northern Mariana Islands, the Marshall 
Islands, the Federated States of Micronesia and Palau will receive 
$391,000 per awardee plus a population-based allocation.
    In addition to the base amount, approximately $7,200,000 is 
available for Level One chemical laboratory capacity. Only Level One 
chemical laboratory activities may be supported with these funds. Level 
Two and Level Three activities should be supported by base funding.
    CDC may increase the number of Level One chemical laboratories from 
5 to 10 over the next five years. However, for budget year one, 
applicants may only apply for Level One status using their existing 
funds. Applicants who wish to apply for Level One funding must have: 
(a) Completed all current Level Two trainings (b) successfully 
completed method evaluation (c) successfully completed at least one 
proficiency test for each method, and (d) be in ``qualified'' status. 
New applicants for Level One chemical laboratory capacity should refer 
to Appendix 1.
    Beginning in FY06, CDC envisions that allocation of funds among 
eligible entities and among preparedness priorities will be influenced 
increasingly by considerations of (1) the risks and likely medical 
consequences of various forms of terrorism and other public health 
emergencies when stratified across States and localities, (2) awardees' 
performance in enhancing public health and healthcare emergency 
preparedness, and (3) the relative merits of applicants' proposed 
initiatives toward selected preparedness priorities as determined by 
national competition.
    Grantees that fail to comply with the terms and conditions of this 
cooperative agreement, including responsiveness to program guidance, 
measured progress in meeting the performance measures, and adequate 
stewardship of these federal funds, may be subject to an administrative 
enforcement action. Administrative enforcement actions may include 
temporarily withholding cash payments or restricting a grantee's 
ability to draw down funds from the Payment Management System until the 
grantee has taken corrective action.
    In circumstances where the grantee is unwilling or unable to take 
corrective action, and in other appropriate circumstances, CDC may 
withhold (deny) a continuation award and require that the grantee repay 
any disallowed costs to the federal government from non-federal funds.
    In all instances, grantees are reminded that continuation of 
funding under this cooperative agreement is additionally contingent 
upon continued availability of funds.
    Anticipated Award Date: August 31, 2005.
    Budget Period Length: 12 months (August 31, 2005-August 30, 2006).
    Project Period Length: Year one of a five year project period.
    Throughout the project period, CDC's commitment to continuation of 
awards will be conditioned on the availability of funds, evidence of 
satisfactory progress by the recipient (as documented in required 
reports), and the determination that continued funding is in the best 
interest of the Federal Government.

III. Eligibility Information

Eligible Applicants

    Eligibility is limited to those currently funded through 
cooperative agreement 99051 and authorized under 42 U.S.C. 247d-3.

Cost Sharing or Matching

    Matching funds are not required for this program.

IV. Application and Submission Information

IV.1. Electronic Applications Via the DSLR MIS System Are Due on July 
13, 2005 11:59 PM EST

    See below for more details on accessing and submitting via the DSLR 
MIS system.

IV.2. Content and Form of Submission

    CDC will provide an Internet-based system for submitting 
applications, including narrative and budget, electronically. This 
system will also enable applicants to complete most required forms 
electronically, which can then be signed and uploaded into the system. 
Applicants are required to use

[[Page 30463]]

this system in lieu of paper-based applications. Under separate cover, 
CDC will provide detailed instructions on obtaining a digital 
certificate to access the CDC Web portal https://sdn.cdc.gov and use 
the electronic application system. Any questions or problems concerning 
use of the Internet-based application should be directed to your 
project officer.
Cooperative Agreement Forms
     All forms will be available from the Secure Data Network 
(https://sdn.cdc.gov). In addition, Form PHS 5161-1 is available from 
the CDC Procurement and Grants office at the following Internet 
address: http://www.cdc.gov/od/pgo/forminfo.htm.
     Application budget preparation guidance is also available 
at: http://www.cdc.gov/od/pgo/funding/budgetguide2004.htm.
     Forms SF-424 (Cover page) and SF-424B (Assurances) are 
available from the DSLR MIS application site and the Office of 
Management and Budget: http://www.whitehouse.gov/omb/grants/grants 
forms.html.
     Form SF-424A (Budget Information) will be generated and 
pre-populated automatically from the DSLR MIS budget application site. 
A blank form SF-424A can also be obtained at the following Internet 
address: http://www.whitehouse.gov/omb/grants/grantsforms.html.
    Applications must include a projection of the amount of FY2004 
funds that will be unobligated at the end of budget period five (i.e., 
on August 30, 2005) and report this estimate for each focus area on a 
separate interim FSR form. (See Unobligated Funds, under C. 
Availability of Funds.)
    International Cross-Border Early Warning Infectious Disease 
Surveillance Initiatives (Selected awardees): The DSLR MIS template 
provides space for responses to the International Cross-Border Early 
Warning Infectious Disease Surveillance (EWIDS) initiatives for 
eligible applicants. These cross-border issues reflect the broader 
Departmental goals for cross-border public health security and focus on 
surveillance of infectious disease outbreaks (both bioterrorist-
triggered and naturally occurring) at our borders with Canada and 
Mexico. These activities will be updated in the MIS as part of regular 
progress reports.

IV.3. Submission

    To submit the narrative and budget sections of the application 
electronically, follow the online instructions. The MIS will notify CDC 
that the application is ready for review and prevent any further 
changes to the application by the applicant, pending any 
recommendations from the project officer. The electronic submission 
process must be completed by the application deadline (11:59 p.m. July 
13, 2005 e.s.t.).
Dun and Bradstreet Data Universal Numbering System
    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 http://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.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 for research
     Reimbursement of pre-award costs is not allowed
    Use of Funds: Budget year one will begin on August 31, 2005 and 
extend through August 30, 2006. However, monies may be re-directed 
between/among goals during the year under the following conditions: (1) 
Awardees must notify the CDC Grants Office, and (2) copy their CDC 
Project Officer for all funding re-directions. Prior approval is 
required for all funding re-directions for sums greater than 25% of the 
total budget for BY1, or $250,000 (whichever is less).
    Vehicles: Cooperative agreement funds under this program may not be 
used to purchase vehicles or supplant any current State or local 
expenditures.
    Supplantation: The Public Health Service Act, Title I, Section 
319(c) specifically States: ``SUPPLEMENT NOT SUPPLANT.--Funds 
appropriated under this section shall be used to supplement and not 
supplant other Federal, State, and local public funds provided for 
activities under this section.'' Therefore, the law strictly and 
expressly prohibits supplantation.
    Unobligated Funds: Please submit interim Financial Status Reports 
(FSRs) estimating the unobligated balance of funds as of August 30, 
2005 with the application. Please provide a summary and individual 
Focus Area FSRs with your application. Send the FSRs to CDC's 
Procurement and Grants Office (PGO). Estimated unobligated funds should 
also be reported in Section A--Budget Summary of Standard Form (SF) 
424A.
Direct Assistance
    Direct Assistance is a financial assistance mechanism, authorized 
by statute, where by goods or services are provided to recipients in 
lieu of cash. Direct assistance generally involves the assignment of 
Federal personnel, the provision of equipment, or the use of federally 
negotiated contracts. Applicants must discuss all requests for direct 
assistance with the Division of State and Local Readiness project 
officer prior to submitting an application.
    Funding awarded through direct assistance is part of the total 
award, not an addition to the award. Direct assistance funds MUST be 
used in the Federal Fiscal Year (FY) in which they are appropriated. 
Personnel funded through direct assistance may be split between two 
federal fiscal years. For example, a career epidemiology field officer 
hired through direct assistance may be funded from August 31-September 
30, 2005, with FY05 funding provided with this award and from October 
1-August 30, 2006, with FY06 funding.
    Requests for equipment to be purchased through direct assistance:

Direct Assistance (Contracts and Task Orders)

    a. To obligate Direct Assistance funds in an amount of less than 
$100,000,

[[Page 30464]]

each applicant must submit a Performance-based Statement of Work for 
each contract or task order supported by Direct Assistance Funding.
    b. To obligate Direct Assistance funds in an amount greater than 
$100,000, but less than $500,000, each applicant must submit the 
following items for each contract or task order supported by Direct 
Assistance funding:
     Performance-based Statement of Work: The Division of State 
and Local Readiness maintains a variety of Statement of work templates 
available to any applicant upon request. Although performance-based 
Statements of work are tailored to the specifics of each project, it 
should contain these common elements:

--Background--general, non-technical terms and explains why the 
acquisition is required; its relationship to past, current, or future 
projects; summary of statutory and applicable program authorities and 
regulations;
--Project Objective--a succinct Statement of the purpose of the 
acquisition; outlining expected results; and anticipated benefits.
--Scope of Work--an overall, non-technical description of the work to 
be performed; expands upon project objectives, while avoiding going 
into all of the details required. Identifies and summarizes various 
phases of the projects; define limits in terms of specific objectives, 
time, special provisions, or limitations. The Scope of Work must be 
consistent with the detailed requirements.
--Detailed Technical Requirements--Clearly and precisely describe the 
work in terms of what is to be the required output rather than either 
how the work will be accomplished or the number of hours to be 
provided. Provide requirements that do not limit a contractor to 
providing a specific product or service, rather the contractor is 
provided with the objectives to be accomplished, the end goal, or the 
desired achievement, including all pertinent information needed for a 
contractor or vendor to submit a proposal. As the contractor is, being 
hired based upon their expertise and ability to perform, the 
performance-oriented requirements Statement of work places maximum 
responsibility for performance on the contractor. Identify any 
budgetary, environmental, or other constraints. Clearly and firmly 
define and the criteria for acceptance for all end supplies or 
deliverables associated with the contract.
--Reporting Schedule--Specify how the contractor shows that it has 
fulfilled it obligations. Clearly identify the performance-based 
criteria to be used by the Government for acceptance. Define the 
mechanism by which the contractor can demonstrate progress and 
compliance with the requirements, and present any problems it may have 
encountered. The preparation and submission of technical and financial 
progress reports on a timely basis reflect on a contractor's efforts to 
certify satisfactory progress. Specific requirements to submit periodic 
financial and technical progress reports, to include format and 
templates will be provided by the Division of State and Local 
Readiness.
--Special Consideration--Include all and any information that does not 
fit into one of the other sections of the Statement of work.

--References--Provide a detailed list and description of any studies, 
reports, and other data referred to elsewhere in the Statement of work.
     Independent Government Cost Estimate: The independent 
government cost estimate is the government's estimate of the costs 
associated with a particular contract project. The cost estimate 
determines the amount of money that should be set aside for funding the 
project and the cost estimate serves as a standard to which the 
offeror's costs or price proposals will be compared when the offeror's 
proposal is evaluated. The cost estimate includes direct costs (i.e., 
labor, material, travel, per diem, printing, consultants, etc.) and 
indirect costs (i.e., fringe benefits, overhead, and general and 
administrative expense rates). For this is the government's assessment 
of the probable cost of the supplies or services to be acquired and 
serves as a basis for determining the reasonableness of an offeror's 
proposed costs and understanding of the Statement of work. The 
cooperative agreement applicant may request assistance in developing a 
cost estimate from their project officer in the Division of State and 
Local Readiness.
     Quality Assurance Surveillance Plans: These plans must 
recognize the responsibility of the contractor to carry out its quality 
control obligations and must contain measurable inspections and 
acceptance criteria corresponding to the performance standards 
contained in the original performance-based Statement of work. This 
plan must focus on the level of performance required by the 
performance-based Statement of work, rather than the methodology used 
by the contractor to achieve that level of performance. The plan may 
also include:
--Technical progress and financial status reports (already a 
requirement for all direct assistance projects);
--Site visits to evaluate contract performance against scheduled or 
reported performance;
--Review of invoices and vouchers to assess reasonableness of costs 
claimed and relate the total expenditures to the physical progress of 
the contract, based on monitoring activities (i.e., site visits, 
progress reports, etc.)

    1. Please submit the following documents, electronically, to 
Gregory Lanman in the Division of State and Local Readiness at 
[email protected]:
    a. Contract/Task Order less than $100,000: Submit a performance-
based Statement of work as described and outlined in this document.
    b. Contract/Task Order greater than $100,000, but less than 
$500,000: Submit a performance-based Statement of work; independent 
cost estimate; and quality assurance surveillance plan as described and 
outlined in this document.
    c. If you are considering a contract or task order in an amount 
larger than $500,000; please contact Gregory Lanman in the Division of 
State and Local Readiness at (404) 639-7127 as soon as possible.
    2. Upon receipt of each contract/task order package, the Division 
of State and Local Readiness will obtain proposals and quotes for the 
requested services, supplies, or equipment through federal contract 
vehicles. The grantee will receive the proposals for review and 
selection according to their technical evaluation factors. Contract/
task order awards will be based upon your evaluation criteria and 
selection decision.
    3. The Division of State and Local Readiness will obligate all 
Direct Assistance funding and will assume an active partnership as part 
of your Quality Assurance Surveillance Plan. This partnership will 
include oversight of the contract/task order, monitoring contract/task 
order expenditures and funding balances, and by coordinated site visits 
by the Project Officers of the Division of State and Local Readiness.
    4. For additional information or if you have any questions, please 
contact Gregory Lanman in the Division of State and Local Readiness at 
(404) 639-7127 or by e-mail at [email protected].
    Direct Assistance (Equipment): CDC will provide a list of equipment 
that may be purchased through direct assistance. Generally, direct 
assistance equipment purchases are limited to the purchase of 
laboratory equipment.

[[Page 30465]]

    Direct Assistance (Personnel): In fiscal year 2005, CDC personnel 
will be available to provide on-site assistance to State, territorial 
and local public health agencies in the form of Direct Assistance 
awards. Placement of these Direct Assistance personnel will be based on 
the needs of host agencies in a variety of public health disciplines, 
including public health management, laboratory science, epidemiology, 
health communications, and environmental health. Direct Assistance 
personnel assigned through this cooperative agreement will receive 
training in critical aspects of public health preparedness and 
emergency response to prepare them to respond to local, State, regional 
and national public health emergencies.
    Deployment of Direct Assistance personnel associated with this 
cooperative agreement, including specific positions in the Career 
Epidemiology Field Officers (operated by the National Center for Health 
Marketing), will be coordinated with the Field Services Activity in the 
CDC Portfolio Management Project.
    Requests for new Public Health Readiness Field Program assignees 
during this budget period should be discussed with the grantee's 
project officer prior to including them in the budget and budget 
justification sections of your annual funding application. Direct 
Assistance Personnel costs will be based on published pay and 
allowances/reimbursement rates established by the Office of Personnel 
Management. The value of personnel for the budget period will be 
deducted from the amount of financial assistance that would otherwise 
be made available to the recipient under the applicable allocation, 
formula, or other determination of award amount but will be deemed to 
be part of the award and to have been paid to the recipient.
    Public Health Readiness Field Program personnel detailed to a 
recipient remain Federal employees and are subject to increases, 
adjustments, and any other benefits that would otherwise apply. 
Provision for changed costs will be negotiated with the recipient in 
advance as this may change the amount of financial assistance provided. 
Recipients will be instructed as to the process and timing for 
submitting travel authorizations and claims for reimbursement as well 
as other requests to incur costs or be reimbursed for costs related to 
personnel details. Recipients shall maintain documentation of payments 
for in-State and local travel costs and other payments on behalf of 
detailees as grant-related records. These records are subject to review 
and audit by or on behalf of CDC.
    Direct Assistance Personnel assigned through the Public Health 
Readiness Field Program are subject to the provisions of the existing 
Agreement to Detail that defines the respective responsibilities of CDC 
and recipients regarding Direct Assistance assignments of CDC 
personnel. CDC will review this agreement with recipient officials upon 
execution of the detail.
    Recipients interested in the Direct Assistance staffing option, 
should contact their Division of State and Local Readiness project 
officer to discuss specific staffing needs and how to reflect the 
request for Direct Assistance personnel in your application. Be 
prepared to discuss the specific duties and responsibilities proposed 
for the Direct Assistance assignee and where the assignee would work in 
your organizational structure.

V. Application Review Information

V.1. Evaluation Criteria

    Applications will be reviewed for technical acceptability by 
project officers from the Coordinating Center of Terrorism Preparedness 
and Emergency Response and subject matter experts through out CDC. 
Technical reviewers will be assessing the applications to determine:
     The applicant's current capability to perform the outcomes 
and critical tasks.
     That the operational plan clearly and adequately addresses 
the goals, outcomes, tasks, and measures.
     The extent to which the applicant clearly defines an 
evaluation plan that leads to continuous quality improvement of public 
health emergency response.
     The extent to which the applicant presents a detailed 
budget with a line item justification and any other information to 
demonstrate that the request for assistance is consistent with the 
purpose and objectives of the cooperative agreement.
     Where applicable, the extent to which the applicant 
presents an operational plan for funds for early detection, reporting 
and investigation of infectious disease outbreaks (both bioterrorist-
triggered and naturally occurring) at our borders with Canada and 
Mexico.

V.2. Criteria for Level One Chemical Laboratory Capacity

    New (competitive) applications for Level One chemical laboratory 
capacity will be evaluated according to the following criteria:
    1. Description of the jurisdiction covered (10 points): the extent 
to which the application clearly identifies the jurisdiction(s) covered 
by the proposed activities.
    2. Capacity (30 points): the extent to which the applicant 
demonstrates experience in measurements using mass spectrometry, 
general experience with a bench-top mass spectrometer, and experience 
using tandem mass spectrometry for analysis of environmental and 
biological samples.
    3. Operational Plan (40 points): (a) The extent to which the 
applicant's operational plan clearly and adequately addresses all 
recipient activities (see Appendix 1) (b) the extent to which 
laboratory space plans meet or exceed the minimum requirements (c) the 
extent to which applicant clearly describes past experiences in 
application content (d) the extent to which applicant clearly describes 
plans for hiring or designating appropriately qualified staff.
    4. Coordination (10 points): the extent to which the applicant 
demonstrates that the proposed activities will be coordinated with 
relevant activities currently underway in the applicant's jurisdiction 
or proposed under other sections of the cooperative agreement program. 
The extent to which the applicant clearly demonstrates how these 
activities will be coordinated within the jurisdiction (e.g., at the 
State level, between State and local agencies, between local agencies, 
with MMRS if present, and as appropriate, with other States).
    5. Support (10 points): inclusion of a letter of support from the 
State administration agreeing to provide CDC with surge capacity in 
cases of emergencies. This letter should also show commitment by the 
State to develop this capacity in their State public health laboratory 
and allow their State employees to be part of the CDC response.
    6. Budget (not scored): the extent to which the applicant presents 
a detailed budget with a line item justification and any other 
information to demonstrate that the request for assistance is 
consistent with the purpose and objectives of the cooperative 
agreement.

V.3. Review and Selection Process

    Applications will be reviewed for completeness by the Procurement 
and Grants Office (PGO) staff, and for technical acceptability by the 
Coordinating Office of Terrorism Preparedness and Emergency Response 
and CDC subject matter experts. Incomplete applications and 
applications that are non-responsive to

[[Page 30466]]

the eligibility criteria will not advance through the review process. 
Applicants will be notified that their application did not meet 
submission requirements.
    New applications for Level One chemical laboratory capacity will be 
evaluated by an objective review panel using the criteria listed in the 
``V.1. Criteria'' section above. In addition, these applications will 
also be reviewed by senior federal staff taking into account the 
results of the independent review, program needs and relevance to 
national goals, geographic location, and budgetary considerations.

VI. Award Administration Information

VI.1. Award Notices

    Successful applicants will receive a Notice of Grant Award (NGA) 
from the CDC Procurement and Grants Office. The NGA shall be the only 
binding, authorizing document between the recipient and CDC. The NGA 
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 and 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-9 Paperwork Reduction Act Requirements
     AR-10 Smoke-Free Workplace Requirements
     AR-11 Healthy People 2010
     AR-12 Lobbying Restrictions
     AR-16 Security Clearance Requirement
     AR-21 Small, Minority, and Women-Owned Business
     AR-24 Health Insurance Portability and Accountability Act 
Requirements
     AR-25 Release and Sharing of Data
    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.

VI.3. Technical Reporting Requirements

    Quarterly Progress Reports for Budget Period One--Progress reports 
for activities undertaken in budget period, as well as special topics 
related to the goals and objectives, are due on January 15, 2006 (for 
activities undertaken August 31-November 30, 2005), April 15, 2006 (for 
activities undertaken December 1, 2005-February 28, 2006), and July 15, 
2006 (for activities undertaken March 1-May 30, 2006). These reports 
must be submitted through the DSLR MIS. CDC will provide templates for 
these reports to assess program outcomes related to activities 
undertaken in BY 01. In addition, awardees may be required to submit 
information upon request based on changing threat status or national 
security priorities.
    Financial Status Reports--A mid-year estimated financial status 
report is due May 30, 2006, for the period August 31, 2005-February 28, 
2006. The final Financial Status Report (FSR) is due 90 days after the 
end of the budget period, ending on August 30, 2006. The due date for 
the FSR is November 30, 2006. Estimated FSRs (through August 30, 2005) 
are requested with your continuation application (See Unobligated Funds 
on page 3).
    Final Reports--This cooperative agreement will end on August 30, 
2006. An original and two copies of the final FSR will be due to the 
Grants Management Officer named below by November 30, 2006. Final 
project reports (for activities from June 1-August 30, 2006) should be 
submitted through the DSLR MIS by November 30, 2006.
    Please submit the hard copy of your financial status reports to: 
Rebecca B. O'Kelley, Acting Chief, Attn: Sharon Robertson, Acquisition 
and Assistance, Branch VI, Procurement and Grants Office, Centers for 
Disease Control and Prevention, 2920 Brandywine Road, MS K-75, Atlanta, 
GA 30341-4146. Telephone: 770-488-2748. E-mail address: [email protected].
    Please copy your Project Officer on any electronic submissions.

VII. Agency Contacts

    We encourage inquiries concerning this announcement. Programmatic 
technical assistance for this request may be obtained from your Project 
Officer.
    For general questions, contact:

Sharon Robertson, Grants Management Specialist--Regions 1, 2, 3, 4, 10, 
Acquisition and Assistance Branch VI, Procurement and Grants Office, 
Centers for Disease Control and Prevention (CDC), 2920 Brandywine Road, 
Atlanta, Georgia 30341-4146. Telephone: 770-488-2748. E-mail address: 
[email protected].

Angela Webb, Grants Management Specialist--Regions 5, 6, 7, 8, 9, 
Acquisition and Assistance Branch VI, Procurement and Grants Office, 
Centers for Disease Control and Prevention (CDC), 2920 Brandywine Road, 
Atlanta, Georgia 30341-4146. Telephone: 770-488-2784. E-mail address: 
[email protected].

VIII. Other Information

    Attachments will be available from the Secure Data Network (https://sdn.cdc.gov).
    Appendix 1: Requirements for Level One and Level Two Chemical 
Laboratories.
    Appendix 2: Early Warning Infectious Disease Surveillance (EWIDS) 
Guidance.
    Appendix 3: Cities Readiness Initiative (CRI) Guidance.
    Appendix 4: DRAFT Measurement Descriptions and Methods of Data 
Collection.
    Appendix 5: Funding Table.

    Dated: May 20, 2005.
William P. Nichols,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention.
[FR Doc. 05-10537 Filed 5-25-05; 8:45 am]
BILLING CODE 4163-18-P