How do we apply if we are not a large city and the State has already decided on its target communities?

An application in this instance does not qualify, this year.

Contiguous is adjoining geographic areas where the boundary of the area can be drawn on a map without lifting the pencil.

A bona fide agent is the official fiscal agent the governor or mayor determines will function on behalf of the State or Local Health Department, respectively. The bona fide agent, in most instances is a foundation, or non-profit organization, that serves as the legal agent for applying for Federal grants for the State or local health agency. Other entities (such as Departments of Education, a non-profit organization, a University) may be proposed as a bona fide agent but, again, the mayor or Governor must determine those agents and the agents must have an established capability to serve as fiduciary agents.

Regardless of the determination of the bona fide agent, applicants are required to include the Health Department in the leadership team.

Yes, however, if the neighboring communities are served by a different health department, or its bona fide agent, a formal relationship will need to be established between the two entities to identify roles, resources and commitments. An official letter of transmittal from the Mayor or Chief Executive Officer should be included in the application.

No. Each community must focus on diabetes, obesity, asthma and the related risk factors – physical activity, nutrition, tobacco and environmental exposures. Each community, however, may elect to address the disease and risk factors in varying ways tailored to the needs and resources of the individual community.

No. Successful applicants will have the infrastructure, capacity, and plans underway to begin intervention efforts during the first year of funding. Because of the short time given to prepare FY 2003 applications, some latitude will be given to the grantees to revise proposed plans during the first year.

Each funded community must address diabetes, obesity, and asthma and their related risk factors (nutrition, physical activity, tobacco, environmental exposures). Funds should be primarily devoted to community and school interventions. Program expenses such as personnel, supplies, contracts, travel, etc., are acceptable. Program expenses also include such areas as direct education, community education, assessments, planning, evaluation, communications, information technology, improved access to services, policy and environmental changes, and various wellness programs.

Expenses such as direct patient care, diagnostic medical testing, patient rehabilitation, pharmaceutical purchases, facilities construction, basic research, and lobbying are not allowed.

Successful applicants should begin hiring staff and distributing their funds immediately. Solidifying the leadership of the program should be considered critical as well. It is important that interventions begin as soon as possible and that the data collection systems be established so that progress can be measured from the very beginning. CDC and other HHS agencies are planning a workshop for successful applicants before the end of 2003 to provide program guidance and develop a more detailed evaluation framework.

The overall Steps initiative focuses generally on reducing the burden of chronic diseases (such as asthma, diabetes, obesity, cancer, heart disease, and stroke) and addressing the associated risk factors of those diseases (such as tobacco use, poor nutrition and lack of physical activity, and environmental exposures).

Funding through this RFA is designated specifically to address obesity, diabetes, asthma and their risk factors - physical inactivity, poor nutrition, tobacco and environmental exposure. Depending on the success of first year programming and the availability of future funding, a wider scope of diseases and/or additional communities, States, and Tribes may be funded.

Successful applicants should refer to the Recipient Activities and Evaluation Criteria section of the RFA and create a plan that details their proposed evaluation needs, methods for collecting evaluation data, and a willingness to work with CDC and other HHS agencies to develop an overarching evaluation strategy (post-award).

In addition, applicants must:

1. agree to collect baseline measures
2. agree to collect and report on core performance measures – to be determined by CDC and other HHS agencies in collaboration with grantees (post award) – to document how intervention strategies are being implemented and are successfully addressing STEP priorities.
3. agree to participate in a STEPS-wide external evaluation to document the effectiveness of the cooperative agreement program.
4. address plans and capacity to collect and analyze sufficient data.

Grantees will participate in other evaluation activities such as regular debriefings, descriptive case studies, etc. and must be able to collect and analyze sufficient data (as part of the evaluation component) to indicate progress toward outcome measures during years 1 and 2 in order to receive funding in years 3 through 5.

Applicants should include evaluation activities in their activity-based budget, including budgeting for 2 trips in the first year, plus staff time.

If an applicant is not currently collecting BRFSS and/or YRBSS data in the selected communities are they still eligible to apply for STEPS funding?

Funded communities (post-award) must administer YRBSS and BRFSS in the targeted intervention areas. Where possible communities are highly encouraged to work with an entity that is currently conducting these surveys in the state.

In consultation with CDC, additional questions can be added to the surveys that specifically address the impact of the community intervention; likewise, funded communities are not required to use all of the questions in the modules and may drop unrelated questions. Neighborhood identifiers that are at a large enough scale to preserve confidentiality may also be added to the surveys.

In addition, applicants should give consideration to measuring program participation, community changes in policies and environmental supports, and any other areas deemed critical to provide early evidence of success.

The grant recipient is the lead/fiduciary agency; there is only one lead/fiduciary agent per grant. That agency will be eligible to receive up to five percent of their total direct costs to cover indirect costs. This limitation supercedes established indirect cost rate agreements that are higher than 5% but does not supercede lower negotiated indirect cost rate agreements.

All the applications will receive a technical review from experienced CDC program staff to assist the objective review panels - these technical reviews are not part of the scoring however. Following technical reviews, applications will be reviewed by a panel of Federal experts (the objective reviews) who will judge the merit of the application according to the review criteria in the RFA. Each member of the objective review panel votes on approval or disapproval with a score provided for the approved applications. The scores of the panel are averaged for each approved application and then the choices for cooperative agreement awards are based on the rankings of the scores. CDC has received 212 letters of intent.

The page limitation includes: a) Description of Lead Agency, b) Description of Community Consortium c) Description of Community, d) Description of Intervention Area, e) Community Action Plan, f) Evaluation & Monitoring Plan, g) Communications Plan, h) Financial Contributions, i) Budget Plan.

The page limitation does not include: a) Official Transmittal Letter, b) Table of Contents, c) Executive Summary, d) Numeric Budget Sheets, e) Resumes and Job Descriptions, and f) Appendices.

Once applicants have developed a 5-year project budget, they should summarize their first year’s activities using Attachment D. This form allows us to review the applicant’s budget based on specific activities under each program objective or goal.

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U.S. Department of Health and Human Services