A Cultural Approach to Good Health and Wellness in Indian Country FAQs
Thank you for your interest in the Notice of Funding Opportunity (NOFO) for CDC-RFA-DP24-0025, A Cultural Approach to Good Health and Wellness in Indian Country (GHWIC). As a reminder, questions about this NOFO should be emailed to: GHWIC0025@cdc.gov. Questions must be received by 06/25/2024 in order to ensure a response by the application deadline of June 28, 2024.
Information Webinar:
May 7, 2024 3:00 p.m.
Application Due Date:
June 28, 2024
Question: If a tribal organization only provides services to a portion, but not all the Tribes/Villages/Urban Indian Organizations in their IHS Area, are they eligible under Component 2?
Answer: All tribal organizations are eligible to apply for Component 2, however, please see the other required qualifying factors on page 9 of the NOFO. Tribal organizations that support all Tribes/Villages/UIOs in their award area will be funded. Tribal organization applicants must provide official documents that identify the Tribes, Villages, or UIOs their organization serves. This might include the organization’s charter, resolution, bylaws, or letters on official letterhead.
Question: For urban Indian communities, is it only the Title V clinic that can apply for these funds?
Answer: The Urban Indian Organization that holds the current Title V Indian Health Care Improvement contract with the Indian Health Service would be the eligible applicant for Component 1.
Question: Do federally qualified health centers qualify for this NOFO?
Answer: CDC cannot determine eligibility through the FAQ process. Please see page 9 of the NOFO where eligible applicants are listed along with additional required qualifying factors.
Question: Federally recognized tribes are eligible for Component 1. Are they also eligible to apply for Components 2 or 3?
Answer: As stated in the NOFO, Component 1 will fund federally recognized Tribes, Villages, and UIOs. Component 2 and Component 3 will fund tribal organizations as defined by US Code 25 USC § 1603(26).
Question: Are organizations who have been funded under previous GHWIC cooperative agreements less likely to be funded by this new iteration of GHWIC?
Answer: Organizations that meet the eligibility criteria on page 9 of the NOFO may apply for funding under this GHWIC NOFO.
Question: Are tribal colleges eligible under Component 1 funding?
Answer: As stated in the NOFO on Page 9, Component 1 will fund federally recognized Tribes, Villages, and UIOs. If the tribal college can demonstrate that they are governed by and report directly to a single tribe (not multiple tribes), then they can be considered for Component 1 funding.
Question: I am a tribal member that leads a native 501c3 organization and two native-owned businesses. We would like to help and give back to my local tribal community and would like to know if we can do that through GHWIC. What suggestions can be offered?
Answer: Questions related to eligibility and proposed activities cannot be answered via the FAQ process. Please see eligibility criteria beginning on page 9 of the NOFO. You can find the required strategies and activities for each Component starting on page 13 of the NOFO.
Question: We are a 501c3, not a tribal organization, tribe, or UIO. Can you confirm if we qualify for Component 3?
Answer: We are unable to answer eligibility questions via the FAQ process. You will find the eligibility criteria on page 9 of the NOFO. Tribal organizations as defined by US code U.S.C 1603 (26) are eligible to apply for Components 2 and 3.
Question: How should an applicant that does not lobby complete the Disclosure of Lobbying Activities?
Answer: The Disclosure of Lobbying Activities form should be filled out with “N/A” if not applicable.
Question: May an applicant send two applications for two different programs?
Answer: Tribal Organizations can submit a separate application for both Component 2 and Component 3. However, an applicant may not submit two applications for the same Component. If multiple applications are received from the same applicant for the same Component, only the application with the last on-time submission will be accepted.
Question: Is a letter of intent required?
Answer: No, a letter of intent is not required.
Question: Our tribe is interested in applying under Component 1. If we apply and don’t get funded, can we reapply under Component 2 as a subrecipient?
Answer: Subawards will be determined and made by Component 2 recipients in year one of their award. Applicants do not apply to be a subrecipient for Component 2 as part of this NOFO.
Question: Is there a page limit for the project narrative?
Answer: Yes, the narrative is limited to 20 pages, single space, 12-point font, with 1-inch margins. This includes the work plan. Project narrative content beyond 20 pages will not be reviewed. See required formatting beginning on page 46 of the NOFO.
Question: Are resumes included in the narrative page limit?
Answer: No. Attachments required by this NOFO are not included in the page limit. More information on “Attachments” begins on page 49 of the NOFO.
Question: If our Tribe is a current GHWIC recipient, how much information on previous experience and successes should we include in our application?
Answer: Please refer to the NOFO section on organization capacity, beginning on page 25. You can also refer to the component-specific scoring criteria under Merit Review, which starts on page 53 of the NOFO.
Question: We’re considering some activities that include sacred practices, and we’re hesitant to include many details in our work plan or narrative. How do we handle those situations?
Answer: Applicants are not expected to provide information concerning details of sacred tribal practices. However, the application must contain sufficient description of the activity so that it can be reviewed by CDC.
Question: Does the work plan include both the template and a narrative description or is the work plan template all that is needed?
Answer: You should provide a detailed description of the work you plan to do in Year 1, and a high-level overview of the work you will do in Years 2 through 5 in the Approach section of your application. Component-specific directions start on page 13 of the NOFO. You must also provide a work plan for your project. You may use the sample work plan template that is on page 37 of the NOFO. If you use another format, make sure to include all elements listed within the sample work plan.
Question: Should the work plan be included in the narrative or as an attachment?
Answer: The work plan is a part of the 20-page project narrative; however, the work plan can be a separate document.
Question: Is a work plan template available?
Answer: An example workplan can be found on page 37 of the NOFO. Page 36 states, “We’ve provided a sample work plan template at the end of this section. You may use a different format for your work plan, but you need to include all required elements listed here.”
Question: Can I use my organization’s SAM.gov registration or will I need to register as an individual?
Answer: Yes, you can utilize your organization’s SAM.gov registration. SAM.gov registration is intended for organizations, not individuals. It assigns a Unique Entity ID (UEI) number associated with your organization’s physical location.
Question: Is the evaluation and performance measurement plan included in the 20-page limit of the Project Narrative?
Answer: Yes, the evaluation and performance plan is included in the 20 page limit of the Project Narrative.
Question: Where can I find the five required forms of the application package that are outlined in the chart on Page 46 of the NOFO?
Answer: Per the NOFO on page 43, the application package has all the forms you need to apply. You can find the application package on Grants.gov by doing a grants search for the opportunity number CDC-RFA-DP-24-0025.
Question: Tribal organization applicants are to submit official documentation showing tribes served. Is this requirement different than a letter of support or resolution from tribes that support GHWIC funding?
Answer: CDC is not asking for letters of support. The official documentation should identify the Tribes, Villages, or UIOs your organization serves. Again, this might include your organization’s charter, resolution, bylaws, or letters on official letterhead.
Question: Our application references information from our Community Health Assessment. Can we include the full assessment as an attachment?
Answer: Please do not include your full Community Health Assessment (CHA) as an attachment. If you would like, you could reference the CHA in your narrative text and include a hyperlink to the document if you have one. Otherwise, if you have a one- or two-page summary of the CHA, you may include that as an attachment.
Question: Do Component 2 subrecipients have to implement all activities that are listed under the particular strategy?
Answer: Component 2 applicants must describe in their application narrative how they will make sure their subrecipients address all Component 1 strategies and activities over the 5-year period of performance.
Question: Is 10-point font permitted in the tables?
Answer: Yes, per the NOFO on page 46, footnotes and text in graphics may be 10-point font.
Question: Is a table within the narrative considered a graphic?
Answer: Yes, a table within the narrative is considered a graphic.
Question: How will our application be reviewed?
Answer: CDC uses a 3-step merit review of all applications. First, applications are reviewed to see if they meet all responsiveness criteria (see page 53 of the NOFO). Applicants that are considered responsive will move to the second step, a merit review. During the merit review process, panelists review and score each application according to the Component-specific criteria in the NOFO, which starts on page 53. After the merit review, CDC develops separate rank order lists of the top scoring applications. The top-ranking applicants will be funded. CDC reserve the right to fund applications out of rank order depending on geographic distribution of the highest scoring applications. We may fund out of rank order to achieve geographic diversity, including distribution across all IHS Areas. See page 64 of the NOFO for more information about funding out of rank order.
Question: How many awards will be made?
Answer: CDC expects to make up to 30 awards. We anticipate making up to 16 Component 1 awards, up to 13 Component 2 awards, and up to one award for Component 3.
Question: How will we know if we are funded?
Answer: CDC will send a Notice of Award (NoA) to your authorized business official if you are funded. If you are not funded, CDC will email or write you a letter if your application is disqualified as nonresponsive or if it is approved by unfunded. Approved but unfunded means that the application was approved but CDC does not have sufficient funds to make additional awards beyond the estimated number stated in the NOFO.
Question: Can a tribal organization be funded for Component 1?
Answer: No. Component 1 awards will be made to Federally recognized American Indian Tribes, Alaska Native Villages, or Urban Indian Organizations. Component 2 and Component 3 awards will be made to tribal organizations.
Question: How much can Component 1 applicants apply for?
Answer: Component 1 applicants can apply for up to $400,000 per year.
Question: What’s the maximum amount a Component 2 applicant can apply for?
Answer: Tribal organizations that apply to support all 41 UIOs can apply for up to $1,250,000 per year. The amount tribal organizations can apply for to support all the Tribes/Villages/UIOs in their IHS Area ranges from $500,000 – $1,450,000 per year. Funding depends on the number of federally recognized Tribes/Villages in the IHS Area. Please see page 7 of the NOFO for the amounts for each IHS Area.
Question: How much can a Component 3 applicant apply for?
Answer: Component 3 applicants may apply for up to $600,000 per year.
Question: The Component 2 requirement states “use at least 50% of your total award for at least two subawards to Tribes, Villages, UIOs, and other tribal entities within your award area” Does that 50% refer to total costs or total direct costs?
Answer: Component 2 recipients are required to use at least 50% of their total annual award for subawards.
Question: Is it possible to schedule a phone conversation to see if our proposal would be a good fit for this NOFO?
Answer: No, CDC is unable to speak to individual applicants about their applications. CDC will respond to questions sent to GHWIC0025@cdc.gov. Although CDC cannot answer questions about specific proposed activities, we will do our best to answer all other questions.
Question: Can a Component 2 applicant subaward to a tribe that is applying for Component 1?
Answer: Component 2 recipients may not offer subawards to Component 1 recipients. If a Component 2 applicant plans to subaward to a tribe that receives a Component 1 award, the Component 2 recipient would have to revise their plans after awards are announced.
Question: Is the Component 2 requirement to provide training and technical assistance to all Area tribes or can it be a subset of the Area tribes?
Answer: Component 2 recipients are expected to provide training, technical assistance, and resources available to all Tribes, Villages, UIOs, and other tribal entities within their award area.
Question: Is it possible to set up a call with someone at CDC to discuss our proposal ideas?
Answer: No. CDC cannot discuss applicants’ proposed activities or answer questions about proposed activities. Applicants can refer to the required, component-specific strategies and activities section of the NOFO and the GHWIC Implementation Guide [PDF-1 MB, 20 pages] to inform their proposed activities.
Question: Can applicants propose strategies and activities that are not listed in the NOFO?
Answer: Recipients will be required to implement all component-specific strategies and activities listed in the NOFO. If you propose strategies not listed in the NOFO, those would be in addition to those required and must align with the NOFO outcomes.
Question: One of the Implementation Guide’s example activities for diabetes prevention states (page 8): “Help participants overcome barriers to participation in the program (e.g., healthy food vouchers, transportation). (Additional guidance coming from CDC.)”. When will the additional guidance be provided by CDC?
Answer: The “additional guidance coming from CDC” referred to in the Implementation Guide will be provided to recipients through CDC’s Technical Assistance after awards are made.
Question: Does GHWIC require subrecipients of C2 programs to implement all three C1 strategies?
Answer: C2 recipients are required to make sure that each subawardee must address at least one C1 strategy. All three strategies must be addressed across the group of subawardees over the 5-year period of performance. The NOFO does not specify how C2 recipients will ensure all strategies have been addressed.
Question: Is a letter of support needed from our partners that depicts their support for this project?
Answer: Letters of support are not required in your application, however, existing and proposed partnerships may be described in your work plan (p. 35-37), in the Approach section (NOFO p. 13-24), and in the Organizational Capacity section (NOFO p. 25-28).
Question: Will the National DPP require recipients to have a new cohort every year or would years 1, 3, and 5 be adequate?
Answer: We cannot answer questions on proposed activities via the FAQ process. You can propose and justify how you will address prediabetes in your application narrative, which will be reviewed and scored along with the rest of your application.
Question: Can we focus on one activity or do we have to do all listed activities for all chronic diseases?
Answer: CDC cannot provide technical assistance on the application. For each component’s required activity listed in the NOFO, applicants are given flexibility to choose how the activity is implemented over the 5-year period of performance. The recipient must be able to report on the required activities, performance measures, and outcomes for their component.
Question: If we need to teach a prediabetes class separate from our current diabetes classes, do we need to include National DPP materials specifically, or would the Association of Diabetes Care & Education Specialists (ADCES) accredited curriculum be okay?
Answer: We cannot answer questions on proposed activities via the FAQ process. You can propose and justify how you will address prediabetes in your application narrative, which will be reviewed and scored along with the rest of your application per the NOFO requirements.
Question: Are recipients required to measure long-term outcomes?
Answer: No. Recipients are not required to measure long-term outcomes.
Question: Is IRB approval needed to use surveys? For example, activities that involve surveying our community members.
Answer: This funding opportunity is non-research only. Please see Guidelines for Defining Public Health Research and Public Health Non-Research [PDF-38 KB, 13 pages] (Revised October 4, 1999) (cdc.gov) for more information. All activities will have to be approved within the proposed work plan. Recipients will work with their CDC project officer and GHWIC evaluators to finalize their evaluation plans within the first 6 months of award. Evaluation plans cannot be finalized until work plans are approved and finalized.
Question: Do we need to use the outcomes exactly as written in the logic model provided in the NOFO, or do we create our own outcomes?
Answer: The logic model shows the required program strategies and the expected outcomes. We will require you to report on the asterisked (*) outcomes.
Question: Are we allowed to hire our own external evaluator with these funds?
Answer: Applicants may consider internal staff or external contractors for their evaluation efforts.
Question: Is there a template for the evaluation and performance measurement plan that needs to be included in the application?
Answer: No, there is not a template for the evaluation and performance measurement plan. Please see specific required elements beginning on Page 33 of the NOFO under Evaluation and performance measurement plan.
Question: We will be applying as a Component 1 program. After looking at the performance measures of the NOFO, we do not currently have the organizational capacity to collect the clinical data. We would like to ask if we could receive a waiver on reporting the clinical data.
Answer: Recipients will be required to report on performance measures annually, and a waiver for this requirement is not possible. The required performance measures for Component 1 are on pages 31 and 32 of the NOFO. CDC will work with recipients to finalize performance measures after award.
GHWIC does not require the reporting of clinical data; however, recipients may choose to report optional clinical data to demonstrate performance or to evaluate the effectiveness of its program. Optional clinical data submitted to CDC would need to be self-reported, de-identified, and aggregated. CDC encourages recipients to allocate 10% of their funding to support program evaluation and performance measurement, which could include a contract for evaluation services.
Question: Can you clarify what it means to “incorporate evaluation and performance measurement into planning, implementing, and reporting project activities?”
Answer: Planning and conducting evaluation activities and collecting performance measures are part of the whole program, including the planning, implementing, and reporting stages. Where applicable, applicants should describe how evaluation and performance measurement will be woven into their whole program.
Question: Is the budget template, found in the CDC Budget Guidelines [PDF-550KB, 8 pages], an application requirement, strong recommendation, or just something to use if we find it helpful in preparing the budget?
Answer: Applicants should follow the format outlined in the CDC Budget Guidelines to ensure all required information is included in the budget and budget justification and avoid any delays in making awards.
Question: We do not have a federally negotiated indirect cost rate agreement. Is there guidance for organizations that do not have a negotiated rate?
Answer: If the applicant organization does not have an approved indirect cost rate agreement, costs normally identified as indirect costs (rent, telephone) can be budgeted and identified as direct costs OR if the applicant organization has never established an approved negotiated indirect cost rate agreement, the applicant may charge a de minimis rate of ten (10) percent of modified total direct costs (MTDC) as defined in 45 CFR 75.414(f).
Question: The NOFO says funding generally does not support the purchase of furniture or equipment. Is this specific to office furniture and equipment or does it refer to items such as refrigerators, stoves, and tables?
Answer: Anything with a unit cost of $5,000 or more is considered equipment. Applicants wishing to purchase equipment with GHWIC funding must be clearly justified in the budget narrative, including how the proposed equipment will help you achieve the NOFO outcomes. CDC must approve any equipment prior to purchase.
Question: Should the Budget and Budget Narrative be for Year 1 only?
Answer: Your budget narrative should be for Year 1 only. Please refer to the instructions on required budget forms to include the requested information.
Question: Page 39 of the NOFO states that unallowable costs include “giveaway items to promote your program, such as pens, bags, or clothing.” Would it be allowable to purchase items as a part of the program and then give those items as an incentive to those who take part in the program, such as a cup with our logo on it?
Answer: Giveaway items to promote your program, such as pens, bags, or clothing, are not an allowable cost. However, supplies may be provided to community members in ways that support specific outcomes. These specific cases will be discussed with the assigned Project Officer once awards are made.
Question: On page 39 of the NOFO under Unallowable costs, there is a bullet point that states “You may not use funds for: Clinical care except as allowed by law.” What exceptions are allowable by law?
Answer: Clinical care is defined as directly managing the medical care and treatment of individual patients. The federal government may have funding streams that allow for the provision of medical care and treatment. However, GHWIC funds may not be used for those purposes. The intent of GHWIC is to establish systems and practices for screening and testing community members for chronic diseases and their risk factors, and making referrals for prevention, management, and control. Recipients are encouraged to work with health care providers, social service organizations, and community and tribal organizations to implement screening and testing activities. GHWIC funds may not be used to provide direct clinical care or follow-up treatment, diagnose medical conditions, or purchase medical equipment.
Question: Blood glucose testing supplies, medical devices, or direct medical care cannot be supported with these federal funds. Please refer to page 39 of the NOFO.
Answer: Blood glucose testing supplies, medical devices, or direct medical care cannot be supported with these federal funds and are not an allowable cost. Please refer to page 39 of the NOFO.
Question: Page 49 of the NOFO lists the cost category format that the budget narrative must follow. When comparing to the SF-424A, there is not a Consultant object class on the form. Which category on the SF-424a can consultant costs be added?
Answer: The Consultant costs should be added to the Contractual object class category.
Question: Is the time that a provider spends with a client to screen for diabetes an allowable cost?
Answer: Paying a provider to screen is a direct clinical cost and is not allowed.
Question: Do prevention and screenings (e.g. health fair blood pressure monitoring, PHQ-9 screens, risk factor assessments, resource navigation) count as direct medical care?
Answer: Risk factor assessments and resource navigation are not considered direct medical care.
Question: Can you please send me a definition of what would be included under “Contractual Costs”?
Answer: Your organization may not have the staff or expertise inside your organization to do some of the work of the cooperative agreement and may want to establish a contract or consultant agreement with an individual or an organization to do that work. You must have prior approval from CDC to enter into that contract or consultant agreement. Please refer to the CDC Budget Preparation Guidelines, pages 3 and 7, for the information you must include in your budget and budget narrative for CDC to approve a contract or a consultant agreement. https://www.cdc.gov/grants/documents/Budget-Preparation-Guidance.pdf.
Question: To fulfil the required activity 4, we are proposing to create and implement a remote blood pressure monitoring and diabetes prevention monitoring activities. This would include purchasing blood pressure cuffs, glucometers, weight scales, and pulse oximeters. These activities will be monitored by a Nurse Practioner. Are these items considered medical devices?
Answer: The objective of the first diabetes prevention activity under Strategy 2 is to screen tribal members using the American Diabetes Association/CDC Prediabetes Risk Test and to refer those at high risk for type 2 diabetes to 1) a health care provider for blood glucose testing and 2) a type 2 diabetes prevention program. The intent of this strategy is not to provide clinical care or to diagnose or monitor health conditions, so blood glucose testing supplies, medical devices, or direct medical care cannot be supported with these federal funds. The objective of the second diabetes prevention activity under Strategy 2 focuses on establishing a new (or maintaining an existing) type 2 diabetes prevention program— either as part of the National Diabetes Prevention Program (National DPP) or by offering a community-selected, evidence-informed type 2 diabetes prevention program using elements of the National DPP PreventT2 curriculum. Regular participant weigh-ins are an important part of the National DPP lifestyle change program, so the purchase of a scale may be allowable for your program. If you are selected for funding, we encourage you to discuss this with your CDC Project Officer.
Question: Would leasing a vehicle be an allowable cost?
Answer: No, the purchase or leasing of a vehicle is considered an unallowable cost.
Question: Who do I ask if I have questions about this NOFO?
Answer: CDC will respond to questions sent to GHWIC0025@cdc.gov.
Question: How many years will this project be?
Answer: The period of performance is 5 years, subject to the availability of funds.
Question: What’s the approximate project start date?
Answer: The start date will be September 30, 2024.
Question: Will the webinar recording, or notes be available to those unable to attend the informational webinar?
Answer: The script from the webinar will be available on the NOFO webpage following the informational webinar. All questions and answers will also be posted on this Frequently Asked Questions page. We will make every attempt to include the webinar recording.
Question: Where can any updates to the NOFO be found?
Answer: On the NOFO webpage on www.grants.gov locate and click the “subscribe” button next to the “apply” button. By subscribing, alerts for any changes to the NOFO will be sent to you. CDC will also announce any updated versions on the NOFO webpage.
Question: Our tribe is undergoing an audit of federal awards. If we apply to GHWIC, what impact would this have on us? Should we wait until this audit has concluded and apply for future opportunities?
Answer: It is preferred that applicants have a current audit on file however, currently undergoing an audit would not disqualify you from applying for GHWIC.