Purpose
- CDC announced available funds for a cooperative agreement for state and local tuberculosis (TB) prevention and control activities and laboratory services.
- The goal is to prevent TB transmission and progression from latent TB infection to active TB disease.
Background
CDC is continuing its 40-year approach of funding priority activities in TB programs through cooperative agreements to complement TB prevention and control activities and laboratory services at state and local levels to reduce TB morbidity and mortality. The goal of this five-year cooperative agreement (CDC-RFA-PS-25-0003) is to prevent TB transmission and prevent progression from latent TB infection to active TB disease.
Officials in health departments are responsible for TB control and prevention activities and laboratory services under the statutes and regulations of states, cities, or territories. This funding complements those efforts. It is not meant to replace or reduce state and local investment in priority activities and responsibilities such as diagnosing and treating TB, providing inpatient care, tracing contacts, finding, and treating latent TB infection, and managing health department clinics
Resource
Applicant informational webinar
CDC held an informational webinar for applicants of CDC-RFA-PS 25-0003 on July 12, 2024.
Frequently asked questions
Key dates
July 12, 2024: TB Elimination and Laboratory informational webinar
September 9, 2024: Application due date
October 4, 2024: Application due date for those who were unable to successfully upload attachments A and B with original application (see Frequently Asked Questions for details)
December 1, 2024: Awards announced via electronic copy of the Notice of Award from CDC Office of Grant Services
Funding by category
CDC TB Cooperative Agreement funding consists of three parts:
- Prevention and Control (P&C)
- Human Resource Development (HRD)
- Public Health Laboratory Strengthening
CDC distributes TB Cooperative Agreement funds according to a case-based formula for P&C and HRD, and a workload-based funding formula for the laboratory. This formula is based on years of experience and collaboration with public health partners.
Part 1 - Prevention and Control
The funding for prevention and control is allocated using a formula approach to ensure equitable distribution of resources based on changing TB epidemiology and program performance.
The purpose of this worksheet is to help applicants estimate the maximum funding amount for P&C that may be made available to them in the first year of the 2025-2029 Cooperative Agreement, FY 2025.
- This worksheet provides the dollars ($) per case for each of the variables in the funding formula using surveillance data from the frozen 2023 dataset.
- The $ per case are calculated based on the 3-year averages of U.S. total cases and reflect the application of 100% distribution using the 2024 cooperative agreement formula.
Needs Component
- Using the data from the Frozen 2023 Dataset, Funding Formula Variables Snapshot Report in the National Tuberculosis Indicators Project (NTIP), enter the 3-year averages reported for your program in the column for Awardee 3-year Average.
- Multiply $ per Case by the Awardee 3-year Average for each variable.
- Sum the subtotals of each variable under the Needs Component to obtain the amount for the Total Needs Component.
- Replace the amount for the Total Needs Component with $125,000 if this amount is less than $125,000.
| Needs Component | $ per Case | Awardee 3-year Average | Subtotal |
|---|---|---|---|
| Incident Cases | $3,371 | x | = |
| U.S.-Born Minorities and Non-U.S.–Born | $775 | x | = |
| Smear Positive Pulmonary | $2,537 | x | = |
| Multidrug-Resistant TB | $43,719 | x | = |
| Medical Risk Factors | $1,091 | x | = |
| Social Risk Factors | $2,460 | x | = |
| Class B Arrivals | $224 | x | = |
| Total Needs Component | $ |
Performance Component
Sum the subtotals for each variable under the Performance Component to obtain the amount for the Total Performance Component.
| Performance Component | $ per Case | Awardee 3-year Average | Subtotal |
|---|---|---|---|
| Completion of Treatment | $1,077 | x | = |
| Drug Susceptibility Testing | $558 | x | = |
| Contact Latent TB Infection Completion | $984 | x | = |
| Immigrants and Refugees Examined | $625 | x | = |
| Total Performance Component | $ |
Total Estimated Prevention and Control Funding
Add the Total amounts for the Needs and Performance Components to obtain the maximum estimated P&C funding that may be available to your program for FY 2025.
Part 2 - Human Resource Development
A fixed funding amount is allocated for Human Resource Development (HRD) based on the TB incidence level in each project area.
The table below provides the funding amount available to applicants by TB incidence level. Applicants should add the HRD funding amount available for their project area to the total estimated funding from the P&C section to obtain the grand total for their FY 2025 Funding.
| Incidence Levels | HRD Funding Amount |
|---|---|
| 0 - 49 Cases | $18,000 |
| 50 - 499 Cases | $24,629 |
| ≥ 500 Cases | $41,781 |
Part 3 – Public Health Laboratory Strengthening
Laboratory funding is allocated using a workload-based formula approach to ensure equitable distribution of resources. The funding formula is calculated using a 3-year average (currently, 2021 through 2023) of reported data for each of the below categories:
- Total number of clinical specimens processed for smear and culture
- Number of individual patients for whom a clinical specimen was processed for smear and culture
- Number of individual patients for whom a reference isolate was received to rule out or confirm the identification of Mycobacterium tuberculosis complex (MTBC)
- Number of individual patients for whom a nucleic acid amplification test (NAAT) result was positive for MTBC
- A base amount for this category is determined by the number of patients for whom a clinical specimen is received and processed
- A base amount for this category is determined by the number of patients for whom a clinical specimen is received and processed
- Number of individual patients for whom first-line MTBC drug susceptibility testing (DST) was performed and/or, if DST was not performed in-house, for whom an isolate was referred to another laboratory for DST.
- For enhancement of laboratory systems, an equal amount of funding is given to each laboratory to strengthen and enhance TB laboratory services through exploration and incorporation of new or best technologies and practices (e.g., MALDI-TOF, laboratory information management systems, etc.).
| Per patient basis | ||||||
|---|---|---|---|---|---|---|
| Total number of specimens | TB culture inoculated | TB culture inoculated | NAA testing of clinical specimen | DST for first-line drugs | Lab System-Equal Amounts | |
| FY2025 | 10%
Split across sites proportionately |
10%
Split across sites proportionately |
10%
Split across sites proportionately |
10%
Split across sites by base amounts and remaining proportionately |
25%
Split across sites proportionately |
10%
Split across sites evenly |
Funding estimation for laboratory systems
For funding estimation, applicants should use the formula variables described above at the following funding amounts to calculate an estimated maximum laboratory funding amount using 2023 workload volume data based on these indicators:
- $10 per total number of clinical specimens processed for smear and culture (Indicator 1)
- $20 per number of individual patients for whom a clinical specimen was processed for smear and culture (Indicator 2)
- $100 per number of individual patients for whom a reference isolate was received to rule out or confirm the identification of MTBC (Indicator 4)
- $700 per number of individual patients for whom a NAAT result was positive for MTBC (Indicator 3a)
- $340 per number of individual patients for whom first-line MTBC DST was performed and/or, if DST was not performed in-house, for whom an isolate was referred to another laboratory for DST (Indicator 5)
- $12,908 for laboratory systems
These amounts are then totaled to estimate the amount of laboratory funding to request for FY2025.
Example
Laboratory A estimates FY2025 laboratory funding using the calculations below:
| 1257 clinical specimens processed x $10 | = $12,570 |
| 281 patients with specimens processed for smear and culture x $20 | = $5,620 |
| 0 patients with reference isolate received x $100 | = $0 |
| 44 patients with NAAT positive results x $700 | = $30,800 |
| 47 patients with first-line DST performed x $340 | = $15,980 |
| Laboratory systems | = $12,908 |
| Total funding amount for laboratory budget | $77,878 |
Note: A revised budget may be requested once the final funding formula is applied.
Project priorities
Strategies and activities
- Diagnosis/treatment of persons with TB disease and persons with latent TB infection,
- Examination of immigrants and refugees who have an overseas B classification for TB;
- Targeted testing for, and treatment of latent TB infection
- Program planning, evaluation, and improvement;
- Epidemiologic surveillance and response;
- Human resource development and partnership activities; and
- Public health laboratory strengthening.
Expected outcomes
Expected outcomes include but are not limited to:
- Decreases in TB incidence;
- Increases in patients completing treatment within 12 months;
- Increases in HIV and drug susceptibility testing in TB cases;
- Increases in latent TB infection testing and treatment completion rates of those recommended for treatment;
- Increases in accuracy and completeness of surveillance, genotyping, and whole-genome sequencing data;
- Improvement in turnaround times for specimen receipt and laboratory testing and
- Implementation of TB elimination plans.
Example work plans
Example work plans are provided below. CDC-RFA-PS 25-0003 applicants may use this layout if desired. Applicants may choose to format their required work plan in a different manner, as long as it contains all of the required elements for each strategy.
Frequently asked questions
Visit the Frequently Asked Questions page to view questions and answers related to: