NOA - OVERDOSE DATA TO ACTION (00).PDF

1. DATE ISSUED MM/DD/YYYY 1a. SUPERSEDES AWARD NOTICE dated
08/12/2019 except that any additions or restrictions previously imposed DEPARTMENT OF HEALTH AND HUMAN SERVICES
remain in effect unless specifically rescinded
Centers for Disease Control and Prevention
2. CFDA NO.
93.136 - Injury Prevention and Control Research and State and Community Based Programs CDC Office of Financial Resources
3. ASSISTANCE TYPE Cooperative Agreement 2939 Brandywine Road
4. GRANT NO. 1 NU17CE924996-01-00 5. TYPE OF AWARD Atlanta, GA 30341
Formerly Other
4a. FAIN NU17CE924996 5a. ACTION TYPE New
6. PROJECT PERIOD MM/DD/YYYY MM/DD/YYYY NOTICE OF AWARD
From 09/01/2019 Through 08/31/2022 AUTHORIZATION (Legislation/Regulations)
7. BUDGET PERIOD MM/DD/YYYY MM/DD/YYYY Section 311(c)(1) of the PHS Act (42 USC § 243(c)(1))
From 09/01/2019 Through 08/31/2020
8. TITLE OF PROJECT (OR PROGRAM)
Enhancing our Understanding of the Opioid Epidemic in Maricopa County in order to Augment Existing Interventions
9a. GRANTEE NAME AND ADDRESS 9b. GRANTEE PROJECT DIRECTOR
MARICOPA, COUNTY OF Jeanene Fowler
1645 E Roosevelt St 4041 N. Central Avenue, Suite 1400
Phoenix, AZ 85006-3638 Program Operations
Phoenix, AZ 85012-3314
Phone: 602-506-4926
10a. GRANTEE AUTHORIZING OFFICIAL 10b. FEDERAL PROJECT OFFICER
Mr. Max Porter Ms. Tracey Hardy
4041 N. Central Ave 4770 Buford Highway NE
Suite 1400 Mail Stop F62
Department of Public Health DUIP
Atlanta, GA 30341
ALL AMOUNTS ARE SHOWN IN USD
11. APPROVED BUDGET (Excludes Direct Assistance) 12. AWARD COMPUTATION
I Financial Assistance from the Federal Awarding Agency Only a. Amount of Federal Financial Assistance (from item 11 m) 2,688,960.00
II Total project costs including grant funds and all other financial participation I b. Less Unobligated Balance From Prior Budget Periods 0.00
c. Less Cumulative Prior Award(s) This Budget Period 0.00
a. Salaries and Wages ……………….................. 764,031.00
d. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION 2,688,960.00
b. Fringe Benefits ……………….................. 328,812.00
13. Total Federal Funds Awarded to Date for Project Period 2,688,960.00
c. Total Personnel Costs .…...….…… 1,092,843.00 14. RECOMMENDED FUTURE SUPPORT
34,200.00 (Subject to the availability of funds and satisfactory progress of the project):
d. Equipment …………………………….
e. Supplies ……………………………. 27,707.00 YEAR TOTAL DIRECT COSTS YEAR TOTAL DIRECT COSTS
a. 2 d. 5
f. Travel ……………………………. 44,000.00 b. 3 e. 6
g. Construction ……………………………. 0.00 c. 4 f. 7
h. Other ……………………………. 51,729.00 15. PROGRAM INCOME SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING
ALTERNATIVES:
i. Contractual …………………….……… 998,800.00 a. DEDUCTION b
b. ADDITIONAL COSTS
c. MATCHING
j. TOTAL DIRECT COSTS 2,249,279.00 d. OTHER RESEARCH (Add / Deduct Option)
e. OTHER (See REMARKS)
k. INDIRECT COSTS 439,681.00
16. THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY, THE FEDERAL AWARDING AGENCY
ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY
l. TOTAL APPROVED BUDGET 2,688,960.00 OR BY REFERENCE IN THE FOLLOWING:
a. The grant program legislation.
b. The grant program regulations.
c. This award notice including terms and conditions, if any, noted below under REMARKS.
m. Federal Share 2,688,960.00 d. Federal administrative requirements, cost principles and audit requirements applicable to this grant.
In the event there are conflicting or otherwise inconsistent policies applicable to the grant, the above order of precedence shall
n. Non-Federal Share 0.00 prevail. Acceptance of the grant terms and conditions is acknowledged by the grantee when funds are drawn or otherwise
obtained from the grant payment system.
REMARKS (Other Terms and Conditions Attached - Yes No)
GRANTS MANAGEMENT OFFICIAL:
Brownie Anderson-Rana, Grants Management Officer
2939 Flowers Road
Mailstop TV2
Atlanta, GA 30341-5509
Phone: 770-488-2771
17. OBJ CLASS 41.51 18a. VENDOR CODE 1866000472B9 18b. EIN 866000472 19. DUNS 602062515 20. CONG. DIST. 07
FY-ACCOUNT NO. DOCUMENT NO. ADMINISTRATIVE CODE AMT ACTION FIN ASST APPROPRIATION
21. a. 9-939ZUCS b. 19NU17CE924996OPCE c. CE d. $2,688,960.00 e. 75-19-0952
22. a. b. c. d. e.
23. a. b. c. d. e.

PAGE 2 of 2 DATE ISSUED
NOTICE OF AWARD (Continuation Sheet) 08/12/2019
GRANT NO. 1 NU17CE924996-01-00
Direct Assistance
BUDGET CATEGORIES PREVIOUS AMOUNT (A) AMOUNT THIS ACTION (B) TOTAL (A + B)
Personnel $0.00 $0.00 $0.00
Fringe Benefits $0.00 $0.00 $0.00
Travel $0.00 $0.00 $0.00
Equipment $0.00 $0.00 $0.00
Supplies $0.00 $0.00 $0.00
Contractual $0.00 $0.00 $0.00
Construction $0.00 $0.00 $0.00
Other $0.00 $0.00 $0.00
Total $0.00 $0.00 $0.00
2

AWARD ATTACHMENTS
MARICOPA, COUNTY OF 1 NU17CE924996-01-00
1. FY19 Terms and Conditions CE924996 Maricopa
2. CE19-1904_SpecialTermsandConditions
3. Maricopa_AZ_Summary Statement
4. Maricopa_AZ_Work Plan Recommendations

AWARD INFORMATION
Incorporation: In addition to the federal laws, regulations, policies, and CDC General Terms and
Conditions for Non-research awards at
https://www.cdc.gov/grants/federalregulationspolicies/index.html, the Centers for Disease Control and
Prevention (CDC) hereby incorporates Notice of Funding Opportunity (NOFO) number CE19-1904,
entitled “Overdose Data to Action”, and application dated April 30, 2019, as may be amended, which are
hereby made a part of this Non-research award, hereinafter referred to as the Notice of Award (NoA).
Approved Funding: Funding in the amount of $2,688,960 is approved for the Year 01 budget period,
which is September 1, 2019 through August 31, 2020. All future year funding will be based on
satisfactory programmatic progress and the availability of funds.
The federal award amount is subject to adjustment based on total allowable costs incurred and/or the
value of any third party in-kind contribution when applicable.
Note: Refer to the Payment Information section for Payment Management System (PMS) subaccount
information.
Financial Assistance Mechanism: Cooperative Agreement
Substantial Involvement by CDC: This is a cooperative agreement and CDC will have substantial
programmatic involvement after the award is made. Substantial involvement is in addition to all post-
award monitoring, technical assistance, and performance reviews undertaken in the normal course of
stewardship of federal funds.
CDC program staff will assist, coordinate, or participate in carrying out effort under the award, and
recipients agree to the responsibilities therein, as detailed in the NOFO.
• Providing cross-site and recipient-specific surveillance technical assistance, such as
providing tools to identify nonfatal and fatal drug poisonings using ICD-9-CM, ICD-10-
CM, text searches of ED chief complaint and ICD-10 cause of death codes;
• Providing technical assistance to revise annual work plans;
• Assisting in advancing program activities to achieve project outcomes;
• Providing scientific subject matter expertise and resources;
• Collaborating with recipients to develop evaluation plans that align with CDC
evaluation activities;
• Providing technical assistance on recipient’s evaluation and performance measurement plan;
• Providing technical assistance to define and operationalize performance measures;
• Facilitating the sharing of information among recipients;
• Participating in relevant meetings, committees, conference calls, and working groups
related to the cooperative agreement requirements to achieve outcomes;
Objective/Technical Review Statement Response Requirement: The review comments on the
strengths and weaknesses of the proposal are provided as part of this award. A response to the
weaknesses in these statements must be submitted to and approved, in writing, by the Grants
Management Specialist/Grants Management Officer (GMS/GMO) noted in the CDC Staff Contacts
section of this NoA, no later than 30 days from the budget period start date. Failure to submit the
required information by the due date, October 1, 2019, will cause delay in programmatic progress and
will adversely affect the future funding of this project.

Budget Revision Requirement: By October 1, 2019 the recipient must submit a revised budget for
total approved amount with a narrative justification and SF424A. Failure to submit the required
information in a timely manner may adversely affect the future funding of this project. If the information
cannot be provided by the due date, you are required to contact the GMS/GMO identified in the CDC
Staff Contacts section of this notice before the due date.
Recipient must submit the following:
Revise overall budget into cost categories with detailed budget breakdown for each. Review the budget
narrative math and revise to reflect the accurate total amounts.
• Personnel/Fringe:
o Submit names of each staff member listed (surveillance and prevention). Breakout fringe
into the Fringe cost category and provide calculation.
• Equipment:
o Move to Supply cost category (less than $5k); provide staff names for computers.
• Supplies:
o Provide names of staff for computers/laptops
• Travel:
o Provide names of staff traveling for each trip (surveillance)
o Provide detailed budget breakdown for travel (air, lodging, transportation etc.) using
gsa.gov rates.
• Other:
o Revise budget for additional funds.
o Provide detailed budget breakdown.
• Contractual:
o Provide complete elements and breakdown in detailed budgets for each contractor
listed.
• Submit Grants Assurance and Certifications
Expanded Authority: The recipient is permitted the following expanded authority in the administration of
the award.
☒ Carryover of unobligated balances from one budget period to a subsequent budget period.
Unobligated funds may be used for purposes within the scope of the project as originally approved.
Recipients will report use, or intended use, of unobligated funds in Section 12 “Remarks” of the
annual Federal Financial Report. If the GMO determines that some or all of the unobligated funds
are not necessary to complete the project, the GMO may restrict the recipient’s authority to
automatically carry over unobligated balances in the future, use the balance to reduce or offset CDC
funding for a subsequent budget period, or use a combination of these actions.
Program Income: Any program income generated under this grant or cooperative agreement will be
used in accordance with the Addition alternative.
Addition alternative: Under this alternative, program income is added to the funds committed to the
project/program and is used to further eligible project/program objectives.
Note: The disposition of program income must have written prior approval from the GMO.
FUNDING RESTRICTIONS AND LIMITATIONS

Notice of Funding Opportunity (NOFO) Restrictions:
Program funds cannot be used for purchasing naloxone, implementing or expanding drug
“take back” programs or other drug disposal programs (e.g. drop boxes or disposal bags),
purchasing fentanyl test strips, or directly funding or expanding direct provision of
substance abuse treatment programs. Such activities are outside the scope of this NOFO.
Indirect Costs:
Indirect costs are approved based on the recipient’s approved Cost Allocation Plan dated July 1, 2018.
REPORTING REQUIREMENTS
Required Disclosures for Federal Awardee Performance and Integrity Information System
(FAPIIS): Consistent with 45 CFR 75.113, applicants and recipients must disclose in a timely manner,
in writing to the CDC, with a copy to the HHS Office of Inspector General (OIG), all information related
to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the
federal award. Subrecipients must disclose, in a timely manner in writing to the prime recipient (pass
through entity) and the HHS OIG, all information related to violations of federal criminal law involving
fraud, bribery, or gratuity violations potentially affecting the federal award. Disclosures must be sent in
writing to the CDC and to the HHS OIG at the following addresses:
CDC, Office of Grants Services
Julie Davis, Grants Management Specialist
Centers for Disease Control and Prevention
OD, Environmental, Occupational Health & Injury Prevention Services Branch
2939 Flowers Rd, MS – TV2
Atlanta, GA 30341
Email: xxg6@cdc.gov (Include “Mandatory Grant Disclosures” in subject line)
AND
U.S. Department of Health and Human Services
Office of the Inspector General
ATTN: Mandatory Grant Disclosures, Intake Coordinator
330 Independence Avenue, SW
Cohen Building, Room 5527
Washington, DC 20201
Fax: (202)-205-0604 (Include “Mandatory Grant Disclosures” in subject line) or
Email: MandatoryGranteeDisclosures@oig.hhs.gov
Recipients must include this mandatory disclosure requirement in all subawards and contracts under
this award.
Failure to make required disclosures can result in any of the remedies described in 45 CFR 75.371.
Remedies for noncompliance, including suspension or debarment (See 2 CFR parts 180 and 376, and
31 U.S.C. 3321).
CDC is required to report any termination of a federal award prior to the end of the period of
performance due to material failure to comply with the terms and conditions of this award in the OMB-
designated integrity and performance system accessible through SAM (currently FAPIIS). (45 CFR

75.372(b)) CDC must also notify the recipient if the federal award is terminated for failure to comply
with the federal statutes, regulations, or terms and conditions of the federal award. (45 CFR 75.373(b))
PAYMENT INFORMATION
The HHS Office of the Inspector General (OIG) maintains a toll-free number (1-800-HHS-TIPS [1-800-
447-8477]) for receiving information concerning fraud, waste, or abuse under grants and cooperative
agreements. Information also may be submitted by e-mail to hhstips@oig.hhs.gov or by mail to Office of
the Inspector General, Department of Health and Human Services, Attn: HOTLINE, 330 Independence
Ave., SW, Washington DC 20201. Such reports are treated as sensitive material and submitters may
decline to give their names if they choose to remain anonymous.
Payment Management System Subaccount: Funds awarded in support of approved activities have
been obligated in a newly established subaccount in the PMS, herein identified as the “P
Account”. Funds must be used in support of approved activities in the NOFO and the approved
application. All award funds must be tracked and reported separately.
The grant document number identified on the bottom of Page 1 of the Notice of Award must be known in
order to draw down funds.
CDC Staff Contacts
Grants Management Specialist: The GMS is the federal staff member responsible for the day-to-day
management of grants and cooperative agreements. The GMS is the primary contact of recipients for
business and administrative matters pertinent to grant awards.
GMS Contact:
Julie Davis, Grants Management Specialist
Centers for Disease Control and Prevention
OD, Environmental, Occupational Health & Injury Prevention Services Branch
2939 Flowers Rd, MS TV-2
Atlanta, GA 30341
Telephone: 770-488-2936
Email: xxg6@cdc.gov
Program/Project Officer: The PO is the federal official responsible for monitoring the programmatic,
scientific, and/or technical aspects of grants and cooperative agreements, as well as contributing to the
effort of the award under cooperative agreements.
Programmatic Contact:
Tracey Hardy, Project Officer
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
4770 Buford Hwy S106-8
Chamblee GA 30341
Telephone: 770-488-5394
Email: tjh0@cdc.gov
Grants Management Officer: The GMO is the federal official responsible for the business and other
non-programmatic aspects of grant awards. The GMO is the only official authorized to obligate federal
funds and is responsible for signing the NoA, including revisions to the NoA that change the terms and
conditions. The GMO serves as the counterpart to the business officer of the recipient organization.

GMO Contact:
Brownie Anderson-Rana, Grants Management Officer
Centers for Disease Control and Prevention
OD, Environmental, Occupational Health & Injury Prevention Services Branch
2939 Flowers Rd, MS TV-2
Atlanta, GA 30341
Telephone: 770-488-2771
Email: bandersonrana@cdc.gov
For and on Behalf of Maricopa County
_________________________________________
Bill Gates, Chairman, Board of Supervisors Date
APPROVED AS TO FORM:
________________________________________
Attorney for County Date
ATTEST:
_________________________________________
Office of the Clerk of the Board Date

CE19-1904 Overdose Data to Action
Terms and Conditions
Surveillance Activities
Recipients must meet reporting timelines for the Surveillance Strategies as outlined in the NOFO. Failure to
meet reporting timelines for the selected tier and selected optional activities will result in a corrective action
letter from the CDC Project Officer. Failure to meet reporting timelines may also result in a restriction of funds
equal to the difference between the selected surveillance tier level and the level that reflects the recipients’
reporting capabilities, or for the amount of the optional activity.
Unallowable Activities
Please note that regardless of the reviewer comments on the quality of a project proposal, the following
activities are NOT allowable:
• Prohibited purchases: Naloxone/Narcan, syringes, fentanyl test strips, harm reduction kits, furniture or
equipment (generally, but note that vehicles may be allowable expenses for linkage to care
activities). Harm reduction and linkage to care activities are acceptable as long as they are not
prohibited purchases.
• HIV/HCV/other STD/STI testing.
• Drug disposal. This includes Implementing or expanding drug disposal programs or drug take back
programs, drug drop box, drug disposal bags.
• The provision of medical/clinical care.
• Wastewater analysis, including testing vendors, sewage testing and wastewater testing.
• Research.
• Direct funding or expanding the provision of substance abuse treatment.
• Development of educational materials on safe injection.
• The prevention of Adverse Childhood Experiences (ACEs) as a stand-along activity. However, activities
related to ACEs are allowable if they pertain to establishing linkage to care, or to providing training to
public safety and first responders on trauma-informed care.
• Public safety activities that do not include clear overlap/collaboration with public health partner and
objectives.
Medication Assisted Treatment (MAT) Waivers
Funds can be used to support training and education around MAT waivers, however, OD2A funds cannot be
used to pay for fees associated with providers obtaining waived status. This applies to both direct
reimbursements and contracts. If training and waiver fee activities occur together, it must be clear that OD2A
funds are not being used to cover the waiver fee itself. Other funding sources can be used to cover waiver fees.
Neonatal Abstinence Syndrome (NAS)
Please note that certain activities that cover neonatal abstinence syndrome (NAS) are allowable, while others are
not. In particular certain NAS-related surveillance and prevention activities may be allowable; however funding
collection of NAS surveillance data is not allowable. Some examples of what would be allowable (noted in the
FAQs) include:
• Surveillance of linkage to care during or after pregnancy for mothers who use opioids during pregnancy.
• Tracking drug use patterns, overdose history, and linkage to treatment and risk reduction services for
pregnant women.
• Linking data sources on pregnant women available at the state and local level.
• Prevention strategies and activities for pregnant women, infants born with NAS, and for healthcare
provider/clinician support and education.

Control of Prescription Drug Monitoring Program (PDMP) Data
The recipient shall comply with Additional Requirement 25 and submit and comply with a Data Management
Plan (DMP), which includes plans for archiving and long-term preservation of the data collected or acquired
under this award. The recipient shall also retain all title held in controlled substance- or prescription data
(“PDMP data”), collected or acquired with federal funds, that are stored in a database operated by or under the
oversight of the recipient, whether or not the PDMP data are in existence at the date of award acceptance or
compiled thereafter during this award’s performance period. Upon request by the recipient at any time, all
contractors and subrecipients (at any tier) shall promptly deliver to recipient the PDMP data in electronic format
as exists on the date of the request by the recipient. The recipient shall ensure that any and all contractors and
subrecipients (at any tier) acknowledge that the recipient retains ownership of and control over the PDMP data.
Prescription Drug Monitoring Program (PDMP) Data Sharing System:
For the purposes of this condition, a “PDMP system” is a local- or state-based data system that received federal
financial assistance since 2002 under an award under this program for the reporting, collection, and use of
PDMP data. “PDMP data” means controlled substance- or prescription data. “The PDMP hub” means Bureau of
Justice Assistance (BJA) designated PDMP data sharing system.
The recipient must ensure that the recipient’s PDMP system has the capacity to exchange data with other PDMP
systems via the PDMP hub.
The recipient must allow other PDMP systems to exchange data via a direct connection to the PDMP hub with
the recipient’s system at no cost to the other PDMP systems or the federal government and regardless of what
interstate data exchange system the recipient chooses to use.
The recipient must ensure that this requirement is reflected in all contracts or subawards, at any tier, with any
vendor or subrecipient, at any tier, under this award.
The recipient must ensure that all contracts or subawards, at any tier, with any vendor or subrecipient, at any
tier, working on the recipient’s PDMP system provides the recipient with the option to use and connect to the
PDMP hub to exchange PDMP data at the lower of—(1) actual cost; or (2) what would be (or in fact is) charged
by the vendor or subrecipient for the use of any data exchange hub substantially equivalent to the PDMP hub.
Within ninety (90) days of accepting this award, the recipient must inform BJA of whether its PDMP system is
connected to the PDMP hub or not. Failure to connect to BJA’s designated PDMP data sharing hub may result in
a failure to comply with the terms and conditions of the award. Additional conditions, and possibly other
actions, such as temporary withholding of payments pending correction, may be imposed in accordance with
applicable award regulations.
The recipient must notify BJA in writing within seven (7) business days if the connection to the PDMP hub
experiences a sustained interruption of service lasting longer than six (6) hours.
Nothing in this condition prohibits the recipient from using or not using any data exchange system that is
otherwise consistent with the requirements of this award (including those contained in this condition).
The provisions of this condition must be included in any subaward (at any tier).

National Center for Injury Prevention and Control
Notice of Funding Opportunity CE19-1904
Overdose Data to Action (OD2A)
SUMMARY STATEMENT
Date Reviewed: June 6, 2019
Applicant Name: Maricopa County
Application Number: NU17CE2019001966
Score: 87 out of 100
This summary statement reflects comments from three distinct objective reviewers. Please address weaknesses and
recommendations noted by program and these reviewers.
Unallowable Activities
Please note that regardless of the reviewer comments on the quality of a project proposal, the following activities are
NOT allowable:
• Prohibited purchases: Naloxone/Narcan, syringes, fentanyl test strips, harm reduction kits, furniture or
equipment (generally, but note that vehicles may be allowable expenses for linkage to care activities). Harm
reduction and linkage to care activities are acceptable as long as they are not prohibited purchases.
• HIV/HCV/other STD/STI testing.
• Drug disposal. This includes implementing or expanding drug disposal programs or drug take back programs,
drug drop box, drug disposal bags.
• The provision of medical/clinical care.
• Wastewater analysis, including testing vendors, sewage testing and wastewater testing.
• Research.
• Direct funding or expanding the provision of substance abuse treatment.
• Development of educational materials on safe injection.
• The prevention of Adverse Childhood Experiences (ACEs) as a stand-along activity. However, activities related to
ACEs are allowable if they pertain to establishing linkage to care, or to providing training to public safety and
first responders on trauma-informed care.
• Public safety activities that do not include clear overlap/collaboration with public health partner and objectives.
Medication Assisted Treatment (MAT) Waivers
Funds can be used to support training and education around MAT waivers, however, OD2A funds cannot be used to pay
for fees associated with providers obtaining waived status. This applies to both direct reimbursements and contracts. If
training and waiver fee activities occur together, it must be clear that OD2A funds are not being used to cover the
waiver fee itself. Other funding sources can be used to cover waiver fees.
Neonatal Abstinence Syndrome (NAS)
Please note that certain activities that cover neonatal abstinence syndrome (NAS) are allowable, while others are not. In
particular certain NAS-related surveillance and prevention activities may be allowable; however funding collection of NAS
surveillance data is not allowable. Some examples of what would be allowable (noted in the FAQs) include:
• Surveillance of linkage to care during or after pregnancy for mothers who use opioids during pregnancy.
• Tracking drug use patterns, overdose history, and linkage to treatment and risk reduction services for pregnant
women.
• Linking data sources on pregnant women available at the state and local level.
• Prevention strategies and activities for pregnant women, infants born with NAS, and for healthcare
provider/clinician support and education.
1

Brief Summary of Application
Summary of Project and Overall Comments:
• The applicant should consider directly tying the surveillance data to the prevention activities.
• The applicant has provided a thoughtful project to address surveillance and prevention strategies; in general,
their approaches are consistent with the NOFO strategies.
• It is evident that they have considerable capacity and already have infrastructure to continue their opioid public
health activities.
• They have provided ample documentation to indicate that they will be working with partners to implement this
NOFO.
• Two areas requiring additional attention. They have proposed a surveillance activity, which in turn will inform
prevention efforts, related to individuals with hepatitis C. It is unclear to the reviewer whether this is an
effective method for capturing injection drug users; it is unclear the percentage of this population will cover. It's
also unclear whether the timelines associated with their surveillance projects are realistic, which is important
because they will be used to inform the prevention projects.
Reviewers' Comments on Approach
Strengths of Section:
• Provides strong compelling background on the impact of substance abuse and overdose among the population
served.
• Concise project objective is stated with expected outcomes listed in Appendix A.
• Surveillance and prevention activities are clearly described and in line with the funding announcement
guidelines.
• Target population is described along with rationale and a description of the health disparities related to this
population.
• Strong work plan is attached.
• Collaborations are detailed and sufficient along with multiple LOS.
• Applicant's surveillance plan builds nicely upon the requirement to report cases of Hepatitis C and opioid
overdose. Surveying those cases will add a qualitative component to the existing quantitative system.
• Applicant appears to have strong, established partnerships with organizations they can collaborate with to
achieve program goals.
• Applicant provides clear background, purpose, and outcomes.
• Letters of support from partners are provided, some of which include project outcomes and describe specific
roles of partners. Some of the letters also mention previous collaborations.
• Target population is clearly identified.
• Range of prevention strategies are described that are consistent with CDC NOFO.
• The applicant’s surveillance plan builds nicely upon the requirement to report cases of Hepatitis C and opioid
overdose.
• The applicant provides adequate and compelling background information.
• The collaborations are detailed and sufficient along with multiple Letters of Support.
• The target population is clearly identified.
• The ranges of prevention strategies are consistent with CDC NOFO.
• The applicant provides a concise project objective.
Weaknesses of Section:
• Strategy 3 activities involve targeting at-risk populations. The application does not state exactly how these hard-
to-reach groups will be contacted.
• The prevention strategies are quite vague, and seem to just be ideas the applicant thinks might work. It would
probably be better to carry out pilot tests before investing a large amount of resources to these activities. In
addition, after pilot testing more details about implementation could be provided.
2

• In Strategy 7, the focus is so strongly on Hepatitis C prevention that the link to opioid misuse is lost. Need more
detail about how the Hepatitis C prevention activities will help with the opioid epidemic.
• The applicant proposed 2 surveillance projects whose outcomes could be useful for prevention purposes.
However, it is unclear whether using Hepatitis C as a means of identifying injection drug use is an efficient or
complete method for identifying opioid users.
• For both surveillance projects, it is unclear whether this is a realistic timeline for these hard to reach
populations. Further thinking is needed for years 2 and 3.
• The applicant doesn’t state how hard to reach groups would be contacted.
• The application strategies are vague.
• The applicant has such a strong focus on Hepatitis C that the link to opioid misuse is lost. More detail is needed.
• There are several questions about using the surveillance for linkage to care vs. using funding for populations
with HIV or Hepatitis C. WHAT THE APPLICANT IS PROPOSING IS NOT ALLOWED (upon further evaluation).
• The timeline associated with surveillance projects may not be realistic.
• It is unclear whether proposed surveillance activity is an effective method.
Recommendations for Section:
• As mentioned before, the applicant should tie the surveillance and prevention strategies together more, provide
more detail about the prevention strategies, and pilot test the proposed prevention activities, as well.
• Hepatitis C project proposed activities needs subject matter review to determine if it is a reasonable approach.
• Project timelines may not be realistic, especially for surveillance projects of hard to reach populations.
• The applicant should tie the surveillance testing together with prevention strategies.
• The proposal needs subject matter review to determine if it is a reasonable approach.
Reviewers' Comments on Evaluation and Performance Measurement
Strengths of Section:
• The evaluation plan is more than adequate and describes feasible steps to monitor and improve data quality and
reporting as well as a plan to address the use and utility of data made available.
• Applicant has proposed surveillance activities are well organized and likely feasible. They build upon an existing
mandatory reporting system. The applicant proposes hiring new staff members to implement the activities
makes it seem likely the data will be constantly monitored to improve quality.
• Applicant includes clear and measureable evaluation questions.
• Several evaluators are on staff. The evaluation plan for prevention activities is well developed with specific
indicators.
• The applicant’s surveillance activities are well organized and feasible and build upon an existing system.
• The applicant includes clear and measurable evaluation questions.
• The work plan is well done.
• Several evaluators are already on staff.
Weaknesses of Section:
• Applicant does not clearly state that surveillance data will be shared with CDC.
• Exactly how the surveillance data will be used is not clear.
• The performance plan for the surveillance projects seem general and lack specificity. It lacks the level of
specificity presented for the prevention outcomes. While some of this information is in the workplan, this
information is also relevant for the performance plan.
• The data sources for some of the evaluations currently do not exist. Some of the prevention activities rely on
successful completion of the surveillance plan.
• The applicant does not clearly state how data will be shared with CDC. – It was later found that they had put
information in application about supplying data to CDC within 6 months.
• Some data sources for some of the evaluations do not exist.
• The performance plan for the surveillance projects seem general and lack specificity.
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• It is not clear how the surveillance data will be used.
Recommendations for Section:
• It would be helpful for the applicant to include more details about prevention efforts and desired outcomes
from them.
• Further development of the evaluation plan for surveillance activities is needed. Much of this information is
available in the work plan.
• Further development of the evaluation plan for surveillance activities is recommended.
Reviewers' Comments on Organizational Capacity to Implement the Approach
Strengths of Section:
• Large established health department serving over half of the AZ population.
• PHAB accredited
• Seven Divisions with long term qualified staff representing a variety of professional disciplines.
• For some activities, applicant proposes working with existing partners to carry out activities, such as faith-based
organizations and the Correctional Health Services. Having an existing relationship with these entities will help
facilitate working together on the proposed activities.
• Recognizing when existing resources will not be adequate to carry out the activities is important. For example, it
is proposed that an epidemiologist will be hired for the PDMP activity. That addition will increase capacity to
respond to queries and requests submitted to the system.
• Applicant's proposed surveillance innovation projects seem feasible as they build off existing systems.
• The applicant provides evidence in the narrative that they have the capacity and experience to successfully
execute this plan. Specifically, they have worked with high risk populations, have evaluation and behavioral
health expertise in house, demonstrate through letters of support and narrative’s that they have extensive
history of collaborating with communities, experience in disseminating mortality and morbidity data, and have
history using data to support NOFO activities.
• The applicant describes the personnel and provides CVs for those who will be part of the project.
• There is already existing capacity for a public health approach to addressing opioid overdoses where data on
opioid overdoses, deaths, cases of neonatal abstinence syndrome, and naloxone administration is documented.
• The applicant proposes working with existing partners, which will help facilitate working together better.
• The applicant recognizes when existing resources will not be adequate to carry out activities
• The applicant’s proposed surveillance innovation projects seem feasible.
• The applicant provides CVs for everyone who is part of the project.
• There is existing capacity for a public health approach to this issue.
• The applicant is a large established health department and is PHAB accredited.
• The applicant currently has long-term qualified staff.
Weaknesses of Section:
• Overall, the prevention strategy activities would be new, and therefore no track record exists to show success in
implementing anything similar.
• Applicant's stated experience disseminating mortality and morbidity data and capacity to use drug overdose
death and morbidity data to support proposed interventions is vague.
• No notable weaknesses.
• No track record exists to show success for the prevention strategy activities.
• The applicant’s stated experience is vague.
Recommendations for Section:
• It is recommended that the applicant pilot test the prevention activities to test their feasibility and ensure
organization has the capacity to carry them out before investing resources in them.
• Pilot testing the prevention activities would be helpful.
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NOFO: CDC-RFA-CE19-1904
Applicant Number: NU17CE2019001966
Applicant Name: Maricopa County, AZ
The programmatic weaknesses and recommendations stated below are in addition to the weaknesses and
recommendations stated in your application review Summary Statement. You will be expected to address
these weaknesses in your revised Work Plan.
Overall
Weakness(es):
• Work plan proposes enhanced surveillance of HCV (as a proxy for injection drug use). This is not an
allowable activity. The enhanced surveillance of Hepatitis C is not an allowable activity.
• Strategy 7’s focus on Hepatitis C does not seem to address opioid prevention.
Recommendations:
• Please clarify whether or not strategy 7 will address opioid prevention.