Extracted text (via pymupdf)
56518 characters
(Subject to the availability of funds and satisfactory progress of the project):
a.
DEDUCTION
b.
ADDITIONAL COSTS
c.
MATCHING
d.
OTHER RESEARCH (Add / Deduct Option)
e.
OTHER (See REMARKS)
c.
This award notice including terms and conditions, if any, noted below under REMARKS.
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
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)
d. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION
c. Less Cumulative Prior Award(s) This Budget Period
a.
d.
b.
e.
c.
f.
13. Total Federal Funds Awarded to Date for Project Period
14. RECOMMENDED FUTURE SUPPORT
Salaries and Wages
Fringe Benefits
………………..................
TOTAL DIRECT COSTS
INDIRECT COSTS
TOTAL APPROVED BUDGET
Federal Share
Non-Federal Share
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
b.
21. a.
17. OBJ CLASS
b.
FY-ACCOUNT NO.
18a. VENDOR CODE
DOCUMENT NO.
18b. EIN
ADMINISTRATIVE CODE
19. DUNS
AMT ACTION FIN ASST
20. CONG. DIST.
APPROPRIATION
22. a.
23. a.
b.
c.
c.
c.
d.
d.
d.
e.
e.
e.
…………………….………
…………………………….
…………………………….
…………………………….
…………………………….
…………………………….
.…...….……
m.
n.
m)
YEAR
TOTAL DIRECT COSTS
YEAR
TOTAL DIRECT COSTS
ALL AMOUNTS ARE SHOWN IN USD
II Total project costs including grant funds and all other financial participation
b. Less Unobligated Balance From Prior Budget Periods
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
ALTERNATIVES:
15. PROGRAM INCOME SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING
ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY
OR BY REFERENCE IN THE FOLLOWING:
16. THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY, THE FEDERAL AWARDING AGENCY
a.
The grant program legislation.
b.
The grant program regulations.
10b. FEDERAL PROJECT OFFICER
10a. GRANTEE AUTHORIZING OFFICIAL
NOTICE OF AWARD
1a. SUPERSEDES AWARD NOTICE dated
Formerly
AUTHORIZATION (Legislation/Regulations)
4. GRANT NO.
5a. ACTION TYPE
6. PROJECT PERIOD
7. BUDGET PERIOD
9a. GRANTEE NAME AND ADDRESS
9b. GRANTEE PROJECT DIRECTOR
MM/DD/YYYY
MM/DD/YYYY
MM/DD/YYYY
MM/DD/YYYY
MM/DD/YYYY
1. DATE ISSUED
2. CFDA NO.
3. ASSISTANCE TYPE
8.
From
Through
From
Through
4a. FAIN
5. TYPE OF AWARD
except that any additions or restrictions previously imposed
remain in effect unless specifically rescinded
………………..................
Total Personnel Costs
Equipment
Supplies
Travel
Construction
Other
Contractual
TITLE OF PROJECT (OR PROGRAM)
2939 Brandywine Road
Atlanta, GA 30341
Section 311(c)(1) of the PHS Act (42 USC § 243(c)(1))
07/29/2020
09/01/2019
08/31/2022
09/01/2020
08/31/2021
Enhancing our Understanding of the Opioid Epidemic in Maricopa County in order to Augment Existing Interventions
982,075.00
421,129.00
1,403,204.00
0.00
13,120.00
46,199.00
75,270.00
718,047.00
2,255,840.00
433,120.00
2,688,960.00
0.00
2,688,960.00
0.00
0.00
3
4
5
b
41.51
0-9390BX6
19NU17CE924996OPCE
$2,688,960.00
I
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
93.136 - Injury Prevention and Control Research and State and Community Based Programs
Ms. Tracy Cruickshank
4041 N. Central Avenue
Suite 1400
Community Health Services
PHOENIX, AZ 85012
MARICOPA, COUNTY OF
1645 E Roosevelt St
Phoenix, AZ 85006-3638
Mr. Max Porter
4041 N. Central Ave
Suite 1400
Department of Public Health
Yarkasah Paye
1600 Clifton Rd
Atlanta, GA 30333
Phone: 404.718.7737
2,688,960.00
07
866000472
602062515
1866000472B9
75-20-0952
Cooperative Agreement
0.00
5,377,920.00
CE
7
8
Pamela Render, Grants Management Officer
2920 Brandywine Road
Mailstop E09
Atlanta, GA 30341
Phone: 770-488-2712
GRANTS MANAGEMENT OFFICIAL:
6
2,688,960.00
5 NU17CE924996-02-00
NU17CE924996
Non-Competing Continuation
Other
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 of
07/29/2020
5 NU17CE924996-02-00
2
PAGE
DATE ISSUED
GRANT NO.
NOTICE OF AWARD (Continuation Sheet)
2
AWARD ATTACHMENTS
MARICOPA, COUNTY OF
5 NU17CE924996-02-00
Terms and Conditions
1.
OD2A Special Terms and Conditions
2.
Technical Review
3.
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 May 6, 2020, 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 02 budget period,
which is September 1, 2020 through August 31, 2021. 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. CDC program support to
recipients will help ensure the success of the cooperative agreement by:
•
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;
•
Coordinating communication and program linkages with other CDC programs and Federal
agencies, such as Centers for Medicare and Medicaid Services (CMS), Food and Drug
Administration (FDA), the National Institutes of Health (NIH), the Substance Abuse and Mental
Health Services Administration (SAMHSA), Department of Justice (DOJ), and the HHS Office of
the National Coordinator for Health Information Technology (ONC);
•
Translating and disseminating lessons learned through publications, meetings, surveillance
measures and other means on promising and best practices to expand the evidence base;
•
Providing guidance on SUDORS data abstraction, use of necessary data sharing platforms (e.g.
NVDRS, NSSP ESSENCE) and CDC templates to collect ED data;
•
Supporting use of CDC ED case definitions by providing recipients computer programming code
such as SAS, R, and ESSENCE to implement the cases definitions if resources are available;
•
Providing ongoing data quality reviews and feedback on required ED and drug overdose death
data submissions; and
•
Providing technical assistance on data management plans.
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.
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.
Cost sharing or matching alternative: Under this alternative, program income is used to finance some or
the entire non-federal share of the project/program.
Note: The disposition of program income must have written prior approval from the GMO.
FUNDING RESTRICTIONS AND LIMITATIONS
Notice of Funding Opportunity (NOFO) Restrictions:
•
Recipients may not use funds for research.
•
Recipients may not use funds for clinical care except as allowed by law.
•
Recipients may use funds only for reasonable program purposes, including personnel, travel,
supplies, and services.
•
Generally, recipients may not use funds to purchase furniture or equipment. Any such proposed
spending must be clearly identified in the budget.
•
Reimbursement of pre-award costs generally is not allowed, unless the CDC provides written
approval to the recipient.
•
Other than for normal and recognized executive-legislative relationships, no funds may be used
for:
o publicity or propaganda purposes, for the preparation, distribution, or use of any material
designed to support or defeat the enactment of legislation before any legislative body
o the salary or expenses of any grant or contract recipient, or agent acting for such recipient,
related to any activity designed to influence the enactment of legislation, appropriations,
regulation, administrative action, or Executive order proposed or pending before any
legislative body
•
See Additional Requirement (AR) 12 for detailed guidance on this prohibition and additioal guidanc
e on lobbying for CDC awardees.
•
The direct and primary recipient in a cooperative agreement program must perform a substantial
role in carrying out project outcomes and not merely serve as a conduit for an award to another
party or provider who is ineligible
•
In accordance with the United States Protecting Life in Global Health Assistance policy, all non-
governmental organization (NGO) applicants acknowledge that foreign NGOs that receive funds
provided through this award, either as a prime recipient or subrecipient, are strictly prohibited,
regardless of the source of funds, from performing abortions as a method of family planning or
engaging in any activity that promotes abortion as a method of family planning, or to provide
financial support to any other foreign non-governmental organization that conducts such activities.
See Additional Requirement (AR) 35 for applicability
(https://www.cdc.gov/grants/additionalrequirements/ar-35.html).
•
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, 2020.
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
Natasha Jones, Grants Management Specialist
Centers for Disease Control
Branch 5 Supporting Chronic Diseases and Injury Prvention
2960 Brandywine Road
Atlanta, Georgia 30341
Email: njones6@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 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.
The grant document number identified beginning at 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:
Natasha Jones, Grants Management Specialist
Center for Disease Control and Prevention (CDC)
Office of Grants Services (OGS)
2960 Brandywine Road MS.E-01
Atlanta, GA 30341
Telephone: 770-488-1649
Email: njones6@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:
Peter Paye
Centers for Disease Control and Prevention
National Center for Injury Prevention & Control
4770 Buford Hwy S106-8
Chamblee GA 30341
Email: kvn7@cdc.gov
Telephone: 404-498-1839
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 information is located on Page 1 of this NOA.
GMO Contact:
Valencia Williams, Grants Management Officer
Centers for Disease Control and Prevention
Office of Grants Services
2960 Brandywine Road
Atlanta, Georgia 30341
Telephone: 404-498-3260
Email: yyr1@cdc.gov
1
CE19-1904 Overdose Data to Action Terms and Conditions
1
Surveillance Activities (Strategy 1-3)
Recipients must meet reporting timelines for the Surveillance Strategies as outlined in the NOFO and in Appendix 3 of the
NOFO. OD2A applicants must demonstrate capacity to meet all of the requirements within the selected tier and optional
activities in each Surveillance Strategy. Applicants are expected to meet reporting deadlines as stated for each budget year.
States will be held accountable for the requirements in the tier for which they apply. Failure to meet the required reporting
timelines for the selected tier and any optional activities selected under Strategy 1 and Strategy 2 may result in corrective
action. States may drop tiers and/or optional activities if they fail to meet reporting timelines. Decisions on surveillance tier
shifts or the elimination of optional activities should be made in collaboration with your CDC Science and Project Officers.
2
Prevention Activities
2.1
PDMP (Strategy 4)
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 making data accessible and for archiving and long-term preservation of the data collected or
acquired under this award (See additional requirements). 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.
Enhanced PDMP (see table 4.2 in NOFO)
Only states and territories that oversee PDMPs can receive enhanced PDMP dollars. In cases where a state does not have a
prescription drug monitoring program, a county, consortium, or other unit of local government within the state that has a
prescription drug monitoring program shall be treated as a state for the purpose of this activity.
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
2
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).
Connection to the Hub (RxCheck)
As stated, the recipient must allow other PDMP systems to exchange data via a direct connection to the PDMP hub. For
these purposes, states/territories are required to use RxCheck to respond to a state that has initiated a request via RxCheck
hub, but are not required to use RxCheck for any inter- or intrastate PDMP requests that the state itself initiates. The award
conditions allow each state/territory to determine its preferred hub for initiating inter- and intrastate data sharing with
another state or states. The award conditions require a state/territory to establish and maintain a connection to RxCheck in
order to ensure it can receive and respond to requests from states that have initiated a request using RxCheck hub (in
accordance with state law). For OD2A Special Conditions a “live” connection to RxCheck, is determined by BJA.
2.2
Peer-2-Peer Learning Coordinators (Optional Prevention Component)
“Peers” refer to OD2A recipients in other jurisdictions. Therefore, Peer-to-Peer curriculum and activities cannot be limited
to activities within the recipient's own jurisdiction and must be offered to those in other jurisdictions.
3
Evaluation Plans
OD2A recipients are required to complete the annual OD2A Self-Assessment survey by September 1, 2020. An
individualized link was shared with each jurisdiction on July 1, 2020 and is provided in your technical review. This survey will
cover year 1 of your OD2A work. The survey will have each recipients’ responses from the baseline assessment conducted
in October 2019, please change your responses to reflect any changes in capacity.
Evaluation plans for year 2 are due in the Partners Portal 90 days after the start of the budget period.
4
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, furniture or equipment.
o
Harm reduction and linkage to care activities are acceptable as long as O2DA funds are not used for
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 for the provision of substance use disorder treatment.
•
The prevention of Adverse Childhood Experiences (ACEs) as a stand-alone 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.
Other unallowables:
•
Medication for Opioid Use Disorder (MOUD): Funds can be used to support training and education related to
treating opioid use disorder (OUD). However, OD2A funds cannot be used to pay for fees associated with obtaining
3
a state medical license nor those associated with registration with the Drug Enforcement Administration (DEA) to
prescribe controlled substances, necessary precursors to obtaining a waiver to prescribe buprenorphine to treat
OUD. This applies to both direct reimbursements and contracts. If training, medical license, and/or DEA registration
fee activities occur together, it must be clear that OD2A funds are not being used to cover the medical license nor
DEA registration fees themselves. Other funding sources can be used to cover those fees.
•
Neonatal Abstinence Syndrome (NAS): Funding the collection of NAS surveillance data is not allowable unless the
activities are covered under the following examples (noted in the FAQs):
o
Surveillance of linkage to care during or after pregnancy for mothers who use opioids during pregnancy.
o
Tracking drug use patterns, overdose history, and linkage to treatment and risk reduction services for
pregnant women.
o
Linking data sources on pregnant women available at the state and local level.
o
Prevention strategies and activities for pregnant women, infants born with NAS, and for healthcare
provider/clinician support and education.
•
Human immunodeficiency viruses (HIV)/Hepatitis C surveillance (HCV): Funding collection of HIV-related and
HCV-related surveillance data is not allowable unless the activities are covered under the following examples:
o
Linking HIV/HCV datasets with drug overdose datasets.
o
Adding questions about substance use and drug overdose to interviews of people who newly acquired HIV
and/or HCV conducted as part of reportable diseases surveillance.
o
Conducting interviews about substance use and drug overdose with people who have HIV and HCV
because these groups are at high-risk of injection drug use.
Activities that must be funded under OD2A prevention and are unallowable under surveillance
•
Implementing prevention programs: A recipient must fund prevention programs with OD2A prevention funds and
not OD2A surveillance funds. For instance, the following activities can only be funded with OD2A prevention funds:
o
Hiring peer navigators to link people treated for an overdose in the emergency department with services.
o
Implementing a pilot project to enhance coordination of treatment of sexually transmitted diseases (e.g.,
HIV) and substance use disorders due to their frequent co-occurrence.
o
Forming a coalition of harm reduction groups in a state to create a strategic plan to expand and enhance
harm reduction related to injection drug use.
•
Collecting or expanding data collection of EMS data using ODMAP: Strategy 8 explicitly lists collecting first
responder data (e.g., EMS and law enforcement) through ODMAP as a suggested activity: “Implement High
Intensity Drug Trafficking Area’s (HIDTA) Overdose Detection Mapping Application (ODMAP).” (p. 32)
Consequently, OD2A prevention funding should be used to fund first responder data collection activities and not
OD2A surveillance funding. Strategy 3 surveillance funding may be used to link EMS data collected in ODMAP to
other data sources (e.g., emergency department data, treatment data, or workers compensation data).
•
Overdose Fatality Reviews (OFR): For the purposes of this NOFO, Overdose Fatality Reviews are considered a
prevention activity and not a surveillance activity. On page 26, Overdose Fatality Review is identified as a
suggested activity related to Strategy 5: Integration of State and Local Prevention and Response Efforts.
Page 1 of 15
National Center for Injury Prevention and Control (NCIPC)
Division of Overdose Prevention (DOP)
Overdose Data to Action (OD2A)
Technical Review
CDC-RFA-CE19-1904
Recipient Name: Maricopa County (AZ)
Grant Number: 1NU17CE924996
Budget Year: Budget Year 2
Requested Amount: $2,688,960
Recommended Amount: $2,688,960
Reviewers:
PO Reviewer: Tracey Hardy
Strategy 1 Lead: Choose an item.
Choose an item.
Strategy 6 Lead: Cherie Rooks-Peck
Choose an item.
Morbidity SO Reviewer: N/A
Strategy 2 Lead: Choose an item.
Choose an item.
Strategy 7 Lead: Josh Schier
Choose an item.
Mortality SO Reviewer: N./A
Strategy 3 Lead: Matt Gladden
Choose an item.
Strategy 8 Lead: Choose an item.
Choose an item.
PSO Reviewer: John Le
Strategy 4 Lead: Wes Sargent
Choose an item.
Strategy 9 Lead: Choose an item.
Choose an item.
EO Reviewer: Sierra Helfrich
Strategy 5 Lead: Aleta Christensen
Choose an item.
Strategy 10 Lead: Choose an item.
Choose an item.
Peer-to-Peer Lead: Choose an item.
Choose an item.
Page 2 of 15
1. Response to Technical Review (check one):
The recipient must submit a response to the weakness(es), and recommendations identified in the technical review by October 1, 2020 (Note:
The recipient’s response should be reflective only of the weaknesses identified therefore, resubmission of the entire application is not
required.)
☐ No response to Technical Review is required. (Note: The recipient should not respond to the technical review as no weaknesses were
identified)
2. Year 2 Work Plan (check one):
☐ Revised Work Plan is needed.
Revised Work Plan is NOT required.
3. Year 2 Budget (check one):
☐ Revised Budget is needed due to a reduction in proposed budget.
☐ Revised budget is needed due to weaknesses or errors identified.
Revised budget is NOT required.
Project Officer Name:
Tracey Hardy
Project Officer Signature: Tracey Hardy
Date
June 5, 2020
Tracey Hardy -S
Digitally signed by Tracey Hardy
-S
Date: 2020.06.05 20:11:29 -04'00'
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A thorough review of the interim progress report has been performed. The review considered the evaluation criteria published in the funding
opportunity announcement. Based on the review, the following was identified.
Section 1: OD2A Summary Technical Review Comments
Technical Review Comments
Strengths:
Annual Performance:
Maricopa County has encountered various programmatic changes during this reporting period, yet they have shown success in several strategies. They
have identified challenges and barriers and the activities they will implement to address them. There are several activities implemented by the recipient
that are innovative and they are noted in this performance report. Maricopa County has demonstrated the ability to analyze situations, develop plans to
address the situations and effectively implement solutions. One example of this is the work completed in Strategy 5.
Year 2 Work Plan:
The Year 2 work plan is detailed, and it builds on the activities from Year 1.
Weaknesses:
Data Management Plan:
Strategy 3 is missing justification for not making the data publicly available. We understand that it is not always possible to make data publicly
available, but if data are not going to be made publicly available as data that can analyzed by others (i.e. only made available in aggregate form), please
note that justification will be required in the final plan. Please see https://www.cdc.gov/grants/additional-requirements/ar-25.html for more information.
A contact for data access will need to be included in the final plan. No updates required at this time.
Evaluation:
The evaluation plan submission is lacking detail to fully understand the plan.
Recommendations:
Year 1 Evaluation Plan:
OD2A recipients are required to complete the annual OD2A Self-Assessment survey by September 1, 2020. The link to your individualized survey is:
https://overdoseprevention.iad1.qualtrics.com/jfe/form/SV_38a3Ui6qcyGhnb7?Q_R=R_bedqKByxAlJgtSJ
This survey will cover year 1 of your work on OD2A. The survey will have each recipient’s responses from the baseline assessment conducted in
October 2019, please change your responses to reflect any changes in capacity.
•
Address any suggested improvements and recommendations conferred to you by your EO in your evaluation plan feedback and incorporate it in
your evaluation plan.
•
OD2A funded jurisdictions are required to report on-going progress of their evaluation activities in the Partner’s Portal, which may include
evaluation results, successes, and lessons learned.
•
Evaluation plans for year 2 are due in the Partners Portal at a future date. This date will be communicated by CDC in the terms and conditions
of your award for year 2.
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Section 2: OD2A Strategy-specific Technical Review Comments
Summary (Strategy 1)
Technical Review Comments
Strengths
N/A
Weaknesses
N/A
Recommendations
N/A
Summary (Strategy 2)
Technical Review Comments
Strengths
N/A
Weaknesses
N/A
Recommendations
N/A
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Summary (Strategy 3)
Technical Review Comments
Strengths
Annual Performance:
Several strengths from Maricopa’s County performance report include the following:
•
Investigation protocol for non-fatal opioid overdoses…details the processes for: how…Investigators will be assigned cases through the
electronic disease reporting system MEDSIS; how to classify a case…how to access the electronic health record and obtain labs and additional
information that may be pertinent to the investigation such as whether the patient was already connected to substance use treatment and/or
behavioral health services by hospital staff; and how to link the individual to substance use treatment and other needed resources that may arise
during the course of the investigation such as housing needs.
•
The recipient created protocol for opioid overdose investigations. They worked with Coconino County, who had already implemented this
activity, for information on their protocols, challenges, and successes.
•
The partnership with the OAR Line, which is funded by ADHS but hosted by a local hospital system.
•
Their work with the local nonprofit Sonoran Prevention Works to review the risk factor information they plan to collect.
•
Even with challenges and barriers they were able to hire for three essential positions.
•
The recipient is working on a protocol for conducting investigations and linking patients to treatment.
Work Plan:
The recipients work plan builds on strengths in Year 1 and include activities that are in line with achieving the stated objectives.
Success Stories:
More in-depth investigations of people who experienced a non-fatal overdose and people with HCV are likely to yield important data that will enhance
OD2A prevention and linkage to care efforts.
Weaknesses
Work Plan:
According to the APR, work on this project has been delayed due to COVID-19. The work plan, however, does not provide any information on these
delays. CDC requests the following information:
•
What is the tentative date that the project is expected to be launched (e.g., a date range is fine such as December 2020 to April 2021)? CDC
understands that this date may change as the COVID-19 pandemic evolves.
•
How long will it take to launch this project if the COVID-19 situation improves and staff are able to focus on this project (e.g., 6 months or 1
year)?
•
Since some level of social distancing may exist for at least the next year, can the current protocol or a modified protocol be implemented when
social distancing is still in affect?
The APR states that 93 patients have been classified as a confirmed, probable, or suspect case per month and that a draft protocol exists to interview
patients. The work plan, however, provides no detail on who will be interviewed (e.g., just confirmed or probable cases or all cases) and if all cases
versus a sample of cases will be investigated. Please clarify and provide these details if available.
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Strategy 3 Priority 2: Enhanced Surveillance of Hepatitis C Virus on People with SUD
•
According to the APR, work on this project has been delayed due to COVID-19. The work plan, however, does not provide any information on
these delays. CDC requests the following information:
•
What is the tentative date that the project is expected to be launched (e.g., a date range is fine such as December 2020 to April 2021)? CDC
understands that this date may change as the COVID-19 pandemic evolves.
•
How long will it take to launch this project if the COVID-19 situation improves and staff are able to focus on this project (e.g., 6 months or 1
year)?
•
Since some level of social distancing may exist for at least the next year, can the current or modified protocol be implemented when social
distancing is still in affect?
The work plan does not describe how many people will be interviewed as part of this effort, whether sampling will be used, and whether people with
HCV acute and chronic infections will be interviewed or people with just HCV acute infections. Please clarify and provide these details if available.
•
Will the need to better integrate lab results to distinguish acute/chronic HCV cases delay implementation of this project into Year 3 of funding?
Recommendations
Work Plan: Strategy 3 comments across Strategy 3 projects
Due to the challenges of COVID-19 and the 3-year length of the OD2A funding announcement, CDC strongly suggests that MCDPH
streamline or consolidate their Strategy 3 activities.
•
Possible approaches include dropping an activity such as Activity 3 (Community Assessment of Risk Related Behaviors and Access to Care for
People with OUD) and/or streamlining or reducing the number of investigations by using sampling. CDC strongly prefers one or two projects
be completed and used during the 3-year funding period instead of all three projects being implemented in Year 3 or delayed further.
•
CDC recommends a call to discuss Strategy 3 in late summer or early fall 2020 to discuss possible ways of addressing the COVID-19 delays.
None of the Strategy 3 projects discuss the type of aggregate data that will be shared with CDC at the end of Year 2 as required by the NOFO
and when this data is likely to be shared. CDC requests the following information:
•
A general description of the type of deliverable that will be shared with CDC (e.g., public or internal report on investigations or high-level
findings backed by summary statistics). This can be modified during Year 2.
•
Whether current COVID-19 delays are very likely to prevent MCDPH from meeting the Year 2 deadline to share aggregate data with CDC for
one or all projects.
Please share finalized interview protocols with CDC.
With substantial Strategy 3 staff time dedicated to COVID-19, please provide any major achievements of deployed staff.
Strategy 3 Priority 6: Community Assessment of Risk Related Behaviors and Access to Care for People with OUD
•
The APR noted that MCDPH “….decided to cancel the Request for Quotes and repost at a later time. Under current social distancing
guidelines, it would not be feasible to meet with stakeholders and conduct focus groups as described in the RRQ.” (p. 11). The work plan,
however, does not provide details on how the timeline and project will be adjusted in Year 2. CDC requests the following information:
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•
Since COVID-19 public health measures are likely to continue throughout the year, does MCDPH think it will be feasible to launch this project
during the 3-year funding period of the OD2A NOFO? If so, please provide a brief description of how.
•
Which at-risk will the feasibility analysis focus on? Alternatively, does it plan to focus on people who inject drugs as well as people who
identify as LGBTQ and people who engage in sex work who misuse opioids and other drugs?
•
CDC would be interested in getting the scope of work described in the Request for Quotes when finalized.
Summary (Strategy 4 Base)
Technical Review Comments
Strengths
Annual Performance:
Despite multiple delays in the hiring of the Maricopa County Epidemiologist at the Arizona Board of Pharmacies (ABOP), ABOP was able to hire an
epidemiologist that will focus on work outside of Maricopa County. MCDPH has collaborated with ABOP to implement processes and systems that
will be utilized by both epidemiologists to insure a swift transition after the hiring of the Maricopa County Epidemiologist
The recipient identified data visualization software that will allow ABOP to develop a PDMP dashboard with enhanced analytics.
ABoP and MCDPH staff have continued to maintain open communication and regular meetings to support and coordinate activities to implement the
evaluation plan as well as regular monitoring of strategy progress and developing plans to overcome challenges encountered
•
Additionally, MCDPH has developed strategies ensuring deliverables are met in the timeliest manner despite delays from variables outside of
the recipient’s control.
MCDPH regularly engages with key partners such as substance abuse coalitions, faith-based organizations and employers
Weaknesses
Annual Performance:
Hire Epidemiologist: The recipient does not wish to roll this to the Year 2 workplan but does not specify a timeline for completion. Given the
uncertainty surrounding COVID-19, delays in hiring may continue which would require these activities to be completed in year 2 of the cooperative
agreement.
Develop and implement a system prioritizing data query requests: The recipient does not wish to roll this to the Year 2 workplan but does not specify a
timeline for completion. Given the uncertainty surrounding COVID-19, delays in hiring may continue which would require these activities to be
completed in year 2 of the cooperative agreement.
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Work Plan:
The jurisdiction provides a lack of detail regarding the data limitations that will arise from the state statutes. Will these effect grant deliverables? If so,
how will these problems be addressed?
Recommendations
Annual Performance:
To the best of their ability, given the uncertainties of COVID-19, the recipient should provide a rough timeline for the hiring of the Maricopa County
Epidemiologist.
Are other contingency plans in place? Once the epidemiologist is hired, are there processes in place to facilitate a timely onboarding and sufficient
training given the current COVID-19 environment? Consider conversion of materials and training to virtual if not already.
Work Plan:
Provide more details regarding how barriers from state statues will be overcome.
Summary (Strategy 4 Enhanced)
Technical Review Comments
Strengths
N/A
Weaknesses
N/A
Recommendations
N/A
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Summary (Strategy 5)
Technical Review Comments
Strengths
Annual Performance:
MCDPH successfully recruited and hired the Substance Exposed Newborn (SEN) Coordinator
•
SEN coordinator has established relationships and recruited members for the SHIFT Taskforce (Formerly SEN)
•
On schedule for the development of the prevention taskforce strategic plan
•
Adapting to the challenges presented by COVID-19 by utilizing virtual meeting platforms for taskforce meetings
Collaboration with Arizona Department of Health Services [ADHS])
•
MCDPH has scheduled and hosted monthly calls with ADHS, discussing project alignment, leverage resources, and identify future
opportunities for collaboration
Maricopa County has been invited to present on parental substance use and child health in a number of different venues.
The recipient is resiliently adapting to coronavirus effects on their strategy 5 activities and is moving SHIFT meetings to a virtual setting.
Maricopa County has infused trauma-informed values into their SHIFT work.
Maricopa Country was very involved in the Community Outreach and Training group and in updating the Rx Toolkit until these items were sunset.
The recipient proactively reached out to CDC on activities pertaining to the Community Outreach and Training Group and the Rx Toolkit as these
activities were affected by leadership change within the Arizona Substance Abuse Partnership and by proprietary issues. These issues are not within
Maricopa County’s control but affect what Maricopa County had planned to do. They are increasing communication with ADHS at present.
Work Plan:
Year 2 plans for the Maricopa SHIFT Taskforce (formerly known as SEN Prevention Taskforce) include the development of a prenatal care plan and
facilitating trainings on those plans. This work will be based on the Children and Recovering Mothers (CHARM) evidence-informed model.
Maricopa County has the involvement of a variety of stakeholders in their SHIFT work.
Maricopa County is planning to develop SHIFT protocols that can facilitate access to care.
Success Stories:
SEN Prevention Taskforce
Data suggests that 901 Arizona babies were born with possible drug related withdrawal symptoms between June 15, 2017 and July 31, 2018. Reported
cases of suspected neonatal abstinence syndrome cases over the same period indicate that 70% are from Maricopa County. The Shift Taskforce was
created to support the work of the statewide Substance Exposed Newborn taskforce for their work within Maricopa County and eventually implement
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the Children and Recovering Mothers model to streamline services for the target population, increase collaboration, and demonstrate improved
outcomes for pregnant women with a SUD.
Weaknesses
Work Plan:
The multi-sector collaboration will need to be effectively managed to identify early strengths, weaknesses and opportunities for growth. The recipient
should inform their Project Officer if there are any technical assistance or training needs that can be provided by CDC.
Maricopa County has little community engagement or education activities planned outside of SHIFT; this is likely due to the very recent sunsetting of
the Community Outreach and Training group though, which was not planned by Maricopa County.
Recommendations
Annual Performance:
Understanding that re-tooling may be a big lift given current coronavirus capacity demand but the recipient previously mentioned naloxone distribution
and conducting a vulnerability assessment. Perhaps they could conduct a vulnerability assessment to move community engagement and education
activities forward under Strategy 5 in year two?
Work Plan:
The plan could be enhanced by commenting on whether and how Maricopa County will present educational material on parental substance use and
child health that is presently scheduled for conferences/events (should in-person gatherings be cancelled due to coronavirus); it would be great to see
these materials distributed in some format since the topics are important and Maricopa County has already put significant time into developing these
materials.
Maricopa County could elaborate a bit more as to what the SHIFT taskforce has achieved since its implementation.
Strategy 5 activities may be strengthened by referring to pregnant people, recognizing that not all people who give birth identify as women
(https://hiveonline.org/wp-content/uploads/2019/10/Trans-pregnancy-best-practices-infographic-2019-pdf.pdf)
Success Stories:
The success story could be enhanced by providing more detail on accomplishments of the SHIFT taskforce.
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Summary (Strategy 6)
Technical Review Comments
Strengths
Annual Performance:
The decision to conduct a readiness assessment of faith-based organizations demonstrates that the recipient is deliberate in their approach to working
with faith-based organizations. This approach also gives the recipient and organizations the opportunity to identify if they understand the issue and are
truly prepared to implement activities that address opioid and substance use and misuse.
Excellent work engaging with a local faith-based non-profit even with the challenges encountered hiring a Faith Based Coordinator. The recipient
moved forward with identifying participants for the faith-based taskforce, completed and reviewed the faith based opioid needs and readiness
assessment and started the draft of an action plan.
Recipient was proactive with their outreach to national faith leaders from the Tennessee Department of Health. This work allowed the recipient to
obtain information regarding recommended strategies and how to engage with local congregations.
The development of the heat map of fatal and non-fatal overdoses in Maricopa County was used to outline high burden areas. This heat map was
beneficial in identifying the areas of need and how those areas overlapped with the location of the faith-based organizations that participated in the
readiness assessment.
Maricopa County shows great adaptability and innovation in their exploration of virtual peer navigation services amidst the barriers presented during
the COVID-19 pandemic.
Work Plan:
Maricopa County’s work with the faith-based community is very strong. In Year 2 of the cooperative agreement, the jurisdiction plans to organize an
action plan, host several trainings, and support a system-level improvement in linkages to care within the faith-based community.
Maricopa County proposes very meaningful work related to juvenile justice linkages to care. Including improvements in EHR to track at-risk children,
trainings, and connecting children involved in the justice system to opioid related care.
The proposed work under this strategy is very strong. COVID-19 has caused substantial barriers to proposed activities, be sure to be in communication
with PO if delays continue.
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Weaknesses
Annual Performance:
Faith Based Coordinator
•
Due to uncertainties arising from the COVID-19 pandemic, Maricopa County has been delayed in hiring their Faith Based Coordinator, putting
this activity behind schedule
Juvenile Justice Linkages to Care
•
Due to uncertainties arising from the COVID-19 pandemic, Maricopa County has been delayed in hiring their Juvenile Specialist, which has
slowed down progress towards this activity
•
Cost analysis proposed in year 1 workplan has been delayed and is behind schedule due to delayed communication between several
stakeholders, in addition to the COVID-19 pandemic.
Correctional Health Services Linkages to Care
•
COVID-19 has slowed down the hiring process for the Peer Navigator Coordinator and all four peer navigators. In addition, peer navigators are
being prohibited from entering Maricopa County jails to slow the spread of COVID-19. Combined, these barriers have slowed progress on this
activity
Recommendations
Work Plan:
Continued communication with Project Officer and CDC Support Team for ensuring grant deliverables in the midst of the COVID-19 pandemic.
Success Stories:
The work with faith-based organizations has the potential to be a major success story for the recipient. It will be important for Maricopa County to
document strengths, weaknesses, opportunities for growth and early wins. This will allow for the recipient to identify problems and develop solutions
that would be an important part of their success story.
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Summary (Strategy 7)
Technical Review Comments
Strengths
Annual Performance:
The recipient established a contract with the Arizona Alliance of Community Healthcare Centers (AACHC) to develop a training assessment and
implement the assessment in the 10 Federally Qualified Healthcare Centers (FQHC) in Maricopa County. This activity identified that previously
identified training was no longer needed. They also identified that a follow-up assessment needed specific questions related to the needs of the
FQHCs.
Given the challenges and barriers experienced in the first six (6) months of the award, it is noted that the recipient has made the following progress:
•
Hiring a program manager at AACHC
•
Developing training topics
•
Creating and collecting content needed to develop the training curriculum
•
Developing training policies, procedures, methods, schedules and evaluation
Work Plan:
The recipients planned progression of training activities mentioned in Y1 APR (10 trainings) to clinicians and providers continues.
Maricopa County’s plan to provide systems-based support to 2 community health systems to include linkage to care type activities is a strength.
Weaknesses
None noted
Recommendations
Annual Performance:
Delays in the hiring of the program manager at AACHC slowed the progress of activities related to this strategy. These delays are outlined within the
APR in a sufficient manner and the recipient should continue communication with the Project Officer and CDC Support Team to ensure grant
deliverables in the midst of the COVID-19 pandemic.
Work Plan:
The Project Officer will work with the recipient to obtain additional detail on the sub-activities that will be conducted to meet the aligned activities.
Summary (Strategy 8)
Technical Review Comments
Strengths
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N/A
Weaknesses
N/A
Recommendations
N/A
Summary (Strategy 9)
Technical Review Comments
Strengths
N/A
Weaknesses
N/A
Recommendations
N/A
Summary (Strategy 10)
Technical Review Comments
Strengths
N/A
Weaknesses
N/A
Recommendations
N/A
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Summary (Peer to Peer Learning Coordinators)
Technical Review Comments
Strengths
N/A
Weaknesses
N/A
Recommendations
N/A
FOR AND ON BEHALF
OF MARICOPA COUNTY
By_________________________________
Clint Hickman, Chairman, Board of Supervisors
______________________________
Date
ATTEST:
_______________________________
Office of the Clerk of the Board
_______________________________
Date
APPROVED AS TO FORM:
_______________________________
Attorney for Maricopa County
_______________________________
Date