Questions and Answers Document

CDC-RFA-DP17-1705
Scaling the National Diabetes Prevention Program in Underserved Areas

Part #9, Week of 6/5- 6/9

Table of Contents
(Click on the topic area below to navigate to each section)

Use of Grant Funds ....................................................................................................................................... 2

Application .................................................................................................................................................... 2
FOA Details .................................................................................................................................................... 3
Eligibility ........................................................................................................................................................ 3
Priority Populations ...................................................................................................................................... 4
Organizational Capacity ................................................................................................................................ 4
DPRP Standards............................................................................................................................................. 4
FOA Requirements/Strategies and Activities ................................................................................................ 5

CDC-RFA-DP17-1705 Questions and Answers 1

Use of Grant Funds

Q1. Transportation is an issue for some who cannot make each class. Is there
funding to assist with this?

A. Yes, grant funds may be used for transportation vouchers for priority population
participants.

Q2. Will the grant work like Chronic Disease Self-Management Education
programs where organizations are reimbursed a set amount per completer? Or
is there funding for the lifestyle coach salary?

A. Funded grantees will propose how they will pay their affiliate delivery sites using
some type of pay for performance model. Pay for performance or value-based
payment methods are used by payers to make a series of payments based on
the achievement of attendance or weight loss milestones. For example, payment
may be made after the completion of 4 sessions, 9 sessions, 16 sessions, and
then at the end of the year-long program. Payment may also be contingent on
achieving weight loss outcomes. CDC does not prescribe a single pay for
performance method; however, grantees are expected to use these type of
arrangements when using grant funds to pay for the cost of enrolling participants.
CDC will work with grantees post-award on the specific payment models.

Q3. Can grant funds be used to pay for health screenings?

A. No, grant funds cannot be used for health screenings.

Q4. Can grant funds be used to pay for a health professionals time/counseling of
a person who receives a health screening?

A. Grant funds can only be used to support the required strategies in the FOA. In
general, under Strategy 2 (Increase clinician screening, detection, and referral of
Adults with prediabetes to CDC-recognized programs), funds can be used to
implement system level policies, procedures, and programs to increase
screenings and referrals. However, this would not include paying individual
clinicians to do counseling or make referrals.

Application

Q5. Is a 10% indirect rate allowed if there is no negotiated rate?

A. The FOA states clearly on p. 28 that if an applicant is requesting indirect costs,

then a copy of the indirect cost-rate agreement is required. If indirect costs are
requested, applicants must include a copy of the current negotiated federal

CDC-RFA-DP17-1705 Questions and Answers 2

 indirect cost rate agreement or a cost allocation plan approval letter for those
under such a plan.

Q6. Regarding Administrative Requirement 8 -- Public Health System Reporting,

please clarify to whom this report should be directed. In the requirement, we
see that it should be sent to the head of the appropriate State and/or local
health agency(s) in the program area(s) that may be impacted by the proposed
project. Yet, as we research the state directories, it is not clear. Is there a
specific title that would be appropriate? If not, could the single point of
contact you reference in the instructions be the recipient? If so, is there a
listing of these points of contact for each state that you could provide?

A. This requirement only applies to funded awardees. CDC will work with funded
grantees post award to ensure that all appropriate administrative requirements
are met.

FOA Details

Q7. In the FOA, theres wording indicating that project data collection funded
through this FOA must be made publicly available. Can you clarify if this
includes identifiable participant information or participant information that
contains PHI (beyond the DPRP report)? I ask because organizations who are
covered entities would need to get special permission from participants in
order to share this data. While we understand CDC has a public health
organization can collect surveillance data, the challenge is the reporting and
approvals that may be needed to provide this information.

A. No information collected either through this FOA or as part of the Diabetes

Prevention Recognition Program will contain any identifiable participant
information.

Eligibility

Q8. Our organization has affiliates sites in 3 states California, Oregon and Hawaii.
We are planning on focusing on Kings County, California and Tillamook
County, Oregon initially. Do we need to indicate a plan for a third state, Hawaii
as well? Does participating in two counties in two state be possible if it
reaches the target numbers? It is not clear if activities need to occur in the 3
states despite reach the participants and growing in two states?

A. Yes, work must occur in affiliate sites in at least three states, even if the
enrollment targets could potentially be met in only two states. The purpose of this
FOA is to expand the infrastructure for the National DPP as widely as possible, in
part so that as many Medicare beneficiaries as possible will have the opportunity
to participate in a program when Medicare coverage is finalized.

CDC-RFA-DP17-1705 Questions and Answers 3

Priority Populations

Q9. Can a grant application specify 1 or 2 priority populations only that will be
targeted? Or is priority given to applications that show a breadth of reach
across multiple priority populations?

A. All applicants must serve Medicare beneficiaries and at least one other priority
population. All applicants are reviewed according to the criteria in the
FOA. There is a criteria related to documenting the approach to reaching priority
populations, but there is no criteria that would result in priority being given to an
applicant solely on the basis of choosing multiple priority populations. An
applicant that provides a strong justification for how it will reach a single priority
population could receive a higher score than an applicant that provides a weak
justification for reaching multiple priority populations.

Organizational Capacity

Q10. We would like clarification on the term full-time staff person as it relates to
this grant application. By full-time, do you mean full-time employee of our
organization? Is it acceptable to assign a current full-time staff member to
oversee the project on a part-time basis, (i.e., if awarded 50% of the full-time
employees job will be devoted to the program)? Or do you mean that our
organization must devote the services of one of our employees to the project
full-time, (i.e., name an employee on staff who will devote 100% of their time
to the project)? Likewise, please respond to the same question regarding the
full-time program evaluator.

A. The overall grant must be led by a full-time program manager (100% time or 40
hours/week) and the evaluation effort must be led by a full-time evaluator (100%
time or 40 hours/week). The program manager should be an employee of the
applicant organization. Organizations may contract for evaluation support as long
as the contracted evaluator is working 100% time (or 40 hours/week) on the
grant.

DPRP Standards

Q11. Is a Fully Recognized face-to-face Program that switches to using a

virtual training and virtual tools to collect weight and physical
activities still Fully Recognized or do they have to start the Recognition
Process all over; revert back to Pending status?

A. Any CDC-recognized organization (full or pending) that makes changes to its

curriculum or delivery method must resubmit the new curriculum or information
about delivery modality to the DPRP for review. If the changes are approved, the
DPRP will work with the organization on transition issues.

CDC-RFA-DP17-1705 Questions and Answers 4

Q12. On page 4 of the Diabetes Prevention Recognition Program, please confirm
that we are correct to assume that either a traditional blood draw for A1c and a
rapid diagnostic test are acceptable for participant eligibility. Assuming rapid
diagnostic testing is acceptable in meeting the terms of participant eligibility,
is it permissible for the grant applicant to provide financial support to cover
total costs of rapid diagnostic screenings inside or outside the grant?

A. A traditional blood draw for A1c is an acceptable blood-based diagnostic

test. The FDA has not yet approved point of care A1c testing using a fingerstick
blood draw for diagnostic purposes. However, in either case, grant funds cannot
be used to cover the costs of diagnostic screening. For purposes of CDC
recognition, up to half of participants may be eligible on the basis of a
Prediabetes Risk Test.

FOA Requirements/Strategies and Activities

Q13. Do applicants and affiliate site programs need to meet the requirements of
the 2015 DPRP Standards and Operating Procedures?

A. All affiliate sites are expected to apply for CDC recognition and meet the
requirements of the 2015 DPRP Standards.

Q14. We have had trouble meeting CDSME standards for completers in our very
rural area. Having everyone show up for classes for 6 consecutive weeks is
difficult. We do not have flexibility, and if we dont have the minimum
attendance at each session, there is no credit for anyone who completes. Do
online courses or smaller classes offer greater flexibility for meeting CDSME
standards for completers in rural areas? It seems there is more flexibility
with CDC offering on-line options as well as smaller groups. Am I correct or
did I miss something?

A. This FOA will only fund the National DPP lifestyle change program and will not
fund CDSME programs. All delivery sites will need to meet the intensity and
duration standards (attendance and retention) as specified in the DPRP
Standards. We have CDC-recognized organizations in rural areas that have
received full CDC recognition, so this is possible. Funded grantees will need to
provide the affiliate delivery sites with the necessary TA and Training to help
them achieve full CDC recognition. CDC will also provide TA and Training to
funded grantees and affiliate sites.

Q15. What is the minimum class size for diabetes courses?

CDC-RFA-DP17-1705 Questions and Answers 5

 A. The DPRP Standards do not specify a minimum class size. In general, we
recommend that classes be between 10-20 participants to allow for some drop
off in attendance and still have enough participants staying in the program for the
full 12 months to meet the DPRP intensity and duration standards.

Q16. Can the organizations reschedule an individual if they cannot participate in a

specific class?

A. Yes, make-up classes are allowed, either in person or virtually (online, telephone,
videoconferencing, etc.).

CDC-RFA-DP17-1705 Questions and Answers 6