FY20 (Year 4)

Work Plan in Response to CIO Project Plan

OT18-1802 Cooperative Agreement

Strengthening Public Health Systems and Services through National Partnerships to Improve and Protect the Nation’s Health


YEAR 3 WORK PLAN
Describe the project activities. Include the project description, topic areas, strategies, activities, outputs, performance measures, and outcomes.
16		Target Population Description (25 words maximum) *
		Community health centers and the patients, and communities served
17		Project Description (250 words maximum) *
		The COVID-19 pandemic has caused significant disruption to the nation’s public health and healthcare infrastructure. Community health centers serve as the safety net to the highest-risk patients and often serve as first responders to emergencies such as hurricanes, fires and public health crises. The National Association of Community Health Centers (NACHC) proposes to engage local health centers as trusted brokers to build the evidence base of effective interventions to reduce disparities in adult vaccination rates amongst diverse populations (homeless, mobile, rural, refugees, behavioral health, LGBTQ, farmworker, non-English speakers, immigrants etc). NACHCS approach will include a package of mechanisms to contribute to the evidence-based messaging and models: · Grants to health centers who serve high risk patient populations to engage patients and their communities to co-create messaging and interventions that add value to patients’ health and wellness. · Establish a learning community of grantees to use human centered design and design thinking to engage patients and communities ensuring it is culturally responsible, scalable and sustainable to implement strategies to increase vaccine rates amongst high risk and vulnerable populations. · Engage public health, community based organizations, faith based groups, food banks, REACH, employers, barber shops, contractors to collaboratively address vaccine adoption across individual community eco-system for high risk populations. The results will include · 40 health center grantees to contribute to the evidence base of interventions · A virtual curriculum for engaging high risk communities nationally · New models of local partnerships and touch points across sectors of care to increase adult immunization coverage in high-risk vulnerable communities.
19		Program Strategies* Rank the relevant program strategies in order of emphasis. Use "1" to indicate the primary program strategy, and ascending numbers (i.e. 2, 3, etc.) to indicate strategies of lesser emphasis. Additional fields will display and must be completed for each strategy selected.
	#	19.1. Public Health Systems Infrastructure: Activities to improve operational capacity, such as policies and plans, administration and management, and quality improvement
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.

		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.

		Outputs* Use bullets to list outputs.

		Select the program outcome(s) related to the project.
		Short-term Improved operational capacity to evaluate, manage, and improve public health systems Intermediate Increased capability of public health systems to achieve nationally established standards
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.

		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.

	#	19.2. Leadership and Workforce Development: Activities to improve leadership and workforce competencies, recruitment, and retention
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.

		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.

		Outputs* Use bullets to list outputs.

		Select the program outcome(s) related to the project.
		Short-term Improved leadership capacity to identify and prioritize public health needs Strengthened core and discipline-specific public health competencies among the workforce to improve job performance Intermediate Increased leadership decision-making to address public health needs strategically and systematically Strengthened capability of public health workforce to deliver essential public health services
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.

		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.

	#	19.3. Data and Information Systems: Activities to improve collection, management, interpretation, and dissemination of data to guide decision-making
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.

		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.

		Outputs* Use bullets to list outputs.

		Select the program outcome(s) related to the project.
		Short-term Improved capacity of data and information systems to conduct public health monitoring and surveillance Intermediate Increased capability to use data to inform decision-making and support evidence-based practices and policies
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.

		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.

	#	19.4. Communication and Information Technology: Activities to improve use of communication and information technology to affect health decisions and actions
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.

		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.

		Outputs* Use bullets to list outputs.

		Select the program outcome(s) related to the project.
		Short-term Improved communication and information technology capacity to inform the public efficiently and effectively Intermediate Strengthened capability to use communication and information technology to affect health decisions and actions
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.

		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.

	#	19.5. Partnerships: Activities to improve establishment and maintenance of results-driven partnerships
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.

		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.

		Outputs* Use bullets to list outputs.

		Select the program outcome(s) related to the project.
		Short-term Improved capacity to establish and maintain partnerships within and across sectors to create a shared vision of health Intermediate Strengthened capability to respond to public health priorities collaboratively and strategically
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.

		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.

	#	19.6. Laws and Policies: Activities to improve the ability to interpret and inform laws, including statutes and regulations, and policies that affect health
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.

		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.

		Outputs* Use bullets to list outputs.

		Select the program outcome(s) related to the project.
		Short-term Increased capacity to evaluate laws and policies to affect health Intermediate Strengthened capability to systematically apply and use laws and policies to improve health
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.

		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.

	#	19.7. Programs and Services: Activities to improve the identification of best practices and the implementation of evidence-based/informed programs and services
		Describe the overall project approach, including the activities, outputs, performance measures (process and outcome), and budget period outcomes related to the program strategy.
		Activities* List activities using the format: A1, A2, A3, etc.
		A1. NACHC will conduct an RFP process to launch the health center subaward grant program to target health centers who serve high risk, vulnerable populations including: homeless, migrant, refugees, immigrant, non-English speakers, jail and corrections, LGBTQ, rural and other emerging populations. A2. NACHC will conduct a review process to select up to 40 health centers, primary care association, and health center-controlled networks. A3. NACHC will design a 6 -month virtual learning collaborative for participant 40 health centers (primary care associations and health center controlled networks) using design thinking, human centered design, CDC evidence based messaging, lessons learned from third world countries, apply examples from COVID-19 outreach and models, evidence based care and implementation science to increase immunization rates with individuals and their communities that are hesitant to engage in health care/systems. A4. NACHC with health centers and CDC will develop a dashboard for monthly monitoring of key activities, product development, populations served, metrics with bidirectional feedback loop from national, state, community public health to patients/families/communities with information patients’ value to make healthy decisions to stay well. A5. The 40 organizations will convene internal teams for participation in the learning community. Internal teams will include a cross section of individuals such as: Nurses, revenue managers, community health workers, translators, pharmacists, dental hygienists, communications, to leverage all parts of the health center system are coordinated and aligned to meet the needs of the communities and patients. A6. The 40 organizations will work on community workflows (eco-systems) and internal work flows to ensure standardization and harmonization of messaging, evidence-based practices across sectors as well as creating an understanding of the many touch points of vulnerable populations. A7. Participant organizations will identify local partners to engage to ensure adult immunization rate improvement such as employers, local health departments, community based organizations, faith based organizations, REACH Programs, tribes, food banks, botanicas, ethnic markets etc. to work with standardization and harmonization of evidence based messaging and increase access to adult immunization services. A8. NACHC will create a data governance structure to meet health center compliance on sharing of data with community partners, local health department, state health departments etc. A9. NACHC will summarize results of promising practices to reach vulnerable populations with hesitancy and distrust of the health care system to improve adult immunization rates and reduce disparities.
		Process Measures* List process measures using the format: PM1, PM2, PM3 etc.
		PMI Number of applications awarded for subaward program PM2 Protocol for review process PM3 Personas and goal for virtual learning community PM4 Number of process measures for learning community that are actionable by patients PM5 Number and profile of organization teams PM6 Number and type of locations populations engage PM7 Number and types of partners organizations collaborate to reduce vaccine hesitancy and engage in increasing immunization rates. PM8 Number of policies for data governance PM9Number and types of promising practices
		Outputs* Use bullets to list outputs.
		· Subaward grantee program · Virtual learning community curriculum co created with communities using design thinking and human centered design tools · Data governance tools/templates · Promising practices for scale and spread
		Select the program outcome(s) related to the project.
		Short-term Improved operational capacity to evaluate, manage, and improve public health systems Intermediate Increased capability to implement evidence-based/informed public health programs, policies, and services to address public health needs
		Budget Period Outcomes* List budget period outcomes using the format: BPO1, BPO2, BPO3, etc.
		BP01 RFP BP02 RFP review process and selected participant organizations from health centers, primary care associations, and health center-controlled networks. BP03 Virtual learning community curriculum BP04 Infographic summarizing dashboard results BP05 Data Governance Tools and templates BP06 Promising Practices
		Outcome Measures* List outcome measures using the format: OM1, OM2, OM3, etc.
		OM1 10% improvement of adult immunization rates in participant organizations of high risk vulnerable populations. OM2 10 % reduction in vaccine hesitancy with health center teams and vulnerable populations.
20		ORGANIZATIONAL CAPACITY*
		Describe your plan for organization capacity as it relates to this project. Include specific organizations or entities as applicable. (6,752 characters max)
		NACHC is a non-profit, serving as the voice for the nation’s network of community health centers spanning 1,400 organizations and 13,000 sites serving 30 million patients annually (nearly 116 million patient visits; UDS, 2018). NACHC will leverage its capabilities, infrastructure, and reach to deliver the proposed program including: · Serving as a source of information, data, training, resources, research, and advocacy on key issues affecting the delivery of health care for the medically underserved and uninsured · Working with Primary Care Associations (PCAs ) and Health Center Controlled Networks (HCCNs ) to ensure support to health centers at state and federal levels · Building partnerships and linkages that stimulate public and private sector investment in the delivery of quality health care services to medically underserved communities · Using data-driven approaches and clinical evidence reinforced by implementation science and quality improvement strategies to address current challenges and improve outcomes that protect the nation’s health With nearly 100 staff members, NACHC’s organizational structure includes divisions: Clinical Affairs, Training and Technical Assistance, PCA and HCCN Relations, Public Policy and Research, Communications, Partnership and Resource Development, and Administration. NACHC engages a robust committee network that explores, researches, and develops best practices and protocols for health center operations.
21		PROGRAM EXPERIENCE*
		Describe your plan for program experience as it relates to this project. Include specific organizations or entities as applicable. (6,752 characters max)
		NACHC has a long history of collaborative work across multiple sectors to address both public health disparities and emergencies. NACHC currently is working on COVID-19 through CSTLTS mechanism in year one and is scheduled to complete all deliverables on time which include: Multi State initiative, Business Crisis Plan for health centers, National Strategy for COVID 19 and a Communication Strategy. NACHC has partnered with other CSTLTS recipients to align and coordinate work in communities including: NASTAD, ASTHO, YMCA and AMA and other public health entities. NACHC’s Partnership and Resources Division has created sustainable partnerships with Direct Relief providing resources to health centers and patients after all of the natural disasters that happened in the past 5 years. NACHC led the engagement activities with CSTLTS in addressing Zika outbreaks in migrant populations and within Puerto Rico. During the Ebola response, NACHC led coordinated efforts around the country, working with state and local partners by providing training, a collaborative space to share and spread ideas, and fact sheets for providers and patients. Lastly, NACHC has a long history of working with federal grants and cooperative agreements. NACHC has been a recipient of the HRSA/BPHC Training and Technical Assistance Cooperative Agreement for 40 years
22		COLLABORATIVE WORK*
		Describe your plan for collaboration as it relates to this project. Include specific organizations or entities as applicable. (6,752 characters max)
		NACHC will collaborate with the CDC, HRSA BPHC, ASTHO, NACCHO and the CDC Foundation to continue to build on lessons learned from COVID 19 and to ensure alignment and coordination at the state and local levels.
23		CONTRACTUAL WORK*
		Describe your plan for sub-contractual work. Include recommended criteria for identifying and selecting subcontractors. (6,752 characters max)
		Under the CSTLTS Cooperative Agreement, NACHC has successfully subcontracted with over 180 consultants, health centers, national partners and other organizations to deliver exceptional products to the Technical Monitors and to the wider public health community. Because combatting COVID-19 requires a timely response, NACHC will select contractors based on their ability to mobilize quickly and effectively in an expedited fashion. Where possible, NACHC will work with established consultants and contractors who have been vetted and reviewed under the current CSTLTS Cooperative Agreement. When needed, NACHC will create requests for proposals with scoring criteria. NACHC plans to contract with the Center for Care Innovation who has a long history of working with the safety net with design thinking and human centered design. As this is a subaward program NACHC will create and application and RFP process from identification of health center organizations to address leadership, capacity, and commitment.
YEAR 3 BUDGET INFORMATION
24		*Is this project partially funded by special appropriations funding (i.e. is funded by both umbrella/PPHF dollars and special appropriations such as opioid or COVID-19)?**			Yes No
24a		Umbrella/PPHF Funding Amount (Enter whole numbers only)			$ (TYPE FIELD)
24b		Special Appropriations Funding Amount (Enter whole numbers only)			$ (TYPE FIELD)

YEAR 3 BUDGET—UMBRELLA/PPHF*
25		PERSONNEL SALARIES AND WAGES TOTAL	(TYPE FIELD)	30		TRAVEL TOTAL	(TYPE FIELD)
26		FRINGE BENEFITS TOTAL	(TYPE FIELD)	31		OTHER TOTAL	(TYPE FIELD)
27		CONSULTANT BENEFITS TOTAL	(TYPE FIELD)	32		CONTRACTUAL TOTAL	(TYPE FIELD)
28		EQUIPMENT TOTAL	(TYPE FIELD)			DIRECT COSTS TOTAL	(READ ONLY)
29		SUPPLIES TOTAL	(TYPE FIELD)	33		INDIRECT COSTS TOTAL	(TYPE FIELD)
						BUDGET TOTAL	(READ ONLY)

YEAR 3 BUDGET—SPECIAL APPROPRIATIONS (Complete only if project is partially funded by special appropriations funding)
34		PERSONNEL SALARIES AND WAGES TOTAL	(TYPE FIELD)	39		TRAVEL TOTAL	(TYPE FIELD)
35		FRINGE BENEFITS TOTAL	(TYPE FIELD)	40		OTHER TOTAL	(TYPE FIELD)
36		CONSULTANT BENEFITS TOTAL	(TYPE FIELD)	41		CONTRACTUAL TOTAL	(TYPE FIELD)
37		EQUIPMENT TOTAL	(TYPE FIELD)			DIRECT COSTS TOTAL	(READ ONLY)
38		SUPPLIES TOTAL	(TYPE FIELD)	42		INDIRECT COSTS TOTAL	(TYPE FIELD)
						BUDGET TOTAL	(READ ONLY)

GRAND BUDGET TOTAL			(READ ONLY)

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