Tribal Public Health Capacity Building and Quality Improvement Umbrella Cooperative Agreement


This program's ultimate outcomes are 1) decreased morbidity and mortality among American Indians (AI) and Alaska Natives (AN); 2) advanced capacity of Indian Country to identify, respond to, and mitigate public health threats; 3) improved capacity of the workforce to deliver essential public health services; 4) increased culturally-appropriate practice-based evidence programs and policies that are effective and sustainable throughout Indian Country; and 5) improved capacity to collaboratively and strategically address AI/AN health needs and advance health equity.

General information about this opportunity
Last Known Status
Program Number
Federal Agency/Office
Centers For Disease Control and Prevention, Department of Health and Human Services
Type(s) of Assistance Offered
B - Project Grants
Program Accomplishments
Not applicable.
301(a) and 317(k)(2) of the Public Health Service Act [42 USC 241(a) and 247b(k)(2), as amended], Executive Order 13175
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Executive Order 13175, "Consultation and Coordination with Indian Tribal Governments," 65 FR 67, 249, issued by President Clinton on November 6, 2000, and the Presidential Memorandum for the Heads of Executive Departments and Agencies on Tribal Consultation, 74 FR 57881, signed by President Obama on November 5, 2009 [ /content/101569] encourage strengthening intergovernmental relations between the federal government and AI/AN tribal nations. As such, eligibility for this CoAg is limited to federally recognized American Indian and Alaska Native (AI/AN) tribal nations and regional tribally designated organizations. AI/AN tribal nations have the right of self-determination and governance over their citizens. In addition, AI/AN tribal nations and regional tribally designated organizations have a unique understanding of AI/AN cultures, fluency in Native languages, knowledge of indigenous history and traditional practices. These entities are the best qualified to address AI/AN public health needs in an efficient, effective, and culturally-appropriate manner. AI/AN tribal public health infrastructure and capacity initiatives and quality improvements are more likely to be sustained when they begin as tribal initiatives rather than as external initiatives. This CoAg will further efforts in Indian Country by supporting a culturally- appropriate approach advocated for and by the CDC/ATSDR Tribal Advisory Committee, tribal public health practitioners and partners. Direct funding will support tribal governments and tribal-serving organizations in making sound and efficient public health planning and resource allocation. The funding method for this CoAg will allow for more programs in CDC to provide direct funding to Indian Country in order to improve tribal public health systems and reach the outcomes stated in the logic model.
Beneficiary Eligibility
Eligible applicants should be able to demonstrate tribal affiliation including (1) a record of effectively working with American Indian and Alaska Native populations (2) an ability to methodically and efficiently reach tribal members in American Indian and Alaska Native communities and (3), if recipient is a tribally owned and operated organization, it should provide a letter of approval from Tribal council for the proposed program.
An applicant must be in one of the applicant types listed here to be eligible for funding. o Federally recognized AI/AN tribal nations must demonstrate support from the tribe by providing an official letter from a currently elected tribal leader, or a tribal resolution o Regional AI/AN tribally designated organizations must demonstrate support in the form of tribal resolutions or letters of support from currently elected tribal leaders from at least half of the tribes within the organization's service area Official email correspondence from elected leaders will be accepted. Files should be named "Tribal Support", and uploaded as PDFs at CDC will consider any application that does not include this documentation as non- responsive and it will not receive further review. Please note the following NOFO-specific terms: Federally recognized AI/AN tribal nations refers to Native American tribal governments (Federally recognized) and American Indian or Alaska Native tribal governments (federally recognized). Regional AI/AN tribally designated organizations refer to Native American tribal organizations (other than federally recognized tribal governments) and American Indian or Alaska Native tribally designated organizations.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is not applicable.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. Each application should address one of the following target population categories: 1) Category A: HHS Regions I, II, III, and IV; 2) Category B: HHS Regions V, VI, and VII; and 3) Category C: HHS Regions VIII, IX, and X. Applications should reflect one or more of the seven collaboratively identified Tribal practices around health and wellness. Each applicant identifies the practices, which will guide their programmatic approach: (1) Family and community activities that connect cultural teachings to health and wellness. (2) Seasonal cultural and traditional practices that support health and wellness. (3) Social and cultural activities that promote community wellness. (4) Tribal, intertribal, governmental, and nongovernmental collaborations that strengthen well-being. (5) Intergenerational learning opportunities that support well-being and resilience. (6) Cultural teachings and practices about traditional healthy foods to promote health, sustenance, and sustainability. (7) Traditional and contemporary physical activities that strengthen well-being.
Award Procedure
The primary funding opportunity under this listing uses a two-part strategy. Funding Strategy 1: Initial Funding - Responsive applications submitted under this funding opportunity will be reviewed objectively as described in the Review and Selection Process section of this NOFO. Awards under Funding Strategy 1 will support building capacities and capabilities. Applicants selected for Funding Strategy 1 will become part of a group of organizations that are eligible for funding under Funding Strategy 2. Funding Strategy 2: CIO Project Plans - The second funding strategy is subject to the availability of appropriated funds and agency priorities. To maximize CDC's program priorities and health system needs in Indian Country, applicants funded under Funding Strategy 1 will be eligible to apply for additional funding under Funding Strategy 2. Under Funding Strategy 2, CDC will publish and compete CIO project plans according to geographic categories. The plans will be published on as a supplement. Organizations will submit "Work Plans in Response to CIO Project Plans" that are relevant to the geographic category and target population for which they were awarded funding under Funding Strategy 1. Refer to the NOFO at for details.
Check for any relevant NOFO information regarding processes for applying for assistance.
Approval/Disapproval Decision Time
From 1 to 15 days.
Not applicable.
Project period of performance is 1 to 5 years. After initial awards, and subject to availability of funds, projects may be continued non-competitively contingent upon satisfactory progress by the recipient (as documented in required reports) and the determination that continued funding is in the best interest of the Federal government.
How are proposals selected?
Refer to the NOFO at for specific details. An objective review panel with experience working with tribes or tribal organizations will evaluate complete applications. Reviewers will be primarily selected from a pool of CDC subject matter experts with demonstrated experience working with tribes or in tribal settings to establish cultural competence. The specific objective reviewer scores will be used to produce a rank order of proposals. However, proposals may be funded out of rank order based upon the following criteria: health conditions and geographical diversity of populations that the applicants will directly serve.
How may assistance be used?
Historically, tribal public health systems have been separated from the larger US public health system, which has led to limited strategic partnerships with federal, state, and local partners; underdeveloped infrastructure; data access barriers; and diminished public health workforce. Tribal health systems provide public health services across the United States and are central to reducing health disparities in tribal nations. Building tribal public health infrastructure enhances Indian Country's capacity to prevent disease, promote health, and prepare for and respond to emerging threats and chronic challenges. Implementation of business practice improvements leading to efficiencies and cost savings; education/training of workforce; integration of technology in data collection and information systems, implementation of culturally adapted and traditional evidence-based public health programs, policies and services; development of capacity to meet national standards; development of strategic partnerships to enhance capacity to implement evidenced-based public health intervention strategies; improvement responsiveness to disease trends through culturally relevant public health communication tools; and improvement in quality, availability and accessibility of public health tools and resources.
What are the requirements after being awarded this opportunity?
Performance Reports: Annual Federal Financial Reports (FFR) and performance/progress reports are required. Final FFRs and performance reports are required. Other reporting may be required and will be outlined in the NOFO or the Notice of Award.
Not applicable.
In accordance with 2 CFR ?200, as codified in 45 CFR ?75, there is a 3-year record retention requirement; records shall be retained beyond the 3-year period if final audit has not been done or findings resolved. Property records must be retained in accordance with HHS Grants Policy Statement requirements.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formula is not applicable to this assistance listing.

Matching requirements are not applicable to this assistance listing.

MOE requirements are not applicable to this assistance listing.
Length and Time Phasing of Assistance
Financial assistance is provided for a 12-month budget period with a period of performance of up to five years subject to the availability of funds and satisfactory progress of the recipient. Notice of Award
Who do I contact about this opportunity?
Regional or Local Office
None/Not specified.
Headquarters Office
Caroline Gardner
2400 Century Center Parkway, MS V24-6
Atlanta, GA 30329 USA
Phone: 4046394276
Website Address
Financial Information
Account Identification
(Cooperative Agreements) FY 22$19,822,936.00; FY 23 est $19,822,936.00; FY 24 est $19,822,936.00; FY 21$16,624,502.00; FY 20$67,024,658.00; FY 19$12,780,459.00; FY 18$15,431,446.00; FY 17$550,000.00; -
Range and Average of Financial Assistance
Not applicable/available.
Regulations, Guidelines and Literature
The Notice of Funding Opportunity specifies applicable HHS/CDC regulations and requirements are detailed in corresponding Notice of Award
Examples of Funded Projects
Not applicable.


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