Jones, Tracy From: Sent: To: Subject:

Grant, Gail B. (CDC/OID/NCHHSTP) <gab2@cdc.gov> Thursday, July 26, 2012 1:48 PM Keller, Jimmy R .RE: DRAFT/FOA

Thanks, Gail

From: Keller, Jimmy R. (CDC doh.state.f1.us) Sent: Thursday, July 26, 2012 1:07 PM To: Grant, Gail B. (CDC/OID/NCHHSTP) Cc: Keller, Jimmy R. (CDC doh.state.fl.us) Subject: RE: DRAFT/FOA
See my edits below in blue font.

Jimmy R. Keller, DHSc Senior Public Health Advisor Tuberculosis Program Division of Disease Control & Health Protection Florida Department of Health Phone: 850-245-4311 BlackBerry: 850-251-4621 Fax: 850-921-9906 E-mail: jimmykeller@doh.state.fl.us Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.

From: Grant, Gail B. (CDC/OID/NCHHSTP) [mailto:gab2@cdc.gov] Sent: Thursday, July 26, 2012 12:09 PM To: Keller, Jimmy R Cc: Grant, Gail B. (CDC/OID/NCHHSTP) Subject: DRAFT/FOA

Jimmy-

Please, FYI, only. Do not share.

This is a work in process. I want to get something to Dan today so that he can review. See what we must address for the reviewers to post this FOA below in italics.

I have been working on this, but you may see redundancy, misspellings, other. It is a working draft.... Again, just for your information. I realize you all are calling it a cluster. I will discuss on this end. Make that change if you need to in the document. I appreciate your time.
Gail JimmyIn this section, we must:

Provide a detailed explanation, substantiated by evidence, as to how you concluded there is only one eligible candidate. List the characteristics ofthe applicant's organization that make them uniquely qualified to perform the programmatic activities. List any prior activities the organization has performed in cooperation with CDC. List the relationship ofthe new project to any prior or ongoing CDC-funded activities}.
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Reasons to Justify Foreign Single Eligibility Competition

Since 2009 and again in February, 2012 CDC has conducted, at the request of the State of Florida, Bureau of TB and Refugee Health, an Epi-Aid at the Duval (Jacksonville) County TB program to assist in describing the epidemiology of a cluster of cases of Mycobacterium tuberculosis complex strain belonging to the PCROO 160 genotype cluster (spoligotype: 7777767777, 12 locus MIRU-VNTR: 224325143323), which is considered by the CDC to be" the largest TB outbreak" in two decades. This investigation, associated with 13 deaths (two of which may have resulted in delayed diagnosis ofTB) has been among persons with a history of homelessness, incarceration, other immunocompromising diseases (i.e., HIV), substance abuse, and mental health issues continues to spark local and national media interest and most recently resulted in an inquiry to CDC from a U.S. Senator. Homelessness coupled with any of the other risk factors in a highly-transient population present current and future challenges for TB programs. This year, after a disproportionate number of cases with the same PCR type were noted in Duval County, the CDC, working with the state TB program and local officials, were invited back to the state to describe the epidemiology of the cases identified in the investigation, determine chains of transmission, provide recommendations for TB control and prevention, including prioritization of TB contact s . A subsequent visit was made post the Epi-Aid as there have been, considering strained resources, challenges in meeting some of the CDC recommendations for containing the TB strain that is causing this large cluster of cases; some have included, but are not limited to clinic capacity, other contact investigations and data management. Duval county has already established relationships (TB Coalition) with entities in the county that represent and serve this population, the state continues to work collaboratively with CDC and has received and trained strike teams as
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directed by the state's Surgeon General. This makes Duval County unique to conduct this work; however, there are still TB program gaps that will need to be addressed for operations to be fully successful. Some include, but are not limited to expanding staff capacity and support for these additional human resources (disease intervention specialist, epidemiologist, medical, and tech support). While CDC is in the second rotation of senior public health advisors assigned to the county to assist with day-to-day operations, develop standard operations procedures, assist with locating and management of over 2,000 contacts considered to be a high-priority, and to serve as a liaison between shelters, the jail, and a local resource center serving this population, there is a need to provide additional resources to address an outbreak of this magnitude and complexity. This includes, but is not limited to: active case finding, periodic TB screening, evaluation and further prioritization of contacts for treatment for latent TB infection, to implement a formal TB infection control program with standard operating procedures (administrative controls) at all impacted sites, and to follow best practices (utilizing data from other national TB control programs). Also, to better assess recommendations that will be made in August 2012 when lead engineers from the National Institute for Occupational Safety and Health travel to Jacksonville to meet with state and local TB program officials to conduct a ventilation assessment in sites where, according to CDC, transmission occurred.

In this section, you must provide a detailed explanation, substantiated by evidence, as to how you concluded there is only one eligible candidate.

List the characteristics of the applicant's organization that make them uniquely qualified to perform the programmatic activities. List any prior activities the organization has performed in cooperation with CDC. List the relationship of the new project to any prior or ongoing CDC-funded activities].

We hereby certify that the above information is accnrate and complete.

Recommend Approval:

Michael Melneck, Management Official, NCHHSTP ] ( ) Concur ( ) Non-concur:

Date

Barbara Benyard, Lead Management Specialist Acquisition and Assistance Branch I, PGO ( ) Recommend Approval () Recommend Disapproval (provide basis for disapproval) Comments: Date Carla Harper, Branch Chief Acquisition and Assistance Branch I, PGO

( ) Recommend Approval () Recommend Disapproval Comments:

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