Quitline FAQ

Are incentive items allowed in the work plan and budget? We typically list NRT as a “behavior modification” item, and in this plan intend to likewise utilize small dollar amount gift cards ($10-20) or other nominal items as incentives/rewards for participation in cessation activities. Is this allowable through this FOA?

Although data from research studies have indicated that offering incentives for cessation in conjunction with biochemical verification of smoking status holds promise for increasing quit rates, the use of incentives though quitlines, which do not biochemically verify smoking status, has not been studied. Proposals that include incentives for callers must clearly demonstrate how the incentives would benefit the grantee in meeting the FOA objectives and requirements and should include evaluation of this new approach.

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Can funds be used to conduct focus groups to get a better understanding of why pregnant women don’t complete all 10 calls with the quitline?

Yes. Funds from this FOA can be used to conduct focus groups to get a better understanding of why pregnant women don’t complete their counseling sessions, but this request will be considered within the context of the total application.

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Can we use these funds to administer a cultural competency training “Undoing Racism” that all tobacco staff would participate in to help better understand the disparities that exist and how we can better assist those populations in their quit attempt?

Training is allowable with award funds, but funding expenditures will be considered within the context of the total work plan. Please provide an understanding of how the training will impact an increase in the quit attempts by disparate populations.

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We need clarification on #5 on page 35 of the FOA: 5. Private Funding: Private funding from non-public sources used for the state quitline for the past five years. Can you define private funding for us? Does this mean health plans or employers purchasing quitline services for their members/employees? Does it mean a private foundation funding some of the state quitline services?

Private funding is funding for the State Quitline that does not come from state or federal public funds. For example, if a private employer is covering the cost of their employees when they call your state Quitline, this would qualify as private funding. Private funding is also funding from contributions to the quitline to support the operation of the quitline, and include such entities as foundations and grant funding from private sources. It would not include health plans paying for quitline services for their members.

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Where do I find the work plan template?

The work plan template can be found at http://www.cdc.gov/tobacco/osh/foa/quitline-capacity/. It is located under "Related Documents".

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Regarding the work plan template, does the "Related Program Outcome" box correspond to the "required and optional strategies"?

"Related program outcomes? refers to the outcomes that can be found beginning on page 8 of the FOA.

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Featured on page 18, within the section corresponding to the subheading "Ensure infrastructure for state quitline" is information about potentially collaborating with the National Cancer Institute (NCI) and CDC to make additional backup counseling services available to callers as needed. Can you please provide additional guidance related to this activity?

The intent here is that, if a state quitline experiences unexpected capacity or budget problems during the Tips campaign and finds that it is no longer able to provide at least a basic level of service to all callers, it will cooperate with CDC and the National Cancer Institute to transfer callers to any backup counseling services that are available at the national level, as needed.

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Are states allowed to receive guidance in creating their application from their Project Officer or a member of OSH’s Evaluation Team?

All questions regarding the application need to be sent to the FOA mailbox. Once awards are made awardees will have the opportunity to consult with and receive technical assistance from their project officer and OSH evaluation staff to revise and refine their workplans and evaluation plans.

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How is a successful quit defined?

We are answering this question on tracking cessation at the population level as definitions for successful cessation are readily available for quitlines. Regarding tracking cessation at the population level, we would recommend tracking both HP 2020 primary cessation measures for adults—TU-4 Increase smoking cessation attempts by adult smokers and TU-5 Increase recent smoking cessation success by adult smokers. At a state level these measures can be tracked using the HP 2020 definitions through BRFSS and are on the BRFSS core (For example, in the 2013 BRFSS survey they are questions 9.3 and 9.4. The 2013 survey is available at http://www.cdc.gov/brfss/questionnaires/pdf-ques/2013%20BRFSS_English.pdf).

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I'm also a little confused about the use of terminology of "strategies", "interventions", and "activities" and how that relates to the required approaches. Will you please clarify these terms?

As it relates to the approaches, the terms interventions, strategies, and activities are used interchangeably throughout the FOA. The FOA interventions, strategies, and activities are (1) ensure infrastructure for state quitline; (2) improve quitline capacity; (3) participate in surveillance and evaluation efforts; (4) identify and target disparate populations; (5) improve sustainability; (6) increase media efforts; (7) enhance quitline protocol and operations; (8) improve understanding of comprehensive cessation coverage for Medicaid recipients; and (9) promote health systems change.

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What area the data requirements included in the quarterly reports to be submitted to the NDQW? May we receive a template for the reporting?

Applicants are expected to complete a quarterly NQDW services survey. Applicants are also expected to submit intake data from their quitline vendor. This information can be completed by forwarding the data that is received from the vendor.

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On page 35 the document states: "percentage of total amounts for the past five years for: Service delivery, promotion/media, Quitline enhancement, Staffing, other…" needs to be reported. How are you defining service delivery and Quitline enhancement?

Service delivery refers to provision of quitline services. Quitline enhancements are improvements to the quitline. Some examples of quitline enhancements are 1) increase efficiencies of quitline operations, such as connecting to or incorporating an interactive voice recording system (IVR) at the state or federal level; 2) incorporate technical enhancements to provide additional forms of assistance to callers who want to quit; and 3) provide quitline services in languages spoken by populations with tobacco related disparities or difficulty accessing services via an English-only line.

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May funds for this FOA be used primarily to enhance statewide counter-marketing campaigns designed to drive smokers to call the New York State Smokers’ Quitline and to educate Medicaid smokers about their available cessation benefits?

Yes, funds from this FOA may be used to enhance statewide counter-marketing campaigns and to educate Medicaid smokers, but this request will be considered within the context of the total application. Please note one-on-one counseling is not allowable with CDC funds.

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Page 20: Performance Measures—Enhancing quitline protocol and operations: Evidence that the state quitline and/or the state tobacco control program is/are, to the extent possible, monitoring the quality of the services provided by other quitlines to which are transferring or referring callers. Can you please explain the rationale for this performance measure, an example of how it may be operationalized, and what does CDC expect awardees to do with this information, should it be obtained?

As described in the 2014 Best Practices, the expectation is that over time state quitlines will increasingly focus on serving uninsured, underinsured (i.e., have health insurance with inadequate cessation coverage), and Medicaid callers while triaging callers who have cessation coverage through their health plans or employers to these entities to receive cessation services. An alternate model is for the state quitline to continue to provide services to some of these callers, but to be reimbursed by the callers' health plans and employers.

The rationale here is that as state quitlines refer increasing numbers of callers to other quitlines, state tobacco control programs have an obligation to verify to the extent possible that these callers are receiving evidence-based cessation services. In other words, awardees should attempt to explore and verify what services are offered by other quitlines; this could potentially be done by the quitline vendor. This is especially important because there is the potential for multiple new cessation service providers to emerge in response to the Affordable Care Act and other changes in the health care landscape. It is possible that some of these new providers may lack experience in delivering cessation services, and may not provide evidence-based cessation services.

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May funds from this FOA be used to support a staff position that focuses on health systems change?

Yes. Funds from this FOA may be used to support a staff position that focuses on health systems change, but this request will be considered within the context of the total application.

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Can you clarify what years are referred to under Organizational Capacity of Applicants to Implement Approach, bullet #6, on pg. 35: "Combined total funding for your state quitline efforts by year"?

Applicants are asked to provide a chart with a history of their federal, state, and private Quitline funding for the past five years. Applicants can select a time period for this chart that best reflects their state. For example, they may organize the chart by calendar year, state fiscal year, or federal fiscal year. For point number 6 on page 35, applicants are only required to report the combined total funding for the state quitline for the last five years. A total for each year does not need to be reported. (the fiscal years included will be different time frames and will vary by state).

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Can funds for CDC-RFA-DP14-1420PPPHF14 be used for incentives for callers who are pregnant and smoking?

Although data from research studies of pregnant women have indicated that offering incentives for cessation in conjunction with biochemical verification of smoking status holds promise for increasing quit rates, the use of incentives though quitlines, which do not biochemically verify smoking status, has not been studied. Proposals that include incentives for callers would have to clearly demonstrate how the incentives would benefit the grantee in meeting the FOA objectives and requirements and should include evaluation of this new approach.

Is the Grants.gov system going to be offline May 10–12?

Grants.gov will be offline on Saturday, May 10th and Sunday, May 11th. The system will be available all day on Friday, May 9th and on Monday, May 12th (the application due date).

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Since this is a non-competitive FOA may state program staff discuss their plans with their Project Officer as we are preparing our responses?

No. All questions need to go to be submitted to the FOA website and will be answered for the benefit of all potential applicants.

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Are all three scheduled calls to explain the FOA to potential applicants the same? Have these calls been recorded?

Yes. The content for all three calls is the same. There may be different questions asked on each of the calls but OSH will compile all of the questions and answers and post these on the website.
All three calls will be recorded. Please contact your project officer for a copy of the recording.

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When will the call notes/recording be available?

The recording will be available the day following the call for those on the call. Please contact your project officer for a copy of the recording. The recording will not be posted to the website.

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We have submitted a few questions, but haven't received an answer. When will responses be available? We have until Friday to complete writing this application, so that we can meet our agency's routing requirements. Thank you!

Prior to posting responses to questions received via the FOA mailbox, responses must be cleared through an internal review process. We will do our best to respond to questions within 2 days of receiving them.

Featured on pages 47-48 is information about acceptable documents. The sixth bullet states "Table of Contents for Entire Submission." Is there a preferred standard table of contents format or layout available for use by states?

There is no preferred or standard table of contents for this FOA.

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On page 2 of the FOA, the deadline is listed as 11:59 pm on May 12, 2014. On page 29, the deadline is listed as 11:59 pm on May 9, 2014. Which date is accurate?

The application is due on Monday, May 12, 2014 at 11:59pm.

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Should #17(proposed project period) be four years? (8/01/14-7/31/18)

The project period for this cooperative agreement is 4 years. As it relates to the work plan, applicants should include project period objectives for the four-year program and annual objectives for each program strategy.

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The checklist (part B #7) has the budget for the entire proposed project period with sufficient detail being provided. Is this checked yes because we are submitting for one year or could it be N/A since the budget for the whole project period is not required?

Applicants are required to do a 1-year budget for year 1 of the project. Grants.gov is prompting the grantee to include estimated budgets for the entire project period on the SF-424A in Section E. If the Grantee completes Section E, then they should check yes on the checklist (part B#7).

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If a state is already addressing many of the requirement strategies, can funds be used on media and to advertise Medicaid cessation services? If so, can funds go directly to the media contractor, or do states have to go through the quitline vendor?

Yes, applicants that are already addressing required strategies can use funds for paid media activities to promote their Quitline and the availability of cessation services. These applicants should clearly demonstrate that required strategies are already being addressed. Applicants should describe what their relationship is with their state Medicaid program.

States can subcontract directly with the media contractor, as long as the subcontract follows PGO guidelines.

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Our state's Funders Alliance funds and operates our state quitline. They will be listed as a subcontractor on our application. Since they are going to be a subcontractor, is a draft MOU still required?

Yes, a draft MOU is requested with the application.

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The quitline primary funding is provided by another agency in our state. We have received a letter of support from them. Will the contract we have with them suffice in place of the MOU?

A draft MOU is requested with the application.

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Is the executive summary included in the 20-page limit for the narrative, or is it a separate document? Should it be added as an attachment, or should it be entered in the abstract field in the grant package for grants.gov?

The executive summary is not included in the 20-page limit. It should be added in the abstract field on grants.gov.

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Are the performance measures detailed on page 18 of the Ensuring Quitline Capacity FOA to be used verbatim or is the language detailed there guidance for states to use to operationalize performance measures?

The performance measures detailed do not need to be used verbatim, but the application should address the performance measures listed.

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On page 19, "participate in surveillance and evaluation efforts", there is a requirement to increase data submitted to the NQDW. What types of data are envisioned, what is the periodicity of submission of these additional data, and how will the data be used? There are cost implications for the project budget if additional data are required. Also, please comment on how the request for increased data will be coordinated with the NAQC annual survey of quitlines, because budget information is already submitted by state quitlines to NAQC.

We require quarterly submission of NQDW services survey and NQDW Intake Questionnaires from the states. Most of the applicants should be familiar with the data submission requirements as we have been requiring this since 2010. Our Services survey was modeled after the NAQC annual survey. In the past, we have shared our quarterly services surveys with NAQC to reduce double work on the states. We will work out a similar process to reduce the burden on states during this funding period as well.

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We are already addressing some of the required activities (for instance, working with Mental Health to provide cessation services to persons with mental illness) under this FOA with our National Tobacco Control Program funding, so may we simply note that and not create additional activities?

States that are already addressing any required activities should describe this in their application. No additional activities need to be created if all aspects of the required activities have already been implemented.

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Pages 32 and 33: c. Applicant Evaluation and Performance Measurement Plan: "Applicants must provide an overall jurisdiction or community-specific evaluation and performance measurement plan that is consistent with the CDC Evaluation and Performance Measurement Strategy section of the CDC Project Description of this FOA. Data collected must be used for ongoing monitoring of the award to evaluate its effectiveness, and for continuous program improvement". The language implies that the inclusion of two evaluation and performance measurement plans is required. Is this correct? If so, can you please explicate the rationale for this, including the key differences between the two plans, and which of the two plans are expected to be more fully developed “within the first six months of the project”?

Applicants are asked to submit one draft evaluation plan with their application that is no longer than five pages. This draft evaluation plan will be the basis for the final evaluation plan that is due within 6 months of the award start date.

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On page 8, the FOA states, "Applicants will be required to indicated which of the following short-term outcomes they will address…The performance measures for these outcomes are detailed in the evaluation and performance section". I am unable to locate outcome measure. Can you please direct me to the correct page(s) of the FOA?

The performance measures are directly linked to required and optional strategies rather than outcomes. Applicants are expected to select performance measures that will result in meeting outcome measures. Performance measures are discussed on pages 18–22 of the FOA.

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Performance measures are noted on pages 18–20 for required and additional activities. Are tobacco control programs expected to be able to address ALL of the performance measures for the seven activities they are conducting? Or are tobacco control programs supposed to select one or two specific performance measures they will use for each activity?

Applicants should refer to pages 32–34 for details on what to include in the evaluation and performance measurement plan.

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Please clarify the expectations for the Work Plan. On Page 23 (section "d. Work Plan") of the FOA, it says that a detailed Work Plan must be submitted with the grant application for Year 1 of the award. However, on Page 35 (section "11. Work Plan") of the FOA, it says that applicants are required to provide a work plan consisting of project period objectives for the four-year program and annual for each program strategy.

As demonstrated in the work plan template (refer to FOA webpage), applicants should include project period objectives for the four-year program and annual objectives for each program strategy. Project period and annual objectives should be written in SMART (specific, measurable, achievable, realistic, and timely) format. Quantitative baselines should be provided for each objective that leads to an increase, decrease, or maintenance over time. The work plan (included in the Project Narrative’s 20 page limit) integrates and delineates more specifically how the awardee plans to carry out achieving the project period outcomes, strategies, activities, and evaluation and performance measurement, including key milestones.

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Are we to include a PPO to address the long term outcomes listed in the FOA in our work plan?

Yes.

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What is meant by the communication plan? Our communication plan that addresses how we will educate the public about the dangers of tobacco use, exposure to secondhand smoke and available cessation support and resources is about 10 pages long. May we attach the plan, so it doesn't impact our 20 page limit? On page 21-22, the FOA mentions as an Annual Performance Measure: "an approved health communications plan to educate the public and increase awareness about: the dangers of tobacco use, the dangers of exposure to secondhand smoke exposure, and available cessation support and resources." Does the response to this FOA need to include a Draft Health Communications Plan within the 20 page Narrative? If so, does it need to address all three areas mentioned here?

The draft health communications plan may be included as an appendix and it will not count against twenty page limit. The communication plan should address in writing the program’s short and long term plans for paid and earned media that will promote education and awareness about the dangers of smoking and exposure to secondhand smoke, including benefits and resources to promote quitting smoking. The written communications plan should provide and outline specific media and communications plans, using examples, in support of the programs short and long term tobacco prevention and cessation goals and objectives. Media can include paid and free tobacco prevention and cessation ad placement, education information and key messages shared via media and communication channels including television, radio, and print. It can also include earned media efforts such as letters to the editor, opinion editorials, and news and newsletter articles and media interviews. If the applicant has an existing written communication plan, the applicant can upload it as an appendix. If you do not currently have a plan this will be an item that will be required as part of the annual performance measures and can be discussed with your project officer.

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What is meant by an approved communication and evaluation plan?

Approval of both the communication and evaluation plan will be determined by the project officer in discussion with the program manager, and, where appropriate, OSH technical staff.

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Is the evaluation plan to be submitted a total of 5 pages and is this a part of the 20 page limit?

The evaluation plan should be no more than 5 pages and is included in the 20 page limit.

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Are performance measures required for required activities? Are measures compared across programs?

Yes, performance measures are required for all required and selected activities. Currently there are no plans to compare measures across state programs.

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Are letters of support needed? On page 31 of the FOA, it discusses letters of support. Are letters of support required from the internal and external partners whom we will work on this project? It is clear that letters of support are required if the state quitline is funded from a different entity than the state health department, but it wasn't clear if letters of support are also required (or simply encouraged) from other collaborative partners.

"Applicants in states where the state quitline is primarily funded by a different entity than the state health department must include a letter of support and draft Memorandum of Understanding from that entity…" (pg. 31). That is the only letter of support required.
"Applicants are expected to collaborate with state and local coalitions and external and internal partners…" (pg.31) "Applicants must describe how they will collaborate". This description is part of the applicant narrative but there are no letters of support required from these entities.

Can states apply for a higher or lesser amount than the mark listed in the funding award estimate document on the FOA webpage?

We recommend that states remain close to the mark provided through the funding award estimate document. Final awards will be dependent on the amount of PPHF funding that is available to OSH/PSB at the time of the awards. The budget marks provided in the funding award estimate document are based on the maximum amount we will receive. No awardee will receive less than $50,000.

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The budget guidelines list Consultants as a budget category, but on the SF-424A Consultants is not a category. Should Consultants be included as part of Contracts or as part of Other on the SF-424A?

Consultants should be included as part of Contracts on the 424A.

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Do you need the 5 year Core funding history?

Applicants should only submit the funding history for the state Quitline and do NOT need to include the core funding history.

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What is the funding amount based on?

The funding amount for each state, district, or territory is based on the 2012 adult cigarette smoker population for 2012; as well as the available funding from the PPHF. The minimum award is $50,000 for any state or jurisdiction.

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Can you clarify the extra funding for California?

The extra funding for California supports the Asian Quitline.