​​CERI Grant Q & A

See *NEW content (as of 12/09/2021) below highlighted yellow. 

This Q&A resource will be updated periodically.  LHJs may submit additional questions to EquityTeam@cdph.ca.gov

Table of Contents

Grant Scope and Purpose
Funding
Work Plan
Allowed and Disallowed Activities
Reporting
Community-Based COVID-19 Equity Projects
State-level Alignment
Technical Assistance
CDC COVID-19 Health Disparities Grant Updates and Feedback Session
Additional Information

Grant Scope and Purpose

What is the purpose of this grant?

• The purpose of this grant is to address COVID-19 related health disparities and advance health equity. More specifically, California is leveraging this funding opportunity to build equity infrastructure. This grant offers a unique opportunity to focus resources on efforts to address upstream drivers for health and equity efforts. LHJs are encouraged to identify ways to use this funding toward structural and systemic change.  

•  CDPH is strongly encouraging establishing one fully dedicated Equity Lead. It is recommended this role be at the leadership level to elevate a focus on equity considerations across the organization.  If based on the local organizational context, a LHJ chooses to support multiple positions using the CERI grant allocation, the following are required:
  

• At least 50% of one FTE must be dedicated fully to equity work 
  

• Designate a single point of contact as the Equity Lead (if the LHJ is funding two staff at 50% to focus on equity, identify one as the lead and one as back-up)
  

• Please note, while this is not a requirement, it is still strongly encouraged that this Equity Lead role be elevated within the organizational leadership structure (a part of the executive team, elevated in the incident command structure, etc.) 
  

• Since this grant is aimed to expand local equity infrastructure, and funds may not be used for supplantation – if splitting the 1 FTE between multiple positions, Work Plans must explicitly address how capacity is being expanded by use of the CERI funds. 

• If you already have an Equity Lead position funded through another funding stream, please designate this person in your workplan and list the funding stream. The CERI funding can then be used to bring on additional equity staff or towards other equity infrastructure.

• CDPH recognizes that there is value in integrating equity with other core functions across an organization, that building teams to address equity can be an important approach to expand capacity, and that split funding can sometimes be leveraged as a sustainability strategy.  While addressing these considerations, we are also promoting use of these funds to provide sufficient capacity for attention to equity as a primary focus, rather than as a secondary responsibility.
  

In terms of defining equity, will OHE's Vulnerable Communities definition serve as the framework for this effort?

• According to the Notice of Funding Opportunity, this grant program relates specifically to populations that have been placed at higher risk and are underserved, which, depending on the needs and priorities of the applicant. This may include African American, Latino, and Indigenous and Native American people, Asian Americans and Pacific Islanders, and other people of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people; people with disabilities; people who live in rural communities; people over the age of 65, and people otherwise adversely affected by persistent poverty or inequality.
  

Funding

What is the methodology for funding allocations?

• This is a description of the proposed funding model: Each jurisdiction (excluding the 11 jurisdictions who received direct allocations from the CDC) will receive a one-time base funding amount of $300,000 for the two-year period. In addition to the base funding, additional supplemental funding will be calculated and awarded based  on each jurisdiction's population size (40%) and share of demographic groups disproportionately impacted by the COVID-19 pandemic, i.e., those in poverty (30%), communities of color (30%). A minimum threshold of $100,000 will be applied for allocation of supplemental funding. For city-based jurisdictions each circumstance is different: Long Beach will receive direct allocation from the CDC, Pasadena will receive partial funding from county of Los Angeles and partial funding from CDPH, Berkeley will receive funding through CDPH.

What is the process for Local Health Jurisdictions to receive allocations?

• Each LHJ has received an allocation letter outlining the award and requirements. LHJs are required to complete a Spend Plan and Work Plan by October 1, 2021 and submit it to the California Department of Public Health at EquityTeam@cdph.ca.gov. 
  

• Advance payments may not be deposited into an interest-bearing account. Since the funds under this grant are federal dollars, any interest incurred would need to be paid back to the CDC. LHJs should establish a separate program number to track funding and expenditures.
  

Is it required to receive the 25% advance payment?

• No, it is not required. LHJs also have the option to receive their first payment after they have submitted their first quarterly expenditure report.

For LHJs that prefer not to receive the 25% advance payment, please notify the Equity Team inbox at EquityTeam@cdph.ca.gov by Friday, September 24, 2021.

Work Plan

Is the aim of the state to approve or disapprove local plans? Are there requirements on plan development or will it be dependent upon LHJ perspectives of what is needed?  

• CDPH is looking for plans that have a shared framework and common strategies and activities. CDPH recognizes that community needs, challenges, and infrastructure are different for each LHJ. The intent is for these resources to be used flexibly in ways that are appropriate for each LHJ, while building collective capacity and alignment for advancing equity statewide. CDPH will conduct a more dedicated session on the Statewide Health Equity Plan process.

What typical position titles are covered under the CERI grant?

• At least 50% of one FTE must be dedicated fully to equity work and LHJs must designate a single point of contact as the Equity Lead. Beyond this requirement, a wide range of titles/classifications can be funded through the grant, such as: Program Specialists, Community Outreach Coordinators, Health Educators, Researchers and Epidemiologists, Analysts, Project Managers, etc. Any position being funded by the grant should be advancing the equity-focused activities outlined in the Work Plan. 

Can LHJ’s have fewer than five activities on each tab in the Work Plan? Is it allowable to have more than five activities?  

• For Tab #1 and #2 of the Work Plan, it is required to include a minimum of one activity on each tab. The Work Plan template comes with five spaces for activities. To add more than five activities, please copy and paste the activity spaces to add more sections. 

Will geographic boundaries/location be considered in determining disparities and underserved populations? 

• Yes, geographic factors and place are definitely encouraged as considerations for understanding and addressing disparities. 

Allowed and Disallowed Activities

*Can this funding be used for focus groups?

• Incentives may be used to encourage participation in focus groups. As with all proposed incentives, information must be included about how the activity and proposed incentive will align to the general guidance for incentives described in the “Allowed and Disallowed Activities” section of this webpage. 

*Can this funding be used for additional workspace to accommodate expanded staff?

• Yes, grant funds may be used to provide a workspace for staff who are assigned to projects funded under this grant. Please note that grant funds may not be used for construction or renovation of building spaces.

*Can funds be used for out of state travel (e.g., attendance at national public health conferences)? 

• Yes, grant funds may be used for travel and conference/training registration fees. Recipients should clearly justify how proposed conferences/trainings benefit or contribute to the success of associated projects funded under this grant.
  

*Will this grant allow sub-contracts to engage community partners and county staff in health equity work or training?

• Yes, sub-contracting is allowed. The LHJ is responsible to ensure that contractors comply with all rules and regulations governing the grant. All sub-contracts outcomes must be reported in the quarterly reporting.
  

*Can this grant be used to offer clinical care services or payment to providers?

• No, the funds may not be used to offer clinical care services (e.g., direct patient care, diagnostic services, mental health services, etc.) and may not be used to compensate clinical care providers for patient care.
  
  Funds may be used for complementary non-clinical activities that support coordination, outreach and access to clinical services.  For proposed activities of this nature, recipients must:

• Describe the specific use of the funds in addressing the goals of the CERI Grant related to COVID-19 impacts and disparities

• Include the following language, to specify "CDC funds will not be used to fund any clinical services."
  Examples:

• Recipients may not use grant funds for vaccine purchase or administration. However, coordination activities that support vaccine administration are allowable (such as community outreach to promote participation).
• An LHJ may fund community health workers to conduct outreach and assist in service navigation to promote access and utilization of mental health services.
• An LHJ may partner with a local health system to bring monoclonal antibody therapy to the county citing the lack of transportation and access to clinical care has resulted in significant COVID-19 disparities. The LHJ role in helping to establish the program (including the program design and development) and funding a temporary program coordinator to oversee and administer the program are allowable activities under this contract. However, funds may not be used to formally compensate the care providers.

Would a Community Health Improvement Plan (CHIP) and Community Health Needs Assessment (CHNA) work toward this grant?

• Yes, these would be considered equity infrastructure activities. These activities must include a specific focus on equity and describe that in the Work Plan.

Would a Community Health Improvement Plan (CHIP) and Community Health Needs Assessment (CHNA) work toward this grant? 

• Yes, these would be considered equity infrastructure activities. These activities must include a specific focus on equity and describe that in the Work Plan.

Would a Community Health Improvement Plan (CHIP) and Community Health Needs Assessment (CHNA) work toward this grant? 

• Yes, these would be considered equity infrastructure activities. These activities must include a specific focus on equity and describe that in the Work Plan.

What are required and allowable activities for this grant funding opportunity?

• All activities should aim to build infrastructure to address disparities in the current COVID-19 pandemic and set the foundation to address future responses.  This grant offers a unique opportunity to focus resources on efforts to address upstream drivers for health and equity efforts. LHJs are encouraged to identify ways to use this funding toward structural and systemic change.  
• Required core activities for LHJs include
• Establish a dedicated Equity Lead staff position and/or other equity-focused organizational capacity building activities.
• Conduct an equity-focused organizational assessment
• Contribute to the Statewide Health Equity Plan
• Participate in engagement activities with other LHJs
• Implement targeted local equity activities.
• Examples include:
• Expand core equity staffing, embed equity into internal policies and practices, such as workforce equity; budgeting and contracting equity; data policy; communications and engagement practices, etc.
• Examples include establishing multisector teams to address community needs, establishing equity action plans, engagement and relationship building with disproportionately impacted communities).
• Leverage strategies and practices aligned with the COVID-19 Health Equity Playbook for Communities (PDF).
  
• Support prevention and mitigation of disparities in COVID-19 and other health outcomes (direct and secondary impacts of the pandemic)
• Address structural and/or social determinants of health (housing and homelessness, wraparound services, economic security, schools and childcare, transportation, climate change, isolation support, community safety, etc.)
• For LHJs receiving base funding only, the priority of this funding is to "Establish a dedicated Equity Lead and/or other equity-focused organizational capacity building activities." If your organization already has existing staff and organizational capacity funding may be used to expand existing or to initiate new equity activities.  
• The intent is for these resources to be used flexibly in ways that are appropriate for each local context – rural and urban, large and small populations, newly developing equity programs or expanding on current efforts – while building collective capacity and alignment for advancing equity statewide.   
  

*Will this grant allow incentives in order for LHDs to engage community partners and county staff in health equity work or training?

• Yes, incentives are allowed, with restrictions. Under this funding opportunity, incentives are an allowable cost as long as they are reasonable and meet the goals and objectives of the project and the strategies outlined in the notice of funding opportunity, and must be consistent with regulations, policies and procedures of the recipient agency.
• Bonuses/ incentive payments for employees as part of a total compensation package are allowable, provided such payments are reasonable and are made according to a formal policy of the recipient that is consistently applied regardless of the source of funds.
• Incentive payments to volunteers or patients participating in a grant-supported project or program are allowable, provided payments to individuals are used to motivate them to take advantage of grant-supported services, if within the scope of an approved project. Please note clinical care services may not be supported by this grant.

• Examples of allowable incentives: generic gift cards; store vouchers; fare cards for transportation; and gas cards.
  

• Gift Cards/Store Vouchers/Fare Cards/Gas Cards
  

• Select multiple options and vendors that do not imply favoritism of an organization.  Visa and Mastercard generic gift cards are acceptable. The generic gift card may not indicate a specific bank organization.
• The amount and type must be justified based on the activity incentivized. There is not a max value, however it is strongly recommended that the amount should align with other Federal COVID-19 incentives, $25-$100 per activity/event.  For proposed use with an amount above this range, you must receive prior approval from the CDPH Health Equity Team at EquityTeam@cdph.ca.gov.
  
• Ensure there are various options and vendors appropriate to the recipient audience. For example:
• Event-based volunteers (1-2 days participation) may be incentivized with gift cards options for both grocery gift cards from multiple stores and transportation vouchers.
• If engaging youth under the age of 16 it may be more appropriate to offer transit vouchers as opposed to gas cards as many of these youth likely do not directly pay for gas.
  

Gift Card Accountability Guidelines:  There are several processes necessary to carefully track and report how federal funds are used in relation to gift cards.  

Tracking and Reporting: For incentives totaling $3,000 or more of project funding, LHJs are required to include the total number and amount of incentives acquired and disseminated (i.e., how many gift cards were purchased, the total dollar amount, and how many were distributed to participants) in quarterly progress reports.

Gift Card Incentive Acknowledgement Form:

• Provide guidelines to incentive recipients in an Incentive Acknowledgement Form that requires signature and date. This ensures the recipient understands the gift cards are not for resale and may not be used for purchase of alcohol, drugs, tobacco, firearms, ammunition, and lottery tickets.
  
• LHJs should retain these records in case they are needed to address future questions or potential audits'
  
• Sample Statment - Gift Card Incentive Acknowledgement:
  
  I, (Printed Name of Recipient), acknowledge receipt of incentive: gift card/store voucher/fare card/gas card (circle one). I understand this incentive may not be used for purchase of alcohol, drugs,  tobacco, firearms, ammunition, or lottery tickets. Incentives are not to be used for resale.
  
  _______________________                                  ___________
  Recipient Signature                                                 Date

Can this funding be used for a position that works within an entire Health and Human Services Department, not just in Public Health?

• Yes. It is possible for the funds to be used support a Health Equity position within a Health and Human Services department for jurisdiction where public health is part of an integrated Health and Human Services agency. We encourage that the scope of work for the position be written so that it is widely building public health capacity.
  

Community-Based COVID-19 Equity Projects

 What is the focus of state-funded CBO pilots?

• In addition to Local Assistance to Local Health Jurisdictions, CDPH will also be allocating $3 million from the CDC Health Disparities Grant through grants/contacts for pilot projects with community-based organizations (CBOs) to further support advancing equity as part of recovery, with an emphasis on efforts focused on addressing social determinants of health. 
• Additional information on the parameters for this CDPH-administered grant activity will be shared later in 2021. Information about the process and awards will be shared with LHJs.
• An earlier wave of CDC funding was used to fund CBOs through an RFA with a similar scope, see this link for the COVID-19 Health Equity Pilot Projects.

Can Local Health Jurisdiction allocations be used to fund activities with CBOs?

• Yes, investing resources to conduct local equity activities with CBOs, expand engagement with disproportionately impacted communities, and to inform public health planning is an allowable use of funds.

What options are available for regions with very few CBOs?

• It is not a requirement that LHJs fund CBOs, especially in regions where there may not be many active organizations.  Collaboration with other local partners; other government agencies, businesses, faith communities, schools, etc. can be another approach for addressing community engagement. This will also be a theme for continued focus. We are interested in learning more from LHJs about approaches that work best in different regions/conditions and will work to identify and share these through the Technical Assistance / Learning Collaborative process.

State-level Alignment

What are CDPH's plans for coordinating with Local Health Jurisdictions who were funded directly from CDC?

• CDPH is planning on conducting a follow up meeting with the 11 jurisdictions who received direct allocations from CDC in the coming months.  All LHJs will also be engaged in the process to develop and advance the Statewide Health Equity Plan.

How will this health equity funding align with the ELC Equity Investment Plan?

• This funding will help build on the ELC Equity Investment Plan, especially around the most upstream work (e.g., cross cutting and longer-term strategies). It also has a wider flexibility beyond immediate COVID-19 response to focus on secondary health effects and underlying drivers. Activities that were initiated through the ELC Equity Investment Plan could be continued or expanded upon if they are consistent with the use of the CDC Health Disparities Funding. These activities should be complementary and non-duplicative.

If funding for a lead equity position was allocated in under the ELC Grant, would it make sense to move this position to be funded by this grant?

• This is optional at LHJ discretion. Please ensure that all ELC grant requirements, including allocating proportional resources to address disproportionately impacted populations, will be met if moving an equity position from the ELC grant to the CERI grant. The CERI grant is aimed to build equity capacity, so LHJs must describe how overall local equity capacity is being expanded through CERI funding. 
  

How does this funding align and avoid duplication with the required Health Equity Coordinator position through ELC funding?

• The CDC Health Disparities funding is intended to compliment and expand the great equity work started using the ELC funding. Much of the ELC Funding focused on immediate COVID-19 response efforts whereas the hope is that the CDC Health Disparities funding can be used to focus more on equity in recovery. The proposed CDPH Office of Health Equity Advancing Community Equity (ACE) Branch will provide ongoing technical assistance and will be continuing the Epidemiology and Laboratory Capacity (ELC) grant-funded work. With the ELC funding, we asked for an Equity Contact. If you have been able to hire dedicated equity staff, then this health disparities grant funding would build on that infrastructure. If you have not been able to hire dedicated equity staff, this funding will be to develop that infrastructure within your county/jurisdiction.

Will there be more information provided on the Statewide Health Equity Plan?

• Yes, CDPH will provide more information. Key milestones related to the State Equity Plan are identified in the Work Plan template.  A more detailed overview of each state of the Statewide Equity Plan process will be provided for LHJs in relation to these milestones.

Where does Public Health Accreditation fit into this work? Can accreditation be used as a means to an end (i.e. focus on weaving equity into everything while working towards accreditation/re-accreditation at the same time and provide a model for the rest of the nation focused on equity)?

• According to the notice of funding opportunity (NOFO), "Applicant entities may use funds for activities as they relate to the intent of this NOFO to meet national standards or seek health department accreditation through the Public Health Accreditation Board (www.phaboard.org). Activities include those that enable a public health organization to deliver public health services such as activities that ensure a capable and qualified workforce, up-to-date information systems, and the capability to assess and respond to public health needs. Use of these funds must focus on achieving a minimum of one national standard that supports the intent of the NOFO. Proposed activities must be included in the budget narrative and must indicate which standards will be addressed."
• We encourage LHJs to consider integrating equity into all aspects of their work including, but not limited to, the accreditation/reaccreditation process.

Technical Assistance

Will CDPH or CDC provide the organizational assessment tool?

• Yes, CDPH developed a baseline organizational assessment tool that can be customized based on local context. This tool will be informed by existing local examples and shared for feedback before finalized.
  

What Technical Assistance and Training will be provided to support LHJs?

• An intro webinar for initial questions regarding grant work plan, framework, allocations and performance metrics, as well as ongoing support for project implementation will be held in early September.
• Sample duty statements for Equity Officer and other levels of equity staff roles will be shared to support staff planning and recruitment.
• Ongoing TA support will be available through the Equity TA Team
• Learning collaboratives including training, peer support, sessions on proposed topics will also be organized.  
• Send questions at any time to EquityTeam@cdph.ca.gov
  

CDC COVID-19 Health Disparities Grant Updates and Feedback Session

Will the slides from the informational webinar be available?

• Yes, the slide deck was emailed to participants following the meeting on 7/1/21. If you did not receive it, please contact Katey.Rosenquist@cdph.ca.gov.

Will a recording from the informational webinar be available?

• The informational webinar was not recorded, but we can provide a copy of the meeting slides that contain all of the information that was covered.

Additional Information

Where can I find additional information?

• CDPH will share further resource materials as they become available and post further Q&A responses periodically.
• The CDC COVID-19 Health Disparities grant webpage also includes regularly updated question and answer resources.
• For additional questions, please contact EquityTeam@cdph.ca.gov