Sexually Transmitted Diseases (STDs)

Improving Sexually Transmitted Disease Programs through Assessment, Assurance, Policy Development, and Prevention Strategies, or STD AAPPS, is a new funding opportunity from CDC’s Division of STD Prevention.

STD AAPPS was published on grants.gov on June 14, 2013. Applications will be accepted until midnight EST on September 12, 2013. The anticipated award date is January 1, 2014. The budget period length is 12 months and the project period length is 5 years.

Eligible applicants for this funding include all 50 states; Los Angeles, CA; San Francisco, CA; District of Columbia; Chicago, IL; Baltimore, MD; New York City, NY; Philadelphia, PA; Commonwealth of Puerto Rico; and the U.S. Virgin Islands or their Bona Fide Agents. A Bona Fide Agent is an agency/organization identified by the state or local government as eligible to submit an application under the state or local eligibility in lieu of a state application.

Although the public health foundations of STD AAPPS and the expiring cooperative agreement are similar, there are some notable differences:

• STD AAPPS eliminates separate program components for the infertility prevention project and syphilis elimination, thereby providing greater flexibility to grantees to direct resources to support STD prevention that reflect their local situation.
• STD AAPPS provides awardees the opportunity to develop work plans, performance measures, and evaluation activities that are focused on program efficiency, cost-effectiveness and scalable interventions with high health impact.
• STD AAPPS incorporates a funding formula that balances the need to direct resources to populations with the greatest burden of infections with the need to maintain efficient and effective infrastructure. Funding is equally divided to address each of these needs.
• STD AAPPS makes changes that support STD programs taking advantage of opportunities created by changes in the health care delivery system:
  • Opportunity for improvement of STD surveillance, electronic laboratory reporting, electronic health record case reporting and integrated data systems;
  • Opportunity for meaningful use of data for public health purposes;
  • Opportunity for participating in public health department billing efforts to receive reimbursement for  services provided;
  • Opportunity for public health and primary care to collaborate in new ways to expand STD prevention services and quality of existing services;
  • Opportunity to collaborate with state Medicaid programs choosing to expand and health insurance exchanges as they prepare for the changes that will take place in January 2014. 
• STD AAPPS enhances program capacity and supports modernization of the STD public health work force so they are fit for purpose.

Current funding does not appropriately align funding with burden and need.  In November 2011, CDC began active solicitation and collection of formal comments as part of DSTDP’s consultative process. Grantees requested moving funding to be more in alignment with disease burden, while mitigating harm to programs.  In order to give full consideration of all stakeholder input, DSTDP’s modelers developed a robust system to compare various formulas and considered more than 100 different formulas before applying the one outlined in STD AAPPS FOA.

The proposed formula is a conservative approach that begins to balance need while minimizing harm to established efficient and effective programs.  This change is also essential to support program adaptation and integration with the changing public health and health care environment.  In addition, CDC is committed to defining the parameters and resources needed to support efficient and cost-effective STD prevention programs at the state and local level during the next five years of this FOA. 

DSTDP noted several problems with basing a funding formula solely on burden:

• A funding formula based solely on burden would create a radical change in funding (more so than the proposed formula). In some cases it could cause large decreases in funding for some programs over the course of the project period. In other cases, the implementation of a burden-only formula does not allow much time for programs that would be getting large increases to prepare ;
• A burden-only formula did not take into account resources that would be required to maintain minimum core public health functions for STD prevention in a jurisdiction;
• A funding formula based solely on burden did not take into account anticipated cases based upon population changes; and
• A burden-only formula could potentially penalize programs that are doing a good job preventing STD among at-risk populations in their jurisdictions.

After assessing multiple approaches and combinations of the formula using size of population, disease burden, and rates of disease, a formula that took into account both burden/rates and population, rose to the top as being the most balanced approach.

As with STD AAPPS overall, removing separate program components for IPP reflects the increasing proportion of STD prevention activities occurring in private clinical venues. Infertility prevention remains a core priority of CDC's STD prevention funding. STD AAPPS simply allows that funding to expand infertility prevention services wherever they are needed, including private venues.

Please send your questions to stdaappsfoa@cdc.gov. DSTDP staff monitors this inbox on an ongoing basis and will assign your question to the appropriate staff. Frequently asked questions will be posted to the STD AAPPS FAQ webpage.

Additionally, DSTDP has scheduled a series of webinars over the course of the coming months for applicants. Webinar schedules, registration information, and recordings are available at the STD AAPPS Webinar page.