TLDR
The Centers for Disease Control and Prevention awards approximately $11 billion annually in grants and cooperative agreements, primarily to state and local health departments but with substantial direct funding to nonprofits through programs including Racial and Ethnic Approaches to Community Health (REACH), the National Implementation and Dissemination for Chronic Disease Prevention program, Diabetes Prevention Program funding, Public Health Associate Program host sites, HIV prevention and surveillance partnerships, and Prevention and Public Health Fund (PPHF) initiatives. CDC awards are governed by 2 CFR Part 200 (Uniform Guidance) and HHS's adoption at 45 CFR Part 75. Direct nonprofit applicants apply through Grants.gov; many CDC dollars also flow as subawards from state and local health departments. The biggest first-year challenges are managing CDC's heavily prescriptive cooperative agreement work plans, meeting performance-period reporting requirements in REDCap or program-specific data systems, and documenting allowable evaluation and indirect costs.
The Centers for Disease Control and Prevention is one of the most operationally hands-on federal grantmakers. While the bulk of CDC funding flows to state and local health departments, the agency directly funds hundreds of nonprofits each year - community-based organizations addressing chronic disease disparities, HIV/AIDS service organizations, suicide prevention coalitions, tribal health organizations, professional public health associations, and academic-community partnerships. The dominant award instrument is the cooperative agreement, which means a CDC project officer participates in ongoing work plan decisions, performance reviews, and technical assistance. This collaborative posture is a feature, not a bug, but it changes the day-to-day rhythm of grant administration compared with hands-off discretionary grants.
What CDC funds
CDC’s nonprofit-relevant programs cluster around several categorical priorities.
Chronic disease prevention and disparities. REACH (Racial and Ethnic Approaches to Community Health) funds community-based organizations and academic-community partnerships to address cardiovascular disease, diabetes, obesity, and related chronic conditions in priority populations. National implementation programs fund nonprofit umbrella organizations to disseminate evidence-based interventions. The National Diabetes Prevention Program funds delivery organizations as recognized lifestyle change program providers, with reimbursement under Medicare Diabetes Prevention Program coverage.
Infectious disease and HIV. HIV prevention cooperative agreements fund community-based AIDS service organizations and health departments to deliver high-impact HIV prevention. STD/HIV surveillance partnerships fund population-specific surveillance work. Hepatitis prevention and surveillance projects fund harm reduction organizations and integrated service providers. Vaccine confidence and immunization equity programs fund nonprofits to address vaccine hesitancy in priority populations.
Injury and violence prevention. Suicide prevention cooperative agreements fund state coalitions and community-based organizations. Sexual violence prevention funds rape crisis centers and statewide coalitions. Drug overdose prevention funds harm reduction nonprofits and treatment organizations. Adverse Childhood Experiences (ACEs) prevention funds early-childhood and family-services organizations.
Tribal and community capacity. The Tribal Public Health Capacity Building Program funds tribal nonprofits and tribal health organizations. The Public Health Infrastructure Grant flows to state and local health departments but commonly subawards to nonprofit partners.
Workforce and training. Public Health Associate Program host site cooperative agreements place CDC fellows at nonprofit organizations. Various preparedness and response training programs fund nonprofit professional associations.
Award sizes range widely. REACH awards average about $1.5 million per year for five years. National implementation cooperative agreements can reach $5 million per year. Categorical community-based prevention awards often run $200,000 to $500,000 per year.
Application requirements
CDC discretionary awards are submitted through Grants.gov.
Prerequisites. Active SAM.gov registration with valid UEI; Grants.gov Workspace account; current indirect cost rate documentation (NICRA or 10% de minimis election under 2 CFR 200.414(f)); demonstrated experience requirements (most CDC NOFOs require some demonstrated experience in the relevant content area or with the priority population).
Application package. Standard forms include SF-424, SF-424A, SF-424B, SF-LLL, project narrative (page-limit varies by program; typically 25-50 pages), budget narrative, work plan, evaluation plan, organizational capacity narrative, and program-specific attachments. CDC NOFOs are typically more prescriptive than other federal grantmakers about evaluation methodology, performance measure selection, and work plan structure. Read the NOFO carefully for required outcome measures and embed them into your work plan.
Post-award setup. Awards are issued through CDC’s grants office and managed in HHS’s GrantSolutions or in CDC’s internal systems. Drawdowns flow through the Payment Management System (PMS). First-time PMS setup typically takes 7-14 business days; do this immediately on receipt of the Notice of Award.
Compliance specifics
CDC awards are governed by 45 CFR Part 75 (HHS’s adoption of 2 CFR Part 200) plus HHS Grants Policy Statement plus CDC-specific terms in your Notice of Award.
Cost principles. The five Uniform Guidance criteria apply - necessary, reasonable, allocable, conformant, consistent, documented. CDC compliance reviews are particularly attentive to evaluation costs (which must be allowable as direct costs and consistent with the approved evaluation plan), participant incentives (which must comply with HHS Grants Policy Statement limits), and travel costs (which must comply with Federal Travel Regulation rates if not on the recipient’s own travel policy).
Procurement. 2 CFR 200 Subpart D applies. Sole-source justifications for evaluators, communications firms, and contracted clinical services are scrutinized.
Time-and-effort documentation. Standard 2 CFR 200.430(i) records-of-effort requirements apply. CDC project officers commonly request personnel activity reports during routine monitoring.
Reporting cadence. SF-425 Federal Financial Reports are typically semi-annual, due 30 days after the end of each semi-annual period and 90-120 days after the budget period end for the final. Programmatic reports and performance measurement reports are typically annual, sometimes semi-annual or quarterly depending on the program. Cooperative agreement work plans may be updated quarterly in collaboration with the CDC project officer. Many CDC programs require performance data submission through REDCap or program-specific data systems on monthly or quarterly cadence.
Single Audit. Nonprofits expending $1,000,000 or more in federal awards in a fiscal year must obtain a Single Audit under 2 CFR 200 Subpart F (45 CFR 75 Subpart F).
Subrecipient monitoring. CDC grantees that subaward portions of their awards become passthrough entities under 2 CFR 200.332. The risk assessment, subaward agreement content, and ongoing monitoring requirements apply.
CDC-specific monitoring. Beyond the Single Audit, CDC project officers conduct routine programmatic monitoring through monthly or quarterly check-ins, mid-year reviews, and annual performance review meetings. Cooperative agreements include collaborative work plan negotiation, which means project officer concerns about progress are typically addressed through work plan adjustments rather than enforcement actions in the first instance.
IRB and human subjects. Many CDC awards involve research or surveillance with human subjects. The recipient must hold a Federalwide Assurance (FWA) with the HHS Office for Human Research Protections and operate or contract with an Institutional Review Board (IRB). IRB approval letters become part of the compliance file before any human-subjects work begins.
HIPAA. Awards that involve Protected Health Information must comply with HIPAA Privacy and Security Rules. Business Associate Agreements with vendors handling PHI become part of the compliance file.
Deadlines and NOFO cadence
CDC NOFO release patterns vary by program area:
- REACH - five-year cycle; most recent recompete in 2023, next anticipated in 2028.
- HIV prevention cooperative agreements - five-year cycles, with several program-specific recompetes scattered across the cycle.
- Suicide prevention - five-year cycles with annual supplemental opportunities.
- National Diabetes Prevention Program organization recognition - continuous-application; recognition is not a grant but enables Medicare DPP reimbursement.
- Public Health Associate Program host site - annual recruitment cycle.
- Smaller categorical and supplemental opportunities - released throughout the year on the CDC Grants Dispatch listserv.
Subscribe to the CDC Grants Dispatch listserv to receive every NOFO release. Build CDC opportunities into your annual grant calendar even when you don’t expect a major recompete that year, because supplemental opportunities (especially in chronic disease and infectious disease prevention) appear regularly.
Common mistakes
Five recurring failure modes for first-time CDC recipients:
- Underestimating the cooperative agreement workload. Cooperative agreements require active engagement with the CDC project officer. Treating one like a hands-off grant leads to performance concerns.
- Evaluation costs charged but not in the approved evaluation plan. Evaluation budget categories that don’t match the approved evaluation plan get disallowed.
- Participant incentive limits. HHS Grants Policy Statement caps individual participant incentives. Exceeding the cap without prior CDC approval is unallowable.
- Late performance data submission. REDCap and program-specific data submission deadlines are typically more frequent than financial reporting deadlines. Late performance data triggers project officer follow-up.
- IRB lapses. IRB continuing review must be current throughout the project. A lapsed IRB approval halts human-subjects activity and can disallow associated costs.
Where to go next
Read the practical guide to 2 CFR Part 200 for the cost principles framework that governs every CDC award. Review federal grant reporting requirements before your first SF-425 cycle. If your work overlaps with HRSA-funded community health centers, the HRSA Section 330 reporting guide covers adjacent reporting expectations. The free grant compliance checklist walks through the documentation set CDC recipients should maintain through closeout.
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- Cooperative Agreement
- A federal financial assistance instrument under 2 CFR Part 200 used when substantial federal involvement is anticipated during performance. CDC project officers participate in ongoing work plan decisions, protocol development, and technical assistance. The compliance framework is identical to a grant but the day-to-day relationship with the federal agency is more interactive.
DEFINITION
- REACH
- Racial and Ethnic Approaches to Community Health, a CDC cooperative agreement program funding community-based organizations and academic-community partnerships to address chronic disease disparities. Five-year project periods with annual continuations.
DEFINITION
- PPHF
- The Prevention and Public Health Fund, established by the Affordable Care Act, that supplements annual appropriations for several CDC chronic disease and prevention programs. PPHF-funded awards carry the same Uniform Guidance compliance requirements as appropriations-funded awards.
DEFINITION
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