Tag Archives: DHHS

Language update for grant writers: the CDC has a new list of seven forbidden words/terms

The Washington Post reports that “CDC gets list of forbidden words” from its political masters. We find it hard to judge how serious the list is, because knowledge of the ban itself is only by way of “an analyst who took part in the 90-minute briefing”—not exactly an authoritative source for final policy. Still, the article has been making the rounds and the supposedly forbidden terms are “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”* As grant writers, we’re always sensitive to the vagaries of evolving language and ideas, as you can see from our 2014 post “Cultural Sensitivity, Cultural Insensitivity, and the ‘Big Bootie’ Problem in Grant Writing.”

(EDIT: It appears that “After firestorm, CDC director says terms like ‘science-based’ are not banned.” Alternately, it’s also possible that the word ban was being discussed, but the reaction to the leak caused the CDC to can it.)

While most PC language emerges from the political left, this CDC directive comes from the Trump administration. There’s a bit of humor in this, as right-wing commentators often cite the PC “language police,” raising the dire specter of Orwell’s 1984 and his 1946 essay, “Politics and the English Language.” It seems the wingtip is now on the other political foot.

Still, the CDC banned words are standard proposalese that we frequently use in CDC, HRSA, and many other proposals. Some combination of these words are also found in virtually every RFP. “Evidence-based practice” (EBP) is so ubiquitous as to be cliché, even though RFPs rarely define what is supposed to constitute a given EBP. I find this true: “When I see the words used by others, my immediate reaction is to think someone is deploying it selectively, without complete self-awareness, or as a bullying tactic, in lieu of an actual argument, or as a way of denying how much their own argument depends on values rather than science.” People who understand EBPs just cite the evidence and let the evidence speak for itself; people who don’t use the term EBPs as a conceptual fix-all.

Despite the putative ban, grant writers should continue to use these buzzwords, because proposal reviewers—both federal program officers and peer reviewers—expect to read them. Reading them is a good substitute for thinking about what they mean. In addition, there’s often a disconnect between the political appointees (e.g., Deputy Under Assistant Secretary for Obscure Grant Programs), who nominally run federal agencies, and the career civil servants or lifers who actually operate the agencies. Lifers often refer to the political appointees as “the summer help,” since they come and go with new administrations—or more frequently. Peer reviewers are practitioners, who are likely to be PC in the extreme and unlikely to attend to most administration instructions. As grant writers, our audience is composed of reviewers, not the summer help, so that’s who we’ll continue to write to.

For those of us of a certain age, it’s also ironic that the CDC picked seven words to ban, instead of six or eight, given comedian George Carlin’s 1972 monologue “Seven Words You Can’t Say on Television.”


* Mother Jones has a parody of this kerfuffle with seven replacements for the banned words: vulnerable=snowflake, entitlement=welfare, diversity=anti-white, transgender=deviant, fetus=unborn child, evidence-based=elitist, and science-based=atheist.

Another (and Exhaustively Named) Insider RFP: CMS Transforming Clinical Practice Initiative (TCPI), Support and Alignment Network (SAN)

We may be seeing an increase in “insider” RFPs.

By “insider” RFPs, we mean RFPs that don’t allow any random nonprofit to compete. HUD’s Continuum of Care (CoC) program (explained at the link) is an example: a nonprofit already has to be a CoC member to get a Cut of the Cash (which is another sort of “CoC”), which naturally creates barriers for new organizations that wish to try to do things better or at least differently than the existing funded organizations. The grant system as we presently know it got started in earnest in the ’60s because it was believed that local organizations were better suited to figure out what needed to be done than centralized federal bureaucrats. In addition, the threat of funding stream removal may make local organizations more disciplined than government bureaucracies—an idea that anyone who has dealt with a DMV may appreciate.

But designating small groups of eligible applicants is one way to get around open competition, particularly if the eligibility details are cryptic. As you may imagine given the title of this post, we have an example in mind: the Centers for Medicare & Medicaid Services (CMS) just issued the Transforming Clinical Practice Initiative (TCPI), Support and Alignment Network (SAN) FOA. Unless you’re already a professional organization or medical specialty group you’ll probably have no idea what it means to:

leverage primary and specialist care transformation work and learning in the field. The action by PTNs and SANs is planned to contribute to the overall operational efficiency and movement of the clinician practices through the 5 Phases of Transformation and their achievement of the TCPI goals.

I love leveraging transformations in order to effect effective and immediate action by PTNs and SANs and BBQs. Don’t you? “Cryptic” does not do this acronym stew justice.

In short, this is another insider RFP. For, say, organizations devoted to nurses, there are only going to be a handful of eligible applicants, because there are only so many nursing organizations that could be construed to be eligible applicants.

For applications like TCPI SAN, some interesting competitive dynamics can still take place within warring fiefdoms. For example, there are at least two large general-purpose national nurse organizations or trade groups, which we know because we’ve worked with one. Not surprisingly the two groups don’t like each other very much. As often happens, one likes one set of ideals that the other opposes, and vice-versa. Also not surprisingly, they fight for the same dues, grant opportunities, and foundation support; though both want to cast their aspersions as ideological or intellectual in nature, it’s always a good idea to follow the money too.*

In addition, there might be specialists within specialists groups. Is nursing the right level of specialty, or is oncology nursing? Is the association of surgeons correct, or the association of neurosurgeons? Those are the distinctions that’ll come into play in TCPI grant applications. We look forward to grabbing our axes, forming a shield wall, and fighting to the end.**


* A theme you should notice running throughout Grant Writing Confidential and indeed world history itself. How much of the 100 Years War was about the souls of English- and Frenchmen and the merits of Protestantism versus Catholicism, and how much was about money, trade, land, and political control? Today most historians probably argue as the latter, but almost any battle, whatever else it may be about, will also be cast as a war of ideas. Ideas are easier to fight and die for.

** I’ve been watching Vikings, which is set in an imagined 800 AD and in which a lot of characters die unpleasant deaths. The link also goes to the Blu-Ray version, which is to say the European version, which is to say a version much better and realer than the one that airs on American TV.

Office of Family Assistance Issues the “Pathways to Responsible Fatherhood Grants Program” FOA, Provides a Generous 30-Day Deadline, and Makes Mothers Eligible

The Department of Health and Human Services, Administration for Children and Families, Office of Family Assistance* just issued a Funding Opportunity Announcement (DHHS-speak for RFP) with tens of millions of dollars available and no matching requirement for the Pathways to Responsible Fatherhood Grants program. This new program was apparently hidden in plain sight in a somewhat obscure piece of federal legislation named the Claims Resolution Act of 2010. In addition to resolving the wonderfully named Pigford II settlement (I am not making this up, and no, I am not going to Google Pigford II or its presumable predecessor, Pigford I), this legislation also created and funded the Fatherhood program and at least two more new competitive grant programs: the Community-Centered Healthy Marriage and Relationship (CCHMR) Grants Program and the Community-Centered Responsible Fatherhood Ex-Prisoner Reentry Pilot Project.

There is $52,00,000 available for the Fatherhood program and $57,000,000 for the Marriage program, while the ex-prisoner dads get a comparatively paltry $6,000,000. Even better, none require matching funds, which is so unusual that the fact is worth mentioning twice. It’s open season if your agency is interested in new service delivery programs, and which agency isn’t?

The only bad news is the deadline: all three were published on June 29, with July 28 deadlines. OFA is giving applicants exactly 30 days (including the Fourth of July, which is a family holiday) to write complex responses to new programs. Last year, I blogged about stupid deadlines. The only good news about a deadline like this: there will likely be fewer than usual applications due to the combination of the long holiday weekend, summer vacations, and the struggles inherent in new FOAs and regulations.

Tireless OFA workers did not forget to include a bit of unintentional humor in the Fathers FOA, which, despite its name, says that “programs funded under this FOA must offer services on an equal basis to fathers and mothers.” I guess it could have been called the Responsible Parenting Program, but where’s the fun in that? Perhaps the Prisoners grants must be provided on an equal basis for non-prisoners. There is also the minor problem of whether all marriages—if you know what I mean, and I think you do—can be assisted through marriage grant activities. If we get hired to write this proposal, I will let readers know how I dance around this potential minefield.

Enough blogging.

Unlike you civilians and federal programs officers, who will be stuffing yourselves with tofu dogs and drinking beer, I will be slaving over a hot proposal or two this long holiday weekend. I’ll take a little time out to cruise PCH in my new bright red Mini Cooper S Ragtop. If I have time, I’ll get a dog harness so my golden retriever can ride in the back, adding to the clown aspect of driving it. If I wear a Fez,** I think the look will be complete. Suggestions for 7-character personalized plates will be appreciated.


* “DHHS ACF OFA,” if you want to see the whole string. Perhaps the subagency should have been named the “Office of Assistance to Families” to improve the acronym.

** I think Steely Dan is the only rock group that worked “Fez” into song lyrics, but I could be wrong. Personally, “I’m never going to do it without the fez on.”

Where Have All the RFPs Gone?

Subscribers to our Free Grant Alerts will probably have noticed relatively few large federal RFPs so far in this fiscal year, which began October 1. To paraphrase Peter, Paul & Mary, Where Have All The RFPs Gone?. I assume this dearth is because federal program officers are still churning through the tidal wave of Stimulus Bill proposals submitted in the last fiscal year. I predicted this problem in Stimulus Bill Passes: Time for Fast and Furious Grant Writing and said . . .

Unfortunately, we don’t have a National Guard of Program Officers who train one weekend a month shuffling papers to be ready to answer the call. That means Federal agencies will find themselves up to their eyeballs in spending authority with existing staff levels pegged at much smaller budgets.

Since federal agencies are running their regular programs while trying to spend additional Stimulus Bill funding and implementing entirely new programs, one imagines that our cadre of GS 10s and 11s, who are supposed to move the endless paperwork associated with shoveling federal funds out the door, simply have not gotten around to the FY ’10 RFP processes.

For example, just about every LEA and youth services nonprofit is waiting breathlessly for the Department of Education’s enormous and well-publicized Investing in Innovations (i3) Fund to be issued. The i3 program website still says, “The Department of Education anticipates accepting applications in early 2010, with all applications due in early spring of 2010. The department will obligate all i3 funding by September 30, 2010.” Hmmmm. Early 2010 has come and gone, so there is no chance that having proposals due in “early spring” is going to happen. But the Department of Education will still try to obligate i3 funds by the end of the fiscal year. This means that when the i3 RFP is finally issued, it will be during a fantastically busy time because the Department of Education has not issued most of their other programs either.

One indicator of the likely chaos at the Department of Education: the planned competitions for the Talent Search (TS) and Education Opportunity Centers (EOC), two of the very large “TRIO Programs”, “have been delayed. At this time, the Department expects to have a closing date for TS and EOC applications in fall 2010.” No sign yet of the annual RFP process for the Carol M. White Physical Education Program (PEP) either. We’ve been hired to write several PEP proposals and have been told by clients that the RFP will be issued in early April. On the PEP website, the last “funding status” information is from 2006!

The Department of Education is not alone in being tardy this year. We have yet to see any of the 30 or so NOFAs that HUD issues every year, any SAMHSA RFAs, few Department of Labor SGAs and almost no Department of Energy FOAs. We are also waiting for the DHHS Office of Adolescent Pregnancy Prevention (OAPP) to issue the FY ’10 RFP for their new teen pregnancy program. It was funded in the DHHS departmental budget authorization last fall but has yet to emerge. This program will be sex education/family planning-based, rather than abstinence-based, which has been the federal funding focus in teen pregnancy in recent years.

We know OAPP is coming because one of our clients, for whom we have written funded abstinence-based grants was contacted by their OAPP Program Officer to encourage them to switch approaches and apply for the new program. We’ve been hired to write the proposal when OAPP awakes from its slumber. As is said in Jamaica, “Soon come.” Just for fun, follow this link to the DHHS “FY ’10 Grants Forecast Page” and see what you get. That’s right, a blank page! This is not unusual, as most federal agencies will not tell you in advance when RFPs will be issued.

While you’re waiting for FY ’10 RFPs to blossom, figure out what funds will be available for your organization in the next several months and do everything you can to get ready to write the proposals. For most federal programs, the application period this year will be short.

RFP Lunacy and Answering Repetitive or Impossible Questions: HRSA and Dental Health Edition

I’ve talked before about RFP absurdity, and now I’ll talk about lunacy more generally: the HRSA “Service Expansion in Mental Health/Substance Services, Oral Health and Comprehensive Pharmacy Services” program (see the RFP in a Word file here) asks in Section 2.6, “Applicant describes how oral health services will be provided for special populations, such as MSFWs, homeless clients, and/or public housing residents.” The services provided are supposed to be dental—teeth cleaning, cavity filling, bridges, etc., and last time I checked, teeth cleaning is the same for pretty much everyone: you go in, sit on an uncomfortable chair, and let the dental hygienist muck around in your mouth. The RFP writer is probably trying to say, “How will you recruit these hard-to-reach populations and make sure they get their teeth cleaned?”

Furthermore, the question the RFP writer probably means to ask in Section 2.6 has probably already been asked in Section 2.5: “Applicant demonstrates how the oral health services will take into account the needs of culturally and linguistically diverse patients.” Here, once again, as far as I know “special populations” are like the rest of us—do the homeless need their teeth cleaned in some special kind of way? Don’t culturally and linguistically diverse populations also need, um, you know, clean teeth?

These two questions are also odd because they presume to demonstrate extraordinary sensitivity but actually implies that the homeless, public housing residents, and the like aren’t human like the rest of us. Every human has about the same dental procedure performed: a dental hygienist or dentist evaluates you by examining your mouth, screens for oral cancer, scrapes the plaque off, takes X-rays, and then decides what to do next. If you need a root canal, you get a root canal. As Shylock says in “The Merchant of Venice,” “If you prick us, do we not bleed? If you tickle us, do we not laugh? If you clean our teeth, do we not have fresh breath?” Okay, the last rhetorical question is an insertion, but it shows what’s so wrong with the presumptions behind the RFP and the way those presumptions weaken the RFP itself.

Questions like 2.4 are almost as bad: “Applicant also describes how the oral health service will be delivered within the context of the patient’s family and community to address specialized oral health needs.” Oral health service is usually delivered within the context of an operatory, where the dental hygienist and dentist work on your mouth. It’s not usually, so far as I know, delivered along with a Big Mac at McDonald’s. I answered this query by writing:

Oral health service will be delivered within the context of the patient’s family and community by understanding, respecting, and integrating both family and community life into the continuum of dental care. This means that extended family will be included in the care process to the extent necessary, and community norms will be evaluated and respected in providing care.

I have no idea what this means, as when I have a toothache I normally am not terribly interested in what my family or community says—I’m interested in what a dentist says she’ll do to fix it. But regardless of what it means, it’s one of three questions in the RFP that essentially ask the same question. When you’re confronted with page limitations and repetitive questions, you have two fundamental choices: repeat what you said, either verbatim or in slightly different words, or refer to the answers given in preceding statements. In general, we think it’s better to repeat what was said previous, or at least repeat portions of it if possible, because the reviewer will at least be able to put a check in the box indicating that the question was answered. It’s in front of the reviewer, which is particularly important if different reviewers are reading different proposal sections.

But in situations with extreme page limitations, we will sometimes refer to previous answers. But to do so, it’s vital that you pinpoint the section where the preceding answers occurred. Don’t just say, “as stated above,” unless what you’ve stated is immediately above. Say, for example, that, “as stated in Section 2.4, we’re committed to delivering services to special populations in the context of family and community…” That way, if the reviewer is bold enough to look at the preceding section, the reviewer might actually be able to find the relevant material. No matter how long and dreary the proposal, it’s incumbent on the grant writer to go find where the material exists and leave a pointer to that material in the later section. It’s also vital to answer the question rather than just observing, no matter how accurately, that the question has already been answered, which is a fast way to lose points by acting superior to the reviewer.

No matter how repetitive a question might be, you should answer it.


Why so many RFPs are so poorly constructed is a fine question and one I wish I could answer well. One assumption is that the people who write RFPs almost never respond to them, or, if they ever do have to respond to respond, it’s to someone else’s RFP. With that in mind, the best rational reason I can imagine is that it’s hard to figure out who would be best at delivering services and who most needs services. The problem is similar to figuring out how much to pay should be offered in a large organization. Tim Harford discusses it in The Logic of Life:

All the problems of office life stem from the same root. To run a company perfectly you would need to have information about who is talented, who is honest, and who is hardworking, and pay them accordingly. But much of this vital information is inherently hard to uncover or act upon. So it is hard to pay people as much or as little as they truly deserve. Many of the absurdities of office life follow logically from attempts to get around that problem […] (89)

The various levels of government don’t have perfect information about who will use grant funds well, and hence they issue byzantine RFPs to try and extract this information by force. But I’m not convinced funders are really getting anything better than they would if they issued a one-page RFP that said, “Provide dental health to at-risk populations. Tell us who, what, where, when, why, and how you’re going to provide them in a maximum of 30 double-spaced pages. You must submit by June 13. Good luck!” Instead, we get mangled RFPs like the one mocked above and blog posts that, like this one, are designed chiefly to demystify a process that shouldn’t be shrouded in the first place.