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Federal health funding comes in two forms that are routinely confused, and the
difference decides who is doing the work.
| Acquisition | Purchasing supplies and services for the CDC — contracts, purchase orders, inter-agency agreements. Often called simply "contracts" |
| Assistance | Grants and cooperative agreements — transferring federal money, resources, technical assistance and expertise to public health stakeholders, including state and local governments. Often called simply "grants" |
The CDC's own summary is the clearest statement of it:
**Contracts acquire supplies and services for the agency, while grants
assist recipients in accomplishing a public purpose.**
In an acquisition, the CDC is the customer and the outcome belongs to the CDC.
In assistance, the recipient is doing the work and the CDC is enabling it —
which is why assistance is the mechanism that **involves and engages public
health stakeholders** rather than merely paying them.
Grant or cooperative agreement
Within assistance there is a further distinction, and it is about involvement
rather than money:
- A cooperative agreement is used when **the CDC has substantial
involvement** in the funded activities - A grant is used when the CDC has no need for substantial involvement
So a state health department under a cooperative agreement is working
alongside federal staff; under a grant it is working on its own. Same money,
different relationship — and worth knowing which one you are in before the
first progress call.
Source: Centers for Disease Control and Prevention.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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