Ryan White HIVAIDS Program Part A PreApplication Technical

Ryan White HIV/AIDS Program Part A Pre-Application Technical Assistance Webinar HRSA-21 -055 July 30, 2020 Division of Metropolitan HIV/AIDS Programs (DMHAP) HIV/AIDS Bureau (HAB)

HIV/AIDS Bureau Vision and Mission Vision Optimal HIV/AIDS care and treatment for all Mission Provide leadership and resources to assure access to and retention in high quality, integrated care, and treatment services for vulnerable people with HIV and their families 2

Agenda • Purpose of Notice of Funding Opportunity • Award Information • Eligibility • Application and Submission Information • Application Review Information • Application Submission Tips • Question and Answer *Also included are a list of acronyms, knowledge checks, resources, and acknowledgements 3

Acronyms • • CQM – Clinical Quality Management • • DUNS – Data Universal • Numbering System • EHB – Electronic Handbooks • EHR – Electronic Health Records • • EIIHA – Early Identification of • Individuals with HIV/AIDS • • HAB – HIV/AIDS Bureau • HRSA – Health Resources and • Services Administration • GMS – Grants Management Specialist LPAP – Local Pharmacy Assistance Program MAI – Minority AIDS Initiative MIS – Management Information System NOFO – Notice of Funding Opportunity (formerly FOA) PO – Project Officer RWHAP – Ryan White HIV/AIDS Program SAM – System for Award Management 4

Purpose of NOFO • This notice solicits applications for the Ryan White HIV/AIDS Program (RWHAP) Part A HIV Emergency Relief Grant Program • RWHAP Part A provides direct financial assistance to an eligible metropolitan area (EMA) or a transitional grant area (TGA) that has been severely affected by the HIV epidemic • Grant funds assist eligible jurisdictions to develop or enhance access to a comprehensive continuum of high quality, community-based care for people with HIV who are low-income through the provision of formula, supplemental, and Minority AIDS Initiative (MAI) funds Please refer to page 1 of the NOFO 5

Updates in FY 2021 NOFO • Narrative Section: Evaluation and Technical Support Capacity: there are now only three Evaluative Measures. • Highlighted in this NOFO: As part of your FY 2021 annual progress report, due May 29, 2022, you will be asked to provide a narrative describing the impact of MAI-specific interventions on improving viral suppression and other HIV-related health outcomes for the MAI subpopulations identified in the NOFO Demonstrated Needs section. 6

Award Information • Approximately $620, 000 available to fund up to 52 applicants • Approximately $10, 800, 000 will be used for priority funding and $53, 000 will be used for MAI funding • Ceiling amounts for each EMA/TGA listed in Appendix B • Two-thirds of funds are formula based (determined by number of living HIV/AIDS cases). The remaining funds are discretionary supplemental awards based on the demonstration of additional need and MAI funding (determined by living cases of HIV among minorities) Please refer to page 7 of the NOFO 7

Eligibility Information • Eligible applicants include RWHAP Part A recipients that are classified as an EMA or as a TGA and continue to meet the status as an eligible area as defined in statute • Cost sharing/matching is not required • Applicant may request up to the ceiling amount in Appendix B • Maintenance of Effort Information (MOE) – Attachment 11 • Please refer to pages 8 to 9 of the NOFO 8

Application and Submission Information Two Components of the NOFO: 1) HRSA-21 -055 Ryan White HIV/AIDS Program Part A HIV Emergency Relief Grant Program focuses on the program-specific content, including goals, expectations, and requirements of the program 2) HRSA’s General Instructions • SF-424 Application Guide (“Application Guide”) • Links are found throughout the NOFO 9

Application Package Applicants must include the following: • SF-424 Application for Federal Assistance • Project Abstract (uploaded in box 15 of the SF-424) • Project/Performance Site Location Form • Project Narrative (uploaded to the Project Narrative Attachment Form) • SF-424 A Budget • Budget Narrative (uploaded to the Budget Narrative Attachment Form) • Attachments (Section IV 2. v. of NOFO) • Grants. gov Lobbying Form • SF-424 B Assurances • Key Contacts 10

Project Abstract The project abstract should be single spaced, limited to one page, and include the following: • General Overview of the HIV epidemic in the EMA/TGA, including epidemiologic, demographic and geographic information. May present this in a table format • System of Care in EMA/TGA, including core medical and support services, locations, client access, and special services for disproportionately affected populations • Overall Viral Suppression Rate for the EMA/TGA • Data on subpopulations that highlight disparities in this outcome measure Please refer to page 11 of the NOFO & page 34 of the SF-424 Application Guide 11

Project Narrative Sections: • Introduction • Needs Assessment • Methodology • Work Plan • Resolution of Challenges • Evaluation and Technical Support Capacity • Organizational Information Please refer to pages 12 to 31 of the NOFO 12

Project Narrative – Needs Assessment Demonstrated Need • Demonstrated Need includes: Epidemiological Overview HIV Care Continuum Co-occurring Conditions Complexities of Providing Care • No new unmet need estimates are required • Supplemental funds will be targeted to: • Eligible areas where epidemiological data demonstrated HIV prevalence rates are increasing • Where there is documented demonstrated need and service gaps • Where there is a demonstrated disproportionate impact on vulnerable populations Please refer to pages 12 to 15 of the NOFO 13

Project Narrative – Needs Assessment Early Identification of Individuals with HIV/AIDS (EIIHA) Description and discussion of EIIHA activities Presentation of three target populations that are the focus of EIIHA efforts Description of planned or ongoing efforts to remove legal barriers to routine testing Please refer to page 15 of the NOFO 14

Project Narrative – Needs Assessment Local Pharmaceutical Assistance Program (LPAP) This section must be completed only if an LPAP is newly funded. Please note the following: • The LPAP section is not scored • LPAP may not be used to provide short-term or emergency medication assistance • Refer to the National Monitoring Standards and PCN 16 -02 for a complete list of LPAP requirements • See the National Monitoring Standards and the LPAP letter of clarification sent to RWHAP Parts A and B recipients on August 29, 2013. Please refer to page 16 of the NOFO 15

Knowledge Check 1 Question #1 16

Project Narrative – Methodology Impact of the Changing Health Care Landscape Please describe the following: Health care coverage options available to people with HIV in the jurisdiction • Impact of access to healthcare services and health outcomes The effects changes in the health care landscape have on: • Service provision and the complexity of providing care to people with HIV • Changes in RWHAP Part A allocations Please refer to page 17 of the NOFO 17

Project Narrative – Methodology Planning Responsibilities • Planning and Resource Allocation • Administrative Assessment • Letter of Assurance from Planning Council Chair(s) or Letter of Concurrence from Planning Body • Resource Inventory Please refer to pages 17 to 20 of the NOFO 18

Dollar Amount Part A $ Part B $ Part C $ Part D $ Part F $ CDC $ SAMHSA $ HOPWA $ Federal $ State $ Local $ Total $ % Treatment Adherence Counseling Substance Abuse Services (residential) Respite Care Rehabilitation Services Referral for Health Care & Support Services Psychosocial Support Services Outreach Services Other Professional Services: Legal Services Medical Transportation Linguistic Services Housing Services Health Education/Risk Reduction Food Bank/Home-delivered Meals Emergency Financial Assistance Child Care Services Non-Medical Case Management Services Supportive Services Substance Abuse Outpatient Care Medical Case Mgmt, incl. Tx Adherence Medical Nutrition Therapy Mental Health Services Hospice Services Home & Community-based Health Services Home Health Care Health Insurance Premium &Cost-Sharing Early Intervention Services Oral Health Care AIDS Pharmaceutical Assistance AIDS Drug Assistance Program Treatment (Tx) Outpatient/Ambulatory Health Services Core Medical-related Services Condom Distribution PLWH/Partner Prevention Services HIV Testing & Policy Alignment Efforts Prevention Services Funding Source Number of Agencies Methodology - SAMPLE Attachment 5 Coordination of Services and Funding Streams Table FY 2020 Funding Amount 100% 19

Project Narrative – Work Plan HIV Care Continuum Table & Narrative Stages of the HIV Care Continuum Goal Outcome I. Diagnosed Increase percentage who are aware of their HIV status Percentage of HIV positive tests in the measurement year Baseline: Numerator/Dominator, % Target: Numerator/Dominator, % II. Linked to Care Increase percentage of clients who attend a routine medical care visit within 30 days of HIV diagnosis Percentage of people diagnosed with HIV in a given calendar year that had one or more documented medical visits, viral load or CD 4 tests within 3 months after diagnosis Baseline: Numerator/Dominator, % Target: Numerator/Dominator, % III. Retained in Care Increase percentage of clients retained in care Percentage of diagnosed individuals who had two or more documented medical visits, viral load or CD 4 tests, performed at least 3 months apart in the observed year. Baseline: Numerator/Dominator, % Target: Numerator/Dominator, % IV. Prescribed ART Increase percentage of clients with access to prescribed HIV/AIDS medications consistent with PHS treatment guidelines Percentage of patients, regardless of age, with a diagnosis of HIV prescribed antiretroviral therapy for the treatment of HIV infection in the measurement year. Increase the number of clients with a viral load of <200 copies/m. L at last test in the 12 -month measurement period Percentage of patients, regardless of age, with a diagnosis of HIV with a HIV viral load <200 copies/m. L at last HIV viral load test in the measurement year. Baseline: Numerator/Dominator, % Target: Numerator/Dominator, % V. Virally Suppressed Baseline: Numerator/Dominator, % Service Category Target: Numerator/Dominator, % Please refer to pages 20 to 21 of the NOFO 20

Project Narrative – Work Plan Funding for Core & Support Services • Service Category Plan Table o RWHAP Part A o MAI • Service Category Plan Narrative • Core Medical Services Waiver (if applicable) Please refer to pages 21 to 22 of the NOFO 21

Work Plan – SAMPLE Attachment 8 Service Category Plan Table PART A Example: Outpatient Ambulatory Medical Care Example: Medical Case Management Priority Number Service Category 2020 Allocated 2021 Anticipated Funding Amount UDC Served Service Unit Definition Service Units $2, 000 2000 1 unit = 1 visit 4500 $1, 200, 000 1200 1 unit = 1 visit 3800 $1, 500, 000 2500 1 unit = 1 visit 25, 000 $2, 000 2600 1 unit = 1 visit 30, 000 2021 -1 2021 -2 22

Work Plan - SAMPLE Attachment 8 Service Category Plan Table MAI Example: Outpatient Ambulatory Medical Care Example: Medical Case Management Priority Number Service Category 2020 Allocated Funding Amount 2021 Anticipated UDC Served Service Unit Definition Service Units Funding Amount UDC Served Service Unit Definition MAI Only Service Units 2021 -2 $400, 000 175 1 unit = 1 visit 500 $350, 000 200 1 unit = 1 visit 400 2021 -1 $250000 150 1 unit = 1 visit 1500 $300000 150 1 unit = 1 visit 2000 Target populations Hispanic Women Childbearing Age 23

CORE MEDICAL SERVICES WAIVER Submission Service Category Plan Table Allocation Table Before Application Match Waiver Request Not Applicable for Application With Application Match Waiver Request After Application Match Intended Waiver Request Not Applicable for Application Instructions for CMS Waivers can be found at: https: //hab. hrsa. gov/sites/default/files/hab/Global/13 -07 waiver. pdf Please refer to page 22 of the NOFO 24

Knowledge Check 2 Question #2 25

Project Narrative – Resolution of Challenges SAMPLE Table 26

Project Narrative - Evaluation and Technical Support Capacity Clinical Quality Management 1) Describe how performance measure data are analyzed to evaluate for disparities in care, and actions taken in the last grant year to eliminate disparities 2) Describe how CQM data have been used to improve patient care/outcomes/satisfaction, and/or change service delivery in the jurisdiction, including strategic long-range service delivery planning Please refer to page 23 of the NOFO 27

Project Narrative - Organizational Information • Grant Administration • Program Organization o The individual responsible for the grant has at least 0. 5 FTE allocated to RWHAP Part A • Grant Recipient Accountability o Monitoring o Third Party Reimbursement o Fiscal Oversight • Maintenance of Effort (MOE) Please refer to pages 24 to 26 of the NOFO 28

Staffing Plan SAMPLE Table % FTE Name Education/ Credentials Title Project Role Experience Admin CQM MAI HIV Services Oversight of RWHAP award and project implementation 5 -years as program coordinator, previously Data/CQM Manager for same entity 0. 15 0. 25 0. 45 Oversight of clinic staff, SOPS and CQI projects 15 -years providing HIV primary care 0. 15 0. 20 0. 15 0. 45 4 -years working in HIV clinic scheduling appointments, making referrals, medical data entry 0. 60 0. 10 0. 05 0. 50 Mrs. Doe MPH Program Coordinator Dr. Jones MD Medical Director Ms. Kona Associates Degree CQM Coordinator, Retention Specialist Oversight of CQM Activities Vacant MSW Medical Case Manager Treatment adherence training 29

Budget Requirements Budget information consists of two parts: 1. SF-424 A Budget Information for Non. Construction Programs (included in the application package) 2. Budget Narrative/Justification Please refer to pages 26 to 31 of the NOFO & pages 17 to 31 of the SF-424 Application Guide 30

Budget Requirements: SF-424 A Budget Information Add info to column (a) Totals autopopulate! Enter dollar amounts for column (a) rows 1, 2, & 3 Add CFDA #s to column (b) Totals cannot exceed amount in Appendix B of NOFO 31

Budget Requirements: SF-424 A Budget Categories Totals autopopulate! Columns autopopulate! Enter object class category amounts into columns 1 -3 not : r nde i m e n l ca a t To m ed a e c ex t in oun dix pen B! Ap R 32

Budget Requirements: SF-424 A Other Budget Information Please remember to complete items 21 & 22 in Section F 33

Budget Narrative/Justification SAMPLE Table 1 34

Budget Narrative/Justification SAMPLE Table 2 35

Salary Limitation The current salary rate limitation applicable to RWHAP domestic grants and cooperative agreements increased from $192, 300 in 2019 to $197, 300 in 2020. • The Departments of Health and Human Services, and Education and Related Agencies Appropriations Act, 2020 (P. L. 116 -94), Division A § 202, states, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II. ” • As a reminder, RWHAP funds and program income generated by RWHAP awards may not be used to pay salaries in excess of the rate limitation. 36

Knowledge Check Question #3 37

Funding Restrictions In addition to the general funding restrictions included in Section 4. 1 of the SF-424 Application Guide, funds may not be used for the following: • Cash payments to intended recipients of RWHAP services • International travel • Pre-exposure (Pr. EP) or postexposure (PEP) prophylaxis medications or related medical services • Payment for any item or service that has been (or can be expected to be) paid by a state compensation program, insurance policy, federal or state health benefits program, or any entity that provides health services on a prepaid basis • Development of materials • Syringe Services Programs* designed to promote or encourage • Construction* intravenous drug use or sexual activity *Discuss with your HAB project officer. Please refer to pages 35 to 36 of the NOFO 38

Attachments • List of Attachments can be found in Section IV. 2. v. of the NOFO • Upload attachments in the order specified to the Attachments Form in the application package • Label each attachment clearly • Unless otherwise noted, attachments count toward the page limit Please refer to pages 32 to 33 of the NOFO 39

Attachments - Maintenance of Effort (MOE) Please refer to page 33 of the NOFO 43

Application Review Information • HRSA’s Division of Independent Review (DIR) is responsible for managing the objective and independent application review performed by a committee of qualified experts • Applications will be reviewed and rated based on the review criteria in Section V of the NOFO if they • are submitted by the published deadline • do not exceed the page limit • do not request more than the ceiling amount, and • pass the initial HRSA eligibility and completeness screening • The competitive objective review process is based solely on the merits of your application. It is critical that you paint a clear picture of your proposed project and the capabilities that your organization brings to the work Please refer to pages 36 to 41 of the NOFO 41

Application Review Information • Review criteria are used to review and rank applications. For this opportunity, there are six review criteria: Criteria Criterion 1: Need Criterion 2: Response Criterion 3: Evaluative Measures Criterion 4: Impact Criterion 5: Resources/Capabilities Criterion 6: Support Requested Total Points 66 12 2 10 5 5 100 Please refer to pages 36 to 41 in the NOFO 42

Application Package: Where is it? • On HRSA’s website at https: //www. hrsa. gov/grants/ • Click on the “Apply for a Grant” link for info. • At https: //www. grants. gov/ • Search by opportunity number (HRSA-21 -055) or • CFDA Number: 93. 914 • The Application Guide is available at https: //www. hrsa. gov/sites/default/files/hrsa/grant s/apply/applicationguide/sf-424 -app-guide. pdf or click the links in the NOFO 43

Application Submission Tips • Read the NOFO and the SF-424 Application Guide carefully and follow instructions. • Include your agency name and the name of this program on all pages (RWHAP Part A HIV Emergency Relief Grant Program). • Apply early; do not wait until the last minute in case you run into challenges! • Make sure the person who can submit for your organization will be available. • Ensure SAM. gov and Grants. gov registration and passwords are current immediately! Have your PIN numbers and passwords handy! 44

Grants. gov Contact Information • When to contact Grants. gov Helpdesk • Error messages • Other technical issues • Application did NOT transmit to HRSA • If you have any submission problems, please contact Grants. gov immediately! • Grants. gov Contact Center (24/7 except federal holidays) • 1 -800 -518 -4726, • Send an email to: support@grants. gov, or visit • https: //grants-portal. psc. gov/Welcome. aspx? pt=Grants 45

Tracking Grants. gov Submissions Submission Type Competing Application E-mail Subject Time Frame Sent by Recipient 1 st e-mail Submission Receipt Within 48 hours Grants. gov AOR 2 nd e-mail Most Crucial Submission Validation Receipt OR Rejected with Errors Within 48 hours Grants. gov AOR 3 rd e-mail Grantor Agency Retrieval Receipt Within hours of second e-mail Grants. gov AOR 4 th e-mail Agency Tracking number assignment Within 3 business days Grants. gov AOR SF-424 Application Guide, section 8. 2. 5 The Grants. gov Contact Center can be reached by email at support@grants. gov, or by telephone at 1 -800 -518 -4726 46

Reminders • Your application must be electronically submitted through and successfully validated by Grants. gov no later than October 7, 2020, 11: 59 p. m. EDT. • We recommend submission of the application at least four business days before the due date. e 4 days befor Due date! 47

Contact Information Applicants who need additional information may contact: Program Contact Grants Contact Chrissy Abrahms Woodland Director, Division of Metropolitan HIV/AIDS Programs Olusola Dada Grants Management Specialist Division of Grants Management Operations, OFAM CAbrahms@hrsa. gov ODada@hrsa. gov (301) 443 -1373 (301) 443 -0195 48

Q&A - Your Questions are Welcome! HAB Target. HIV Website https: //www. targethiv. org/searches/webcasts 49 52

Thank you for attending and Thanks to the following HRSA HAB Staff…. . DMHAP NOFO Workgroup Members: Durkia Hudson, CDR Holly Berilla, LCDR Andy Tesfazion, Mae Rupert, Deborah Medina, Emerson Evans, Sera Morgan, Michael Carrigan, Sonya Hunt Gray, Kristina Barney, Marean Duarte, LCDR Jessica Kreger, and LCDR Jonathon Fenner Presenters: • • Chrissy Abrahms-Woodland, Director, DMHAP LCDR Jonathon Fenner, Public Health Analyst, DMHAP Durkia Hudson, Public Health Analyst, DMHAP Emerson Evans, Public Health Analyst, DMHAP 50

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