Ryan White HIV/AIDS Program Part A Pre-Application Technical Assistance Conference Call HRSA-18-066 September 12, 2017 Steven R. Young, MSPH Director, Division of Metropolitan HIV/AIDS Programs (DMHAP) HIV/AIDS Bureau (HAB) Health Resources and Services Administration (HRSA)

Agenda HAB Vision and Mission Purpose of Funding Opportunity Award Information Eligibility Application and Submission Information Application Review Information Application Submission Tips Question and Answer

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

HIV/AIDS Bureau Vision and Mission 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 living with HIV and their families

Please refer to pages 1 to 2 of the NOFO 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 low-income people living with HIV (PLWH) through the provision of formula, supplemental, and Minority AIDS Initiative (MAI) funds. Please refer to pages 1 to 2 of the NOFO

Updates in FY 2018 NOFO New - Appendix B Updated - Budget Section Updated - Work Plan Requirements Updated - Demonstrated Need Section Unmet Need Requirements Updated - Clinical Quality Management Section New CQM Plan Submission

Please refer to pages 4 to 5 of the NOFO Award Information Approximately $619,617,500 available to fund up to 52 applicants Approximately $9,572,100 will be used for priority funding and $51,208,700 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 pages 4 to 5 of the NOFO

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 5 to 6 of the NOFO

Application and Submission Information Two Components of the NOFO: HRSA-18-066 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 HRSA’s General Instructions SF 424 Application Guide (“Application Guide”) Links are found throughout the NOFO

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-424A Budget Budget Narrative (uploaded to the Budget Narrative Attachment Form) Attachments (Section IV 2. v. of NOFO) Grants.gov Lobbying Form SF-424B Assurances Key Contacts

See pages 8 in the NOFO and 37 in the SF424 Application Guide Project Abstract The project abstract should be single spaced and be limited to one page Project abstract should include: General Overview of HIV epidemic in the EMA/TGA, including epidemiologic, demographic and geographic information. May present in table format. System of Care in EMA/TGA, including 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 See pages 8 in the NOFO and 37 in the SF424 Application Guide

FY18 NOFO Narrative Overview Needs Assessment Demonstrated Need Epidemiologic Overview Co-occurring Conditions Complexities of Providing Care EIIHA LPAP Methodology Impact of the Changing Health Care Landscape Planning Responsibilities Planning and Resource Allocation Administrative Assessment Letter of Assurance/Concurrence Resource Inventory Work Plan HIV Care Continuum Table and Narrative Funding for Core and Support Services Please refer to pages 9 to 18 of the NOFO

FY18 NOFO Narrative Overview - Continued Resolution of Challenges Submit table with the headings: Challenges/Barriers Proposed Resolutions Intended Outcomes Current Status of Implementing RWHAP Part A and HIV Care Continuum Evaluation and Technical Support Capacity Clinical Quality Management Organizational Information Grant administration MOE Please refer to pages 18 to 21 of the NOFO

Needs Assessment - Demonstrated Need Demonstrated Need includes statutorily required: Epidemiological Overview 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 9 to 13 in the NOFO

Needs Assessment – Early Identification of Individuals with HIV/AIDS (EIIHA) Please refer to page 11 in the NOFO Presentation of three target populations that are focus of EIIHA efforts Description of planned or ongoing efforts to remove legal barriers to routine testing Description and discussion of EIIHA Activities

Needs Assessment - Local Pharmaceutical Assistance Program (LPAP) . This section must be completed only if an LPAP is newly funded 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

Knowledge Check Question #1

Methodology - Introduction Impact of the Changing Health Care Landscape Planning Responsibilities Please refer to pages 12 to 15 of the NOFO

Methodology – Impact of Changing Health Care Landscape Health care coverage options available to PLWH in the jurisdiction Impact of access to healthcare services and health outcomes The effects of changes in the health care landscape Service provision and the complexity of providing care to PLWH Changes in RWHAP Part A allocations

Methodology - Planning Responsibilities Planning and Resource Allocation Administrative Assessment Letter of Assurance from Planning Council Chair(s) or Letter of Concurrence from Planning Bodies Resource Inventory Please refer to pages 13 to 15 in the NOFO

Methodology - SAMPLE Attachment 5

Work Plan Your work plan should include objectives and key action steps that are: SPECIFIC MEASURABLE ACHIEVABLE REALISTIC & TIME FRAMED!

Work Plan – HIV Care Continuum Table & Narrative Stages of the HIV Care Continuum Goal Outcome Service Category 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 CD4 tests within 3 months after diagnosis   III. Retained in Care clients retained in care Percentage of diagnosed individuals who had two or more documented medical visits, viral load or CD4 tests, performed at least 3 months apart in the observed year. IV. Prescribed ART 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. V. Virally Suppressed Increase the number of clients with a viral load of <200 copies/mL 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/mL at last HIV viral load test in the measurement year. Please refer to page 16 in the NOFO

Work Plan - Funding for Core and Support Services Service Category Plan Service Category Plan Table RWHAP Part A MAI Service Category Plan Narrative Core Medical Services Waiver (if applicable) Please refer to pages 16 to 17 in the NOFO

Service Unit Definition Work Plan - SAMPLE of Attachment 8 Service Category Plan Table PART A Service Category Priority Number 2017 Allocated 2018 Anticipated   Funding Amount UDC Served Service Unit Definition Service Units Example: Outpatient Ambulatory Medical Care 2017-1 $2,000,000 2000 1 unit = 1 visit 4500 $1,200,000 1200 3800 Medical Case Management 2017-2 $1,500,000 2500 25,000 2600 30,000  

Service Unit Definition Work Plan - SAMPLE of Attachment 8 Service Category Plan Table MAI Service Category Priority Number 2017 Allocated 2018 Anticipated MAI Only   Funding Amount UDC Served Service Unit Definition Service Units Target populations Example: Outpatient Ambulatory Medical Care 2017-2 $400,000 175 1 unit = 1 visit 500 $350,000 200 400 Hispanic Women Child-bearing Age  Medical Case Management 2017-1 $250000 150 1500 $300000 2000  Hispanic Women

Core Medical Services Waiver (if applicable) Submission Service Category Plan Table Allocation Table Before Application Match Waiver Request Not Applicable With Application Include with Waiver Request Instructions for CMS Waivers can be found at: http://hab.hrsa.gov/healthcarelandscape/13-07waiver.pdf

Resolution of Challenges - SAMPLE Table

Evaluation and Technical Support Capacity Clinical Quality Management Describe how performance measure data are analyzed to evaluate for disparities in care, and actions taken in the last grant year to eliminate disparities Describe how CQM data have been used to improve and/or change service delivery in the jurisdiction, including strategic long-range service delivery planning Note: A CQM Plan will be required as a component of your Program Submission Please refer to pages 18 to 19 in the NOFO

Knowledge Check Question #2

Organizational Information Grant Administration Program Organization Grant Recipient Accountability Monitoring Third Party Reimbursement Fiscal Oversight Maintenance of Effort (MOE) . Please refer to pages 19 to 21 of the NOFO

Staffing Plan – SAMPLE Table Name Education/ Credentials Title Project Role Experience % FTE Admin CQM MAI HIV Services Mrs. Doe MPH Program Coordinator Oversight of RWHAP award and project implementation 5 years as program coordinator, previously Data/CQM Manager for same entity .15 .25 .45 Dr. Jones MD Medical Director Oversight of clinic staff, SOPS and CQI projects 15 years providing HIV primary care .20 Ms. Kona Associates Degree CQM Coordinator, Retention Specialist Oversight of CQM Activities 4 years working in HIV clinic scheduling appointments, making referrals, medical data entry .60 .10 .05 Mr. Torres MSW Medical Case Manager Treatment adherence training 3 years providing HIV medical case management .50

Budget Requirements Budget information consists of three parts: SF-424A Budget Information for Non- Construction Programs (included in the application package) Program-specific line item budget (Attachment 13) Budget justification narrative See pages 22 to 26 in the NOFO, and 20 to 34 in the SF-424 Application Guide

Budget Requirements: SF-424A 93.914 ` ` RWHAP Part A HIV Emergency Relief Grant Program ` Cannot exceed amount in Appendix B

Budget Requirements: SF-424A

Budget Requirements: SF-424A

Line Item Budget

Line Item Budget

Budget Justification Narrative Provide clear justification of costs explaining amounts requested for each line of the budget Budget narrative should be submitted by funding type (Part A and MAI), and divided by the three RWHAP Part A cost categories: Administrative, CQM, and HIV Services Descriptions must be specific to the cost category For non-HIV services contracts, provide a clear explanation as to the purpose of each contract, how the costs were estimated, and the specific contract deliverables Upload budget justification to Application Packet under Mandatory Budget Narrative Filename

Knowledge Check Question #3

Salary Limitation Effective January 8, 2017, the salary rate limitation applicable to RWHAP domestic grants and cooperative agreements is $187,000. The Consolidated Appropriations Act, 2017, Division H, § 202, (P.L. 115-31) 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.” Please see Section 4.1.iv Budget – Salary Limitation of HRSA’s SF-424 Application Guide for additional information. 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.

Salary Rate Limitation Example Individual’s full time salary: $255,000 Amount that may be claimed on the federal RWHAP award due to the legislative salary limitation: Individual’s base full time salary adjusted to Executive Level II: $187,000 50% of time will be devoted to project Direct salary: $127,500 Fringe (25% of salary): $31,875 Total: $159,375 50% of time will be devoted to project Direct salary: $93,500 Fringe (25% of salary): $23,375 Total: $116,875

Please refer to pages 29 to 30 in the NOFO 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 Construction International travel PrEP or PEP medications or related medical services Syringe Services Programs Payment for any item of service that can reasonably be expected to be paid under any State compensation program, insurance policy, any Federal or State health benefits program, or by an entity that provides health services on a prepaid basis Development of materials designed to promote or encourage intravenous drug use or sexual activity Please refer to pages 29 to 30 in the NOFO

Please refer to pages 27 to 28 of the NOFO 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 27 to 28 of the NOFO

Attachments - Maintenance of Effort (MOE) Please refer to page 28 of the NOFO

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

Application Review Information Review criteria are used to review and rank applications. For this opportunity, there are 6 review criteria: Criteria Points Criterion 1: Need 66 Criterion 2: Response 16 Criterion 3: Evaluative Measures 2 Criterion 4: Impact 5 Criterion 5: Resources/Capabilities 6 Criterion 6: Support Requested Total Points 100 Please refer to pages 31 to 35 in the NOFO

Application Package: Where is it? On HRSA’s website at www.hrsa.gov/grants Click on the NOFO “apply at Grants.gov” link At www.grants.gov Search by opportunity number (HRSA-18-066), or CFDA Number: 93.914 The Application Guide is available at https://www.hrsa.gov/grants/apply/applicationguid e/sf424guide.pdf or click the links in the NOFO

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 all your PIN numbers and passwords handy!

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, or support@grants.gov, or https://grants-portal.psc.gov/Welcome.aspx?pt=Grants

Tracking Grants.gov Submissions Submission Type E-mail Subject Time Frame Sent by Recipient Competing Application 1st e-mail Submission Receipt Within 48 hours Grants.gov AOR 2nd e-mail Most Crucial Submission Validation Receipt OR Rejected with Errors 3rd e-mail Grantor Agency Retrieval Receipt Within hours of second e-mail 4th e-mail Agency Tracking number assignment Within 3 business days SF424 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

Reminders Your application must be electronically submitted through and successfully validated by Grants.gov no later than October 30, 2017, 11:59 pm ET. We recommend submission of the application at least four business days before the due date. 4 days before Due date!

Applicants who need additional information may contact: HRSA Contacts Applicants who need additional information may contact: Program Contact Grants Contact Steven R. Young, MSPH Director, Division of Metropolitan HIV/AIDS Programs SYoung@hrsa.gov (301) 443-9091 Olusola Dada Grants Management Specialist Division of Grants Management Operations, OFAM ODada@hrsa.gov (301) 443-0195

Q&A - Your Questions are Welcome! HAB TARGET Website http://careacttarget.org/webcasts.asp 54