1. HIV/AIDS Bureau Division of State HIV/AIDS Programs (DSHAP) Ryan White HIV/AIDS Program Part B Technical Assistance Webinar October 31, 2013 FY 2014 ADAP ERF Funding Opportunity Announcement HRSA-14-049

2. 2 DSHAP Mission To provide leadership and support to States/Territories for developing and ensuring access to quality HIV prevention, health care and support services.

3. 3 Agenda Opening Remarks/ AnnouncementsHeather Hauck Question and Answer Part B HRSA-14-049 Funding Opportunity Announcement Heather Hauck Questions and Answer Closing RemarksHeather Hauck

4. 4 Presenter Heather Hauck Director Division of State HIV/AIDS Programs

5. 5 Announcements & Updates

6. 6 Announcements Important Deadlines: Ryan White Part B HIV Care Grant Program FOA: Deadline December 9, 2013 Part B/ADAP (X07) Reporting Requirements: Interim FFR SF-425 due: Nov. 28, 2013 Grantees are unable to submit the report because the portal in EHB is missing ADAP Quarterly Report (AQR): due January 31, 2014 Unobligated Balances (UOB) & Estimated Carryover: due January 31, 2014

7. 7 Announcements FY 2012 ADAP ERF (X09) FFR Due into EHB January 30, 2014 Carryover Request due into EHB January 30, 2014 Budget Period July 1, 2012 – September 29, 2013 is not eligible for carryover Budget Period August 1, 2012 – September 29, 2013 is eligible for carryover Budget Period September 1, 2012 – September 29, 2013 is eligible for carryover

8. 8 Announcements Upcoming Technical Assistance Activities: Webinar on Changes to HAB Performance Measure Portfolio: November 6, 2013 1:00 – 2:00 pm EST Webinar on RSR Basics: November 6, 2013 2:00 – 3:00 pm EST Rescheduled Webinar on Enhancing Linkages to HIV Care in Jail Settings: November 19, 2013 1:30 pm EST

9. Core Medical Services Waiver http://www.gpo.gov/fdsys/pkg/FR-2013-10-25/pdf/2013-25276.pdf Effective: September 23, 2013

10. 10 Questions

11. Funding Opportunity Announcement: HRSA-14-049 FY 2014 Limited New Competition AIDS Drug Assistance Program (ADAP) Emergency Relief Funds (ERF)

12. 12 Objectives To provide pre-application technical assistance to applicants of the FY 2014 ADAP ERF Funding Opportunity Announcement.

13. 13 Summary of Funding Approximately $40 million – $75 million in ADAP ERF to fund up to 59 grantees Applicants may apply for a ceiling amount up to $11 million per year Project period of one (1) year starting April 1, 2014 Application due date in grants.gov – November 25, 2013 11:59 p.m. EST

14. 14 FY 2014 FOA Changes FY 2014 ADAP ERF budget period (April 1, 2014 – March 31, 2015) New HRSA FOA template – please follow the specific headers in each section The SF-424 Application Guide is available at http://www.hrsa.gov/grants/apply/applicationguide / http://www.hrsa.gov/grants/apply/applicationguide / Information on the National HIV/AIDS Strategy (NHAS) is located in the SF-424 Application Guide

15. 15 For States/Territories that can demonstrate need for additional resources to prevent, reduce or eliminate waitlists or implement “cost cutting” and/or “cost- saving” measures Purpose

16. 16 States with waiting list must use all funding awarded to remove clients from the waiting list. States that did not report a waiting list, must use funding to address “cost-cutting measures” and/or support the implementation of “cost- saving” measures during the project period to prevent a waiting list. Purpose

17. 17 Cost-cutting measures : Reductions in ADAP financial eligibility below 300% of FPL Capped enrollment Formulary reductions with respect to ARVs Restrictions with respect to ADAP insurance eligibility criteria (i.e.,< 300% FPL) Cost-saving measures: Improved systems and procedures for back billing Medicaid Improved client recertification Part B structural or operational changes such as collection of rebates, expanding insurance assistance Purpose

18. 18 HRSA has prioritized the following cost- containment strategies through its monitoring and technical assistance efforts: Purchase of insurance, collection of rebates, back billing of Medicaid, CMS data-sharing agreements for TrOOP expenditures, six-month re-certification, and controlling ADAP administrative costs. Purpose

19. 19 Eligibility All 50 states, the District of Columbia, Commonwealth of Puerto Rico and U.S. Virgin Islands are eligible to apply if there has been a reported ADAP waiting list and/or cost containment measures since CY 2011.

20. 20 Cost Sharing/Matching Cost Sharing/Matching is NOT required for this program.

21. 21 Project Narrative New HRSA template: follow the headings and subheadings as the structure has been significantly reorganized. Example: Resolution of Challenges, Evaluation and Technical Support Capacity

22. 22 Introduction & Project Abstract Introduction: Briefly describe how the State/Territory will utilize ADAP ERF funds addressing a waiting list and/or cost cutting and/or cost savings measures Project Abstract: See section 4.1.ix of HRSA’s SF-424 Application Guide

23. 23 Needs Assessment ADAP State/Territory Profile: Submit as Attachment 1. Appendix A: provides a description ADAP profile for Fiscal Years 2011 & 2012 Sample format http://hab.hrsa.gov/adapprofilehttp://hab.hrsa.gov/adapprofile

24. 24 Methodology Average Client Costs: Medication and insurance assistance cost per client FY 2014 ADAP ERF budget period (April 1, 2014 – March 31, 2015) States must provide step by step calculations and clearly identify all data elements required to complete the calculations Examples listed on pgs. 7-9 of FOA

25. 25 Methodology Previously awarded applicants: If the amount requested in this application is different from your program’s last awarded amount, please describe the factors which account for this difference.

26. 26 Methodology ORC Reviewers will review and determine: Whether the average client cost calculation submitted by applicants follow instructions provided; Whether the calculations are correct; if incorrect, the error will be identified along with its impact on the applicant’s calculations; Whether the applicant’s plan and budget request reflect their average cost calculations; and If applicable, whether in preparing the plan and budget, the applicant utilized the most recent number of individuals on the State’s waiting list reported to HRSA.

27. 27 Work Plan Planned Services & Implementation Plan: Applicants may use table format similar to FY 2014 Part B Implementation Plan Submit as Attachment 4. The Implementation Plan estimated costs should be based on the Average Monthly Client Medication Cost and/or Average Monthly Client Cost for Insurance Assistance for ADAP ERF budget period (April 1, 2014 – March 31, 2015) All cost calculations & budget amounts are subject to review by the ORC.

28. 28 Resolution of Challenges Describe specific actions taken to avoid, reduce, or eliminate a waiting list. The measures listed in the FOA (page 11) are examples of some required and some possible measures.

29. 29 Evaluation Provide a brief description of the anticipated impact of specific ADAP ERF funded activities on proposed or currently implemented cost containment and waitlist elimination. Provide a brief description of the methods in place to evaluate the effectiveness of the ADAP ERF Implementation Plan.

30. 30 Organizational Information Agency Oversight Management/Administration of the ADAP Organizational chart (Attachment 6) Budget See instructions in section 4 HRSA’s SF-424 Application Guide In Section B of SF-424A the budget categories are Waiting List and Cost Containment

31. 31 Summary of Attachments Attachment 1: ADAP Profile Attachment 2: Position Description for key personnel Attachment 3: Biographical Sketches for key personnel Attachment 4: Implementation Plan Attachment 5: Agreements and Compliance Assurances Attachment 6: ADAP Organizational Chart Attachment 7-15: Other Relevant documents

32. 32 Application and Submission HRSA requires applicants for this funding opportunity announcement to apply electronically through Grants.gov. Applicants must download the SF424 application package associated with this funding opportunity following the directions provided at Grants.gov. Application due date in grants.gov – November 25, 2013 11:59 p.m. EST

33. 33 Application Format Requirements The total size of all uploaded files may not exceed the equivalent of 40 pages when printed by HRSA. The 40-page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support. Attachments must be clearly labeled (see pg. 15 of the FOA).

34. 34 Application Review Information CriterionDescriptionScore 1NEED: Corresponds to Section IV’s Needs Assessment 20 points 2RESPONSE: Corresponds to Section IV’s Resolution of Challenges and Introduction 40 points 3EVALUATIVE MEASURES: Corresponds to Section IV’s Evaluation and Technical Support Capacity 10 points 4RESOURCES/CAPABILITIES: Corresponds to Section IV’s Work Plan, Staffing Plan, and Biographical Sketches 20 points 5SUPPORT REQUESTED: Corresponds to Section IV’s Budget,, Project Narrative, and Methodology 10 points

35. 35 Agency Contacts Program issues and/or technical assistance regarding this funding announcement may be obtained by contacting: Heather Hauck, Tel: 301-443-6547 Fax: 301-443-8143, Email: hhauck@hrsa.govhhauck@hrsa.gov Business, administrative, or fiscal issues related to this funding opportunity announcement by contacting: Karen Mayo, Tel: (301) 443-3555 Fax: (301) 594-4073, E-mail: KMayo@hrsa.govKMayo@hrsa.gov

36. 36 Application Assistance Applicants may need assistance when working online to submit their application forms electronically. Applicants should always obtain a case number when calling for support. For assistance with submitting the application in Grants.gov, contact Grants.gov 24 hours a day, seven days a week, excluding Federal holidays at: Grants.gov Contact Center Telephone: 1-800-518-4726 (International Callers, please dial 606-545-5035) E-mail: support@grants.gov iPortal: http://grants.gov/iportal

37. 37 Questions