Application Template_supportingdocs_ PE_12800.pdf
PDF 193 KB Posted
- Attached to
- 2024-HIV Prevention Services CDC High Impact HIV Prevention/Surveillance for Health Depts (Rebid)
- Solicitation number
- PE-12800-NONST-2026-000000018
- Issued by
- Fulton County, Georgia
About this file
This is an Application Template for Request for Proposal #PE-12800-NONST-2026-000000018, issued by a health department in response to the CDC's RFA-PS24-0047 for High Impact HIV Prevention and Surveillance Services. Proposers must submit comprehensive applications addressing HIV testing services in either non-healthcare settings (Category A), healthcare settings (Category B), or both. The application requires five major sections: an executive summary identifying the applicant organization and approach (500 words maximum); a detailed work plan (5,000 words maximum) that includes problem understanding, specific goals with measurable metrics, implementation strategies, innovative prevention components, and an HIV Awareness Day event plan; project team qualifications with narrative summaries and staff resumes (1,000 words maximum); relevant project experience demonstrating prior HIV prevention work and cultural competence (1,000 words maximum); and key personnel availability documentation showing time allocation and current workload (500 words maximum).
The template specifies required metrics for measuring success, including number of HIV tests conducted, number of previously unaware individuals diagnosed, and linkage to care achievements at 7-day and 30-day intervals, along with enrollment in PrEP programs. Applicants must also demonstrate data collection and entry capacity, reporting capability, and compliance with confidentiality and data security policies. The application requires submission of organizational background information, registration status, mission statement, certifications, years of operation, and professional references. Organizations previously funded for similar work must provide testing data summaries, while those without prior funding must submit implementation plans. No specific response deadline, award date, or contract term information is provided in this template document.
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Text version
REQUEST FOR PROPOSAL # PE-12800-NONST-2026-000000018
2024-HIV Prevention Services CDC-RFA- PS24-0047 High Impact HIV Prevention and
Surveillance for Health Departments
RFP Proposer Application Template
Section 1: Executive Summary (500 words max) Legal Name of Entity:
Business Type: Tax ID #:
Establishment Date: Annual Organization Budget:
Address:
City: State: Zip Code:
Website:
Approach & Understanding (500 words max):
Primary Contact: Contact Title:
Contact Phone Number: Contact Email:
Include a brief statement of approach to the work, understanding of the project’s goals and objectives and demonstrated understanding of the project’s potential problems and concerns:
Section 2: Work Plan (5,000 words max) Select Category A and or B if selecting both categories, the Proposer shall include content as described below for each category individually.
Category A: HIV Testing in Non-Healthcare Setting
1. Understanding the Problem (500 words max)
2. Goals (500 words max)
Metrics:
- # of HIV tests
- # unaware diagnosed
- # linked to care in 7 days
- # linked to care in 30 days
- # linked into PrEP
3. Work Plan (5,000 words max)
- Outreach Strategy
- Testing Methodology
- Linkage to Care Plan
- Program Management & Implementation
4. Component 3: Innovative HIV Prevention (1,000 words max)
- Choose Treat or Prevent Pillar
- Detail groundbreaking prevention activities
- How they differ from past practices
5. Component 4: HIV Awareness Day Event (500 words max)
- Event Chosen:
- Event Description:
- Target Population:
6. General Questions
- Data Collection/Entry Capacity
- Reporting Capacity
- Attachment E: Policies on confidentiality and data security
- Timeliness Assurance
Category B: HIV Testing in Healthcare Setting
1. Understanding the Problem (500 words max)
2. Goals (500 words max)
3. Work Plan (5,000 words max)
4. Component 3: Innovative HIV Prevention (1,000 words max)
5. Component 4: HIV Awareness Day Event (500 words max)
6. General Questions
Section 3: Project Team Qualifications (1,000 words max) Provide narrative summary and attach resumes of all key staff. Highlight project lead’s qualifications.
Section 4: Relevant Project Experience (1,000 words max) Business Background:
- Registration
- Mission
- Certifications
- Years in operation
Prior Experience:
- HIV Prevention history
- Population-specific work
- Process/outcome metrics
- Cultural competence & language access
- Previously funded: testing data summary
- Not previously funded: testing implementation plan
- Attachment G: References
Section 5: Availability of Key Personnel (500 words max) Include % time dedicated to project and current workload.
| REQUEST FOR PROPOSAL # PE-12800-NONST-2026-000000018 |
| Section 1: Executive Summary (500 words max) |
| Section 2: Work Plan (5,000 words max) |
| Category A: HIV Testing in Non-Healthcare Setting |
| Category B: HIV Testing in Healthcare Setting |
| Section 3: Project Team Qualifications (1,000 words max) |
| Section 4: Relevant Project Experience (1,000 words max) |
| Section 5: Availability of Key Personnel (500 words max) |
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