FY2022_National NOFO FAQs_Batch 1_11.29.2021.pdf

Publication Month Year

HHS Office of Population Affairs Web: opa.hhs.gov | Email: opa@hhs.gov Twitter: @HHSPopAffairs | Y

Updated November 16, 2021

HHS Office of Population Affairs Web: opa.hhs.gov | Email: FY22.TitleXNOFO.National@hhs.gov Twitter: @HHSPopAffairs | YouTube: HHSOfficeofPopulationAffairs

PA-FPH-22-001 Notice of Funding Opportunity

FREQUENTLY ASKED QUESTIONS

file://ct-files/g-drive/Fertility%20and%20Family%20Structure/OPA%20Communications/Option%20Year%202/1-%20Strategic%20Communications/1.8%20Graphic%20Design/opa.hhs.gov file://ct-files/g-drive/Fertility%20and%20Family%20Structure/OPA%20Communications/Option%20Year%202/1-%20Strategic%20Communications/1.8%20Graphic%20Design/opa.hhs.gov mailto:FY22.TitleXNOFO.National@hhs.gov

AUTHORITY AND ELIGIBILITY

1. What is the authority for the Title X family planning service grant program?

Established in 1970, Title X is governed by statutory language (42 U.S.C. 300 et seq.)

and regulations (42 CFR part 59, subpart A). This funding opportunity announcement closely follows the language and intent of the statute and is consistent with the implementing regulations.

2. Who may apply?

As stated under Section E, pages 12-13, of the NOFO any public or private nonprofit entity located in a State (which includes one of the 50 United States, District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, the U.S. Outlying Islands (Midway, Wake, et al.), the Marshall Islands, the Federated State of Micronesia, and the Republic of Palau) is eligible to apply for a grant under this announcement. Faith-based organizations and American Indian/Alaska Native/Native American (AI/AN/NA) organizations are eligible to apply for Title X family planning services grants. Examples of eligible organizations include:

• State Governments

• U.S. territories

• County Governments

• City or township governments

• Special district governments

• Independent school districts

• Public and State controlled institutions of higher education

• Native American tribal governments (Federally recognized)

• Public Housing authorities/Indian housing authorities

• Native American tribal organizations (other than federally recognized tribal

• governments)

• Nonprofits having 501(c)(3) status with the IRS, other than institutions of

• higher education

• Nonprofits without 501(c)(3) status with the IRS, other than institutions of

• higher education

• Non-profit private institutions of higher education

3. Can current Title X grantees apply to this NOFO? Do you need to be a current Title

X grantee to apply?

Yes, current Title X grantees may apply to this NOFO. No, you do not need to be a current Title X grantee to apply. Any eligible identity defined under Section E, page 13, of the NOFO may apply.

PREPARING TO APPLY

1. Will the “Applicant Technical Assistance Webinar: Tuesday, November 9, 2021 at 3:00 p.m. ET” be recorded and accessible after the webinar is over?

Yes, the Technical Assistance Webinar for this NOFO will be recorded and accessible afterwards. The link to the recording will be shared on Grants.gov.

https://opa.hhs.gov/sites/default/files/2020-07/title-x-statute-attachment-a_0.pdf https://www.federalregister.gov/documents/2021/10/07/2021-21542/ensuring-access-to-equitable-affordable-client-centered-quality-family-planning-services https://www.grants.gov/web/grants/view-opportunity.html?oppId=334698

2. Will the slides from the “Applicant Technical Assistance Webinar: Tuesday, November 9, 2021 at 3:00 p.m. ET” be accessible after the webinar is over?

Yes, the Technical Assistance Webinar slides for this NOFO will be posted to Grants.gov under “Related Documents” tab.

3. How will we know if any updates are made to this NOFO?

Applicants should subscribe to PA-FPH-22-001, https://www.grants.gov/web/grants/view-opportunity.html?oppId=334698 on Grants.gov to receive any updates to the announcement or supporting materials.

To subscribe to an opportunity, find the opportunity on Grants.gov by searching the NOFO number or the CFDA/Assistance Listing number. Once you are on the opportunity page (https://www.grants.gov/web/grants/view-opportunity.html?oppId=334698) click the red Subscribe button and follow the instructions.

4. When is the application due?

All applications are to be submitted through Grants.gov and received no later than Tuesday, January 11, 2022, at 6:00 p.m. Eastern Time.

5. What is the start date for new projects?

Projects have an anticipated start date of April 1, 2022.

6. What is the length of project periods for this grant application?

The project period for this grant is up to five years. OPA will fund awards in annual increments (budget periods). 42 CFR § 59.8(b) states that “the grant will initially be for one year and subsequent continuation awards will also be for one year at a time.”

Budget periods may also vary from the estimate indicated in the NOFO due to timing of award issuance or other administrative factors.

7. Is funding for all five years guaranteed once awarded?

Funding for all approved budget periods beyond the first is generally level with the initial award amount and is contingent upon the availability of funds, satisfactory progress of the project, adequate stewardship of Federal funds, and the best interests of the Government. “Neither the approval of any application nor the award of any grant https://www.grants.gov/web/grants/view-opportunity.html?oppId=334698 https://www.grants.gov/web/grants/view-opportunity.html?oppId=334698 https://www.grants.gov/web/grants/view-opportunity.html?oppId=334698 https://www.grants.gov/ commits or obligates the United States in any way to make any additional, supplemental, continuation, or other award with respect to any approved application or portion of an approved application.” 42 CFR § 59.8(c).

8. Is this funding opportunity new or is it a continuation of funding already out?

This is a new competition for funds to support new Title X family planning services grants. It is not a continuation funding opportunity for existing grants.

9. How do I register my organization in the System for Award Management (SAM)?

If you are registering a new entity or renewing your registration, you must submit a notarized letter formally appointing an Entity Administrator to SAM.gov. For detailed instructions on the content of the letter and process for domestic entities see:

https://www.fsd.gov/gsafsd_sp?sys_kb_id=8cfe46491b1cb8909ac5ddb6bc4bcbbb&id=k b_article_view&sysparm_rank=1&sysparm_tsqueryId=c6131c131bdcf0d0a7d7da49bc4b cb1a

A quick start guide for registrants is available at https://www.fsd.gov/sys_attachment.do?sys_id=80f49f211bdcfc909ac5ddb6bc4bcb76.

You should allow a minimum of five days to complete an initial SAM registration. Allow up to 10 business days after you submit your registration for it to be active in SAM. This timeframe may be longer if SAM flags the information you provide for manual validation.

You will receive an email alerting you when your registration is active.

If your organization is already registered in SAM, you must renew your SAM registration each year. Organizations registered to apply for Federal awards through http://www.grants.gov will need to renew their registration in SAM. You should make sure your SAM registration information is accurate, especially your organization’s legal name and physical address including your ZIP+4. For instructions on updating this information see:

https://www.fsd.gov/sys_attachment.do?sys_id=d08b64ab1b4434109ac5ddb6bc4bcbbc.

10. How can I ensure that my application is not disqualified?

You can ensure that your application is not disqualif ied by carefully following the Application Responsiveness and Disqualif ication Criteria found under Section E, pages 12-15, of the NOFO.

11. How long does it take for Grants.gov to notify the applicant of successful submission?

Grants.gov may take up to 48 hours to notify you of a successful submission.

Organizations are strongly encouraged to submit applications a minimum of 3-5 days prior to the application closing date. (NOFO, Section F, page 32) To ensure adequate time to submit your application successfully, OASH recommends that you register as early as possible in Grants.gov because the registration process can take up to one month. You must register an authorizing official for your organization.

OASH does not determine your organization’s authorizing official; your organization makes that designation. For information on registering for Grants.gov, refer to https://grants.gov or contact the Grants.gov Contact Center 24 hours a day, 7 days a week (excluding Federal holidays) at 1-800-518-4726 or support@grants.gov. (NOFO, Section A, page 6) https://www.fsd.gov/gsafsd_sp?sys_kb_id=8cfe46491b1cb8909ac5ddb6bc4bcbbb&id=kb_article_view&sysparm_rank=1&sysparm_tsqueryId=c6131c131bdcf0d0a7d7da49bc4bcb1a https://www.fsd.gov/gsafsd_sp?sys_kb_id=8cfe46491b1cb8909ac5ddb6bc4bcbbb&id=kb_article_view&sysparm_rank=1&sysparm_tsqueryId=c6131c131bdcf0d0a7d7da49bc4bcb1a https://www.fsd.gov/gsafsd_sp?sys_kb_id=8cfe46491b1cb8909ac5ddb6bc4bcbbb&id=kb_article_view&sysparm_rank=1&sysparm_tsqueryId=c6131c131bdcf0d0a7d7da49bc4bcb1a https://www.fsd.gov/sys_attachment.do?sys_id=80f49f211bdcfc909ac5ddb6bc4bcb76 http://www.grants.gov/ https://www.fsd.gov/sys_attachment.do?sys_id=d08b64ab1b4434109ac5ddb6bc4bcbbc https://grants.gov/ mailto:support@grants.gov

12. Will a job description suffice instead of a resume if we do not have key personnel in place at the time of grant application submission?

Yes, you may submit job descriptions of key personnel instead of CV/resume if such personnel are yet to be hired at the time of application submission.

13. Can an organization submit multiple applications as long as they are for distinct projects?

Yes, an organization can submit multiple applications as long as each application is for a distinct project. Under Section E, page 14, of the NOFO the following statement appears: "If you successfully submit multiple applications from the same organization for the same project, we will only review the last application received by the deadline." This means that if an organization submits multiple applications, and they are for the same project (not distinct), then we will only review the last application received by the deadline. An organization may submit multiple applications for distinct projects.

14. When submitting 2 applications, how do we assure our projects are deemed as 2 separate applications and not for the same project? The current grant guidelines state: "If you successfully submit multiple applications from the same organization for the same project, we will only review the last application received by the deadline". (Added 11/16/2021) When creating the applications, please make sure to clearly describe the differences in your projects. For example, make sure to clearly define the proposed service area, type of services that will be provided, etc. This is a way to delineate the difference between applications for different projects that will be administered by the same organization.

When multiple applications from the same organization for the same project are submitted, we will only review the last application received by the deadline.

15. Is the disparity impact statement required as part of the NOFO application? Is there a framework for the disparities impact statement? (Added 11/16/2021) The disparity impact statement is not required as part of the NOFO application. As part of the federal award’s program specific terms and conditions, all successful applicants, upon funding, may be expected to develop one using local data to identify populations at highest risk for health disparities and low health literacy. Additional information and links to resources are available in Section K of the NOFO.

Section B, page 10, of the NOFO includes HHS resources that recipients may refer to when developing their project disparities impact statement.

16. Do we have to run a formal recruitment before this grant app is submitted? Or, if we are not showing a geographic or quality need in our assessment – can we describe the process we use instead? (Added 11/16/2021) PA-FPH-22-001 does not include information specifically addressing running a formal recruitment before an application is submitted. As noted on Section F, page 18, of the NOFO, applicants should describe their process for assessing the need for services within the proposed service area and how they have/will continue to use the results of their assessment to inform and improve service delivery. This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

17. Should we write the narrative in the order of the NOFO? If so, what about items that are repeated in several sections? (Added 11/16/2021) Applicants are encouraged to write the narrative in the order of the NOFO. Please review all program requirements, eligibility information, evaluation criteria, and other information in this funding announcement to ensure that your application complies with all requirements and instructions. As requested during the applicant TA webinar, please provide information as requested for each section so that the reviewers do not have to search for the information while scoring your application.

18. In the instructions for Project Narrative content (p.18) it is noted that information should be provided about each direct service site (location, hours of service, # of clients served, range of methods used, etc.). This same information is also requested as part of the Work Plan (P. 28-29). Is it acceptable to provide this information in only one location in the application, or must this information appear in both the Project Narrative document and the Appendix Work Plan?

(Added 11/16/2021) Applicants should include the information in question in both the Project Narrative and Work Plan.

19. Does the work plan need to be double spaced if we are providing it in table format? (Added 11/16/2021) Section F, page 16 of the NOFO states “[y]ou may single-space tables or use alternate fonts but you must ensure the tables are easy to read”.

20. Does OPA have any type of template they prefer for the work plan on the competing applications? If so, can you please share it? (Added 11/16/2021) The NOFO does not include a sample preferred work plan template. Please refer to Section F, pages 28-29, of the NOFO for what should be included in the work plan.

APPLICATION REVIEW

1. When will HHS/OASH determine the actual award amount?

The actual award amounts will be determined after applications have been reviewed and risk assessment completed. Nothing is final until the NOA is issued.

2. Are applicants encouraged to base their requests off their past funding levels?

The NOFO states the table on pg. 63 will not be used as the basis for determining funding, but how much does funding history factor into the review process?

(Added 11/16/2021) Your budget narrative should justify the overall cost of the project you propose as well as the proposed cost per activity, service delivered, and/or product. There is no expectation that an application for this competition mirror a previously awarded application. The data is provided in response to frequent requests for the information; however, the Title X family planning services grants are discretionary grants and NOT formula or block grants.

The budget narrative should define the amount of work you have planned and expect to perform, what it will cost, and an explanation of how the result is cost effective. For example, if you are proposing to provide services to clients, you should describe how many clients are you expecting to serve, the unit cost of serving each client, and how this is cost effective.

Section G, page 37, of the NOFO includes the budget review criteria: “the relative availability of non-Federal resources within the community to be served and the degree to which those resources are committed to the project, including the degree to which the budget and budget narrative identify other sources of revenue, including but not limited to the estimated amount of program income and how the applicant proposes to invest it back into the proposed Title X project.”

As stated under Section F, page 21, of the NOFO, the information included in Section K.5 is provided only as background information for applicants interested in historical data and the information in the Table will not be used as the basis for determining funding levels in the current competition.

PROGRAM EXPECTATIONS

1. Can an applicant apply for a service area that is not the entire state, for example, only the eastern part of the state or even a smaller service area?

Yes, applications for a part of a service area may be submitted. The funding is not allocated on a state-by-state basis. You may propose any service area for which you are capable of serving consistent with all applicable statutes, regulations, and policies. Applicants should be very specific in the application regarding the service area as well as the plan for providing services throughout the requested service area, including evidence of how the family planning needs of all those in need of service locally throughout the proposed area to be covered will be addressed. You must include a coverage map of your proposed service area that clearly shows the location of proposed Title X service sites compared to the need for services.

2. How should FQHCs who use a sliding fee schedule that ends at 200% FPL and charge everyone a nominal fee handle the differences with Title X’s requirements of no charge for clients with incomes < 100% FPL and slide to 250% FPL?

Please refer to the HHS Office of Population Affairs Policy Program Notice 2016-11, Title X Program Policy Notice Integrating with Primary Care Providers. This Program Policy Notice clarif ies how Title X grantees may remain in compliance with Title X regulations and requirements when integrating services with the Health Resources and Services Administration (HRSA) Health Center Program grantees and look-alikes.

3. Does an applicant have to provide all services specified in the funding opportunity or can they provide just one specific service, for example, only education services?

In order to fulf ill the requirements in the Title X statute, the project, made up of the applicant and any subrecipients, must provide a broad range of acceptable and effective medically approved family planning methods (including natural family planning methods) and services (including pregnancy testing and counseling, assistance to achieve https://www.hhs.gov/opa/title-x-family-planning/about-title-x-grants/program-policy-notices/index.html pregnancy, basic infertility services, STI services, preconception health services, and adolescent-friendly health services) to clients throughout the proposed service area.

“If an organization offers only a single method of family planning, it may participate as part of a project as long as the entire project offers a broad range of acceptable and effective medically approved family planning methods and services. Title X service sites that are unable to provide clients with access to a broad range of acceptable and effective medically approved family planning methods and services must be able to provide a prescription to the client for their method of choice or referrals to another provider, as requested.” 42 C.F.R. § 59.5(a)(1).

4. Do contraceptive methods and services need to be provided by the grant recipient? Is contraception considered a part of “broad-range” of family planning services?

Yes, Title X regulations require that projects must “provide a broad range of acceptable and effective medically approved family planning methods (including natural family planning methods) and services (including pregnancy testing and counseling, assistance to achieve pregnancy, basic infertility services, STI services, preconception health services, and adolescent-friendly health services).” 42 CFR § 59.5(a)(1). This requirement is based on the statutory requirement that “voluntary family planning projects . . . shall offer a broad range of acceptable and effective family planning methods and services (including natural family planning methods, infertility services, and services for adolescents).” 42 U.S.C. § 300(a). Additionally, 42 CFR § 59.5(a)(1) also states that, “If an organization offers only a single method of family planning, it may participate as part of a project as long as the entire project offers a broad range of acceptable and effective medically approved family planning methods and services”

Yes, contraception is considered a part of the “broad range” of acceptable and effective medically approved family planning method.

5. Please specify which nationally recognized standards of care are considered acceptable?

As identif ied in the NOFO under Section B, pages 10-11, “[q]uality healthcare is safe, effective, client-centered, timely, efficient, and equitable. Furthermore, client-centered care is respectful of, and responsive to, individual client preferences, needs, and values and where client values guide all clinical decisions.” Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) was originally released in 2014 with ongoing updates and provides evidence-informed guidelines for the delivery of family planning and related preventative health services.

Page 11 of the NOFO states “we expect recipient networks to have the capacity to support implementation of QFP. We expect that recipients will provide initial and ongoing training and professional development for their staff on QFP and other relevant, nationally recognized standards of care.” QFP incorporates recommendations for providing family planning clinical services from various federal agencies and professional medical associations. These include, but are not limited to recommendations from:

• Centers for Disease Control and Prevention (CDC)

• U.S. Preventive Services Task Force (USPSTF)

• American Academy of Pediatrics (AAP)

• American College of Obstetricians and Gynecologists (ACOG)

• American Society for Reproductive Medicine (ASRM)

6. How will the new grant opportunity account for the current transition from FPAR

1.0 to FPAR 2.0?

As described under Section B, page 11, of the NOFO, “[p]rior to 2022, Title X recipients reported aggregate-level FPAR data to OPA on an annual basis (referred to here as FPAR 1.0). Beginning in 2022, we are adopting FPAR 2.0, which is the next iteration of FPAR data reporting that will collect encounter level data for Title X Family Planning Service recipients … Additional information about FPAR 2.0, including the data elements and response options, is available on the OPA website at: https://opa.hhs.gov/research-evaluation/title-x-services-research/family-planning-annual-report/fpar2. Recipients will start collecting FPAR 2.0 encounter-level data in 2022 and report it for the first time in 2023. We are using a phased implementation approach with two data reporting options that both begin in January 2023. The preferred approach is for recipients who can submit any FPAR 2.0 encounter data to do so. The FPAR 2.0 system will calculate aggregate recipient and site-level data. Recipients who cannot submit any FPAR 2.0 encounter-level data will request and obtain a waiver from OPA to continue to report aggregate-level FPAR 1.0 data with a plan to transition to FPAR 2.0 by 2024.”

“The cost sharing requirements outlined above are waived for any grant made to the U.S. Virgin Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of the Marshall Islands. Although projects are expected to identify additional sources of funding and not solely rely on Title X funds, there is no specific amount of level of f inancial match requirement for this program.” (NOFO, Section E, page 14)

7. On page 17 of the NOFO, it states: “Describe your process for assessing the need for services within the proposed service area and how you have/will continue to use the results of your assessment to inform and improve service delivery.” What type of needs assessments should we use? (Added 11/16/2021) PA-FPH-22-001 does not include information specifically addressing expectations regarding the type of needs assessment. Applicants are encouraged to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this funding announcement to ensure that their application complies with all requirements and instructions. This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

8. May we use the first-year funds to perform a needs assessment? (Added 11/16/2021) PA-FPH-22-001 does not restrict use of first-year funds to perform a needs assessment.

Section G, page 37, of the NOFO includes the budget review criteria: “the relative availability of non-Federal resources within the community to be served and the degree to which those resources are committed to the project, including the degree to which the budget and budget narrative identify other sources of revenue, including but not limited https://opa.hhs.gov/research-evaluation/title-x-services-research/family-planning-annual-report/fpar2 https://opa.hhs.gov/research-evaluation/title-x-services-research/family-planning-annual-report/fpar2

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Recipients must comply with the U.S. Department of Health and Human Services (HHS) Grants Policy Statement (GPS) and Uniform Administrative Requirements (45 CFR part 75). This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

9. Can we provide a list of methods from the generally accepted "categories" of methods based on effectiveness without having to justify why we aren't providing every single brand of method on the market? (Added 11/16/2021) Section F, page 18, of the NOFO asks applicants to describe the broad range of acceptable and effective medically approved family planning methods (including natural family planning methods) and services (including pregnancy testing and counseling, assistance to achieve pregnancy, basic infertility services, STI services, preconception health services, and adolescent-friendly health services) that will be provided directly at the site; and a justif ication for any methods and services that will not be available at the site along with a description of how you will ensure client access for the methods and services not available directly at the site. This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

10. What rationale or evidence is expected to be provided to 'demonstrate that the cost per client and cost per encounter are reasonable'? (Added 11/16/2021) Section F, page 19, of the NOFO says that applicants should:

• Describe how grant funds will be used to best address the identified needs;

• Demonstrate that the cost per client and cost per encounter are reasonable; and

• Describe other non-Title X resources available to address the needs for family planning services within the proposed service area and how grant funds will be used to leverage and expand available resources, and not duplicate them.

This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

11. Do you have to provide all services immediately or can you phase them in over the 5-year grant? (Added 11/16/2021) The 2021 Title X final rule, 42 CFR 59.5, describes the requirements a family planning project must meet. Applicants are encouraged to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this funding announcement to ensure that its application complies with all requirements and instructions. Once funded recipients may expand their family planning projects but must meet the minimum requirements at the outset.

12. What does OPA consider to be the age range for adolescents? (Added 11/16/2021) OPA has not specifically defined the age range for “adolescent” in the 2021 final rule;

however, adolescents are typically defined either as ages 10-19 or ages 10-24, depending on the source.

https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf https://www.ecfr.gov/current/title-42/chapter-I/subchapter-D/part-59/subpart-A

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13. Please clarify the level of detail required for the proposal about individual subrecipients and service sites in both the project narrative and budget. The NOFO guidance appears to request by service site: describe the location of the site compared to identified need… Estimated number of clients and adolescent clients… and services to be provided directly at the site and justification for any methods and services that will not be available at the site… Is it acceptable to group any of this information by subrecipient or area? (Added 11/16/2021) Subrecipient and service site activities must be described in sufficient detail to accurately demonstrate the project effort that each will conduct. If applicants have an extensive subrecipient network and many of the proposed subrecipients have similar characteristics, it is acceptable to group information as appropriate provided the information is clearly presented for the reviewer to make an assessment following the evaluation criteria. This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement and present information in a manner that is sufficiently detailed while abiding by the page limit requirements.

14. Is there a particularly strong partner in our county that our organization could collaborate with on this application? (Added 11/16/2021) Applicants may refer to the list of current Title X recipients and service sites on the OPA website to determine potential partners. Applicants are not limited to the service sites on this list for partnerships.

15. Is there a list of specific broad range of acceptable and effective medically approved family planning methods that we are required to offer onsite or have referral arrangements for? We only offer vasectomies at certain of our sites and refer for female sterilization. Are these considered required, and should we then demonstrate these relationships and rates? (Added 11/16/2021) There is no specific list. 42 CFR § 59.5(a)(1) states “[i]f an organization offers only a single method of family planning, it may participate as part of a project as long as the entire project offers a broad range of acceptable and effective medically approved family planning methods and services”. 42 CFR § 59.5(b)(9) states that Title X projects must “[p]rovide that if family planning services are provided by contract or other similar arrangements with actual providers of services, services will be provided in accordance with a plan which establishes rates and method of payment for medical care. These payments must be made under agreements with a schedule of rates and payment procedures maintained by the recipient. The recipient must be prepared to substantiate that these rates are reasonable and necessary”. This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

16. Are Letters of Commitment required as part of the NOFO application? If there are formal LOCs in place, do they need to be for a definite time period or can they be written and agreed upon to renew annually or unless one of the parties decides to rescind their commitment? (Added 11/16/2021) Letters of Commitment (LOC) are not required as part of the NOFO application. This is a competitive NOFO, as such, applicants should put forward the best proposal the organization can create based on application and evaluation criteria published in the announcement.

https://opa.hhs.gov/grant-programs/title-x-service-grants/current-title-x-service-grantees https://opa.hhs.gov/grant-programs/title-x-service-grants/current-title-x-service-grantees

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17. As a subrecipient now applying to be a recipient, does 42 CFR § 59.5(a)(11)(i) apply to us? It states: “Provide that if an application relates to consolidation of service areas or health resources or would otherwise affect the operations of local or regional entities, the applicant must document that these entities have been given, to the maximum feasible extent, an opportunity to participate in the development of the application. Local and regional entities include existing or potential subrecipients which have previously provided or propose to provide family planning services to the area proposed to be served by the applicant.”

(Added 11/16/2021) Yes, this section does apply to applicants/recipients.

BUDGET

1. What level of detail is OPA looking for in the budget for subrecipient/contractor costs?

Your budget narrative should justify the overall cost of the project as well as the proposed cost per activity, service delivered, and/or product. Provide details on the amount of work you have planned and expect to perform, what it will cost, and an explanation of how the result is cost effective. You must provide a detailed budget and budget narrative for each subrecipient/contractor, by agency title, along with the same supporting information. (NOFO, Section F, page 25) If you plan to select the subrecipients/contractors post-award and a detailed budget is not available at the time of application, you must provide information on the nature of the work to be delegated, the estimated costs, and the process for selecting the delegate agency. (NOFO, Section F, page 25)

2. Is there a “funding formula” for Title X funds?

No, Title X funds are not determined by a funding formula. As stated under Section F, page 21, of the NOFO Section 1001 Title X Services grants are discretionary grants NOT formula or block grants and the funding is not allocated on a state-by-state basis.

An applicant may propose any service area for which they are capable of serving consistent with all applicable statutes, regulations, and policies. The information included in the Table in Section K.5, page 63, of the NOFO is provided only as background information for applicants interested in historical data and will not be used as the basis for determining funding levels in the current competition.

3. Are additional state general funds and federal fund sources allowable additional funding for the purpose of cost sharing and matching?

The NOFO states “while there is not a fixed cost-sharing percentage or amount, projects must include financial support from sources other than Title X. The proposed project budget must reflect non-federal financial support in addition to Title X funds on both the Standard Form (SF) 424A, Budget Information for Non-Construction Programs, and in the budget narrative. Recipients will provide family planning services that are in compliance with the Title X statute, regulations, and legislative mandates and that are

13333 guided by OPA’s key priorities.” (NOFO, page 2, Section E page 13, and Section F page 27). Other Federal funds may NOT be used for Cost Sharing under the cost principles.

Please note that the “amount and source(s) of these funds must be clearly identified separately from the requested Title X support as indicated on the SF 424A, as well as on the SF 424, Application for Federal Assistance. The OASH Grants and Acquisition Management (GAM) Division will review applications to ensure that the requested amount of Title X funding is in compliance with this business requirement.” (NOFO, Section E, page 14)

4. What happens if I have no state general funds for a match?

Program regulations stipulate that projects must identify additional sources of funding and not rely solely upon Title X grant funds. While there is not a fixed cost-sharing percentage or amount, projects must include financial support from sources other than Title X, such as private funding, state funding, and income from private and public insurance for reimbursable services. The Title X family planning services program allows program income to be applied toward the cost sharing obligation. The cost sharing requirements are waived for any grant made to the U.S. Virgin Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of the Marshall Islands. (NOFO, page 2, Section E pages 13-14, and Section F page 27). Please note that other Federal funds may NOT be used for Cost Sharing under the cost principles.

5. Can any federal funds be used for minor renovations to the existing space?

(Added 11/16/2021) Allowable costs must be allocable, reasonable, and necessary for the proposed project.

The determination of allowability is made by the grants management officer (GMO) on a case-by-case basis after receiving a justif ication for the specific renovation desired.

OTHER QUESTIONS

1. How are the National Title X Services NOFO and the Dire Need NOFO different?

The funding notice for national Title X service grants solicits applications for up-to five-year projects to provide Title X family planning services throughout the 50 United States, District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, the U.S. Outlying Islands, the Marshall Islands, the Federated State of Micronesia, and the Republic of Palau. The Dire Need NOFO solicits applications for one-time 15-month grants to help to meet the current and expected increase in demand for Title X family planning services, including emergency contraception and other Title X family planning services for clients both within and outside states where restrictive laws and policies impact reproductive health access.

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