HAB HRSA-21-124 (U10) B-SEC_Final.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

HIV/AIDS Bureau

Office of Program Support

Building the HIV Workforce and

Strengthening Engagement in Communities of Color (B-SEC)

Funding Opportunity Number: HRSA-21-124 Funding Opportunity Type(s): New

Assistance Listings (CFDA) Number: 93.145

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2021

Application Due Date: July 6, 2021

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: May 20, 2021

Sherrillyn Crooks, PA-C Lead Senior Public Health Analyst Office of Program Support Telephone: (301) 443-7662 Email: scrooks@hrsa.gov

Authority: Consolidated Appropriations Act, 2021, Pub. L. 116-260, Division H, title II.

mailto:scrooks@hrsa.gov

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2021 Ryan White HIV/AIDS Program for a 4-year pilot project entitled Building the HIV Workforce and Strengthening Engagement in Communities of Color (B-SEC).

Reducing disparities in HIV infection and improving health outcomes in racial and ethnic communities requires a coordinated, multifaceted approach, as well as a robust workforce. This involves developing strategies for community engagement and to mobilize a broad mix of stakeholders and those who can amplify messages regarding advances in the care and treatment of people with or at-risk for HIV.

The purpose of the B-SEC project is to leverage the long-standing presence and trusted voice of minority serving institutions (MSIs) in communities of color disproportionately affected by HIV by educating and training students in HIV care and treatment, raising awareness about the advances in HIV care and treatment, and reducing stigma in the communities in which the MSIs are located.

The goal of this project is to increase the number of health professionals providing HIV care and treatment to people of color living in Ending the HIV Epidemic (EHE) jurisdictions where over 50 percent of new HIV cases were identified. In addition, the EHE initiative includes states with a substantial number of HIV cases in rural areas.

The award recipient for this pilot project will be an institution with a history of building and fostering successful partnerships with MSIs to advance educational programs. The award recipient must have experience in developing and implementing health-related curriculum in institutions of higher education. The funded entity will address the national shortage of minority-serving health care providers in the HIV workforce by integrating topics in HIV into health-related courses and the HRSA National HIV Curriculum (NHC) into the curricula of a minimum of two accredited, health professions programs at undergraduate MSIs. Using this approach, the majority of students in these programs will be introduced to HIV education regardless of their course of study, and health professions students will be better prepared to enter the HIV workforce.

In addition, the funded institution will be responsible for several key components of this project in collaboration with the undergraduate MSIs that will be participating the project:

the development and launch of community engagement activities and programs, raising and increasing awareness of advances in HIV care and treatment, and reducing HIV stigma in communities of color.

Funding Opportunity Title:

Building the HIV Workforce and Strengthening Engagement in Communities of Color (B-SEC) https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline

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Funding Opportunity Number:

HRSA-21-124

Due Date for Applications:

July 6, 2021

Anticipated Total Annual Available FY 2021 Funding:

$1,900,000

Estimated Number and Type of Award(s): One (1) cooperative agreement

Estimated Award Amount: Approximately $1,400,000 to $1,900,000 per year subject to the availability of appropriated funds

Cost Sharing/Match Required: No

Period of Performance: September 30, 2021 through September 29, 2025 (4 years)

Eligible Applicants: Eligible applicants include public and nonprofit private entities; state and local governments; academic institutions; local health departments; nonprofit hospitals and outpatient clinics; community health centers receiving support under Section 330 of the PHS Act; faith-based and community-based organizations; and Indian Tribes or Tribal organizations with or without federal recognition

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance

HRSA strongly encourages all applicants to participate in a webinar for this funding opportunity to ensure the successful submission of the application. The purpose of the webinar is to assist potential applicants in preparing applications that address the requirements of the NOFO.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Wednesday, June 2, 2021 Time: 3:00 – 4:00 p.m. ET Call-In Number: +1 669 254 5252 US (San Jose) +1 646 828 7666 US (New York) +1 669 216 1590 US (San Jose)

+1 551 285 1373 US

833 568 8864 US Toll-free

Weblink: https://hrsa-gov.zoomgov.com/j/1607854135?pwd=R3ljRlVWaVRqbUV5VHNQeGtZK3F2QT09 Meeting ID: 160 785 4135 Passcode: c6wu1wPJ https://hrsa-gov.zoomgov.com/j/1607854135?pwd=R3ljRlVWaVRqbUV5VHNQeGtZK3F2QT09 https://hrsa-gov.zoomgov.com/j/1607854135?pwd=R3ljRlVWaVRqbUV5VHNQeGtZK3F2QT09

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER TRANSITION

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

Minority Serving Institutions (MSIs)1 play a critical role in the nation’s response to ending the HIV epidemic by educating and preparing the next generation of leaders, health care providers, researchers, educators, and public health professionals;

conducting research that helps us improve the response to the HIV epidemic; and educating their faculty, staff and communities about HIV.

This notice announces the opportunity to apply for the Building the HIV Workforce and Strengthening Engagement in Communities of Color (B-SEC) pilot program. Funding under this announcement will support a cooperative agreement for a 4-year award to a single organization to address the national shortage of minority-serving providers in the HIV workforce. The award recipient will integrate topics in HIV into health-related courses and the HRSA National HIV Curriculum (NHC) into the curricula of participating, accredited, health professions programs at undergraduate MSIs. Integrating topics in HIV into the broader curriculum offers an opportunity for more students to become educated about HIV regardless of their area of study. The NHC will be tailored for the discipline and academic year of the participating students. In addition, the organization will partner with MSIs to develop and implement community engagement activities, raise awareness about the advances in HIV care and treatment, and reduce the stigma that is a barrier to care in many communities of color.

The Building the HIV Workforce and Strengthening Engagement in Communities of Color (B-SEC) pilot project will leverage the long-standing presence and trusted voice of MSIs in communities of color disproportionately affected by HIV to educate and train students in HIV, raise awareness about the advances in the care and treatment of HIV, and reduce stigma. The key components of the framework for this pilot project include:

Development of eligibility criteria and methodology for identifying and establishing partnerships with participating undergraduate MSIs, including the technology platform needed to host and access the NHC and staffing allocated to participate in the curriculum integration;

Support of technology needs and faculty training at participating undergraduate MSIs that meet the eligibility criteria established by the award recipient;

Integration of HIV in two areas in the participating MSI curriculum: 1) Incorporate topics in HIV in the curriculum of health-related courses; and 2) Integrate the NHC into the curriculum of accredited health professions programs at MSIs;

Establishment of opportunities for experiential learning for health professions students;

Training and orientation of partnering MSI faculty on how to integrate the NHC into their existing programs and curricula and provide ongoing technical assistance and training to partnering MSIs;

Collaboration with faculty leading health-related courses to integrate topics in HIV into their existing curriculum;

Establishment of on-campus HIV awareness activities; and

Establishment of an HIV Ambassador Program.

1 Minority Serving Institutions U.S. Department of the Interior https://www.doi.gov/pmb/eeo/doi-minority-serving-institutions-program

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For the purpose of this notice, funding will support a single organization to pilot a 4-year project to address national shortages in the HIV workforce by integrating the NHC into the curricula of at least two participating, accredited, undergraduate MSI programs and training faculty on how to use the newly integrated curriculum. Successful applicants must demonstrate a successful history of establishing partnerships with MSIs to advance health-related educational programs and integrating course curricula into institutions of higher education.

HIV Ambassador Program

The HIV Ambassador Program will garner the support of students, faculty, campus staff, community-based advocates, influencers, peers, and others willing to lead and participate in activities and serve as message multipliers to increase knowledge and awareness of advances in HIV care and treatment and reduce the associated stigma.

Also, HIV Ambassadors will encourage people to get tested and raise awareness about pre-exposure prophylaxis (PrEP) in communities of color. Examples of HIV Ambassador activities include participating in community health fairs, launching a campus call-to-action, implementing activities to commemorate HIV awareness days, participating in high school events, publishing blog posts, and hosting peer-to-peer round table discussions.

The award recipient will be responsible for developing the framework, requirements, and evaluative measures for the HIV Ambassador Program to ensure successful implementation at each partnering MSI.

2. Background

The B-SEC project will be funded through the Minority HIV/AIDS Fund (MHAF), as authorized under the Further Consolidated Appropriations Act, 2021, Pub. L. 116-260, Division H, title II.

Since 2010, the United States has put in place national strategies and priorities for HIV and has emphasized reducing HIV-related health inequities, ensuring that all persons with HIV receive access to treatment and care that is non-stigmatizing, culturally sensitive, and competent2. However, the HIV epidemic continues to disproportionately impact racial and ethnic minority populations3. The Centers for Disease Control and Prevention (CDC) reported that among the estimated 36,400 persons newly infected with HIV in the United States at the end of 2018, 15,300 (42%) were Black/African American, 10,300 (28%) Hispanic/Latino, 9,000 (25%) White, and the remaining 5% divided among Asians, American Indians/Alaska Natives, native Hawaiians/Other Pacific Islanders, and persons of multiple races4. The estimates for HIV incidence rates (new infections per 100,000 population) show that Blacks/African Americans have the highest rates - 8.7 times higher than for Whites.4 Additionally, Blacks/African Americans had the highest HIV prevalence rate of 1,434 per 100,000 population at the end of 2018, 2 White House Office of National AIDS Policy. The National HIV/AIDS Strategy for the United States. July 2010. [The White House:

Washington] 3 Song R, Hall HI, Green TA, Szwarcwald CL, Pantazis N. Using CD4 Data to Estimate HIV Incidence, Prevalence, and Percent of Undiagnosed Infections in the United States. J Acquir Immune Defic Syndr. 2017;74:3-9. [PubMed Abstract] 4 Centers for Disease Control and Prevention. Estimated HIV Incidence and Prevalence in the United States, 2014–2018. HIV Surveillance Supplemental Report. 2020;25 (No. 1):1-77. Published May 2020. [CDC HIV Surveillance Supplemental Report] https://obamawhitehouse.archives.gov/sites/default/files/uploads/NHAS.pdf https://obamawhitehouse.archives.gov/sites/default/files/uploads/NHAS.pdf http://www.ncbi.nlm.nih.gov/pubmed/27509244 https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-25-1.pdf

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which is 7.2 times higher than in Whites, underscoring the disproportionate burden of HIV carried by communities of color within the United States.4

Mortality rates due to HIV are highest in the Southern region of the U.S. (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas), where HIV/AIDS-related deaths disproportionately impact Black communities. Factors such as stigma, fear, discrimination, and homophobia may prevent racial and ethnic minorities from accessing HIV prevention and care services.

The HIV workforce shortage has also been exacerbated by providers’ reluctance to treat people with HIV due to stigma while others are overwhelmed by the complexity of treatment and staying up-to-date with treatment recommendations.5

As a result of the increasing number of racial and/or ethnic minorities affected by HIV, racial diversity in the HIV workforce is crucial. According to article published by the National Institutes of Health (NIH), race-related attitudes may influence the quality of communication in patient-physician interactions and thus impact the disparities in treatment and information exchange.6 The article also notes that good patient-physician communication is associated with positive health outcomes.6

HRSA’s HIV/AIDS Bureau (HAB) recognizes the need for a well-staffed and trained workforce with ample representation of minority-serving health care providers to help improve care and treatment of minorities with HIV. Reducing disparities in HIV infection and improving health outcomes in racial and ethnic minorities will require a coordinated, multifaceted approach. This involves developing strategies for community engagement managed by community leaders and influencers to mobilize a broader mix of stakeholders and those who can amplify messages regarding advances in HIV care and treatment.

In addition to the NHC, HRSA HAB (Bureau) currently supports two HIV workforce pipeline programs designed to recruit students and health care providers along the graduate-level education and training continuum: the Interprofessional Education Program (IPE), a required component of the Regional AIDS Education and Training Centers (AETC) Program, and the Integration of the NHC e-Learning Platform into Health Care Provider Professional Education Programs across the country. HRSA HAB intends to incorporate the lessons learned and best practices from these programs and this pilot to inform the Bureau’s ongoing HIV workforce initiatives.

The Ryan White HIV/AIDS Program (RWHAP)

The Ryan White HIV/AIDS Program (RWHAP) provides a comprehensive system of HIV primary medical care, essential support services, and medications for low-income people with HIV. The program funds grants to states, cities, counties, and local community-based organizations to provide care and treatment services to people with HIV to improve health outcomes and reduce HIV transmission among hard-to-reach populations.

5 The American Academy of HIV Medicine, HIV Specialist, Workforce Supply & Demand.

https://aahivm.org/wp-content/uploads/2017/03/FINAL-August-2016.pdf 6 National Institutes of Health, US National Library of Medicine, The Effects of Race and Racial Concordance on Patient-Physician Communication NIH Effects of Race and Racial Concordance https://aahivm.org/wp-content/uploads/2017/03/FINAL-August-2016.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591056/#:~:text=Racial%20concordance%20refers%20to%20having,physicians%20having%20different%20racial%20identities

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The RWHAP has five statutorily defined Parts (Parts A, B, C, D and F) that provide funding for core medical, support services, and medications; technical assistance;

clinical training; and the development of innovative models of care to meet the needs of different communities and populations affected by HIV.

An important framework in the RWHAP is the HIV care continuum, which depicts the series of stages a person with HIV engages in from initial diagnosis through their successful treatment with HIV medication to achieve viral suppression. Supporting people with HIV to reach viral suppression not only increases their own quality of life and lifespan, it also prevents sexual transmission to an HIV-negative partner.

The HIV care continuum framework allows recipients and planning groups to measure progress and to direct HIV resources most effectively. RWHAP recipients are encouraged to assess the outcomes of their programs and should work with their community and public health partners to improve outcomes across the HIV care continuum. HRSA encourages recipients to use the performance measures developed for the RWHAP at their local level to assess the efficacy of their programs and to analyze and improve the gaps along the HIV care continuum.

Strategic Frameworks and National Objectives

National objectives and strategic frameworks like the Healthy People 2030, the HIV National Strategic Plan: A Roadmap to End the HIV Epidemic (2021 – 2025); the Sexually Transmitted Infections National Strategic Plan for the United States (2021 – 2025); and the Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination (2021 – 2025) are crucial to addressing key public health challenges facing low-income people with HIV. These strategies detail the principles, priorities, and actions to guide the national public health response and provides a blueprint for collective action across the federal government and other sectors. The RWHAP supports the implementation of these strategies and recipients should align their organization’s efforts, within the parameters of the RWHAP statute and program guidance, with these strategies to extent possible.

Expanding the Effort: Ending the HIV Epidemic

According to recent data from the 2019 Ryan White Services Report (RSR), the RWHAP has made tremendous progress toward ending the HIV epidemic in the United States. From 2015 to 2019, HIV viral suppression among RWHAP patients who have had one or more medical visits during the calendar year and at least one viral load with a result of <200 copies/mL reported, has increased from 83.4 percent to 88.1 percent.

Additionally, racial/ethnic, age-based, and regional disparities reflected in viral suppression rates have significantly decreased.7 For example, the disparities in viral suppression rates between Black/African Americans and white clients have decreased since 2010.8 These improved outcomes mean more people with HIV in the United

7 Health Resources and Services Administration. Ryan White HIV/AIDS Program Annual Client-Level Data Report 2019.

http://hab.hrsa.gov/data/data-reports. Published December 2020. Accessed December 2, 2020.

8 Black/African American clients went from 79.4 percent viral suppression in 2015 to 85.2 percent in 2019, while 88.3 percent of white clients were virally suppressed in 2015 and 91.8 percent in 2019 http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html https://health.gov/healthypeople https://www.hiv.gov/federal-response/hiv-national-strategic-plan/hiv-plan-2021-2025 https://www.hiv.gov/federal-response/hiv-national-strategic-plan/hiv-plan-2021-2025 https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://hab.hrsa.gov/sites/default/files/hab/data/datareports/RWHAP-annual-client-level-data-report-2019.pdf http://hab.hrsa.gov/data/data-reports

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States will live near normal lifespans and have a reduced risk of transmitting HIV to others.9

In February 2019, the Ending the HIV Epidemic (EHE) initiative was launched to further expand federal efforts to reduce HIV infections. This 10-year initiative seeks to achieve the important goal of reducing new HIV infections in the United States to fewer than 3,000 per year by 2030. The initiative promotes and implements four strategies to substantially reduce HIV transmissions – Diagnose, Treat, Prevent, and Respond. The initiative is a collaborative effort among key HHS agencies, primarily HRSA, CDC, the National Institutes of Health (NIH), the Indian Health Service (IHS), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

For the RWHAP, the EHE initiative expands the program’s ability to meet the needs of clients specifically focusing on linking people with HIV who are either newly diagnosed, diagnosed but currently not in care, or are diagnosed in care but not yet virally suppressed to the essential HIV care and treatment and support services needed to help them achieve viral suppression.

Using Data Effectively: Integrated Data Sharing and Use

HRSA and CDC’s Division of HIV/AIDS Prevention support integrated data sharing, analysis, and utilization for the purposes of program planning, conducting needs assessments, determining unmet need estimates, reporting, quality improvement, enhancing the HIV care continuum, and public health action. HRSA strongly encourages RWHAP recipients to:

Follow the principles and standards in the Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs: Standards to Facilitate Sharing and Use of Surveillance Data for Public Health Action.

Establish data sharing agreements between surveillance and HIV programs to ensure clarity about the process and purpose of the data sharing and utilization.

Integrated data sharing, analysis, and utilization of HIV data by state and territorial health departments can help further progress toward reaching the HIV National Strategic Plan goals and improve outcomes on the HIV care continuum.

HRSA strongly encourages complete CD4, viral load (VL) and HIV nucleotide sequence reporting to the state and territorial health departments’ HIV surveillance systems to benefit fully from integrated data sharing, analysis, and utilization. State health departments may use CD4, VL, and nucleotide sequence data to identify cases, stage of HIV disease at diagnosis, and monitor disease progression. These data can also be used to evaluate HIV testing and prevention efforts, determine entry into and retention in HIV care, measure viral suppression, monitor prevalence of antiretroviral drug resistance, detect transmission clusters and understand transmission patterns, and assess unmet health care needs. Analyses at the national level to monitor progress

9 National Institute of Allergy and Infectious Diseases (NIAID). Preventing Sexual Transmission of HIV with Anti-HIV Drugs. In:

ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2016 Mar 29]. Available from:

https://clinicaltrials.gov/ NCT00074581 NLM Identifier: NCT00074581.

https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf https://clinicaltrials.gov/

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toward ending the HIV epidemic can only occur if all HIV-related CD4, VL, and HIV nucleotide sequence test results are reported by all jurisdictions. CDC requires the reporting to the National HIV Surveillance System (NHSS) all HIV-related CD4 results (counts and percentages), all VL results (undetectable and specific values), and HIV nucleotide sequences.

Program Resources and Innovative Models

HRSA has a number of projects and resources that may assist RWHAP recipients with program implementation. These include a variety of HRSA HAB cooperative agreements, contracts, and grants focused on specific technical assistance (TA), evaluation, and intervention activities. A list of these resources is available on TargetHIV. Recipients should be familiar with these resources and are encouraged to use them as needed to support their program implementation.

E2i: Using Evidence-Informed Interventions to Improve Health Outcomes among People Living with HIV E2i uses an implementation science approach to evaluate and understand existing and new intervention strategies that can be used in RWHAP provider settings. Once interventions or strategies are demonstrated and evaluated using implementation science, manuals, guides, interactive online tools, publications, and instructional materials are developed and disseminated for replication and integration into RWHAP provider settings.

Integrating HIV Innovative Practices (IHIP) Resources on the IHIP website include easy-to-use training manuals, curricula, case studies, pocket guides, monographs, and handbooks, as well as informational handouts and infographics about SPNS generally. IHIP also hosts TA training webinars designed to provide a more interactive experience with experts, and a TA help desk exists for you to submit additional questions and share your own lessons learned.

Replication Resources from the SPNS Systems Linkages and Access to Care There are intervention manuals for patient navigation, care coordination, state bridge counselors, data to care, and other interventions developed for use at the state and regional levels to address specific HIV care continuum outcomes among hard-to-reach people with HIV.

Dissemination of Evidence Informed Interventions The Dissemination of Evidence-Informed Interventions initiative ran from 2015-2020 and disseminated four adapted linkage and retention interventions from prior SPNS and the Minority HIV/AIDS Funds (MHAF) from the HHS Secretary’s Office initiatives to improve health outcomes along the HIV care continuum. The initiative produced four evidence-informed care and treatment interventions (CATIs) that are replicable, cost-effective, capable of producing optimal HIV care continuum outcomes, and easily adaptable to the changing health care environment. Manuals are currently available at the link provided and will be updated on an ongoing basis.

https://targethiv.org/help/ta-directory https://targethiv.org/e2i https://targethiv.org/e2i https://targethiv.org/ihip https://targethiv.org/library/replication-resources-spns-systems-linkages-and-access-care https://targethiv.org/deii

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HRSA HAB also recognizes the importance of addressing emerging issues, as well as supporting the needs of special populations. To help recipients in responding to these critical issues, HRSA HAB funds projects to provide technical assistance and resources for recipients. Examples of projects include:

Building Futures: Supporting Youth Living with HIV

The Center for Engaging Black MSM Across the Care Continuum (CEBACC) Using Community Health Workers to Improve Linkage and Retention in Care

II. Award Information

1. Type of Application and Award

Type of applications sought: New

HRSA will provide funding in the form of a four-year cooperative agreement. A cooperative agreement is a financial assistance mechanism where HRSA anticipates substantial involvement with the recipient during performance of the contemplated project.

HRSA program involvement will include:

Participating in the discussions regarding the adoption and design of technological models and tools as described in the project narrative;

Facilitating meetings between the recipient of HRSA-21-124, the recipient of the NHC, and other relevant HRSA programs;

Reviewing and providing recommendations (on an as-needed basis) on training curricula, publications, and other resources;

Participating in the planning and coordination of meetings, including participation in the recipient meetings with participating MSIs and partners as needed and appropriate;

Assisting in establishing linkages and partnerships between the award recipient and the regional AETCs, minority-serving HIV organizations, and HRSA-supported projects to enhance project goals;

Ensuring timely submission of project goals, objectives, and outcomes into HRSA programmatic and data reporting efforts;

Reviewing all project reports and materials prior to dissemination;

Facilitating the dissemination of project information to stakeholders and the broader public; and

Reviewing all conference presentations (oral, poster, roundtable, etc.) that share cooperative agreement data, activities, work products, practices and/or best lessons learned.

The cooperative agreement recipient’s responsibilities will include:

Collaborating with MSIs to integrate topics in HIV into health-related courses and the NHC into the training curricula of accredited, undergraduate, health professions programs that are commensurate with the targeted discipline and academic year of the program;

https://targethiv.org/library/hrsa-hab-building-futures-supporting-youth-living-hiv https://targethiv.org/cebacc https://targethiv.org/chw

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Training faculty on how to implement the integrated curricula;

Developing an HIV Ambassador Program to better engage communities of color in surrounding areas of the participating MSIs in HIV care and treatment and to reduce HIV-related stigma;

Evaluating the impact of the integrated curricula on the knowledge, willingness, and ability of students to work with people with HIV and/or in communities of color at high risk for HIV;

Contributing data and collaborating with the recipient of HRSA-22-021, National HIV Curriculum e-Learning Platform: Enhancements and Operations, to evaluate the effectiveness of the modified NHC, as well as system-level impacts of the overall project;

Collaborating with HAB and various programs within the AETC network, including NHC programs, regional and national AETCs, to carry out programmatic activities, as appropriate;

Submitting data to HRSA on program outcomes and impact;

Identifying activities to be planned jointly with undergraduate programs, with HAB input and approval;

Informing HAB of project activities and allowing ample time to receive input and/or technical assistance;

Attending the biennial AETC Program Administrative Reverse Site Visit meetings; and

Attending the biennial National Ryan White Conference on HIV Care and Treatment.

2. Summary of Funding

HRSA estimates approximately $1,400,000 to $1,900,000 to be available annually to fund one recipient. Funding for modifications and enhancements to the NHC as required by this project will be provided directly to the award recipient of HRSA-22-021, the National HIV Curriculum e-Learning Platform: Enhancements and Operations, by the federal government and will be deducted from the total funds available for the project.

The level of effort for the modifications will vary each year of the project.

Table 1. Indicates the estimated funding available for the recipient of HRSA-21-124 for Years 1 through 4:

Table 1.

HRSA-21-124 Summary of Funding:

Year 1 $1,800,000

Year 2 $1,400,000

Year 3 $1,800,000

Year 4 $1,900,000

You may apply for a ceiling amount of up to the funding amounts referenced in Table 1.

for the total cost (includes both direct and indirect, facilities and administrative costs) per year. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

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The period of performance is September 30, 2021 through September 29, 2025 (4 years). Funding beyond the first year is subject to the availability of appropriated funds for the B-SEC pilot project in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government. In addition, HRSA may reduce recipient funding levels beyond the first year if recipients are unable to fully succeed in achieving the goals listed in application.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include public and nonprofit private entities; state and local governments; academic institutions; local health departments; nonprofit hospitals and outpatient clinics; community health centers receiving support under Section 330 of the PHS Act; faith-based and community-based organizations; and Indian Tribes or Tribal organizations with or without federal recognition

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA will consider any application that exceeds the ceiling amount non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 non-responsive and will not consider it for funding under this notice.

NOTE: Multiple applications from an organization are not allowable.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once before the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for each NOFO you are reviewing or preparing in the workspace application package in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov. You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this NOFO.

2. Content and Form of Application Submission

Section 4 of HRSA’s SF-424 Application Guide provides instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract. You must submit the information outlined in the Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

See Section 8.5 of the Application Guide for the Application Completeness Checklist.

Application Page Limit The total size of all uploaded files included in the page limit shall not exceed the equivalent of 65 pages when printed by HRSA. o The page limit includes the project and budget narratives, attachments, and letters of commitment and support required in the Application Guide and this NOFO. Please note: Effective April 22, 2021, the abstract is no longer an "attachment" that counts in the page limit. The abstract is SF form "Project_Abstract Summary” and it will not count in the page limit. Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-21-124, it may count against the page limit.

Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit of XX will not be read, evaluated, or considered for funding.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html

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Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3321).

3) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 8: Other Relevant Documents.

See Section 4.1 viii of HRSA’s SF-424 Application Guide for additional information on all certifications.

Program Requirements

The award recipient under Notice of Funding Opportunity, National HIV Curriculum e- Learning Platform: Enhancements and Operations, HRSA-22-021, will be responsible for implementing modifications and updates to the NHC e-Learning platform and the funding to make the modifications will be included in the award under HRSA-22-021.

The recipient funded under this announcement will be required to collaborate with the award recipient of HRSA-22-021. The purpose of the collaboration is to:

Provide updates and content for modifying the NHC e-learning platform modules to integrate the NHC into MSI undergraduate programs;

Participate as a member on the advisory board meetings convened by the award recipient of HRSA-22-021, provide recommendations and feedback on proposed changes to the NHC for current users and instructional design based on the recipient’s work with the MSIs; and

Participate in NHC collaborative meetings led by the award recipient of HRSA- 22-021 to coordinate technical assistance, feedback and recommendations specific to the integration of the NHC into health professional programs i.e.

learner groups, quizzes/exams, and certificate programs.

HRSA strongly encourages the recipient under this announcement to collaborate with the following entities and groups to develop a support network to assist the award recipient in achieving the goals of the project:

The Regional AIDS Education and Training Centers (AETC) – Leverage existing educational resources and expertise to develop university and community-based training plans, as well as develop and seek opportunities for preceptorships and shadowing opportunities;

The recipients of HRSA-22-022, Integration of the National HIV Curriculum e- Learning Platform (NHC) into Health Care Provider Professional Education - Garner lessons learned and guidance on effective methods to integrate the NHC into partnering MSIs;

National, minority-serving HIV organizations – Seek technical assistance to develop population-specific training plans and/or provide technical assistance on fostering and launching community engagement activities; and

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Other entities that have existing relationships with minority-serving organizations and provide student training (i.e. HRSA-funded health centers, health systems, hospitals, community-based organizations, and health departments located in EHE jurisdictions.

Program-Specific Instructions In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 Application Guide (including the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract Project Abstract. Use the Standard OMB-approved Project Abstract Summary Form

2.0 that is included in the workspace application package. Do not upload the abstract as an attachment.

ii. Project Narrative This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and well-organized so that reviewers can understand the proposed project.

Successful applications will contain the information below. Please use the following section headers for the narrative:

INTRODUCTION -- Corresponds to Section V’s Review Criterion #1 Need

Briefly describe the purpose of the proposed project. You must articulate your planned approach to work with and establish partners to integrate topics in HIV and the NHC into multiple curricula, establish the HIV Ambassador Program, and other activities to raise awareness about advances in HIV prevention and treatment and reduce stigma on campus and in the communities in which they are located. Include details regarding the criteria for selecting at least two partnering MSIs located in EHE jurisdictions, the assessment of the institution’s ability to host the NHC, and training faculty. Include a description of your organization’s capacity and infrastructure to design and support health-related curriculum and integrate course curricula in institutions of higher education. Additionally, describe your organization’s history and ability to establish or leverage existing relationships in the jurisdictions identified in the Ending the HIV Epidemic Initiative. You should demonstrate an understanding of the education and training needs of diverse MSI undergraduate programs. Provide a brief description of your planned approach to implement a community-based program designed to reach racial and/or ethnic minority groups that will increase HIV awareness and reduce stigma.

NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion #1 Need

Outline the needs of the community and/or organization regarding HIV. This section will help reviewers understand the community and/or organization that you will serve with the proposed project.

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Describe the need for an adequate HIV workforce trained to deliver high-quality HIV care and treatment in your target community. Describe the educational needs of undergraduate students at participating MSIs regarding HIV. This section must also include a description of the gaps in capacity to integrate and deliver HIV content in curricula of undergraduate programs (e.g., faculty recruitment/training, technological barriers, and existing course curricula). Discuss any relevant, anticipated barriers that you will need to address. Data must be cited to support the described need.

Describe the incidence of HIV infection the communities of color in which the participating MSIs are located. Use and cite the most recent and relevant local, regional, and/or national data and published research whenever possible to support the information provided. Describe the racial and/or ethnic minority population(s) you will serve and the unmet health needs as they relate to care and treatment, and HIV. Clearly describe how racial and/or ethnic minority population(s) in your service area may benefit from your HIV Ambassador Program, including those who are at risk of and have never been tested for HIV, and people who have been newly identified or recently diagnosed with HIV and those who are out of care.

Provide a summary that demonstrates a comprehensive understanding of HIV-related stigma as a barrier to people seeking and remaining in care, and the need for community engagement to improve awareness of stigma in communities of color.

Describe your organization’s capacity and specific need for funding to successfully implement project activities. Describe how the proposed project builds upon current HIV Workforce initiatives and furthers the objectives of your institution.

METHODOLOGY -- Corresponds to Section V’s Review Criterion #2 Response

Propose the methods and rationale that you will use to address the stated needs and meet each of the previously described program requirements and expectations in this NOFO for each year of the four-year project.

The methodology must:

Describe the methodology used to identify at least two partnering MSIs for the integration of HIV into health-related courses and the NHC within the curricula of undergraduate health professions programs;

Describe how the proposed approach will successfully integrate HIV into health-related courses and undergraduate health professions programs;

Identify the specific health professional programs (e.g. social work, nursing, dental, etc.) for integration of curriculum at each participating MSI and discuss how the topics may vary for the different health professional programs.

Include criteria used to determine the effectiveness of the applied integration method(s);

Include details such as the number of courses identified as those in which HIV and/or the NHC will be integrated;

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Describe the approach to faculty training and orientation to the new curriculum;

Describe the framework for the HIV Ambassador program and the implementation plan for partnering MSIs and your own institution;

Describe the approach to engage communities of color in addressing HIV-related stigma and other barriers to accessing care, including leveraging relationships in EHE jurisdictions.

In addition, include assessments and the development of effective tools and strategies to include HIV in health-related courses and health professions programs as appropriate. Describe how you will determine the curriculum modifications needed for the NHC as well as the framework for the integrated curricula. Describe the anticipated number of students and faculty to be trained for each partnering institution. Your response should include your plan for outreach, collaborations, clear communication, and information sharing and dissemination on campus, in the community, and to proposed partners. Include a plan for ongoing technical assistance and support for training. In addition, describe your approach to foster new and utilize existing partnerships with the community and other organizations and programs.

Describe the rationale for your proposed methodology. If applicable, include a plan to disseminate reports, products, and/or project outputs so key target audiences receive the project information.

Propose a plan for project sustainability after the period of federal funding ends.

HRSA expects recipients to sustain key elements of their projects, e.g., strategies or services and interventions, which have been effective in improving practices and those that have led to improved outcomes for the target population.

Collaborations Describe the proposed collaborations and partnerships needed and planned, to successfully implement the proposed project. This includes the partnering undergraduate MSIs. Clearly describe each proposed partner and explain how its services and/or resources can augment and support the implementation activities you propose. Identify the tasks that each partner will need to perform.

Include a Letter of Interest from each partner and/or collaborating entity on letterhead and signed by an executive in the organization or Dean from an institution of higher education as Attachment 4. The letter should include the organization’s intent to participate in the pilot project.

WORK…