HAB HRSA-22-033 (X07)_ADAP_form_suppl_Final.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

HIV/AIDS Bureau

Division of State HIV/AIDS Programs

Ryan White HIV/AIDS Program

HIV Care Grant Program – Part B States/Territories Formula and AIDS Drug Assistance Program Formula and ADAP Supplemental Awards

Funding Opportunity Number: HRSA-22-033

Funding Opportunity Type(s): Non-Competing Continuation

Assistance Listings (CFDA) Number: 93.917

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: November 8, 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: July 23, 2021

Susan Robilotto, D.O.

Director, Division of State HIV/AIDS Programs Telephone: (301) 443-6554 Email: SRobilotto@hrsa.gov Fax: (301) 443-8143

Authority: 42 USC §§ 300ff-21 to 331b and 300ff-121 (sections 2611-2623 and 2693 of the

Public Health Service (PHS) Act).

mailto:SRobilotto@hrsa.gov

HRSA-22-033 i

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the Ryan White HIV/AIDS Program Part B Base, AIDS Drug Assistance Program (ADAP) Base, ADAP Supplemental, Minority AIDS Initiative, and Emerging Communities program.

The purpose of this program is to assist states and territories in developing and/or enhancing access to a comprehensive continuum of high quality HIV care and treatment for low-income people with HIV. It supports the HIV National Strategic Plan goals to prevent new HIV infections, improve HIV-related health outcomes of people with HIV, reduce HIV-related disparities and health inequities, and achieve integrated and coordinated efforts that address the HIV epidemic among all partners and stakeholders.

Funding Opportunity Title: HIV Care Grant Program - Part B States/Territories Formula and AIDS Drug Assistance Program Formula and ADAP Supplemental Awards

Funding Opportunity Number: HRSA-22-033

Due Date for Applications: November 8, 2021

Anticipated Total Annual Available Funding: $1,340,000,000

Estimated Number and Type of Award(s): Up to 59 Grants

Estimated Award Amount: Varies- formula calculation

Cost Sharing/Match Required: Yes for Part B Formula/Base, Emerging Communities and ADAP Supplemental when applicable to specific states

Period of Performance: April 1, 2022 through March 31, 2027 (five years)

Eligible Applicants: In addition to the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau may apply.

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

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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 Notice of Funding Opportunity (NOFO) to do otherwise.

Technical Assistance

HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Wednesday, August 25, 2021 Time: 02:30 - 04:00 pm

Join ZoomGov Meeting https://hrsa-gov.zoomgov.com/j/16041483625?pwd=am1jaHdvRDI5eWt3UWlUNzAxTnRQUT09

Meeting ID: 160 4148 3625 Passcode: FY22X07TA One tap mobile +16692545252,,16041483625#,,,,*809110554# US (San Jose) +16468287666,,16041483625#,,,,*809110554# US (New York)

Dial by your location +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 Meeting ID: 160 4148 3625 Passcode: 809110554 Find your local number: https://hrsa-gov.zoomgov.com/u/az33lRjaq

Join by SIP 16041483625@sip.zoomgov.com

Join by H.323

161.199.138.10 (US West)

161.199.136.10 (US East) Meeting ID: 160 4148 3625 Passcode: 809110554

The recorded webinar will be available on the TargetHIV website http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa-gov.zoomgov.com/j/16041483625?pwd=am1jaHdvRDI5eWt3UWlUNzAxTnRQUT09 https://hrsa-gov.zoomgov.com/j/16041483625?pwd=am1jaHdvRDI5eWt3UWlUNzAxTnRQUT09 https://hrsa-gov.zoomgov.com/u/az33lRjaq mailto:16041483625@sip.zoomgov.com https://targethiv.org/

HRSA-22-033 iii

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

APPENDIX: FY 2022 AGREEMENTS AND ASSURANCES RYAN WHITE HIV/AIDS

TREATMENT EXTENSION ACT OF 2009 PART B/ADAP GRANT PROGRAM

HRSA-22-033 4

I. Program Funding Opportunity Description

1. Purpose This notice announces the opportunity to apply for funding under the Ryan White HIV/AIDS Program (RWHAP) Part B Base, AIDS Drug Assistance Program (ADAP) Base, ADAP Supplemental, Minority AIDS Initiative (MAI), and Emerging Communities (EC) program. The purpose of this program is to assist states and territories in developing and/or enhancing access to a comprehensive continuum of high quality HIV care and treatment for low-income people with HIV. For the purposes of this program, “states/territories” include the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

A comprehensive system of HIV care includes the 13 core medical services specified in the Public Health Service (PHS) Act, Section 2612(b)(3) [42 U.S.C. 300ff-21(b)(3)].

Comprehensive HIV care beyond these core services may include supportive services that meet the criteria of enabling individuals and families living with HIV to access and remain in primary medical care to improve their medical outcomes. These core and support services assist people with HIV in accessing treatment for HIV infection that is consistent with the Department of Health and Human Services (HHS) Treatment Guidelines (see http://www.aidsinfo.nih.gov).

The RWHAP Part B/ADAP recipients must use grant funds to support, develop and expand systems of care to meet the needs of people with HIV. The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) requires that the RWHAP Part B/ADAP Programs conduct needs assessments and use needs assessment data to make decisions on services needed to eliminate barriers faced by people with HIV in accessing and remaining in medical care.

In June 2015, HRSA HAB and the Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) released a joint guidance for the Integrated HIV Prevention and Care Plan, including the Statewide Coordinated Statement of Need (SCSN), a legislative requirement for RWHAP Part A and B recipients. This guidance was set forth for health departments and HIV planning groups funded by DHAP and HAB for the development of an Integrated HIV Prevention and Care Plan and allowed jurisdictions to submit one Integrated HIV Prevention and Care Plan, including the SCSN, to CDC and HRSA. As HRSA views integrated prevention and care planning as the most appropriate mechanism to fully plan HIV services, CDC DHAP and HRSA HAB have issued joint guidance for the development of the HIV Prevention and Care Plan to cover calendar years 2022 – 2026. Submission of the Integrated HIV Prevention and Care Plan not only meets the legislative and programmatic requirements of CDC and HRSA, but also serves as a jurisdictional HIV/AIDS strategy or roadmap. Important Notes:

Multi-Year Funding: HRSA HAB transitioned the RWHAP Part B/ADAP from an annual application program to a five-year funded program effective in FY 2017.

HRSA HAB will continue the five-year period of performance that will cover FY 2022-FY 2026. In this next five-year period of performance, eligible applicants will https://www.aidsinfo.nih.gov/ https://www.aidsinfo.nih.gov/ http://www.aidsinfo.nih.gov/

HRSA-22-033 5

submit an application in the first year (FY 2022), and non-competing continuation (NCC) progress reports will be submitted for years 2 through 5 (FY 2023 through FY 2026, respectively).

Unmet Need: HRSA HAB updated the estimation methodology used to determine unmet need for HIV-related services. Eligible applicants will need to provide estimates using the new Unmet Need Framework with their applications. See the Demonstrated Need section for additional detail, and reference the TargetHIV website for training materials and tools related to estimating and reporting Unmet Need.

Work Plan: The Implementation Plan is comprised of two components, the Implementation Plan Table and the Implementation Plan Narrative. You will only be required to submit an Implementation Plan Narrative with this funding announcement. The Implementation Plan Table will not be submitted with this application. You will provide the Implementation Plan Table with your Program Terms Report.

Needs Assessment: You will need to submit a brief HIV/AIDS epidemiological data profile and narrative, and a brief outline of the needs assessment with this application. A more in depth epidemiological data profile and narrative and outline of the needs assessment will be submitted with the Integrated HIV Prevention and Care Plan to be submitted in December 2022.

Quality Management Plan: You will be required to submit an updated Quality Management Plan as a reporting requirement with the Program Terms Report, ninety (90) days after the award is made.

The following information will assist you in understanding and completing your FY 2022 grant application:

RWHAP Part B funds, including ADAP, are subject to Section 2612(b)(1) of the PHS Act, which requires that not less than 75 percent of the award (minus amounts for administration, planning/evaluation and clinical quality management) be used to provide core medical services. Support services allowed under RWHAP Part B are limited to services that are needed for people with HIV to achieve their medical outcomes. The service definitions can be found in Policy Clarification Notice (PCN) 16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds at: https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf.

Applicants seeking a waiver to the core medical services requirement must submit a waiver request either with this application, or up to four (4) months after the budget period start date. Submission should be in accordance with PCN 13-07 Uniform Standard for Waiver of Core Medical Services Requirement for Grantees Under Parts A, B, and C, and sample letters can all be found at http://hab.hrsa.gov/manageyourgrant/policiesletters.html. A core medical services waiver request should be included as Attachment 8 if it is submitted with the application.

The Agreements and Compliance Assurances required for this NOFO are found in Appendix A, and require the signature of the Chief Elected Official (CEO), or the CEO’s designee. The Agreements and Compliance Assurances should be included as Attachment 7.

https://targethiv.org/library/updated-framework-estimating-unmet-need-hiv-primary-medical-care https://targethiv.org/calendar/webinar-and-call-archives https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf http://hab.hrsa.gov/manageyourgrant/policiesletters.html

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2. Background

This program is authorized by the PHS Act, Sections 2611 - 23 and 2693 [42 U.S.C. 300ff-

21-300ff-31b and 300ff-121]. HHS administers the RWHAP Part B/ADAP through the HRSA, HAB, Division of State HIV/AIDS Programs (DSHAP). All 59 eligible entities receive RWHAP Part B Base and ADAP Base funding through this program. For more information regarding the RWHAP, please visit the HRSA website: http://hab.hrsa.gov/.

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.

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 in the U.S.

http://hab.hrsa.gov/ http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html

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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.1 For example, the disparities in viral suppression rates between Black/African Americans and white clients have decreased since 2010.2 These improved outcomes mean more people with HIV in the United States will live near normal lifespans and have a reduced risk of transmitting HIV to others.3

In February 2019, the Ending the HIV Epidemic in the U.S. (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, the Centers for Disease Control and Prevention (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.

1 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.

2 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 3 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://hab.hrsa.gov/sites/default/files/hab/data/datareports/RWHAP-annual-client-level-data-report-2019.pdf https://www.hhs.gov/about/news/2020/02/26/hhs-awards-117-million-to-end-hiv-epidemic-in-the-united-states.html 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://hab.hrsa.gov/data/data-reports https://clinicaltrials.gov/

HRSA-22-033 8

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 toward ending the HIV epidemic in the U.S. 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.

An important technical assistance resource is the RWHAP Recipient Compilation of Best Practices Intervention Strategies (Best Practices Compilation). The Best Practices Compilation is currently under development, but will present strategies that have been implemented in real world settings and that improve outcomes along the HIV care continuum. The RWHAP Best Practices Compilation will be an easily searchable resource to support recipients’ work and the needs of the people served by the RWHAP.

In addition, many RWHAP Special Projects of National Significance (SPNS) projects have demonstrated promising new approaches for linking and retaining priority populations into care. As resources permit, RWHAP recipients are encouraged to review and integrate these tools within their HIV system of care in accordance with the allowable service categories defined in PCN 16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals and Allowable Uses of Funds. Examples of these resources include:

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 https://targethiv.org/help/ta-directory https://targethiv.org/bestpractices https://targethiv.org/bestpractices https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf https://targethiv.org/e2i https://targethiv.org/e2i

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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.

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: Non-Competing Continuation

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $1,340,000,000 to be available annually to fund 59 recipients. The actual amount available will not be determined until enactment of the final https://targethiv.org/ihip https://targethiv.org/library/replication-resources-spns-systems-linkages-and-access-care https://targethiv.org/deii https://targethiv.org/library/hrsa-hab-building-futures-supporting-youth-living-hiv https://targethiv.org/cebacc https://targethiv.org/chw

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fiscal year FY 2022 federal appropriation. 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. The period of performance is April 01, 2021 through March 31, 2022 (5 years). Funding beyond the first year may be awarded through a modified non-competing continuation in order to reduce the administrative burden on recipients. Funding beyond the first year is subject to the availability of appropriated funds for the RWHAP Part B/ADAP Program in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

Notification of awards will be sent to the CEO or to the delegated administrative agency responsible for dispersing RWHAP Part B/ADAP funds.

HRSA HAB has transitioned the RWHAP Part B/ADAP from an annual non-competitive funded program to a multi-year funded program, effective FY 2017. The period of performance is five years (April 1, 2022 through March 31, 2027). A non-competitive application will be submitted for FY 2022, and Non-Competing Continuation (NCC) Progress Reports will be submitted annually for FY 2023 through FY 2026.

RWHAP Part B Base, ADAP Base, and EC formula awards are based on the number of reported living cases of HIV in the state or territory in the most recent calendar year as confirmed by CDC and submitted to HRSA. Similarly, for recipients applying for MAI formula funds, awards are based on the number of reported living minority HIV cases for the most recent calendar year as confirmed by CDC and submitted to HRSA. For subsequent budget periods, annual award amounts for these portions will be adjusted based on updated case counts. ADAP Supplemental grants are awarded by the same formula as ADAP Base to states which meet any of the criteria listed in that section of the NOFO and choose to apply; annual eligibility for ADAP Supplemental in subsequent budget periods will be announced through the NCC process.

Please note that the HHS Secretary (Secretary) may reduce the amounts of grants under the RWHAP Part B/ADAP to a state/territory or political subdivision of a state/territory for a FY if, with respect to such grants for the second preceding FY, the state/territory or subdivision fails to prepare audits in accordance with the procedures of Section 7502 of Title 31, United States Code. See Section 2682(a) of the PHS Act.

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

Please see PCN 15-01 Treatment of Costs under the 10% Administrative Cap for Ryan White HIV/AIDS Program Parts A, B, C, and D along with the FAQs for information regarding the statutory 10 percent limitation on administrative costs.

III. Eligibility Information

1. Eligible Applicants

In addition to the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75 https://hab.hrsa.gov/sites/default/files/hab/Global/HRSA-HAB-PCN15-01.pdf https://hab.hrsa.gov/sites/default/files/hab/Global/HRSA-HAB-PCN15-01.pdf https://hab.hrsa.gov/sites/default/files/hab/Global/faqpolicyclarificationnotice15-01.pdf

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the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau are eligible to apply for RWHAP Part B Base, ADAP Base, and MAI funding.

RWHAP Part B/ADAP applicants must designate a lead state/territory agency that will be responsible for administering all assistance received; conducting a needs assessment and preparing a state/territory comprehensive plan; preparing all applications and reports;

receiving notices regarding programs; and collecting and submitting to the HHS Secretary every two years all audits from recipients within the state/territory, including an audit regarding funds expended.

ADAP Supplemental funding: States and territories are eligible to apply for ADAP Supplemental funding if they meet at least one of the following criteria, as reported by the state or territory on the most recent ADAP Data Report (ADR):

a) Financial requirement of Federal Poverty Level (FPL) = or <200 percent;

b) Limited formulary compositions for all core classes of antiretroviral medications;

c) Waiting list, capped enrollment, or capped expenditures;

d) An unanticipated increase of eligible individuals with HIV.

Even if a state/territory meets one of the eligibility criteria listed, it will be deemed ineligible for ADAP Supplemental funds if the state/territory did not obligate 75 percent of its previous FY RWHAP Part B/ADAP award within 120 days of the budget period start date, as reported on the previous FY Interim Federal Financial Report (FFR) within 150 days of the budget period start date.

Note: The Coronavirus Disease 2019 (COVID-19) public health emergency has posed significant challenges for RWHAP recipients, providers, and clients to provide and access care. On February 23, 2021, HRSA HAB released a letter that waived certain statutory penalties and administrative requirements for FY 2020 and 2021 in accordance with the Consolidated Appropriations Act, 2021, Pub. L. 116- 260, Division M, § 307. The requirement to obligate 75 percent of FY 2021 RWHAP Part B/ADAP award within 120 days of the budget period start date has been waived for FY 2021. Therefore, no states/territories will be deemed ineligible if they did not obligate 75 percent of their FY2021 award within 120 days of the budget period start date.

This requirement has only been waived for FY 2020 and FY 2021. Failure to obligate 75 percent of RWHAP Part B/ADAP in FY 2022 or future budget periods will result in penalties assessed to future budget years of the period of performance. ADAP Supplemental funding is determined on an annual basis; receipt of funding in one year does not guarantee funding in any subsequent year.

Eligibility for EC formula awards depends in part on the number of confirmed AIDS cases within a statutorily specified “metropolitan area.” The Secretary uses the Office of Management and Budget’s (OMB’s) census-based definitions of a Metropolitan Statistical Area (MSA) in determining the geographic boundaries of a RWHAP metropolitan area, including an EC. HHS relies on the OMB geographic boundaries that were in effect when a jurisdiction was initially funded as an EC. For all newly eligible areas, the boundaries are based on current OMB MSA boundary definitions.

https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/penalties-waivers-program-letter.pdf

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An EC must have between 500-999 cumulative AIDS cases during the most recent five years. Cumulative AIDS cases are reported and confirmed by the Director of the CDC as of December 31 of the most recent calendar year. States with jurisdictions classified as an EC are eligible to apply for these funds. ECs continue their eligibility for these funds as long as the statutory incidence requirements during the most recent period of five calendar years and prevalence level for three consecutive years have been met.

Areas are notified by letter when they are at risk of losing eligibility.

The following states are eligible to apply for EC formula awards and they are responsible for applying for the eligible MSAs below:

States Emerging Communities*

Alabama Birmingham-Hoover, AL MSA

California Bakersfield, CA MSA

Delaware Philadelphia-Camden - Wilmington, PA-NJ-DE-MD MSA

Florida Lakeland-Winter Haven, FL MSA Port St. Lucie, FL MSA North Port-Bradenton-Sarasota, FL MSA

Georgia Augusta-Richmond County, GA-SC MSA

Kentucky Louisville/Jefferson County, KY-IN MSA

Mississippi Jackson, MS MSA

New York Albany-Schenectady-Troy, NY MSA Buffalo-Cheektowaga-Niagara Falls, NY MSA Rochester, NY

MSA

North Carolina Raleigh, NC MSA

Ohio Cincinnati, OH-KY-IN MSA

Oklahoma Oklahoma City, OK MSA

Pennsylvania Pittsburgh, PA MSA

Rhode Island Providence-Warwick, RI-MA MSA

South Carolina Columbia, SC MSA Charleston-North Charleston, SC MSA

Virginia Richmond, VA MSA

Wisconsin Milwaukee-Waukesha-West Allis, WI MSA

Total: 16 States Total: 21 Emerging Communities

*The list of RWHAP Part B ECs uses the most recent MSA names pursuant to OMB Bulletin 20-

01. Only the EC MSA names have been updated; the MSA codes and boundaries remain the same. Source: https://www.whitehouse.gov/wp-content/uploads/2020/03/Bulletin-20-01.pdf.

The AIDS cases for determining eligibility have been reported to and confirmed by the director of the CDC, based on the boundaries that were in effect when the EC first received funding.

2. Cost Sharing/Matching

Cost sharing/matching is required for this program as described below.

Section 2617(d)(3) of the PHS Act indicates that matching funds are required from states https://www.whitehouse.gov/wp-content/uploads/2020/03/Bulletin-20-01.pdf

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with more than one percent of the total HIV cases reported to the CDC during the previous two FYs (i.e., 2020 and 2021). A state can meet its match requirement through non-federal cash or in-kind resources, which can be provided either directly or through donations to the state from public or private entities, in proportion to the RWHAP Part B/ADAP funding. The same eligible funds can be used to meet both a recipient’s state match requirement and the Maintenance of Effort (MOE) requirement. The match begins at $1 in non-federal funds for every $5 in federal funds and increases to $1 in non-federal funds for every $2 in federal funds in later years (Section 2617(d)(1) of the PHS Act). If required, the state match, inclusive of the rate of the match, is listed on the Notice of Award (NOA). A state/territory may request a reduction in the award amount if unable to meet the match requirement.

State/territory matching funds for ADAP Supplemental awards are required in an amount equal to $1 for each $4 of federal funds provided in the supplemental grant award (Section 2618(a)(2)(F)(ii)(III) of the PHS Act). A state/territory is eligible for a waiver from the match requirement for ADAP Supplemental funding if it also has a state match requirement for the RWHAP Part B Formula/ADAP Base funding, and has met that match requirement. A state/territory may also request a reduction in the ADAP Supplemental award amount if unable to meet the match requirement.

The RWHAP Part B MAI awards are exempt from the matching requirements. EC funds are not exempt from matching requirements.

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.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates), an application is submitted more than once prior to the application due date, HRSA will only accept the applicant’s 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.

Maintenance of Effort The RWHAP Part B/ADAP funds are not intended to be the sole source of support for HIV care and treatment services in the states and territories. Grant funds shall not be used to take the place of current funding for activities described in the application. By signing the 2022 Agreements and Assurances (Appendix A) and the SF-424 application, the recipient agrees to maintain non-federal funding for HIV-related activities at a level which is not less than expenditures for such activities during the FY prior to receiving the award (as authorized by Section 2617(b)(7)(E) of the PHS Act). The Maintenance of Effort (MOE) requirement is important in ensuring that RWHAP funds are used to supplement existing state expenditures for HIV-related care and treatment services and to prevent RWHAP

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Part B/ADAP funds from being used to offset specific HIV-related budget reductions at the state level. Agreements and Assurances for subsequent years will be provided through the non-competing continuation process.

To demonstrate compliance with the MOE provision, states and territories must maintain adequate systems for consistently tracking and reporting on HIV-related expenditure data from year to year. The system must define the methodology used, be written and auditable, and must ensure that federal funds do not supplant state spending, but instead expand and enrich HIV-related activities. Complete the MOE information and submit as Attachment 5.

HRSA will consider any application that fails to satisfy the requirement to provide MOE information non-responsive and will not consider it for funding under this notice.

Note: Multiple applications are not allowable.

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.

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, etc.

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)).

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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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 90 pages when printed by HRSA. The page limit includes the project and budget narratives, some 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 the standard form "Project Abstract Summary.” Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-22- 033, 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) will not be counted in the page limit. It is therefore important to take appropriate measures to ensure the application does not exceed the specified page limit. Any application exceeding the page limit of 90 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.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of this 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).

c. Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachments 10-12: Other Relevant Documents.

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

Temporary Reassignment of State and Local Personnel during a Public Health Emergency

Section 319(e) of the PHS Act provides the Secretary of HHS with discretion upon request by a state or tribal organization to authorize the temporary reassignment of state, tribal, and local personnel during a declared federal public health emergency. The temporary reassignment provision is applicable to state, tribal, and local public health department or agency personnel whose positions are funded, in full or part, under PHS programs and allows such personnel to immediately respond to the public health emergency in the affected jurisdiction. Funds provided under the award may be used to support personnel who are temporarily reassigned in accordance with § 319(e). Please reference detailed

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information available on the HHS Office of the Assistant Secretary for Preparedness (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

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), please include the following:

i. 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.

For information content required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 Application Guide.

In addition, the abstract should include the following information:

A general overview of the HIV epidemiology in the state/territory including demographics and the geography of the epidemic;

A general description of the HIV service delivery system in the state/territory, including what services are available, where those are located, and how clients access those services; and

A general description of the ADAP, including number of clients served, medication and health care coverage assistance program models, and any program limitations currently in place or anticipated in the upcoming budget period.

As noted in the SF-424 Application Guide, the project abstract must be single-spaced and limited to one page.

ii. Project Narrative This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory 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:

(A) FY 2022 Part B Base Grant Application

(B) FY 2022 ADAP Base Grant Application

(C) FY 2022 ADAP Supplemental Grant Application

(D) FY 2022 Emerging Community (EC) Grant Application.

For each header section listed above, use the following subheadings:

• Introduction

• Needs Assessment

• Methodology

• Work Plan

• Resolution of Challenges

• Evaluation

• Organization Information http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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(A) FY 2022 Part B Base Grant Application

The instructions for completing the Part B Base grant application are divided into two sections. Each applicant should only complete the applicable section. The sections are specific to the following two groups:

The 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands and Guam.

The Republic of the Marshall Islands, Federated States of Micronesia, Republic of Palau, American Samoa and Commonwealth of the Northern Mariana Islands.

1. This Section is to be completed by the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands and Guam only.

INTRODUCTION --

This section should briefly describe how the state/territory will utilize RWHAP Part B Base grant funds in support of a comprehensive continuum of high-quality care and treatment for people with HIV.

NEEDS ASSESSMENT

1) HIV/AIDS Epidemiology: The purpose of this section is to briefly describe the HIV/AIDS epidemic in the state/territory. Section 2617(b)(2) of the PHS Act states that the application for RWHAP Part B Base funds shall contain a determination of the size and demographics of the population of people with HIV in the state.

Please note that both the Epidemiology table and narrative should be included as Attachment 9.

a) Table Summarize in a table format the HIV (non-AIDS) and AIDS cases by age, sex, race/ ethnicity, and exposure category through December 31, 2020. Place the table in Attachment 9 of the application and clearly label the data sources.

b) Narrative Based on the most recent state/territory HIV/AIDS epidemiologic profile, provide a brief narrative description of any trends or changes in the age, sex, race/ethnicity, and exposure categories for prevalent cases and for cases newly diagnosed and reported in the previous two years for which data are available. Place the narrative in Attachment 9 of the application.

2) Needs Assessment and Public Advisory Planning Process: The purpose of this section is to describe the Needs Assessment process and ensure that public health agencies receiving RWHAP Part B/ADAP grants have established a public advisory planning process that includes public hearings, as required by Section 2617(b)(7)(A) of the PHS Act.

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a) Needs Assessment

i) Briefly describe any current or planned needs assessment, including the geographic and population scope of the needs assessment, who participates in the process, and how participation from people with HIV.

ii) Briefly describe how planned needs assessments will contribute to the Integrated HIV Prevention and Care Plan, including the SCSN due in December 2022.

b) Public Advisory Planning Process

i) Describe the state/territory’s HIV Public Advisory Planning process model (e.g., integrated care and prevention, statewide or regional, consortia). Please indicate the number and affiliations of the participating parties, including people with HIV, other RWHAP recipients, other HIV related programs, other general and local stakeholders, and community leaders.

ii) If the RWHAP planning entity is not integrated with the CDC HIV Planning Group currently, please indicate what plans exist to integrate and/or what collaborative activities occur currently between the groups.

3) HIV Care Continuum: The ultimate goal of HIV treatment is to achieve viral suppression.