HAB-HRSA-24-062-(P06)-Part-C-Capacity-Final_modified.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

HIV/AIDS Bureau

Division of Community HIV/AIDS Programs

Ryan White HIV/AIDS Program Part C Capacity Development Program

Funding Opportunity Number: HRSA-24-062

Funding Opportunity Type(s): New

Assistance Listing Number: 93.918

Application Due Date: April 16, 2024 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

We will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: February 16, 2024

Modified March 20, 2024 to clarify multiple applications from the same UEI are not allowed.

See section III. Multiple Applications

Brian Fitzsimmons Public Health Advisor HIV/AIDS Bureau Call: 301-845-9820 Email: AskPartCCapacity@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 USC § 300ff-54(c)(1)(B) (Title XXVI, § 2654(c)(1)(B) of the Public Health Service Act) mailto:AskPartCCapacity@hrsa.gov

HRSA-24-062 Part C Capacity i

508 COMPLIANCE DISCLAIMER

Persons using assistive technology may not be able to fully access information in this file. For assistance, email or call one of the HRSA staff listed in Section VII Agency Contacts.

SUMMARY

Funding Opportunity Title: Ryan White HIV/AIDS Program Part C Capacity Development Program

Funding Opportunity Number: HRSA-24-062

Assistance Listing Number: 93.918

Due Date for Applications: April 16, 2024

Purpose: To strengthen organizational infrastructure to respond to the changing health care landscape and to increase capacity to develop, enhance, or expand access to high-quality HIV primary health care services for low-income and underserved people with HIV.

Program Objective(s): The Part C Capacity Development Program supports one short-term activity that can be completed by the end of the one-year period of performance.

Eligible Applicants: • Public or private, non-profit entities

• Community-based organizations

• Tribal (governments, organizations)

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

Anticipated FY 2024 Total Available Funding:

$9,000,000

Estimated Number and Type of Award(s):

Up to 60 grants

Estimated Award Amount: Up to $150,000 per award subject to the availability of appropriated funds

HRSA-24-062 Part C Capacity ii

Cost Sharing or Matching Required:

No

Period of Performance: September 1, 2024, through August 31, 2025 (1 year)

Agency Contacts: Business, administrative, or fiscal issues:

Bria Haley Grants Management Specialist HRSA Division of Grants Management Operations, Office of Federal Assistance Management Email: BHaley@hrsa.gov

Program issues or technical assistance:

Brian Fitzsimmons Public Health Advisor Division of Community HIV/AIDS Programs, HIV/AIDS Bureau Email: AskPartCCapacity@hrsa.gov

Application Guide

You (the applicant organization / agency) are responsible for reading and complying with the instructions included in this NOFO and in HRSA Application Guide (Application Guide). Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

HRSA has scheduled the following webinar:

Day: Tuesday, March 5, 2024 Time: 2 – 4 p.m. ET Weblink: https://hrsa-gov.zoomgov.com/j/1619131538?pwd=ak9BaW5mRVhpZC8rQWtxbytSbFEwQT09 Meeting ID: 161 913 1538 Passcode: SKTdZ6eQ

Attendees without computer access or computer audio can use the following dial-in information.

Call-In Number: 833-568-8864 US Toll-free Meeting ID: 161 913 1538 Passcode: 82151360

We will record the webinar and make available on the TargetHIV Center website at https://targethiv.org/library/nofos.

mailto:BHaley@hrsa.gov mailto:AskPartCCapacity@hrsa.gov http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://hrsa-gov.zoomgov.com/j/1619131538?pwd=ak9BaW5mRVhpZC8rQWtxbytSbFEwQT09 https://hrsa-gov.zoomgov.com/j/1619131538?pwd=ak9BaW5mRVhpZC8rQWtxbytSbFEwQT09 https://targethiv.org/library/nofos

HRSA-24-062 Part C Capacity 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 OR 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. 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: PAGE LIMIT WORKSHEET

HRSA-24-062 Part C Capacity 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program (RWHAP) Part C Capacity Development Program.

The purpose of this program is to strengthen organizational capacity to respond to the changing health care landscape and increase access to high-quality HIV primary health care services for low-income and underserved people with HIV.

Funding will support one short-term activity that can be completed by the end of the one-year period of performance. You may propose an expansion of an activity previously supported under FY 2022 or FY 2023 RWHAP Part C Capacity Development Program funding (HRSA-22-019; HRSA-23-052) or RWHAP Part D Supplemental funding (HRSA-22-037; HRSA-22-156: HRSA-23-050) for either an HIV Care Innovation or Infrastructure Development activity; however, HRSA will not fund the same activity in FY 2024 as HRSA funded previously in FY 2022 or FY 2023. If the proposed project is an expansion of a previously funded activity, you must provide a clear rationale for how the proposed activity builds upon and furthers the objectives of the previously funded HIV Care Innovation or Infrastructure Development activity. You may select only one (1) activity under the selected category.

HIV Care Innovation1

HIV Care Innovation activities support progress along the HIV care continuum to improve the health and increase the life spans of people with HIV and prevent new infections. If applying under this category, select only one of the four activities listed:

• Streamlining RWHAP eligibility

• Inclusive care for underrepresented communities with disproportionately high rates of HIV

• Intimate partner violence screening and counseling

• Coordination or integration of HIV primary care with oral health and/or behavioral health care

Infrastructure Development

Infrastructure Development activities support organizational development and will increase the capacity of organizations to respond to changes in the health care environment. If applying under this category, select only one of the three activities listed:

• Emergency preparedness

1 See Program Requirements and Expectations for more details.

https://www.hrsa.gov/grants/find-funding/hrsa-21-058 https://www.hrsa.gov/grants/find-funding/hrsa-22-019 https://www.hrsa.gov/grants/find-funding/hrsa-22-037 https://www.hrsa.gov/grants/find-funding/hrsa-22-156 https://www.hrsa.gov/grants/find-funding/HRSA-23-050 https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/

HRSA-24-062 Part C Capacity 2

• Telehealth

• Office dental equipment for expanding dental capacity

The selected activity should serve priority populations that are disproportionately impacted by the HIV epidemic and experience adverse health outcomes. Successful applicants will demonstrate the organization’s intent and ability to sustain proposed HIV Care Innovation activities or proposed Infrastructure Development enhancements without additional federal funds beyond the one-year period of performance.

Furthermore, successful applicants will demonstrate that the proposed activity will strengthen organizational capacity to respond to the changing health care landscape and increase access to high-quality HIV primary health care services for low-income people with HIV.

2. Background

The RWHAP Part C Capacity Development Program is authorized by 42 USC § 300ff- 54(c)(1)(B) (Title XXVI, § 2654(c)(1)(B) of the Public Health Service (PHS) Act).

The HRSA 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 awards 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 priority 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 (TA);

clinical training; and the development of innovative interventions and strategies for HIV care and treatment to respond to emerging needs of RWHAP clients.

An important framework in the RWHAP is the HIV care continuum, which is comprised of 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, but 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 required 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.

https://ryanwhite.hrsa.gov/ http://ryanwhite.hrsa.gov/deliverhivaidscare/habperformmeasures.html

HRSA-24-062 Part C Capacity 3

Strategic Frameworks and National Objectives

National objectives and strategic frameworks like Healthy People 2030, the National HIV/AIDS Strategy (NHAS) (2022–2025); 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 provide 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 the extent possible.

Expanding the Effort: Ending the HIV Epidemic in the United States

As demonstrated by recent data from the 2021 Ryan White HIV/AIDS Program Services Report (RSR), the RWHAP has made tremendous progress toward ending the HIV epidemic in the United States. From 2017 to 2021, 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 85.9 percent to 89.7 percent. Additionally, racial and ethnic, age-based, and regional disparities reflected in viral suppression rates have significantly decreased.[1]

The Ending the HIV Epidemic in the U.S (EHE) initiative was launched to further expand federal efforts to reduce HIV infections. 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 and in care but not yet virally suppressed, to the essential HIV care, treatment, and support services needed to help them reach viral suppression.

Using Data Effectively: Integrated Data Sharing and Use

HRSA and the Centers for Disease Control and Prevention (CDC) Division of HIV 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

[1] Health Resources and Services Administration. Ryan White HIV/AIDS Program Annual Client-Level Data Report 2021. https://ryanwhite.hrsa.gov/data/reports. Published December 2022. Accessed December 13, 2022.

https://health.gov/healthypeople https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 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://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2021.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2021.pdf 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 https://ryanwhite.hrsa.gov/data/reports

HRSA-24-062 Part C Capacity 4

• 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 NHAS 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 secure 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 United States 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.

HRSA’s RWHAP Compass Dashboard is an interactive data tool to allow users to visualize the reach, impact, and outcomes of the RWHAP and supports data utilization to understand outcomes and inform planning and decision making. The dashboard provides a look at national-, state-, and metro area-level data and allows users to explore RWHAP client characteristics and outcomes, including age, housing status, transmission category, and viral suppression. The RWHAP Compass Dashboard also visualizes information about RWHAP services received and the characteristics of those clients accessing the AIDS Drug Assistance Program (ADAP).

In addition, RWHAP recipients and subrecipients are encouraged to develop data sharing strategies with other RWHAP recipients and relevant entities to reduce administrative burden across programs. As outlined in Policy Clarification Notice 21-02, Determining Client Eligibility & Payor of Last Resort in the Ryan White HIV/AIDS Program, recipients and subrecipients should use electronic data sources (for example, Medicaid enrollment, state tax filings, enrollment and eligibility information collected from health care marketplaces) to collect and verify client eligibility information, such as income and health care coverage (that includes income limitations), when possible.

RWHAP recipients and subrecipients should first use available data sources to confirm client eligibility before requesting additional information from the client.

https://data.hrsa.gov/topics/hiv-aids/compass-dashboard https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf

HRSA-24-062 Part C Capacity 5

Program Resources and Innovative Models

HRSA has several projects and resources that may assist RWHAP recipients with program implementation. These include a variety of HRSA HIV/AIDS Bureau (HAB) projects focused on specific TA, evaluation, demonstration, and intervention activities. A full list is available on TargetHIV. Recipients should be familiar with these resources and are encouraged to use them as needed to support their program implementation.

Examples of these resources include:

• Access, Care, and Engagement Technical Assistance Center (ACE TA)

• Best Practices Compilation

• Center for Innovation and Engagement (CIE)

• Center for Quality Improvement and Innovation (CQII)

• Dissemination of Evidence-Informed Interventions (DEII)

• Using Evidence-Informed Interventions to Improve Health Outcomes among People Living with HIV (E2i)

• Ending Stigma through Collaboration and Lifting All to Empowerment (ESCALATE)

• Engage Leadership through Employment, Validation, and Advancing Transformation and Equity for persons with HIV (ELEVATE)

• Integrating HIV Innovative Practices (IHIP)

• AIDS Education Training Center Program – National Coordinating Resource Center

II. Award Information

1. Type of Application and Award

Application type: New

We will fund you via a grant.

2. Summary of Funding

We estimate $9,000,000 will be available to fund approximately 60 recipients. You may apply for a ceiling amount of up to $150,000 (reflecting direct and indirect costs).

The period of performance is September 1, 2024, through August 31, 2025 (1 year).

This program notice depends on the appropriation of funds. If funds are appropriated for this purpose, we will proceed with the application and award process.

45 CFR part 75 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards applies to all HRSA awards.

https://targethiv.org/help/ta-directory https://targethiv.org/ace https://targethiv.org/bestpractices https://targethiv.org/CIE https://targethiv.org/cqii https://targethiv.org/deii https://targethiv.org/deii https://targethiv.org/e2i https://targethiv.org/e2i https://targethiv.org/escalate https://targethiv.org/elevate https://targethiv.org/elevate https://targethiv.org/ihip https://targethiv.org/ta-org/aetc-ncrc https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75

HRSA-24-062 Part C Capacity 6

III. Eligibility Information

1. Eligible Applicants

You can apply if your organization is in the United States and is:

• Public or private, non-profit

• Community-based organization

• Tribal (governments, organizations)

Foreign entities are not eligible for this award. (§ 2652 of the PHS Act).

2. Cost Sharing or Matching

Cost sharing or matching is not required for this program.

3. Other

We may not consider an application for funding if it contains any of the following non-responsive criteria:

• Exceeds the funding ceiling amount; or

• Fails to satisfy the deadline requirements referenced in Section IV.4.

Maintenance of Effort

You must agree to maintain non-federal expenditures for early intervention services (EIS) (i.e., counseling of individuals with respect to HIV, high risk targeted HIV testing, referral and linkage to care, other clinical and diagnostic services related to HIV diagnosis, and the provision of therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from HIV) at a level equal to or greater than your total non-federal expenditures for EIS during the most recently completed fiscal year prior to the competitive application deadline.

Federal funds should add to, not replace, existing non-federal spending for such activities. Complete the Maintenance of Effort (MOE) information and submit as Attachment 8.

We will enforce statutory MOE requirements through all available mechanisms.

HRSA-24-062 Part C Capacity 7

Multiple Applications

We will only review your last validated application before the Grants.gov application due date of April 16, 2024.

IV. Application and Submission Information

1. Address to Request Application Package

We require you to apply online through Grants.gov. Use the SF-424 workspace application package associated with this notice of funding opportunity (NOFO). Follow these directions: How to Apply for Grants. If you choose to submit using an alternative online method, see Applicant System-to-System.

Note: Grants.gov calls the NOFO “Instructions.”

Select “Subscribe” and enter your email address for HRSA-24-062 to receive emails about changes, clarifications, or instances in which we republish the NOFO. You will also be notified by email of documents we place in the RELATED DOCUMENTS tab that may affect the NOFO and your application. You’re responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

Application Format Requirements Submit your information as the Application Guide and this program-specific NOFO state. Do so in English and express budget figures in U.S. dollars. There’s an Application Completeness Checklist in the Application Guide to help you.

Application Page Limit The total number of pages that count toward the page limit shall be no more than 30 pages when we print them. We will not review any pages that exceed the page limit.

Using the pages within the page limit, HRSA will determine eligibility using Section III.

Eligibility Information of the NOFO.

These items do not count toward the page limit:

• Standard Office of Management and Budget (OMB)-approved forms you find in the NOFO’s workspace application package

• Abstract (standard form (SF) "Project Abstract Summary”)

• Indirect Cost Rate Agreement

• Proof of non-profit status (Attachment 1)

If there are other items that do not count toward the page limit, we’ll make this clear in Section IV.2.vi Attachments.

https://www.grants.gov/ https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/system-to-system/applicant-system-to-system/

HRSA-24-062 Part C Capacity 8

If you use an OMB-approved form that is not in the HRSA-24-062 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-062 before the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals2 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project. That is, no federal department or agency has debarred, suspended, proposed for debarment, claimed you ineligible, or you have voluntarily excluded yourself from participating.

• If you fail to make mandatory disclosures, we may take an action like those in 45 CFR § 75.371. This includes suspending or debarring you.3

• If you cannot certify this, you must include an explanation in Attachments 10-15:

Other Relevant Documents.

(See Section 4.1 viii “Certifications” of the Application Guide)

Program Requirements and Expectations This section provides descriptions of the activities that you may select for funding. You may submit a proposal for only one of the following two categories: HIV Care Innovation or Infrastructure Development. You may select only one (1) activity under the selected category. You may propose an expansion of an activity previously supported under FY 2022 or FY 20023 RWHAP Part C Capacity Development Program funding (HRSA-22- 019; HRSA-23-052) or RWHAP Part D Supplemental (HRSA-22-037; HRSA-22-156;

HRSA-23-050) for either category; However, we will not accept applications that propose the same activity in FY 2024 that were funded previously under the NOFOs listed above.

HIV Care Innovation

• Streamlining RWHAP eligibility

Consistent with the efforts of HRSA’s HIV/AIDS Bureau (HAB) to implement best practices for facilitating rapid entry to HIV care and treatment, streamlined RWHAP eligibility seeks to minimize client burden by utilizing available data sources before requesting additional information from the client. Available sources of data that could verify eligibility may come from a variety of sources including health information exchanges, Medicaid enrollment, state tax filings, and enrollment and eligibility information collected from health care marketplaces.

2 See definitions at eCFR :: 2 CFR 180.995 -- Principal. and eCFR :: 2 CFR 376.995 -- Principal (HHS supplement to government-wide definition at 2 CFR 180.995).

3 See also 2 CFR parts 180 and 376, 31 U.S.C. § 3354, and 45 CFR § 75.113.

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371 https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371 https://www.hrsa.gov/grants/find-funding/HRSA-22-019 https://www.hrsa.gov/grants/find-funding/HRSA-22-019 https://www.hrsa.gov/grants/find-funding/HRSA-23-052 https://www.hrsa.gov/grants/find-funding/HRSA-22-037 https://www.hrsa.gov/grants/find-funding/HRSA-22-156 https://www.hrsa.gov/grants/find-funding/HRSA-23-050 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180/subpart-I/section-180.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376 https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title31-chapter33&edition=prelim https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-B/section-75.113

HRSA-24-062 Part C Capacity 9

Recent reports from RWHAP recipients and technical expert panels indicate some RWHAP recipients have begun to streamline their eligibility processes across their respective states, jurisdictions, and participating community-based organizations. Many HIV programs, including RWHAP recipients and subrecipients, could benefit from adopting best practices and understanding the facilitators and challenges to implementing such approaches.

• Intimate partner violence screening and counseling

There has been an increased risk of intimate partner violence (IPV) and other forms of trauma since the onset of the COVID-19 pandemic. If you select this activity, you should implement IPV screening and counseling in the clinical setting and establish referral networks to community-based social service organizations. The activity must address one or more of the stages of the HIV care continuum. For resources addressing this topic, access the IPV Toolkit (Intimate Partner Violence Health Partners Toolkit) located on the HRSA Office of Women's Health website.

• Coordination or integration of HIV primary care with oral health and/or behavioral health care

The National HIV/AIDS Strategy: 2022 – 2025 outlines the importance of improved coordination and integration of HIV primary care with other services. Integration between oral health care or behavioral health care services (including mental health services) and primary care can help improve health outcomes for people with HIV and reduce HIV-related disparities and health inequities.

You may select this activity to coordinate or integrate behavioral health care to support the need and access to behavioral and mental health services for people with HIV. Applicants can develop strategies, policies, and procedures to improve care coordination and integration of HIV primary care with oral health and/or behavioral health care. Specific activities may include: developing policies and procedures to facilitate onsite provision of oral health care or behavioral health services; training staff to understand workflow and processes; and, developing policies and procedures to track and coordinate referrals for oral health care or behavioral health services.

The proposed activity must address one or more of the stages of the HIV care continuum. Hiring clinical staff is not allowable as part of this activity.

• Inclusive Care for underrepresented communities with disproportionately high rates of HIV

This activity will focus on educating health care professionals and front-line service staff about the health and social needs of underrepresented https://www.hrsa.gov/about/organization/bureaus/owh/intimate-partner-violence-human-trafficking-community-level#ipvtoolkit https://www.hrsa.gov/office-womens-health https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025

HRSA-24-062 Part C Capacity 10 communities with disproportionately high rates of HIV, such as transgender people with HIV, and how the provision of inclusive care can reduce HIV-related disparities and health inequities in this population. If you select this activity, you should implement inclusive care, education, and training in the clinical setting, and establish collaborative networks with other educational and training programs and community-based social service organizations serving underrepresented communities. The activity must address at least one of the following two educational and training components critical to inclusive care for underrepresented communities with disproportionately high rates of

HIV:

1. Didactic Training and Education: Activities in this category should include training and education for clinical and administrative personnel on topics such as cultural competency, stigma, discrimination, and implicit bias, which can affect the quality of care and health outcomes. Additionally, educational content should address the social determinants of health, medical and pharmacological management of underrepresented communities with disproportionately high rates of HIV, such as transgender people with HIV. For mental health and psychosocial service providers, learning activities may also include training and education on trauma-informed, person-centered care.

2. Model of Care Infrastructure and Clinical Application: Activities in this category should include activities that facilitate an inclusive infrastructure of care. Examples may include modifying existing electronic health records (EHR), medical intake, or registration forms to be more inclusive, tailoring systems and forms to collect sexual orientation and gender identity (SOGI) data, and integrating social determinants of health (SDOH) data into EHR systems.

Other activities may include other structural approaches such as integrating other services that support inclusive care, e.g., onsite pharmacy care, developing referral mechanisms and facilitating referrals to other medical and social support services that support person-centered care for underrepresented communities with disproportionately high rates of HIV, including transgender patients.

Finally, this activity may include strategies that create a more physically inclusive and supportive infrastructure.

HRSA-24-062 Part C Capacity 11

Infrastructure Development

• Emergency Preparedness

Investment in emergency preparedness can help build much needed capacity of safety net clinics to protect their vulnerable populations at risk during public health emergencies and natural disasters.

The Department of Health and Human Services (HHS) supports developing and strengthening the capabilities of health care systems, and their providers, to maintain services and continuity of care during public health emergences and medical disasters.

The areas of focus for this activity are to address the development of organizational assessments of vulnerability, creation of an emergency preparedness plan, staff training and evaluation through drills and exercises, and identification of and collaboration with the local emergency management planners. The activity should result in the development of an implementation plan/toolkit and/or policies and procedures for effective preparation and response to natural disasters (e.g., hurricanes, floods, tornadoes) and public health emergencies (e.g., disease outbreaks) that will maintain continuity of operations and result in minimal interruption to care and treatment for people with HIV. For resources addressing this topic, access the HHS Administration for Strategic Preparedness and Response (ASPR) website; ASPR’s 2022-2026 Health Care Preparedness and Response Capabilities Report, and the ECRI Institute website.

• Telehealth

The ability of patients to access care remotely though telehealth modalities continues to increase. Since telehealth technology allows for care delivery without regard to distance and without the need to travel, this modality can help improve access to quality health care for patients in rural/remote areas and patients that are hard-to-reach.

HRSA’s Office for the Advancement of Telehealth defines telehealth as “the use of electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, health administration, and public health.” This definition includes patient counseling and case management. Telehealth also includes clinical activities such as mHealth, telehomecare, remote monitoring, e-health, and tele-ICUs.

If you select this activity, you must develop and acquire, through lease or purchase, computer hardware and software, audio and video equipment, computer network equipment, interactive equipment, data terminal equipment, and/or other equipment that furthers the objectives of the proposed telehealth activity. You must describe technology requirements https://www.phe.gov/about/aspr/Pages/default.aspx https://www.phe.gov/about/aspr/Pages/default.aspx https://www.phe.gov/about/aspr/Pages/default.aspx https://www.ecri.org/components/CCRM/Pages/SafEnv7.aspx https://www.ecri.org/components/CCRM/Pages/SafEnv7.aspx https://www.hrsa.gov/telehealth https://digital.ahrq.gov/ahrq-funded-projects/use-mhealth-technology-supporting-symptom-management-underserved-persons-living

HRSA-24-062 Part C Capacity 12 and each type of equipment to be employed. Include a concise description of the equipment’s relevance to the project, its cost-effectiveness, timeliness, accuracy of care, and ease of use. Discuss the telehealth reimbursement environment and whether Medicare, Medicaid, and/or private insurance in your state(s) cover telehealth services. For resources addressing this topic, access HRSA’s National Consortium of Telehealth Resource Centers or HRSA Telehealth Programs.

• Dental Equipment for Expanding Dental Service Capacity

If you select this activity, you must purchase dental equipment for the purpose of developing, enhancing, or expanding oral health care services for people with HIV. Specifically, this activity involves creating or expanding a dental operatory in a clinic or in a mobile unit (e.g., van) through purchasing such equipment as dental patient chairs, sterilization units, X-ray imaging instruments, dental operating lights, operatory cabinets, hand pieces, etc.). Purchase of a van is not allowable under this activity.

Program-Specific Instructions Include application requirements and instructions from Section 4 of the Application Guide (budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract). Also include the following:

i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form that you’ll find in the workspace application package. Do not upload the abstract as an attachment or it may count toward the page limit. For information you must include in the Project Abstract Summary Form, see Section 4.1.ix of the Application Guide.

NARRATIVE GUIDANCE

The following table provides a crosswalk between the narrative language and where each section falls within the review criteria. Make sure you’ve addressed everything. We may consider any forms or attachments you reference in a narrative section during the merit review.

Narrative Section Review Criteria

Introduction Criterion 1: NEED

Organizational Information Criterion 5: RESOURCES/CAPABILITIES

Need Criterion 1: NEED

Approach Criterion 2: RESPONSE https://www.telehealthresourcecenter.org/ https://www.telehealthresourcecenter.org/ https://www.telehealthresourcecenter.org/ https://www.hrsa.gov/rural-health/telehealth

HRSA-24-062 Part C Capacity 13

Narrative Section Review Criteria

Work Plan Criterion 2: RESPONSE Criterion 4: IMPACT

Resolution of Challenges Criterion 2: RESPONSE

Evaluation and Technical Support Capacity

Criterion 3: EVALUATIVE MEASURES

Criterion 5: RESOURCES/CAPABILITIES

Budget Narrative Criterion 6: SUPPORT REQUESTED

ii. Project Narrative

This section must describe all aspects of the proposed project. Make it brief and clear.

Provide the following information in the following order. Please use the section headers.

This ensures reviewers can understand your proposed project.

Introduction -- Corresponds to Section V’s Review Criterion(a) #1 Need

Clearly indicate the activity proposed under either HIV Care Innovation or Infrastructure Development. Briefly describe the purpose of the proposed activity. Clearly indicate the category under which the proposed activity falls: 1) HIV Care Innovation or 2) Infrastructure Development. Discuss why your local community and/or organization needs capacity development funds and how the proposed activity will develop, enhance, or expand access to high quality HIV primary care services for low income, uninsured, and underserved people with HIV. If the proposed activity is an expansion of a previously funded activity, clearly describe how the proposed activity builds upon and furthers the objectives of the previously funded activity in maximizing impact.

ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion #5 Resources/Capabilities

This section will help reviewers understand whom you will serve with the proposed project.

Describe the organizational skills, capabilities, and resources, including staff that will contribute to your organization’s ability to carry out the proposed activity.

Highlight key staff with relevant expertise and experience with similar work. This information should align with the staffing plan provided in Attachment 6 and the biographical sketches of key personnel provided in Attachment 4.

Describe the organizational resources that will be used to sustain, without additional federal funds, the project activities, and/or enhancements supported by this award beyond the one-year period of performance. In addition, describe your experience with the fiscal management of grants and contracts. Include information on your organization’s experience managing multiple federal awards.

HRSA-24-062 Part C Capacity 14

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

For HIV Care Innovation activities, clearly describe and document the priority population(s) and their unmet health care needs. More specifically, describe how the affected population(s) is disproportionately affected by the HIV epidemic and has poor health outcomes. Additionally, describe the service needs based on your evaluation of the gaps in the HIV care continuum for your priority population(s) with HIV that your organization serves. Provide data on the five stages of the HIV care continuum for your target population(s) with HIV using the most recent three calendar years of available data. You must clearly define the numerator and the denominator for each stage. Use the same numerators and denominators as outlined for the HHS HIV Core Indicators.

Regarding the Streamlining RWHAP Eligibility activity, discuss the administrative, policy, technological, service-related, and systemic challenges that affect the adoption and/or optimal application of promoting efficiencies to streamline RWHAP client eligibility determination and confirmation; reduce administrative burden of clients, recipients, and subrecipients; and increase client satisfaction.

Describe the method(s) you will use to conduct a local/regional systems assessment of RWHAP recipient organizations, care delivery systems, income based federal programs (e.g., health information exchanges; Medicaid;

Supplemental Nutrition Program for Women, Infants and Children; Healthy Start;

etc.), and/or state or local health care marketplaces to identify current administrative systems, electronic data sources, and tools utilized to determine client eligibility, confirm eligibility, and obtain client consent. Discuss how you will promote sharing and collaboration across all RWHAP parts and others who engage in the peer-to-peer information exchange.

For Infrastructure Development activities, clearly describe the gaps in organizational capacity that exist due to current limitations in system infrastructure.

Include alterations you have made to the current service delivery system and how lessons learned will be applied to this activity. Provide information specific to the selected activity and describe how these gaps or limitations are affecting the optimal provision of quality HIV primary care services and/or affecting your organization’s ability to optimize your response to the changing health care landscape.

Regarding Emergency Preparedness, discuss your organization’s current capacity for responding to emergencies including public health emergencies, disaster preparedness, and continuity of operations. Include any recent capacity needs assessed in carrying out or continuing operations during a recent natural disaster or a public health emergency such as the COVID-19 pandemic. If you received funding under the FY2020 Coronavirus Aid, Relief and Economic Security (CARES) Act, discuss any impact of those awards on your organization’s ability to maintain operations during emergency or disaster recovery. Discuss any https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/core-measures.pdf https://ryanwhite.hrsa.gov/grants/coronavirus/fy-2020-cares-act-funding-ryan-white-hivaids-program-recipients https://ryanwhite.hrsa.gov/grants/coronavirus/fy-2020-cares-act-funding-ryan-white-hivaids-program-recipients

HRSA-24-062 Part C Capacity 15 lessons learned or assessments of your organization’s ability to operate under such conditions and how these funds will be utilized to improve current capacity.

APPROACH -- Corresponds to Section V’s Review Criteria #2 Response

Provide detailed information regarding the proposed methods that you will use to address the stated needs described in the needs section. In addition, provide information regarding involvement of people with HIV in the activity, collaboration and coordination efforts, and sustainability plans as follows:

• Involvement of People with HIV: People with HIV who receive services at a RWHAP-funded organization should be actively involved in the development, implementation, and evaluation of program and clinical quality management (CQM) activities. Describe how you will engage people with HIV and/or organizations that represent them in the implementation of this activity, including decision-making.

• Collaboration and Coordination: In describing the methods by which you will implement the activity, outline the partners and/or collaborating entities needed for this proposed activity, if applicable. Identify the tasks each partner proposes to perform and the amount of funding, if any, you expect to allocate to the partner. Include letters of agreement and/or memoranda of understanding from each partner and/or collaborating entity as Attachment 9.

• Sustainability: Describe how you will maintain the efforts set forth in this activity after the period of federal funding ends. For example, describe how you will support the maintenance of systems, the continuation of personnel time and effort on proposed activities, continued training of new staff, updates to workflows, policies, and procedures, etc. In addition, describe how you intend to share or disseminate relevant information and/or products developed through the funded activity and lessons learned with other providers in the community and/or collaborators to this project.

WORK PLAN -- Corresponds to Section V’s Review Criterion #2 Response, #4 Impact and #6 Support Requested

A work plan is a concise, easy-to-read overview of your goals, strategies, objectives, activities, timeline, outcomes, and staff responsible for implementing the program. You must submit the detailed work plan for the 12-month period of performance of September 1, 2024 – August 31, 2025. Describe the activity’s goal, specify the objectives, and identify the key action steps that you will use to achieve the proposed goal. Use a timeline that includes each step of the proposed activity and target date for each step’s completion and identifies staff responsible for the activities. Identify the measures you will use to evaluate success for each action step.

HRSA-24-062 Part C Capacity 16

The work plan should detail the expected outcomes to demonstrate the impact of the project’s activity. The expected outcomes can include changes in knowledge, awareness, attitudes, skills, behaviors, practices, or more. The outcomes must address at least one or more of the stages of the HIV care continuum. As appropriate, identify meaningful support and collaboration with key partners in planning, designing, and implementing all activities.

Please provide the above information in a table format with the following sections outlined: goal, objectives, action steps, timeline, person responsible, evaluation measures, and outcomes. Submit the work plan as Attachment 7

RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criteria #2 Response

Discuss challenges you are likely to encounter in the planning and implementation of your proposed HIV Care Innovation or Infrastructure Development project, including the impact of COVID-19 on organizational operations and proposed activities.

Describe the specific activities or strategies you will use to mitigate or resolve anticipated challenges in implementing your proposed activity.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion(a) #3 Evaluative Measures and #5 Resources/Capabilities

Describe the systems and processes you will use to track measures and evaluate progress toward meeting the goals and objectives of the proposed activities.

Explain how you will use data to improve service delivery. More specifically, address the following:

• Data Collection and Management: Describe the systems and processes that will support your organization’s monitoring of the proposed activity, including performance measures and outcomes. Include a description of how your organization will collect, manage, and analyze data (e.g., assign skilled staff, data management systems, and software).

• Project Evaluation: Describe the evaluation plan that will monitor ongoing processes and progress toward the goals and objectives of the proposed activity. Describe the plan for the program performance evaluation that will contribute to continuous quality improvement. Describe how you will share evaluation results internally with program staff and externally with key stakeholders (including people with HIV) to improve program implementation and outcomes.

If applicable, provide a brief description of the CQM program, how supplemental CQM activities are linked to the overarching RWHAP CQM work, and other resources devoted to CQM.

HRSA-24-062 Part C Capacity 17

iii. Budget

The Application Guide directions may differ from those on Grants.gov.

Follow the instructions in Section 4.1.iv Budget of the Application Guide and any specific instructions listed in this section. Your budget should show a well-organized plan.

Reminder: The total project or program costs are all allowable (direct and indirect) costs used for the HRSA activity or project. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement (which includes MOE for those projects that propose HIV Care…