hrsa-025-060 FINAL.pdf

Notice of Funding Opportunity

Application due March 18, 2025

HIV AIDS Bureau (HAB) Division of Policy and Data

Addressing Stigma to End the HIV Epidemic in the U.S.

Opportunity number: HRSA-025-060

Contents Before you begin 4

Step 1: Review the Opportunity 5

Basic information 6

Eligibility 8

Program description 10

Award information 19

Step 2: Get Ready to Apply 24

Get registered 25

Find the application package 25

Application writing help 25

Step 3: Prepare Your Application 27

Application contents and format 28

Step 4: Learn About Review and Award 39

Application review 40

Selection process 46

Award notices 46

Step 5: Submit Your Application 47

Application submission and deadlines 48

Application checklist 49

Step 6: Learn What Happens After Award 51

Post-award requirements and administration 52

Contacts and Support 55

Contents 2

Endnotes 58

Contents 3

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks)

You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days)

You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date

Applications are due by 11:59 p.m. Eastern Time on March 18, 2025.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 4 https://sam.gov/ https://grants.gov/

Jump to a step

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 6

Eligibility 8

Program description 10

Award information 19

Basic information Health Resources and Services Administration (HRSA)

HIV AIDS Bureau (HAB)

Division of Policy and Data

Adapting interventions and providing national training to eliminate stigma in HIV care, treatment, and prevention.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

Addressing Stigma to End the HIV Epidemic in the U.S.

Opportunity number:

HRSA-25-060

Announcement version:

New

Federal assistance listing:

93.928, 93.242, 93.939

Statutory authority: 42 USC § 300ff-101 (§ 2691 of the Public Health Service Act);

42 USC § 301, as amended;

42 USC §§ 247(b)(k)(2) and 317(k)(2), as amended; and Consolidated Appropriations Act, 2024, Pub. L. 118-47, Division D, title II.

Key dates

NOFO issue date: January 16, 2025 Informational webinar:

February 12, 2025 Application deadline: March 18, 2025 Expected award date is by:

August 1, 2025 Expected start date:

September 1, 2025 See other submissions for other time frames that may apply to this NOFO.

Summary The Health Resources and Services Administration (HRSA), in partnership with the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), will fund one organization to serve as an Implementation, Capacity, and Evaluation Provider (also known as the “recipient” throughout this NOFO) to increase access to stigma-free, high-quality care, treatment, and prevention services for people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV in the U.S. This funding opportunity is supported by the HRSA Ryan White HIV/AIDS Program (RWHAP) Part F: Special Projects of National Significance (SPNS) Program. Funding supports an implementation science approach to adapt, implement, and evaluate the implementation of anti-stigma interventions. It also builds upon previous and current projects to address stigma that have been funded and supported by HRSA’s HIV/AIDS Bureau (HAB); the NIH Office of AIDS Research; the NIH National Institute of Mental Health’s Division of AIDS Research; and the CDC National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention’s Division of HIV Prevention.

Over the four-year period of performance, the recipient will:

• Deliver national anti-stigma training to HIV care, treatment, and prevention organizations.

• Develop and conduct an evaluation of the national anti-stigma training. Identify evidence-informed, anti-stigma interventions that will be adapted and implemented by demonstration sites.

• Select, monitor, and support approximately 20 demonstration sites to serve as subrecipients who will implement the selected anti-stigma intervention(s).

• Systematically provide, track, measure, and report technical assistance (TA) to the demonstration sites; and ensure fidelity to core components of the selected intervention(s).

Step 1: Review the Opportunity 6

• Develop and conduct a mixed-methods, multi-site evaluation grounded in implementation science (as defined in this NOFO) to assess demonstration sites’ implementation including adaptations, barriers and facilitators, implementation strategies, and costs, among other (effectiveness) outcomes.

• Develop and implement a communications and dissemination plan for the program, including the creation of user-friendly, multimedia materials that appeal to various audiences.

Please refer also to the Program Requirements and Expectations.

Funding details Application Types: New

Expected total available funding in FY 2025: $4,250,000

Expected number and type of awards: One (1) Cooperative Agreement

Funding range per award: $4,250,000 (Year 1), $6,000,000 per year (Years 2-4)

We plan to fund awards in four (4) 12-month budget periods for a total 4-year period of performance of September 1, 2025 to August 31, 2029. You can request up to $4,250,000 (Year 1) and up to $6,000,000 each year (Years 2 – 4).

The program and awards depend on the appropriation of funds and are subject to change based on the availability and amount of appropriations.

Step 1: Review the Opportunity 7

Eligibility Who can apply You can apply if your organization is a domestic public or private nonprofit entity.

Types of eligible organizations These types of domestic* organizations may apply:

• Public institutions of higher education

• Private institutions of higher education

• Non-profits with or without a 501(c)(3) IRS status

• State, county, city, township, and special district governments, including the District of Columbia, domestic territories, and freely associated states

• Independent school districts

• Public housing authorities/Indian housing authorities

• Native American tribal governments

• Native American tribal organizations

* “Domestic” means 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.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria Completeness and responsiveness criteria We will review your application to make sure it meets these basic requirements to move forward in the competition.

We will not consider an application that:

• Is from an organization that does not meet all eligibility criteria.

• Requests funding above the award ceiling shown in the funding range.

• Is submitted after the deadline.

Application limits You may not submit more than one application. If you submit more than one application, we will only accept the last on-time submission.

Step 1: Review the Opportunity 8

Cost sharing This program has no cost-sharing requirement. If you choose to share in the costs of the project, we will not consider it during merit review. We will hold you accountable for any funds you add, including through reporting.

Step 1: Review the Opportunity 9

Program description Purpose The Addressing Stigma to End the HIV Epidemic in the U.S. program will leverage expertise and resources of HRSA, NIH, and CDC to accomplish the goal of increasing access to stigma-free, high-quality care, treatment, and prevention services for people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV in the U.S. HRSA will fund one recipient to serve as the Implementation, Capacity, and Evaluation Provider who will deliver training and work with demonstration sites (subrecipients) to use an implementation science approach to adapt, implement, evaluate, and disseminate anti-stigma interventions that address social, structural, and organizational causes of stigma and discrimination.

The objectives of this program are to:

• Strengthen and promote a culture of anti-stigma across HHS-funded organizations that provide HIV care, treatment, and prevention services.

• Increase the availability and dissemination of tools that HIV care, treatment, and prevention organizations (including those that provide RWHAP and Ending the HIV Epidemic in the U.S. (EHE) initiative recipients and subrecipients) can adopt and adapt to address stigma within their organizations.

• Increase utilization of evidence-informed anti-stigma interventions within HIV care, treatment, and prevention organizations.

• Reduce stigmatizing practices and behaviors among providers and staff at HIV care, treatment, and prevention organizations to improve outcomes.

Refer also to the Program requirements and expectations.

Overview HHS and its agencies are committed to identifying and addressing the challenges that keep people from using available HIV care, treatment, and prevention services. Among these challenges are HIV-related stigma, which CDC defines as “negative attitudes and beliefs about people with HIV…prejudice that comes with …being part of a group that is believed to be socially unacceptable”.[1],[2] HHS is working to address stigma through its programs and initiatives, including within the EHE and the National HIV/AIDS Strategy (NHAS). The time is ripe for leveraging a focused and coordinated HHS response that builds on the latest scientific evidence for stigma measurement,[3] anti-stigma and discrimination interventions to improve HIV outcomes,[4],[5] and implementation science approaches[6] to move these into practice.

Step 1: Review the Opportunity 10

Stigma and discrimination can negatively affect the health and well-being of people with HIV. Stigma has been documented as a factor that results in reduced awareness of HIV status, access to antiretroviral therapy (ART), adherence to ART for reaching durable viral suppression, and engagement in care. Stigma can also negatively affect disproportionately affected populations by resulting in suboptimal HIV testing, access, and uptake of HIV prevention services (e.g., Pre-Exposure Prophylaxis or PrEP), and adoption of prevention strategies.

An HHS-focused and coordinated effort to address stigma is a fundamental part of an “all of government and all of society strategy to end HIV in the U.S.”[7] In response and in collaboration with NIH and CDC, HRSA will award one organization to serve as the Implementation, Capacity, and Evaluation Provider to deliver national anti-stigma training to care, treatment, and prevention organizations (including RWHAP and EHE recipients and subrecipients). The recipient will fund approximately 20 demonstration sites to implement anti-stigma interventions and conduct a multi-site evaluation using an implementation science approach. The recipient will also provide TA to sites and disseminate user-friendly replication products.

Key Definitions For the purposes of this project, the following definitions will be used:

• Stigma:[8] Stigma is a social phenomenon that involves negative attitudes (prejudices) or beliefs (stereotypes) about others typically, but not always, based on defining characteristics. Stigma and the process of stigmatization consists of identifying and labeling a “difference,” linking a labeled person to undesirable characteristics, and separating “them” from “us.”

• HIV care services: All HIV primary medical care, medications, and essential support services allowed through the RWHAP.[9]

• Pre-Exposure Prophylaxis (PrEP): Medicine (pills or shots) that reduces your chance of getting HIV. See also Preventing HIV with PrEP.

• Post-Exposure Prophylaxis (PEP): Medicine that prevents HIV after a possible exposure. See also Preventing HIV with PEP.

• Implementation science is the study of methods to promote or improve the systematic uptake of effective intervention strategies by public health practice, program, and policy. Intervention strategies may occur at the system, community, organization, and individual levels. At HRSA HAB, successful intervention strategies positively impact health and quality of life for people with HIV. One specific model chosen to guide this project is the Stigma Reduction Logic Model.

• Intervention strategies: HRSA HAB categorizes interventions into three levels based on evidence of demonstrated effectiveness. The three levels are collectively known as “intervention strategies” and include:

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 11 https://www.cdc.gov/hiv/prevention/prep.html https://www.cdc.gov/hiv/prevention/pep.html https://pubmed.ncbi.nlm.nih.gov/35703774/

◦ Evidence-based interventions: Interventions that are demonstrated to effectively improve health and/or quality of life, based on published research.

These interventions meet the CDC criteria for being evidence-based.

◦ Evidence-informed interventions: Interventions that are demonstrated to effectively show promise, based on published research. Evidence-informed interventions may demonstrate impact and strength of evidence without meeting CDC methodological criteria for being evidence-based.

◦ Emerging interventions: Innovative practices that have not yet been published or do not have extensive evaluation data but have effectively improved health and/or quality of life.

• Implementation strategies: Methods or techniques used to enhance the adoption or uptake of interventions in specific settings.

• Culturally responsive care: Services that are culturally grounded, attuned, and sensitive to the unique needs of each client and their cultural background. See:

Cultural Competence in Health and Human Services.

• Integrated care: Clinicians’ careful coordination of HIV primary care, mental health care, and supportive services. Clinicians work together systematically and use a multidisciplinary approach to ensure clients receive one consistent message about care and treatment and are included in the treatment planning processes.

See the Substance Abuse and Mental Health Services Administration’s 2023-2026 Strategic Plan.

• Out of care or experiencing barriers to retention in care:

◦ Newly diagnosed within the past 12 months, or

◦ Diagnosed with HIV (more than six months ago) but not fully engaged in care either by:

◦ Not attending at least two HIV medical care encounters at least 90 days apart within a 12-month measurement year (see HAB performance measure).

◦ Being at risk of disconnecting from care by missing their last appointment in the last six months, leaving incarceration, or having another high-risk factor.

◦ Not being virally suppressed—defined as having a viral load of 200 copies/mL or more—at the time of enrollment (see HAB performance measure).

Program requirements and expectations To achieve the objectives stated in the purpose section, you are encouraged to propose innovative strategies through key partnerships and collaborations to address the following:

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 12 https://npin.cdc.gov/pages/cultural-competence-health-and-human-services https://www.samhsa.gov/about-us/strategic-plan https://www.samhsa.gov/about-us/strategic-plan https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio/core-measures/annual-retention-in-care https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio/core-measures/hiv-viral-load-suppression

Anti-stigma training As the recipient, you will deliver national, anti-stigma trainings in English and Spanish to HIV care, treatment, and prevention organizations (including organizations that provide RWHAP and EHE services). You will:

• Tailor relevant components of existing anti-stigma trainings to develop the training curriculum.

• Collaborate with individuals from organizations that could receive the training to finalize the content and select appropriate training locations and training dates.

Training provided under this cooperative agreement must use or enhance existing curricula whenever possible. You should consider jurisdictional HIV data when determining regional training locations to ensure trainings are offered in service areas where there is maximum potential to increase the participation of people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV in the U.S.

• Develop a training recruitment, outreach, and marketing plan that will ensure diverse representation among the organizations that serve people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV in the U.S. (e.g., geographic, facility type, urban/rural, provider type, model of care, population(s) served, etc.).

• Select organizations that will participate in the anti-stigma trainings. You will need to prioritize participant selection from EHE jurisdictions, when possible. HRSA expects at least one training will be conducted during the first project year.

• Recruit, select, and train individuals who will serve as training facilitators.

Consider training facilitator recruitment factors such as lived experience with and representation from priority populations.

• Provide logistical support, as needed, for people with lived experience who need special financial considerations to attend in-person trainings (e.g., people who may not have credit cards to use for up-front costs of attending in-person trainings).

Anti-stigma interventions You will identify appropriate anti-stigma interventions that will be adapted and implemented by demonstration sites. Interventions will be community-centered and take a whole person comprehensive care approach to address social, structural, and organizational causes of stigma. Any interventions selected for this project must be evidence-informed, as defined in this NOFO. Successful applicants will describe a plan that includes, within the first six months of the project start date:

Step 1: Review the Opportunity 13

• Research and identify relevant evidence-informed anti-stigma interventions. In addition to scanning existing interventions, you should consult subject matter experts, including people with lived experience.

• Develop and follow an intervention selection protocol. At minimum, the selection criteria must consider appropriateness for addressing stigma experienced by people who are out of care. You should prioritize interventions that are theory-based[10] and appropriate for implementation within the U.S. and those that demonstrate successful integration of service delivery and research.

• Create an intervention inventory of resources to support implementation of the selected intervention(s).

• Adapt the selected intervention(s), as necessary for use by the demonstration sites.

• Conduct a cost analysis of the selected intervention(s) to include the labor and programmatic costs incurred by each demonstration site. This information will be used to inform feasibility for future replication in other health care, treatment, and prevention settings.

• Throughout the entire period of performance, we expect you to promote integration and sustainability of key elements of the strategies that are effective in improving anti-stigma practices and or/lead to improved outcomes for people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV in the U.S.

Demonstration site support If awarded, you are expected to fund approximately 20 demonstration sites (as subrecipients) to implement the anti-stigma interventions described above.

Specifically, you will:

• Develop and implement a process to request competitive proposals.

• Select and award demonstration sites, ensuring diverse representation (i.e., geographic, facility type, urban/rural, provider type, model of care, population(s) served, etc.). You will also ensure the selected sites have the organizational capacity and ability to feasibly adapt and implement the selected anti-stigma intervention(s).

• Conduct all fiscal, administrative, and programmatic monitoring to ensure sites remain on track with implementation and evaluation activities, and ensure sites remain compliant with federal regulations and program expectations.

• Develop and implement a site visit protocol to guide the content and focus of annual site visits to demonstration sites. At minimum, site visit areas of focus should include fiscal, administrative, evaluation, and programmatic.

Step 1: Review the Opportunity 14

• Monitor the demonstration sites (e.g., through site visits, etc.) to ensure fidelity to the core elements of the anti-stigma intervention(s), including the core elements of the selected intervention(s). Monitoring through site visits also serves as an opportunity to collect and document thorough information on intervention adaptations and implementation strategies, as well as barriers and facilitators to implementation.

• Assess the TA and training needs of sites and deliver TA and trainings that are tailored to the selected intervention(s) and the sites’ needs and ensures fidelity to the core elements of the intervention(s). You will develop a system for tracking and reporting key TA elements.

• Ensure sites maintain the capacity to implement core elements of the selected intervention(s). Additionally, if/when there is turnover of project staff within the demonstration site, you will ensure a process is in place to train new staff on implementing the selected intervention(s).

• Plan, coordinate logistics, host, and deliver convenings for the demonstration sites. The purpose of these peer-focused meetings is to foster knowledge sharing, learning, and innovation across the project. Each year, at least one multi-day convening should be held in person in the Washington, DC metropolitan area. At least two representatives from each demonstration site will be expected to participate in the multi-site convenings.

• Assist sites with developing sustainability plans, including budget projections for continued program integration and ongoing activities after the funding period ends. You will also work with the sites to identify risks to sustainability and mitigation strategies to address the risks if they occur.

Evaluation You will assess components of the national, anti-stigma training. You will also conduct a multi-site evaluation for the cohort of demonstration sites. The evaluation will assess implementation and effectiveness outcomes. The evaluation plan will be grounded in a validated implementation science framework and the Stigma Reduction Logic Model.

You will:

Anti-stigma training evaluation

• Evaluate the training to identify efficacy in reducing barriers and stigma facilitators within multiple (e.g., social/structural, organizational, and individual) domains.

• Evaluate participant comprehension, skill acquisition, behavior changes, and motivational intent to apply the training content in their professional capacity. You should include any existing tools you will use to evaluate the training.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 15 https://pubmed.ncbi.nlm.nih.gov/35703774/

Multi-site evaluation

• Receive appropriate ethics approval for conducting your evaluation.

• Include in-depth, validated qualitative and quantitative components in your evaluation that are site-specific.

• Include implementation, service, and client outcomes as well as program outputs in your evaluation plan.

• Demonstrate the replicability, sustainability, and uptake of the selected anti-stigma intervention(s).

• Conduct an evaluation that supports a better understanding of:

◦ How stigma and discrimination affect the realities of people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV. You should also evaluate how anti-stigma intervention improve their health outcomes.

◦ Adaptations to make anti-stigma interventions easier for uptake and effective in changing outcomes.

◦ Barriers, facilitators, and costs associated with implementing anti-stigma interventions.

◦ TA needed to help sites implement anti-stigma interventions.

• Electronically receive, securely store, and maintain de-identified client-level data collected and reported by demonstration sites. This includes establishing data sharing or business use agreements with the demonstration sites. You will coordinate efforts to assure the quality, completeness, privacy, and confidentiality of the data submitted, collected, and stored meets all applicable laws and regulations. You will also coordinate efforts of the demonstration sites to assure the privacy and confidentiality of participants’ protected health information.

• Support all demonstration sites to develop, review, and refine site-specific logic models.

• Provide training and ongoing support to demonstration sites and conduct ongoing monitoring of data collection and data quality. You will also provide technical input, oversight, and support to sites to complete any required institutional review board (IRB), or other regulatory approvals needed to collect and report evaluation data to you.

Program-specific measures

• Capture client demographics, biomedical and behavioral health indicators, barriers and facilitators to implementation, indicators of stigma reduction, and other measures proposed in collaboration with federal partners. These data must be accurate and submitted on time.

Step 1: Review the Opportunity 16

• At minimum, your evaluation plan will assess the following program-specific measures:

◦ Number and demographics of the national anti-stigma training participants (English and Spanish).

◦ Knowledge and skill of the national anti-stigma training participants.

◦ Extent to which training participants are prepared and committed to making individual- and organizational-level (if applicable) changes, post-training.

◦ Demonstration site characteristics.

◦ Barriers and facilitators to start-up, implementation, and sustainability of the interventions.

◦ Type and degree of adaptation needed to implement the intervention(s) while maintaining fidelity.

◦ Implementation costs for each intervention used.

◦ Impacts of the intervention(s) by stigma domain (i.e., individual, interpersonal, organizational, community, policy).

◦ Impact of the intervention(s) on the intended population’s enacted/perceived stigma and behaviors; mediators of stigma-related behavior, organization, and systems changes.

◦ Sources of stigma.

◦ Effects of stigma on participants and organizations involved in the project.

Communications and dissemination As the funded recipient, you will develop and implement a communications and dissemination plan for the project. Specifically, you will:

• Identify and incorporate existing education and training materials, tools, clinical guidelines, and resources from federal agencies, national medical and professional associations, and partners.

• Form a publication and dissemination committee, consisting of recipient staff, federal staff (i.e., HRSA, NIH, and CDC), and demonstration site representatives to generate study questions, topics for presentations and publications, concept sheets and analyses, and an overall dissemination plan for the project’s products.

Develop a communications and dissemination plan, to include:

◦ A dissemination work plan and timeline for replication materials and evaluation findings. The timeline will include developing and disseminating materials throughout the period of performance and not just at the end of the project. The goal is to promote real-time learning and dissemination of best practices. The timeline should incorporate the time needed for federal and subject matter expert review.

Step 1: Review the Opportunity 17

◦ An outline of methods and processes that will be used to create, review, promote, and distribute materials and strategies that advance replication of successful interventions from this project.

◦ Priority audiences, which should include HIV care, treatment, and prevention providers; clinicians; RWHAP and EHE program leaders; and communities impacted by HIV. Other audiences could include administrative staff and policymakers.

◦ Plans to present with demonstration sites at the National Ryan White Conference on HIV Care and Treatment Conferences (NRWC) and other NIH-and CDC-sponsored conferences. For the NRWC, each demonstration site will be responsible for including travel costs, ground transportation, per diem, and hotel accommodations within its own individual budget; you will not provide these travel costs for sites.

• Create user-friendly, multimedia dissemination materials that appeal to various audiences. These products will include practical guidance to support replication of the approaches implemented by the sites and may include manuscripts to describe the design and outcomes of the project. We also expect you to promote capacity-building for similar HIV care, treatment, and prevention organizations (not engaged in this project) that are interested in implementing the selected anti-stigma intervention(s).

• Disseminate reports, products, and implementation materials according to the plan, making sure materials are disseminated in real-time, throughout the project lifecycle, when feasible.

• Collaborate with HRSA to develop and maintain project-specific webpages on TargetHIV.org. Upon completion of the project, all dissemination products will be hosted on this website and linked through the HRSA RWHAP Best Practices Compilation. In addition to the public website, a secure, password-protected shared location (e.g., SharePoint) for demonstration sites and recipient, HRSA, NIH, and CDC staff will be created and maintained during the project to host the project’s working files.

• Collaborate with national and regional RWHAP AIDS Education and Training Centers (AETCs) and CDC-funded capacity and training programs to optimize the potential for replication of these comprehensive integrated HIV care interventions.

Community-centered activities The recipient and demonstration sites will include collaborations with community members, people with lived experience, and any other partners (e.g., people from the intended audiences) to increase the acceptability and feasibility of the trainings and intervention(s) and the relevance and usefulness of any products developed for this

Step 1: Review the Opportunity 18 program. Although each site’s approach should be tailored for the specific needs of their communities or organizations, each approach should be developed with the goal of replicability in other organizations with similar needs.

In addition, you will recruit individuals with lived experience, service providers who will use the materials or support the anti-stigma activities, evaluators, researchers, and other stigma subject matter experts to guide and support the goals of your proposed project. These individuals will be involved at all stages of the project to include planning, implementation, and evaluation. The coalition should have some interaction with the project dissemination committee.

You are responsible for managing communications about the project with your partners and the demonstration sites (your subrecipients). All subrecipients must report to you (the award recipient) and are held to the same federal award requirements. You must ensure that any compensation for community involvement is consistent with PCN 16-02, RWHAP Services: Eligible Individuals and Allowable Use of Funds, the Supporting Community Engagement in the RWHAP Program Letter, and relevant federal regulations and public policy requirements.

Award information Cooperative agreement terms Our responsibilities Aside from monitoring and technical assistance, we also get involved in these ways:

• Assisting you with the coordination of efforts to plan, develop, and implement the various phases of the project.

• Collaborating, reviewing, and providing feedback on the activities, documentation, procedures, measures, and tools established and implemented for accomplishing the goals of the cooperative agreement throughout the duration of the project. This includes reviewing and providing input on written documents, including information and materials to support the activities conducted through the cooperative agreement, prior to submission for publication or public circulation.

• Participating in the planning and development of project activities, including in-person or virtual meetings, during the period of performance.

• Participating, as appropriate, in conference calls, meetings, and TA sessions that are conducted during the period of performance.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 19 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/hab-community-engagment-program-letter.pdf

• Facilitating the availability and expertise of other appropriate offices within HRSA, NIH, CDC, as well as other relevant federal agencies in the planning, development, and implementation of the project.

• Participate in the dissemination of project activities, products, findings, best practices, evaluation data, and other information developed as part of this project for the broader health care community. This includes dissemination of results (e.g., formal or informal presentations to internal and external partners, presentations at national or regional conferences).

• Helping you circulate project findings, best practices, and lessons learned from the project.

Your responsibilities You must follow all relevant laws and policies. Your other responsibilities will include:

• Completing activities proposed in this NOFO.

• Meeting with the HRSA project officer within three weeks after award, and on mutually agreed upon future dates, to review the current strategies and ensure the project and goals align with HRSA priorities for this activity.

• Providing ongoing, timely communication and collaboration with the HRSA project officer, to include reviewing your activities, work plans, procedures, budget items, contracts, and interagency agreements information and publications prior to circulation.

• Providing the HRSA project officer with the opportunity to review, provide input, and clear project products, as needed. This includes information and materials to support the activities conducted through the cooperative agreement, from the start as part of concept development and including the review of drafts and final products prior to submission for publication or public circulation.

• Obtaining appropriate public-use intellectual property rights in all existing training and other materials, which reserves for the government a royalty-free, non-exclusive, and irrevocable right to reproduce, publish, or otherwise use the work for Federal purposes, and to authorize others to do so.

• Providing HRSA with a complete, updated, and accessible copy of all federally supported materials, including online content, prepared under this cooperative agreement in an electronic zip file format on an annual basis for the duration of the period of performance.

• Collaborating with HRSA and other partners as necessary to plan, execute, and evaluate the project activities.

• Developing and compiling project strategies and tools into replicable products (e.g., workflows, protocols, toolkits, manuscripts, etc.) for dissemination and use by RWHAP and other HHS recipients and subrecipients.

Step 1: Review the Opportunity 20

• Disseminating the project’s products through social media, federally-supported websites (i.e., HRSA, NIH, and CDC), and various regional and national outlets including TargetHIV.org and the RWHAP Best Practices Compilation.

• Disseminating the project’s accomplishments, results from project evaluation activities, and other pertinent information nationally.

• Integrating into the project any new priorities, and when appropriate, considerations from technical expert reports, meeting convenings, and other relevant sources during the period of performance.

• Assuring the appropriate review, approval, and renewal of all multi-site evaluation instruments and documents by an identified IRB.

• Coordinating and leading the logistics for at least one in-person national multi-site meetings with the demonstration sites in each of the four years of the project in the Washington, DC metropolitan area.

• Participating in NRWCs.

• Assisting HRSA with information dissemination to partners upon request.

• Establishing contacts relevant to the project’s goals, such as with federal and non-federal partners and other HRSA, NIH, and CDC projects.

• Assuring all administrative, fiscal, data, and performance reports, as designated by HRSA, are completed, and submitted on time.

• Responding timely to requests made by HRSA for information related to project activities.

Funding policies and limitations Policies

• We will only make awards if this program receives funding. If Congress appropriates funds for this purpose, we will move forward with the review and award process.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Your satisfactory progress in meeting the project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If we receive more funding for this program, we may:

◦ Fund more applicants from the rank order list.

◦ Extend the period of performance.

◦ Award supplemental funding.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 21 https://targethiv.org/ https://targethiv.org/bestpractices

General limitations

• For guidance on some types of costs we do not allow or restrict, see Project

Budget Information in Section 3.1.4 of the Application Guide. You can also see 45 CFR part 75, or any superseding regulation, General Provisions for Selected Items of Cost.

• You cannot earn profit from the federal award. See 45 CFR 75.400(g).

• Congress’s current appropriations act includes a salary limitation, which applies to this program. As of January 2025, the salary rate limitation is $225,700. This limitation may be updated.

Program-specific statutory or regulatory limitations You cannot use funds under this notice for the following:

• Develop new stigma interventions;

• Charges that are billable to third party payers (e.g., private health insurance, prepaid health plans, Medicaid, Medicare);

• To directly provide medical or support services (e.g., HIV care, counseling, and testing) that supplant existing services;

• Cash payments to intended recipients of RWHAP services;

• Purchase or construction of new facilities or capital improvements to existing facilities;

• Purchase or improvement to land;

• Fundraising expenses or lobbying activities and expenses;

• Syringe Services Programs (SSPs) that have not received HRSA’s prior approval or are not in compliance with HHS and HRSA policy. See https://www.aids.gov/ federal-resources/policies/syringe-services-programs/;

• To develop materials designed to directly promote or encourage intravenous drug use or sexual activity;

• PrEP or PEP medications or related medical services. (Please note that RWHAP recipients and sub-recipient providers may provide prevention counseling and information to eligible clients’ partners – see RWHAP and PrEP Program Letter, November 16, 2021); and/or

• International travel.

See Manage Your Grant for other information on costs and financial management.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 22 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75#75.400 https://www.aids.gov/federal-resources/policies/syringe-services-programs/ https://www.aids.gov/federal-resources/policies/syringe-services-programs/ https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.pdf https://www.hrsa.gov/grants/manage-your-grant

Indirect costs Indirect costs are costs you charge across more than one project that cannot be easily separated by project. For example, this could include utilities for a building that supports multiple projects.

To charge indirect costs you can select one of two methods:

Method 1 – Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency at the time of award.

Method 2 – De minimis rate. Per 2 CFR 200.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is 15% of modified total direct costs (MTDC). See 2 CFR 200.1 for the definition of MTDC. You can use this rate indefinitely.

Program income Program income is money earned as a result of your award-supported project activities. You must use any program income you generate from awarded funds for approved project-related activities. Find more about program income at 45 CFR 75.307.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 23 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307

Step 2:

Get Ready to Apply

In this step

Get registered 25

Find the application package 25

Application writing help 25

Get registered SAM.gov You must have an active account with SAM.gov to apply. This includes having a Unique Entity Identifier (UEI). SAM.gov registration can take several weeks. Begin that process today.

To register, go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist to find out what you’ll need to register.

When you register or update your SAM.gov registration, you must agree to the financial assistance general certifications and representations. You must agree to those for grants specifically, as opposed to contracts, because the two sets of agreements are different. You will have to maintain your registration throughout the life of any award.

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-25-060.

After you select the opportunity, we recommend that you click the Subscribe button to get updates.

Application writing help Visit HHS Tips for Preparing Grant Proposals.

Visit HRSA’s How to Prepare Your Application page for more guidance.

See Apply for a Grant for other help and resources.

FAQs will be posted on our TA webpage after the webinar

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 25 https://sam.gov/content/entity-registration https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application/assurances-non-construction-programs https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application/assurances-non-construction-programs https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/search-grants https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant

Join the webinar For more information about this opportunity, join the webinar on February 12, 2025, at 4:00 pm ET.

If you are not able to join through your computer, you can call in:

• Phone number: (833) 568-8864

• Meeting ID: 161 211 4866

We will record the webinar. If you are not able to join live, you can replay it at HRSA HAB NOFO Announcements on TargetHIV.org.

Have questions? Go to Contacts and Support.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 26 https://hrsa-gov.zoomgov.com/meeting/register/vJIsdeipqjMsHEb4ZM-0028MmihvlQDDJNI https://targethiv.org/library/nofos https://targethiv.org/library/nofos

Step 3:

Prepare Your Application

In this step

Application contents and format 28

Application contents and format Applications include five main components. This section includes guidance on each.

Application page limit: 60 pages.

Submit your information in English and express whole number budget figures using U.S. dollars.

Make sure you include each of these:

Components Submission format

Project abstract Use the Project Abstract Summary form.

Project narrative Use the Project Narrative Attachment form.

Budget narrative Use the Budget Narrative Attachment form.

Attachments Insert each in the Attachments form.

Other required forms Upload using each required form.

Required format You must format your narratives and attachments using our required formats for fonts, size, color, format, and margins. See the formatting guidelines in Section 3.2 of the Application Guide.

Project abstract Complete the information in the Project Abstract Summary form. Include a short description of your proposed project. Include the needs you plan to address, the proposed services, and the population groups you plan to serve. For more information, see Section 3.1.2 of the Application Guide.

Project narrative In this section, you will describe all aspects of your project. Project activities must comply with the non-discrimination requirements.

Use the section headers and the order listed.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 28 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=24 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13

Introduction See merit review criterion 1: Need

• Briefly describe the purpose of your project.

• Provide a clear and succinct description of your ability to successfully meet and carry out program requirements and expectations.

• Briefly summarize the following areas of your proposal:

◦ Anti-stigma training evaluation plan;

◦ Multi-site evaluation plan;

◦ Cost analysis plan;

◦ Your plan for supporting dissemination activities and replication; and

◦ TA services that you will provide to the demonstration sites.

Need See merit review criterion 1: Need

• Describe the problem you will address with your proposed activities.

• Describe how you’ll assess the unique needs of the people who live in the communities your project will serve.

• Describe any unmet stigma training needs among HIV care, treatment, and prevention organizations.

• Tell us how you will select the specific locations where the project will be implemented and what needs will be addressed for those communities.

• Use and cite demographic data whenever possible.

Approach See merit review criterion 2: Response

• Tell us how you’ll address your stated needs and meet each of the program objectives, requirements, and expectations described in this NOFO. Include any innovative methods you will use to address the stated needs.

• Describe your plan to disseminate reports, products, or project outputs to partner audiences.

Anti-stigma training

• Share which components of existing anti-stigma trainings you plan to use to develop the training curriculum. What process will you take to select the most relevant components to include?

Step 3: Prepare Your Application 29

• Tell us how you will collaborate with individuals from organizations that could receive the training to finalize the content and select appropriate training locations and training dates.

• How will you determine regional training locations to ensure trainings are offered in service areas where there is maximum potential to increase the participation of people who have yet to be successfully maintained in HIV care and those who experience higher rates of HIV in the U.S.?

• Describe how you will recruit, select, and prioritize who will participate in the trainings.

• Tell us how you will recruit, select, and train individuals who will serve as training facilitators.

• Share your plan to provide logistical support, as needed, to people with lived experience who need special financial considerations to attend in-person trainings.

Anti-stigma interventions

• Tell us how you will develop and follow your intervention selection protocol and how you will prioritize those interventions that are appropriate for implementation within the U.S. and those that demonstrate successful integration of service delivery and research.

• How will you create an intervention inventory or resources to support implementation of the selected intervention(s)?

• Describe what you will do to adapt the selected intervention(s), as necessary for use by the…