HRSA-22-019 (P06) Part C Capacity final.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

HIV/AIDS Bureau Division of Community HIV/AIDS Programs

Ryan White HIV/AIDS Program Part C Capacity Development Program

Funding Opportunity Number: HRSA-22-019

Funding Opportunity Type: New Assistance Listings (AL/CFDA) Number: 93.918

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: February 15, 2022

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

HRSA will not approve deadline extensions for lack of registration.

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

Issuance Date: December 14, 2021

Cypriana Fowell Chief, Northeastern Branch Telephone: (301) 443-2602 Fax: (301) 443-1839 Email: CFowell@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 USC § 300ff-54(c)(1)(B) (§ 2654(c)(1)(B) of the Public Health Service Act).

mailto:CFowell@hrsa.gov

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508 Compliance Disclaimer

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

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB), Division of Community HIV/AIDS Programs is accepting applications for the fiscal year (FY) 2022 Ryan White HIV/AIDS Program (RWHAP) Part C Capacity Development Program. The purpose of this program is 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.

This notice is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds in a timely manner. You should note that this program may be cancelled before award.

Funding Opportunity Title: FY 2022 Ryan White HIV/AIDS Program

Part C Capacity Development Program

Funding Opportunity Number: HRSA-22-019 Due Date for Applications: February 15, 2022 Anticipated Total Available FY 2022 Funding:

$4,000,000

Estimated Number and Type of Award(s): Up to 50 grants

Estimated Award Amount: Up to $150,000 Cost Sharing/Match Required: No Period of Performance: September 1, 2022 through

August 31, 2023 (1 year)

Eligible Applicants: Public and nonprofit private entities, faith-based and community-based organizations and tribes and tribal organizations are eligible to apply for these funds.

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

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Application Guide

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

Technical Assistance

HRSA has scheduled the following technical assistance:

Day and Date: Thursday, January 13, 2022 Time: 2 p.m. – 4 p.m. ET Call-In Number: 833-568-8864 US Toll-free Meeting ID: 161 103 2272 Passcode: 24041013 Weblink: https://hrsa-gov.zoomgov.com/j/1611032272?pwd=UE85ajJ4aDMzTU4vcU5MWURzYnUwdz09

The webinar will be recorded and made available on the TargetHIV Center website at https://targethiv.org/library/nofos.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa-gov.zoomgov.com/j/1611032272?pwd=UE85ajJ4aDMzTU4vcU5MWURzYnUwdz09 https://hrsa-gov.zoomgov.com/j/1611032272?pwd=UE85ajJ4aDMzTU4vcU5MWURzYnUwdz09 https://targethiv.org/calendar/2020-Ryan-White-Conference https://targethiv.org/library/nofos

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Table of Contents

I. Program Funding Opportunity Description

1. PURPOSE

2. BACKGROUND

II. Award Information

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. Eligibility Information

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION and Submission Information

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

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

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

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. Application Review Information

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. Award Administration Information

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. Agency Contacts

VIII. Other Information

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I. Program Funding Opportunity Description

1. Purpose

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 under this program is intended to 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 2020 or FY 2021 RWHAP Part D Supplemental (HRSA-20-068; HRSA-21-059) or Part C Capacity Development funding (HRSA-20-067; HRSA-21-058), however, HRSA will not fund the same activity in FY 2022 as HRSA funded previously in FY 2020 or FY 2021. If the proposed project is an expansion of a previously funded activity, you will be required to 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 Innovation HIV Care Innovation activities support progress along the HIV care continuum to improve the health and increase the life span of people with HIV and prevent new infections. There are four (4) activities from which to choose. If applying under this category, select only one of the four activities listed below:

• Community Health Workers

• Integration of HIV Primary Care with Oral Health and/or Behavioral Health

• Rapid Antiretroviral Therapy (ART)

• Transitioning Youth into Adult HIV 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. There are three (3) activities from which to choose. If applying under this category, select only one of the three activities listed below:

• Office Dental Equipment for Expanding Dental Service Capacity

• Emergency Preparedness

• Telehealth

Collectively, activities will allow applicants to better align with priority areas for the U.S. Department of Health and Human Services (HHS) and HRSA, including investing in mental health, addressing the opioid crisis, and promoting collaboration. The selected activity should target populations disproportionately affected by the HIV https://www.hrsa.gov/grants/find-funding/hrsa-20-068 https://www.hrsa.gov/grants/find-funding/hrsa-21-059 https://www.hrsa.gov/grants/find-funding/hrsa-20-067 https://www.hrsa.gov/grants/find-funding/hrsa-21-058

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epidemic and who have poor health outcomes. Successful applicants will demonstrate your 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 and underserved people with HIV.

According to statute, HRSA shall give preference in making awards for this program to entities that provide primary care services in rural areas or to underserved populations.

You can find more information about these preferences in Section V of this notice of funding opportunity (NOFO).

2. Background

This program is authorized by 42 USC § 300ff-54(c)(1)(B) (§ 2654(c)(1)(B) of the Public Health Service Act).

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

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

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

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

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

Strategic Frameworks and National Objectives

National objectives and strategic frameworks like the Healthy People 2030, the 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 http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html https://health.gov/healthypeople https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2021-2025 https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2021-2025 https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html

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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 organizations’ 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

According to recent data from the 2020 Ryan White Services Report (RSR), the RWHAP has made tremendous progress toward ending the HIV epidemic in the United States. From 2016 to 2020, 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 84.9 percent to 89.4 percent.

Additionally, racial/ethnic, age-based, and regional disparities reflected in viral suppression rates have significantly decreased.1 For example, the disparity in viral suppression rates between Black/African American and White clients has decreased since 2010.2 These improved outcomes mean more people with HIV in the United States will live near normal lifespans and have a reduced risk of transmitting HIV to others.3

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

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

1 Health Resources and Services Administration. Ryan White HIV/AIDS Program Annual Client-Level Data Report 2020. http://hab.hrsa.gov/data/data-reports. Published December 2021. Accessed December 2, 2021.

2 Viral suppression among Black/African American clients went from 81.3 percent in 2016 to 86.7 percent in 2020, while viral suppression for White clients increased from 89.4 percent - in 2016 to 92.5 percent in 2020; therefore the gap in viral suppression between these two groups decrease from 8.1 percentage points different to 5.8 percentage points different.

3 National Institute of Allergy and Infectious Diseases (NIAID). Preventing Sexual Transmission of HIV with Anti-HIV Drugs. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US).

2000- [cited 2016 Mar 29]. Available from: https://clinicaltrials.gov/ NCT00074581 NLM Identifier:

NCT00074581.

https://hab.hrsa.gov/sites/default/files/hab/data/datareports/RWHAP-annual-client-level-data-report-2020.pdf https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline http://hab.hrsa.gov/data/data-reports https://clinicaltrials.gov/

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Using Data Effectively: Integrated Data Sharing and Use

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

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

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

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

HRSA strongly encourages complete CD4, viral load (VL), and HIV nucleotide sequence reporting to the state and territorial health departments’ HIV surveillance systems to benefit fully from integrated data sharing, analysis, and utilization. State health departments may use CD4, VL, and HIV 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.

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

In addition, many RWHAP Special Projects of National Significance (SPNS) projects have demonstrated promising new approaches for linking and retaining priority populations into care. As resources permit, RWHAP recipients are encouraged to review and integrate these tools within their HIV system of care in accordance with the allowable service categories defined in Policy Clarification Notice (PCN) 16-02 Ryan http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf https://targethiv.org/help/ta-directory https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf

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White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds.

Examples of these resources include:

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

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

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

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

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

• Building Futures: Supporting Youth Living with HIV

• The Center for Engaging Black MSM Across the Care Continuum (CEBACC)

• Using Community Health Workers to Improve Linkage and Retention in Care https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf https://targethiv.org/e2i https://targethiv.org/e2i https://targethiv.org/ihip https://targethiv.org/library/replication-resources-spns-systems-linkages-and-access-care https://targethiv.org/deii https://targethiv.org/library/hrsa-hab-building-futures-supporting-youth-living-hiv https://targethiv.org/cebacc https://targethiv.org/chw

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Clinical Quality Management Section 2664(g)(5) of the Public Health Service Act requires RWHAP Part C recipients to implement a Clinical Quality Management (CQM) program to: (1) assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent HHS Guidelines for the treatment of HIV/AIDS and related opportunistic infections, and (2) as applicable, to develop strategies for ensuring that such services are consistent with the HHS guidelines for improvement in the access to and quality of HIV health services. Please see Policy Clarification Notice 15-02 Clinical Quality Management for information on CQM program requirements.

Social determinants of health (SDOH) are conditions in which people are born, grow, live, work, and age. They include factors like socioeconomic status, education, neighborhood and physical environment, community violence, employment, and social support networks, as well as access to health care. Intimate partner violence (IPV) is among these factors that can disproportionately affect underserved communities.

According to Centers for Disease Control and Prevention, National Intimate Partner and Sexual Violence Survey (NISVS), IPV describes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse, and can have both direct and indirect effects on individual, family, and community health. In 2017, HRSA launched its Strategy to Address IPV, an effort to address this critical social determinant of health through agency-wide collaborative action. The Strategy includes four priority areas including (1) Training the nation’s health workforce, (2) Building partnerships to raise awareness, (3) Increasing access to quality care, and (4) Addressing gaps in knowledge about IPV risks, impacts, and interventions. Applicants are encouraged to consider one or more of these priority areas, as relevant, in the development and measurement of their initiative.

Additional resources to assist you in determining how to effectively address intimate partner violence in your HRSA-funded programs may be found in the HRSA Strategy to Address IPV.

II. Award Information

1. Type of Application and Award

Type of applications sought: New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA expects approximately $4,000,000 to be available to fund up to 50 recipients.

You may apply for a ceiling amount of up to $150,000 total cost (includes both direct and indirect, facilities, and administrative costs). The actual amount available will not be determined until enactment of the final FY 2022 federal appropriation. This program notice is subject to the appropriation of funds and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

https://hab.hrsa.gov/sites/default/files/hab/Global/HAB-PCN-15-02-CQM.pdf https://hab.hrsa.gov/sites/default/files/hab/Global/HAB-PCN-15-02-CQM.pdf https://www.hrsa.gov/about/organization/bureaus/owh/intimate-partner-violence-human-trafficking-community-level https://www.hrsa.gov/sites/default/files/hrsa/HRSA-strategy-intimate-partner-violence.pdf https://www.hrsa.gov/sites/default/files/hrsa/HRSA-strategy-intimate-partner-violence.pdf

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The period of performance is September 1, 2022 through August 31, 2023 (1 year).

HRSA will only fund one activity per recipient. HRSA will not fund the same activity in FY 2022 that HRSA funded previously in FY 2020 or FY 2021; however, applicants may propose an expansion of an activity previously supported under FY 2020 or FY 2021 RWHAP Part D Supplemental (HRSA-20-068; HRSA-21-059) or Part C Capacity Development funding (HRSA-20-067; HRSA-21-058) for either HIV Care Innovation or Infrastructure Development. Applicants must present a clear rationale for how the proposed activity builds upon and furthers the objectives of the previously funded activity.

Special Note for current RWHAP Part D WICY recipients: If you apply for funding under this NOFO and you also apply for and are awarded funding under HRSA-22-037 (RWHAP Part D Coordinated HIV Services and Access to Research for Women, Infants, Children and Youth (WICY) Existing Geographic Service Areas), you must be able to demonstrate the ability to administer multiple federal awards (if successful) and ensure adequate quality controls, staffing, and impartiality when prioritizing the needs of the programs. HRSA does not allow duplication of funded activities.

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

III. Eligibility Information

1. Eligible Applicants

Eligible entities include public and nonprofit private entities, faith-based and community-based organizations, and Tribes and tribal organizations. Foreign entities are not eligible for this award.

2. Cost Sharing/Matching

Cost-sharing is not required for this program.

3. Other

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

• Exceeds the ceiling amount

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

If an application fails to address the programmatic goals and requirements outlined in this NOFO, HRSA will not consider it for review or funding under this opportunity.

4. Maintenance of Effort

Applicants applying for HIV Care Innovation activities must agree to maintain non-https://www.hrsa.gov/grants/find-funding/hrsa-20-068 https://www.hrsa.gov/grants/find-funding/hrsa-21-059 https://www.hrsa.gov/grants/find-funding/hrsa-20-067 https://www.hrsa.gov/grants/find-funding/hrsa-21-058 http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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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 (as authorized by section 2664(d) of the PHS Act). Submit information to ensure compliance with the maintenance of effort requirements as Attachment 6.

NOTE: Multiple applications from an organization are not allowable.

HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

IV. APPLICATION and Submission Information

1. Address to Request Application Package

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

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-22-019 in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov.

You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this NOFO.

2. Content and Form of Application Submission

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

See Section 8.5 of the HRSA SF-424 Application Guide for the Application Completeness Checklist.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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Application Page Limitation

The total size of all uploaded files included in the page limitation may not exceed the equivalent of 30 pages when printed by HRSA. The page limitation includes the project and budget narratives, attachments, and letters of commitment and support required in the Application Guide and this NOFO. Hyperlinks to additional documents are not allowed and will not be accessed or reviewed by the ORC reviewers. Standard OMB-approved forms that are included in the workspace application package do not count in the page limitation. Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-22-019, it may count against the page limitation. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limitation. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limitation. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limitation.

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

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

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

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

3) If you are unable to attest to the statements in this certification, you must include an explanation Attachments 9-15: Other Relevant Documents.

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

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

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

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Preparedness and Response (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

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

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment or it will count toward the page limitation. Please use the guidance below. It is most current and differs slightly from that in Section 4.1.ix of HRSA’s SF-424 Application Guide.

Provide a summary of the application in the Project Abstract box of the Project Abstract Summary Form using 4,000 characters or less.

Address Project Director Name Contact Phone Numbers (Voice, Fax) Email Address Website Address, if applicable List all grant program funds requested in the application, if applicable

Because the abstract is often distributed to provide information to the public and Congress, prepare this so that it is clear, accurate, concise, and without reference to other parts of the application. It must include a brief description of the proposed project including the needs to be addressed, the proposed services, and the population group(s) to be served. If the application is funded, your project abstract information (as submitted) will be made available to public websites and/or databases including USAspending.gov.

In addition to the requirements listed in the SF-424 Application Guide, please indicate the project title as “FY 2022 RWHAP Part C Capacity Development Program” and include the following information:

Identification of the category (HIV Care innovation or Infrastructure Development) and the selected activity.

A summary of the proposed activity and its intended impact (i.e., how the activity will develop, enhance, or expand access to high-quality HIV primary care services for low-income and underserved people with HIV).

The funding amount requested for the one-year period of performance.

Identification of the funding preference requested, if applicable.

The project abstract must be single-spaced and is limited to one page in length.

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

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NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria.

Any attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria Introduction (1) Need and (2) Response

Needs Assessment (1) Need

Methodology (2) Response and (4) Impact

Work Plan (2) Response and (4) Impact

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures and

(5) Resources/Capabilities

Organizational Information (2) Response, (4) Impact, and (5) Resources/Capabilities

Budget and Budget Narrative (6) Support Requested

ii. Project Narrative

This section provides a comprehensive description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and organized in alignment with the sections and format below so that reviewers can understand the proposed project.

See below for a description of the activities that you may select for this funding. You may submit a proposal for only one of the following two categories. You may select only one (1) activity under the selected category.

1) HIV Care Innovation

Community Health Workers Community health workers (CHW) have been successfully deployed to support people with HIV to enhance patient access to care and maintain long-term treatment adherence and retention in care. Historically, the job functions of a CHW in HIV care could include the following: peer navigator; peer, client or patient advocate; outreach worker; linkage to care worker; psychosocial support; or non-medical case management. Certification, licensing and workforce development for CHWs continue to evolve, but a number of state and local CHW accrediting bodies, networks, and associations have adopted the roles and competencies noted by the CHW Core Consensus Project (C3).

https://www.c3project.org/roles-competencies

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If you select this activity you will expand your current organizational capacity to implement, enhance, or expand CHW services to serve the eligible populations identified in your needs assessment. Planned activities should address either the implementation of CHW services into your organization’s RWHAP or an enhancement to your organization’s existing CHW program. Proposed activities should include, but are not limited to, development of written policies and procedures for CHW services; provision of training and professional development for both CHWs and their immediate supervisors; plans to integrate CHWs into the HIV care team; and defining the CHW’s role in community engagement. Applicants are required to address sustainability beyond the one-year period of performance for any personnel supported by this award. The CHW activities carried out by your program must address one or more of the stages of the HIV care continuum.and the proposed time and effort must be consistent with the proposed scope of activities. For resources addressing this topic, including resources for the development of a CHW program in HIV care, access the C3 link above and visit HAB’s TargetHIV site on Using Community Health Workers to Improve Linkage and Retention in Care.

Integration of HIV Primary Care with Oral Health or Behavioral Health Develop strategies, policies, and procedures to improve care coordination and integration of HIV primary care with oral health care or behavioral health services (e.g., scheduling appointments, communication strategies). Specific activities may include: developing policies and procedures to facilitate onsite provision of oral health care or behavioral health services; organizing primary care and oral health or behavioral health teams; 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 activity must address one or more of the stages of the HIV care continuum.

Rapid ART Effective rapid ART models include programs that have linked individuals newly diagnosed with HIV to HIV treatment and care, sometimes within the same or next day.4 These pilot projects demonstrated that as a result of rapid ART initiation, more participants were able to achieve viral suppression in a shorter time period compared with standard-of-care groups. Two other large, randomized controlled trials also demonstrated the optimal time to initiate ART, with a 50 percent reduction in morbidity and mortality among individuals with HIV who were randomized to receive ART immediately versus delaying initiation of ART. Through the administration of rapid ART, along with other effective innovative models of care for rapid linkage to and retention in care, HRSA anticipates timely improvements in health outcomes along the HIV care continuum.

If you select this activity you will enhance your organizational capacity to implement or expand rapid ART services, defined as the provision of

4 The RAPID ART Program Initiative for HIV Diagnoses (RAPID) in San Francisco. Beacon et al.

Conference on Retroviruses and Opportunistic Infections. Abstract 93. Boston, Massachusetts, March 4- 7, 2018 http://www.croiconference.org/sessions/rapid-art-program-initiative-hiv-diagnoses-rapid-san-francisco https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum https://targethiv.org/library/using-community-health-workers-improve-linkage-and-retention-care https://targethiv.org/library/using-community-health-workers-improve-linkage-and-retention-care http://www.croiconference.org/sessions/rapid-art-program-initiative-hiv-diagnoses-rapid-san-francisco http://www.croiconference.org/sessions/rapid-art-program-initiative-hiv-diagnoses-rapid-san-francisco

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antiretroviral medication to eligible people with HIV within seven to ten days of identification (for out of care individuals) or diagnosis. Since rapid ART initiation may be resource-intensive, requiring a multi-disciplinary team to coordinate the multiple steps of a positive test result, counseling, patient transportation, clinical evaluation, intake, accelerated insurance coverage, and ART, these and other clinic and system-wide system changes (e.g. workforce development or changes in workflows/procedures) are likely needed to ensure rapid linkage to care and ART initiation. In addition to addressing sustainability beyond the one-year period of performance, you must ensure that activities leverage existing staff, or enhance current collaborations with external organizations, in order to provide sustainable rapid ART services.

Transitioning Youth into Adult HIV Care If you select this activity, you must implement transition-planning activities that include, but are not limited to, written policies and procedures and staff training to assist youth in transitioning from pediatric to adult HIV medical care. Transition planning is a RWHAP Part C program requirement;

therefore, this activity should focus on innovative approaches that build organizational capacity to effectively implement and manage the transition for the youth population (ages 13-24) to adult care and minimize negative impacts of this transition. Recommended activities should focus on collaborations with pediatric/adolescent programs to develop a transition process; capacity building to support the transition into the adult HIV medical care setting; and a mechanism for post-transition assessment.

Implementation efforts should be linked to specific evaluative outcome metrics to measure successful transition. The activity must address one or more of the stages of the HIV care continuum. For resources addressing this topic access US National Library of Medicine National Institutes of Health .

2) Infrastructure Development

Office Dental Equipment for Expanding Dental Service Capacity Purchase dental equipment for the purpose of developing, enhancing, or expanding oral health care services for people with HIV (i.e., creating or expanding an HIV dental operatory or clinic such as dental chairs, sterilization units, X-ray machines,etc.).

Emergency Preparedness

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, tornadoes) and public health emergencies (e.g., disease outbreaks) resulting in minimal interruption to care and treatment for people with HIV. For resources addressing this topic, access the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) website; ASPR’s 2017-2022 Health Care Preparedness and Response Capabilities Report, and the ECRI Institute website.

https://www.ncbi.nlm.nih.gov/pubmed/28754584 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

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Telehealth

Telehealth technologies can help improve access to quality health care. They have been critical during the COVID-19 pandemic, especially in remote areas, settings that lack sufficient health care services, and in the provision of specialty behavioral health care. HRSA’s Federal 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. The term “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 other equipment that furthers the objectives of the proposed telehealth activity. You must describe technology requirements and each type of equipment to be employed. Include a concise description of the relevance to the project, 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.

Use the following section headers for the narrative:

INTRODUCTION -- Corresponds to Section V’s Review Criteria #1 Need and #2

Response 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 is in need of capacity development funds and how the proposed activity will develop, enhance, or expand access to quality HIV primary care services for low-income 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.

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

Outline the needs of the community and/or organization relative to the selected activity.

For HIV Care Innovation activities, clearly describe and document the target population(s) and their unmet health care needs. More specifically, describe how this targeted 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 target population(s) with https://www.telehealthresourcecenter.org/ https://www.telehealthresourcecenter.org/ https://www.hrsa.gov/rural-health/telehealth

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HIV 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 Common HIV Core Indicators.

Regarding Community Health Workers, discuss your organization’s current use of peer navigators, peer outreach and linkage to care, community health workers, or other peer or community-involved service models to increase client linkage, re-engagement, and retention in HIV primary care. If you currently have CHWs, peer navigators, health advocates (etc.) working in your organization, discuss how this activity will enhance your existing CHW program clinical services, organizational structure, and workflow. If you are planning to add CHWs to your current organizational structure, discuss the planning and integration of this program into the operations and workflow of your current structure. Discuss any professional development and training needs.

Regarding the Integration of HIV Primary Care with Oral Health or Behavioral Health, discuss your organization’s need for capacity development funds to implement, enhance or expand the onsite provision of oral health and/or behavioral health treatment.