HRSA 24 057 Linking Eligibility Across RWHAP Parts FINAL.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

HIV/AIDS Bureau

Division of Policy and Data

Linking Eligibility Across the Ryan White HIV/AIDS Program Parts - Dissemination Assistance Provider

Funding Opportunity Number: HRSA-24-057

Funding Opportunity Type(s): New

Assistance Listing Number: 93.928

Application Due Date: March 4, 2024 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

We will not approve deadline extensions for lack of registration.

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

Issuance Date: January 3, 2024

LaQuanta P. Smalley, MPH, BSN, RN, CPN Senior Public Health Analyst, Clinical & Quality Branch, Division of Policy & Data HIV/AIDS Bureau Call: (301) 443-0995 Email: lsmalley@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 300ff-101 (§ 2691 of the Public Health Service Act).

mailto:lsmalley@hrsa.gov

HRSA-24-057 RWHAP Eligibility i

508 COMPLIANCE DISCLAIMER

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

SUMMARY

Funding Opportunity Title: Linking Eligibility Across the RWHAP Parts - Dissemination Assistance Provider

Funding Opportunity Number: HRSA-24-057

Assistance Listing Number: 93.928

Due Date for Applications: March 4, 2024

Purpose: The purpose of this funding opportunity is to:

(1) Examine current eligibility determination and confirmation processes in place across all RWHAP Parts and identify administrative, technical, and legal barriers facing providers and clients.

(2) Identify best practices and facilitators that improve navigation for clients who seek services from multiple RWHAP recipients and subrecipients.

(3) Develop and disseminate materials about eligibility determination and confirmation processes including cost analysis tools, examples, and lessons learned; and

(4) facilitate peer-to-peer information exchange and dissemination of information.

Program Objective(s): The program objectives are as follows:

• Promote efficiencies in the intake, navigation, and determination of RWHAP client eligibility and eligibility confirmations across all RWHAP Parts.

HRSA-24-057 RWHAP Eligibility ii

• Improve the customer experience with applying for and continuing RWHAP services.

• Reduce administrative burden for RWHAP clients and providers.

• Increase the availability of tools that RWHAP recipients and subrecipients can adopt and adapt to help streamline eligibility processes across all RWHAP Parts.

Eligible Applicants: Eligible applicants include entities eligible for funding under RWHAP Parts A through F of Title XXVI of the Public Health Service Act. Tribes and tribal organizations are eligible.

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

Anticipated FY 2024 Total Available Funding:

$2,000,000

We’re issuing this notice to ensure that, should funds become available for this purpose, we can process applications and award funds appropriately. You should note that we may cancel this program notice before award if funds are not appropriated.

Estimated Number and Type of Award(s):

Up to one (1) new cooperative agreement

Estimated Annual Award Amount:

Up to $2,000,000 per award, subject to the availability of appropriated funds

Cost Sharing or Matching Required:

No

Period of Performance: August 1, 2024, through July 31, 2026 (2 years)

Agency Contacts: Business, administrative, or fiscal issues:

Beverly Smith Grants Management Specialist Division of Grants Management Operations, Office of Federal Assistance Management

HRSA-24-057 RWHAP Eligibility iii

Email: bsmith@hrsa.gov

Program issues or technical assistance:

LaQuanta Smalley Senior Public Health Analyst, Division of Policy & Data HIV/AIDS Bureau Email: lsmalley@hrsa.gov

Application Guide

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

Technical Assistance

We have scheduled the following webinar:

Thursday, February 1, 2024 Time: 1:00 – 2:30 p.m. ET Weblink:

https://hrsa-gov.zoomgov.com/j/1613710777?pwd=dUptdjU1L1BKbjd2clBpVmtIZlJJQT09 Meeting ID: 161 371 0777 Passcode: 4JznweHd

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

Call-In Number: 1-833-568-8864 (Toll Free) Meeting ID: 161 371 0777 Passcode: 58414026

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

mailto:BSmith@hrsa.gov mailto:lsmalley@hrsa.gov http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://hrsa-gov.zoomgov.com/j/1613710777?pwd=dUptdjU1L1BKbjd2clBpVmtIZlJJQT09 https://hrsa-gov.zoomgov.com/j/1613710777?pwd=dUptdjU1L1BKbjd2clBpVmtIZlJJQT09 https://targethiv.org/library/nofos

HRSA-24-057 RWHAP Eligibility iv

Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING OR MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

3. UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX A: PAGE LIMIT WORKSHEET

HRSA-24-057 RWHAP Eligibility 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Linking Eligibility Across the Ryan White HIV/AIDS Program (RWHAP) Parts - Dissemination Assistance Provider program.

The Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) will fund one cooperative agreement for up to two years to:

1. Examine current eligibility determination and confirmation processes in place across all RWHAP Parts and identify administrative, technical, and legal barriers facing providers and clients.

2. Identify best practices and facilitators that improve navigation for clients who seek services from multiple RWHAP recipients and subrecipients.

3. Develop and disseminate materials about eligibility determination and confirmation processes including cost analysis tools, examples, and lessons learned.

4. Facilitate peer-to-peer information exchange and dissemination of information.

Specifically, the award recipient will conduct activities noted in the Program Requirements and Expectations section.

The goal of the Linking Eligibility Across the RWHAP Parts - Dissemination Assistance Provider program is to increase access to care for people with HIV by promoting efficiencies in RWHAP eligibility and confirmation across all RWHAP Parts. The program objectives are as follows:

• Promote efficiencies in the intake, navigation, and determination of RWHAP client eligibility and eligibility confirmations across all RWHAP Parts.

• Improve the customer experience with applying for and continuing RWHAP services.

• Reduce administrative burden for RWHAP clients and providers.

• Increase the availability of tools that RWHAP recipients and subrecipients can adopt and adapt to help streamline eligibility processes across all RWHAP Parts.

For the purposes of this funding opportunity, “all RWHAP Parts” refers to RWHAP Parts A through D and Part F (dental programs).

For more details, see Program Requirements and Expectations.

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2. Background

The Linking Eligibility Across the RWHAP Parts - Dissemination Assistance Provider program is authorized by the RWHAP Part F, Special Projects of National Significance (SPNS) Program, 42 USC § 300ff-101 (§ 2691 of the Public Health Service Act).

The HRSA HAB Policy Clarification Notice 21-02, Determining Client Eligibility & Payor of Last Resort in the RWHAP provides guidance for RWHAP recipients and subrecipients “for determining client eligibility and complying with the payor of last resort requirement, while minimizing administrative burden and enhancing continuity of care and treatment services.” Since the release of this notice, HRSA HAB has received questions regarding recipients’ ability to confirm client eligibility from available data sources (e.g., health information exchanges, Medicaid enrollment, state tax filings, enrollment and eligibility information collected from health care marketplaces) before requesting additional information from the client. Information from recipients has shown that integrating data across multiple RWHAP providers reduces client and other administrative burdens such as billing, duplicate data entry, retrieval and analysis of client data, identification of gaps in client/patient care, and savings on handling of paper forms. In addition, strategies such as combined rapid linkage or referrals to HIV services and rapid initiation of antiretroviral therapy that streamline intake and eligibility processes show promising findings of shortened times to viral suppression.1

HRSA HAB staff that monitor RWHAP recipients and technical expert panel convenings indicate some RWHAP recipients have begun to streamline eligibility processes across their respective states, jurisdictions, and community-based organizations. Many RWHAP recipients and subrecipients could benefit from adopting best practices and understanding facilitators and challenges to implement such approaches. In addition, RWHAP recipients and subrecipients need technical assistance (TA) and tools to prevent challenges that cause negative experiences for people with HIV such as having limited access to online eligibility and enrollment platforms. The Linking Eligibility Across the RWHAP Parts - Dissemination Assistance Provider program will respond to the needs of RWHAP stakeholders by promoting system efficiencies and data integration across partner systems that ultimately lead to reduced administrative burden for clients and recipients and a positive client experience.

The Ryan White HIV/AIDS Program

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

1 Benbow, N. D., Mokotoff, E. D., Dombrowski, J. C., Wohl, A. R., & Scheer, S. (2021). The HIV Treat Pillar: An update and summary of promising approaches. American Journal of Preventive Medicine, 61(5), S39-S46.

https://uscode.house.gov/view.xhtml?req=(title:42%20section:300ff-101%20edition:prelim) https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/

HRSA-24-057 RWHAP Eligibility 3

The RWHAP has five statutorily defined Parts (Parts A, B, C, D, and F) that provide funding for core medical, support services, and medications; TA; clinical training; and the development of innovative interventions and strategies for HIV care and treatment to respond to emerging needs of RWHAP clients.

An important framework in the RWHAP is the HIV care continuum, which is comprised of the series of stages a person with HIV engages in from initial diagnosis through their successful treatment with HIV medication to achieve viral suppression. Supporting people with HIV to reach viral suppression not only increases their own quality of life and lifespan, 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 required to assess the outcomes of their programs and work with their community and public health partners to improve outcomes across the HIV care continuum.

Strategic Frameworks and National Objectives

National objectives and strategic frameworks like Healthy People 2030, the National HIV/AIDS Strategy (NHAS) (2022–2025); the Sexually Transmitted Infections National Strategic Plan for the United States (2021–2025); and the Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination (2021–2025) are crucial to addressing key public health challenges facing low-income people with HIV. These strategies detail the principles, priorities, and actions to guide the national public health response and provide a blueprint for collective action across the Federal Government and other sectors. The RWHAP supports the implementation of these strategies and recipients should align their organization’s efforts, within the parameters of the RWHAP statute and program guidance, with these strategies to the extent possible.

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

As demonstrated by recent data from the 2021 Ryan White HIV/AIDS Program Services Report (RSR), the RWHAP has made tremendous progress toward ending the HIV epidemic in the United States. From 2017 to 2021, HIV viral suppression among RWHAP patients who have had one or more medical visits during the calendar year and at least one viral load with a result of <200 copies/mL reported, has increased from 85.9 percent to 89.7 percent. Additionally, racial and ethnic, age-based, and regional disparities reflected in viral suppression rates have significantly decreased.[1]

In February 2019, the Ending the HIV Epidemic in the U.S (EHE) initiative was launched to further expand federal efforts to reduce HIV infections. 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

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

https://health.gov/healthypeople https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2021.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2021.pdf https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline https://ryanwhite.hrsa.gov/data/reports

HRSA-24-057 RWHAP Eligibility 4 care, treatment, and support services needed to help them reach viral suppression.

Using Data Effectively: Integrated Data Sharing and Use

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

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

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

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

HRSA strongly encourages complete CD4, viral load (VL), and HIV nucleotide sequence reporting to the state and territorial health departments’ HIV surveillance systems to benefit fully from secure integrated data sharing, analysis, and utilization. State health departments may use CD4, VL, and nucleotide sequence data to identify cases, stage of HIV disease at diagnosis, and monitor disease progression. These data can also be used to evaluate HIV testing and prevention efforts, determine entry into and retention in HIV care, measure viral suppression, monitor prevalence of antiretroviral drug resistance, detect transmission clusters and understand transmission patterns, and assess unmet health care needs. Analyses at the national level to monitor progress toward ending the HIV epidemic in the United States can only occur if all HIV-related CD4, VL, and HIV nucleotide sequence test results are reported by all jurisdictions. CDC requires the reporting to the National HIV Surveillance System (NHSS) all HIV-related CD4 results (counts and percentages), all VL results (undetectable and specific values), and HIV nucleotide sequences.

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

In addition, RWHAP recipients and subrecipients are encouraged to develop data sharing strategies with other RWHAP recipients and relevant entities to reduce administrative burden across programs. As outlined in Policy Clarification Notice 21-02, 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://data.hrsa.gov/topics/hiv-aids/compass-dashboard

HRSA-24-057 RWHAP Eligibility 5

Determining Client Eligibility & Payor of Last Resort in the Ryan White HIV/AIDS Program, recipients and subrecipients should use electronic data sources (for example, Medicaid enrollment, state tax filings, enrollment and eligibility information collected from health care marketplaces) to collect and verify client eligibility information, such as income and health care coverage (that includes income limitations), when possible.

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

Program Resources and Innovative Models

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

Examples of these resources include:

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

• Best Practices Compilation

• Center for Innovation and Engagement (CIE)

• Center for Quality Improvement and Innovation (CQII)

• Dissemination of Evidence-Informed Interventions (DEII)

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

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

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

• Integrating HIV Innovative Practices (IHIP)

• AIDS Education Training Center Program – National Coordinating Resource Center

II. Award Information

1. Type of Application and Award

Application type: New

We will fund you via a cooperative agreement.

https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://targethiv.org/help/ta-directory https://targethiv.org/ace https://targethiv.org/bestpractices https://targethiv.org/CIE https://targethiv.org/cqii https://targethiv.org/deii https://targethiv.org/deii https://targethiv.org/e2i https://targethiv.org/e2i https://targethiv.org/escalate https://targethiv.org/elevate https://targethiv.org/elevate https://targethiv.org/ihip https://targethiv.org/ta-org/aetc-ncrc https://targethiv.org/ta-org/aetc-ncrc

HRSA-24-057 RWHAP Eligibility 6

A cooperative agreement is like a grant in that we award money, but we are substantially involved with program activities.

Aside from monitoring and TA, we also get involved in these ways:

• Reviewing, providing recommendations, and concurring with final work plans and project budgets.

• 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.

• Reviewing and providing feedback on written materials prior to external communication and dissemination.

• Facilitating connections with the broader network of RWHAP recipients and subrecipients, and the HIV care and treatment community.

• Collaborating in the development of guides and tools and the design, operation, direction, and evaluation of activities, including meetings, training activities, and workshops.

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

• Anticipating and providing guidance on the changes taking place in the health care environment that will affect the planning process.

• Coordinating with other HRSA HAB programs to address training and TA needs as they may relate to new/emerging strategic initiatives.

• Providing the expertise of HRSA personnel and other relevant TA resources to support the efforts of the project activities.

• Facilitating relationships between the recipient and other relevant stakeholders.

• Facilitating partnership and communication with other federal agencies, HRSA recipients, and community stakeholders to improve coordination efforts.

You must follow all relevant federal regulations and public policy requirements. Your other responsibilities will include:

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

• Modifying activities as necessary in keeping with the changing trends and needs of people with HIV and RWHAP recipients and subrecipients.

• Negotiating with HRSA to update existing work plans at least annually.

• Ensuring any training and TA delivered to RWHAP recipients and subrecipients is cleared and coordinated with other HRSA training and TA resources.

HRSA-24-057 RWHAP Eligibility 7

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

• Disseminating the project’s products through social media, various regional and national outlets and HRSA-supported websites, including but not limited to, TargetHIV.org and the RWHAP Best Practices Compilation.

• Integrating new priorities during the period of performance (i.e., through monitoring calls or other communication), as needed.

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

• Integrating considerations, when appropriate, from technical expert reports, meeting convenings, and other relevant sources into the project activities.

We encourage you to collaborate with partner organizations, as needed, to achieve cooperative agreement requirements, program expectations, and goals.

2. Summary of Funding

We estimate $2,000,000 will be available each year to fund one recipient. You may apply for a ceiling amount of up to $2,000,000 annually (reflecting direct and indirect costs).

The period of performance is August 1, 2024, through July 31, 2026 (2 years).

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

Support beyond the first budget year will depend on:

• Appropriation

• Satisfactory progress in meeting the project’s objectives

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

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

If you’ve never received a negotiated indirect cost rate, you may elect to charge a de minimis rate of 10 percent of modified total direct costs (MTDC)*. You may use this for the life of the award. If you choose this method, you must use it for all federal awards until you choose to negotiate for a rate. You may apply to do so at any time. See Section 4.1.v. Budget Narrative in the Application Guide.

*Note: One exception is a governmental department or agency unit that receives more than $35 million in direct federal funding.

http://www.targethiv.org/ https://targethiv.org/bestpractices https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75

HRSA-24-057 RWHAP Eligibility 8

III. Eligibility Information

1. Eligible Applicants

You can apply if your organization is in the United States, 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, or the Republic of Palau and is an entity eligible for funding under RWHAP Parts A through F of title XXVI of the Public Health Service (PHS) Act, including:

• Public or private, non-profit

• State or local government

• Academic institution

• Local health department

• Non-profit hospital or outpatient clinic

• Community health center receiving support under Section 330 of the PHS Act

• Community-based

• Tribal (governments, organizations) with or without federal recognition.

2. Cost Sharing or Matching

Cost sharing or matching is not required for this program.

3. Other

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

• Exceeds the funding ceiling amount

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

Multiple Applications

We will only review your last validated application before the Grants.gov due date.

IV. Application and Submission Information

1. Address to Request Application Package

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

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

HRSA-24-057 RWHAP Eligibility 9

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

Select “Subscribe” and enter your email address for HRSA-24-057 to receive emails about changes, clarifications, or instances where we republish the NOFO. You will also be notified by email of documents we place in the RELATED DOCUMENTS tab that may affect the NOFO and your application. You’re responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

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

Application Page Limit The total number of pages that count toward the page limit shall be no more than 45 pages when we print them. We will not review any pages that exceed the page limit.

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

Eligibility Information of the NOFO.

These items do not count toward the page limit:

• Standard OMB-approved forms you find in the NOFO’s workspace application package

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

• Indirect Cost Rate Agreement

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

If you use an OMB-approved form that is not in the HRSA-24-057 workspace application package, it may count toward the page limit. You may want to use the “Page Limit Worksheet” found in the Appendix of this NOFO.

Applications must be complete and validated by Grants.gov under HRSA-24-057 before the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

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

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

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180/subpart-I/section-180.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995

HRSA-24-057 RWHAP Eligibility 10

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

• If you cannot certify this, you must include an explanation in Attachments 8-15:

Other Relevant Documents.

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

Program Requirements and Expectations To meet the purpose, goals, and objectives of the Linking Eligibility Across the RWHAP Parts - Dissemination Assistance Provider program, the awarded recipient is expected to conduct the following activities:

• Perform a systems assessment of a representative sample of RWHAP recipients and subrecipients across multiple RWHAP Parts and other systems (e.g., health information exchanges; Medicaid; Supplemental Nutrition Program for Women, Infants and Children (SNAP); Healthy Start; etc.) to identify current administrative systems and processes, technologies and tools utilized to determine client eligibility, eligibility confirmation, and obtain client consent for intra-agency data sharing. The representative sample will represent the diverse population of RWHAP recipients and subrecipients as a whole.

• Document processes, best practices, and innovations for client eligibility determination and confirmation that are efficient, cost effective, accessible to all RWHAP Parts, and lead to user and client satisfaction. Processes could include, but may not be limited to, secure data centralization (e.g., storage, warehouse, system, etc.) and/or interoperability (e.g., exchanging information between different systems).

• Identify facilitators, challenges, and barriers related to administrative, technical, and legal/policy issues affecting state and jurisdictional implementation of seamless, integrated, and comprehensive data exchanges across multi-program funding sources (e.g., RWHAP, Housing Opportunities for Persons with AIDS (HOPWA), and pharmaceutical assistance).

• Sponsor and coordinate peer-to-peer information exchanges to share support, guidance, and feedback on best practices that promote efficiencies in the determination of client eligibility.

• Develop and promote dissemination of materials, manuals, and tools on data-sharing or other strategies among RWHAP recipients and relevant entities.

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

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

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

i. Project Abstract

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

NARRATIVE GUIDANCE

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

Narrative Section Review Criteria

Introduction Criterion 1: NEED Criterion 2: RESPONSE

Organizational Information Criterion 5: RESOURCES/CAPABILITIES Criterion 6: SUPPORT REQUESTED

Need Criterion 1: NEED

Approach Criterion 2: RESPONSE Criterion 4: IMPACT

Work Plan Criterion 2: RESPONSE Criterion 4: IMPACT Criterion 6: SUPPORT REQUESTED

Resolution of Challenges Criterion 2: RESPONSE

Evaluation and Technical Support Capacity

Criterion 2: RESPONSE Criterion 3: EVALUATIVE MEASURES Criterion 5: RESOURCES/CAPABILITIES

Budget Narrative Criterion 5: RESOURCES/CAPABILITIES Criterion 6: SUPPORT REQUESTED

ii. Project Narrative

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

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

This ensures reviewers can understand your proposed project.

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

Briefly describe the purpose of your proposed project. This section should describe how your project addresses the goal to increase care for people with HIV by promoting efficiencies in RWHAP eligibility and confirmation across Parts, and the objectives listed in the “Purpose” section of this NOFO. Summarize how you will conduct the project activities stated in the “Purpose” section of this NOFO.

Organizational Information – Corresponds to Section V’s Review Criteria #5 Resources/Capabilities, and #6 Support Requested

Describe your mission, structure, and scope of current activities, and how these elements all contribute to the organization’s ability to implement the program requirements and meet program expectations.

Also, describe your organization’s:

• Understanding and ability to help entities navigate different governmental, stakeholder, and/or client interests, requirements, and dynamics.

• Experience supporting peer networks (e.g., through TA, etc.), especially for organizations that operate in complex environments.

• Flexibility in working with recipients and subrecipients that face disproportionate challenges.

• Comfort level with using new technologies.

• Experience collaborating with other HIV stakeholders and agencies pertinent to the work of your project.

• Experience in hosting webinars or webcasts and developing curricula, “How-To” manuals, implementation guides, and strategy toolkits related to HIV service delivery.

• Experience working with RWHAP recipients and subrecipients across all RWHAP Parts; and

• Ability to perform timely startup and implement short-term projects in the allotted time.

Include a one-page project organizational chart (as Attachment 2) that illustrates the organizational structure of the project (not the entire organization); include contractors (if applicable) and other significant collaborators. If you will use consultants and/or contractors to provide any of the proposed services, describe their roles and responsibilities on the project. Include signed letters of agreement, memoranda of understanding, and brief descriptions of proposed and/or existing contracts related to the project in Attachment 3.

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Include a staffing plan for the proposed project staff, job descriptions to include roles and responsibilities; and information to show who will manage/oversee the various project activities. Include this plan as Attachment 4. See Section 4.1. of the Application Guide for additional information.

If project staff, consultants, or contractors serve on other federal awards, please list the federal award number, funding agency, project staff, and the full-time equivalent (FTE) for that respective federal award. Project staff cannot bill more than 1.0 FTE across all federal awards.

Include short biographical sketches of key project staff (each not to exceed two pages in length) as Attachment 5. See Section 4.1. of the Application Guide for information on the content for the sketches. If a biographical sketch for an individual not yet hired is included, you must attach a letter of commitment signed by the individual.

Discuss your organization’s experience, if any, with implementing a cooperative agreement. Describe your experience with fiscal management of grants and contracts. Also, discuss how your organization will follow the approved plan, as outlined in the application; properly account for the federal funds; and document all costs to avoid audit findings.

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

Summarize what you see as the primary issues regarding linking eligibility across the RWHAP Parts to increase care for people with HIV. Discuss the administrative, policy, technological, service-related, and systemic challenges that affect wider-scale adoption and/or optimal application of promoting efficiencies to streamline RWHAP client eligibility determination and confirmation; reduce administrative burden of clients, recipients, and subrecipients; and increase client satisfaction.

Discuss the challenges that come with the evaluating, disseminating, and replicating best practices and, as applicable, evidence-based strategies to implement streamlined eligibility across RWHAP recipients, subrecipients, and all RWHAP Parts. When appropriate, support your needs assessment narrative with citations of literature and publications. Explain how your proposed project may contribute to or add to the existing evidence base and the effectiveness of streamlined eligibility and confirmation within the RWHAP.

Approach -- Corresponds to Section V’s Review Criteria #2 Response and #4 Impact

Tell us how you will address the stated needs and meet each of the previously described project objectives, expectations, and responsibilities in written in the "Purpose" section of this NOFO. Discuss specific actions you will take to complete the project activities within the two-year project period.

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Include any innovative methods you will use, and include what you will do to address the following:

Systems Assessment

• Describe how you will conduct a systems assessment of a representative sample of RWHAP recipients and subrecipients with a distribution across multiple Parts for RWHAP recipient organizations, systems, and/or income based federal programs (e.g., health information exchanges; Medicaid;

SNAP; Healthy Start; etc.) to identify current administrative systems, technologies, and tools utilized to determine client eligibility, eligibility confirmation, and obtain client consent. The representative sample will represent the diverse population of RWHAP recipients and subrecipients as a whole. Include details about processes and the sampling method that will be used to conduct the assessment.

• Explain the processes you will follow to capture and catalogue best practices, innovations, facilitators, challenges/barriers, and related tools for client eligibility determination and confirmation policies and procedures across RWHAP service categories as described in HRSA HAB Policy Clarification Notice 16-02 RWHAP Eligible Individuals and Allowable Uses of Funds, RWHAP Parts, and multi-program funding sources (e.g., RWHAP, HOPWA, pharmaceutical assistance).

• Tell us how you will engage stakeholders and RWHAP communities including meaningful engagement of people with lived experience at all levels of implementation of your project.

Information Exchange

• Describe the methods you will use to sponsor and coordinate peer-to-peer information exchanges to share support, guidance, and feedback on best practices that promote efficiencies in the determination of client eligibility.

Include the technology or medium that will be used to host the information exchange and what you expect to be the business rules for using the information exchange.

• Explain how you will recruit and market participation for the peer-to-peer information exchange.

• Discuss how you will promote sharing and collaboration across all RWHAP Parts and others who engage in the peer-to-peer information exchange.

Dissemination

• Discuss your plan to develop and disseminate highly accessible tools and materials that describe the best practices, facilitators, and challenges/barriers to streamline eligibility identified through this project.

• Describe how the products and tools for dissemination will include the experiences of RWHAP recipients and subrecipients involved in this project.

mailto:https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf mailto:https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf mailto:https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf

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• Explain your plans to disseminate information to both RWHAP recipients and subrecipients directly involved and those who are not involved in the project.

• Describe your plan to promote materials and webinars related to the project using social media, regional and national outlets, and HRSA-supported websites, including but not limited to, TargetHIV.org and the RWHAP Best Practices Compilation.

• Describe how you will ensure progress toward the creation of materials and products that are ready for timely dissemination during and at the end of this project.

• Explain your process for adapting existing products for use in this project.

This includes the integration of products and materials that are published after the project starts (e.g., recommendations from technical expert reports, meeting convenings, and other relevant sources).

Sustainability

• Recommend actions for continuing capacity-building with similar RWHAP recipients and subrecipients (not engaged in this project) after the project ends.

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

Describe how you will achieve each of the objectives during the period of performance. Use a table to clearly show the following details:

1. Goals

2. Objectives that are specific, measurable, achievable, realistic, and time-framed (SMART)

3. Action steps or activities

4. Staff (including partners and collaborators) responsible for each action step; and

5. Anticipated dates of completion for each objective and/or action step. The work plan should be in table format.

Provide objectives and action steps only for the goals set for Year 1. Write objectives in SMART terms, providing numbers (not just percentages) for targeted outcomes, as applicable. Include key action steps or activities for each of your first-year objectives that you anticipate undertaking to implement the project.

Consider Year 1 action steps, including, but not limited to:

• Hiring appropriate staff.

• Identifying meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities.

http://www.targethiv.org/ https://targethiv.org/bestpractices

HRSA-24-057 RWHAP Eligibility 16

• Beginning project evaluation activities.

• Participating in the 2024 National Ryan White Conference on HIV Care and

Treatment.

• Establishing quality control mechanisms that align with HRSA’s review processes.

All work plan goals, objectives and activities must directly relate to the methods described in the Approach section of this NOFO. The work plan should be included as Attachment 1.

RESOLUTION OF CHALLENGES – Corresponds to Section V’s Review Criterion #2 Response

Discuss (1) challenges that you are likely to face with designing and implementing the project activities described in the work plan, (2) potential risks to project implementation, and (3) approaches you will use to resolve such challenges and mitigate risks.

EVALUATION AND TECHNICAL SUPPORT CAPACITY – Corresponds to Section V’s Review Criteria #2 Response, #3 Evaluative Measures, and #5 Resources/Capabilities

The project performance evaluation should describe process and outcome measures and how you will monitor ongoing processes and the progress towards the goals and objectives of the project. Describe the plan to evaluate the performance of your project and how you will use the proposed evaluation activities to contribute to continuous quality improvement. Describe the inputs (e.g., organizational profile, collaborative partners, key personnel, budget, and other resources), key processes, and expected outcomes of the funded activities.

Describe the systems and processes you will use to support effective tracking of the performance outcomes, including a description of how your organization will collect and manage data (e.g., assigned skilled staff, data security procedures, data management software). These systems and processes should (1) facilitate immediate startup of the project and (2) ensure accurate and timely reporting of performance outcomes. Describe the data collection strategy to collect, analyze, and track data to measure process and impact/outcomes, and explain how the data will be used to inform project development. Describe any potential obstacles for implementing the project performance evaluation and your plan to address those obstacles.

Staff expertise should be directly linked to the activities proposed in the project narrative and work plan. Describe the experience, skills, and knowledge of proposed staff (including partners, consultants and contractors, if applicable) as they relate to previous work of similar nature to include the following:

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• Experience performing RWHAP client eligibility and confirmation across all Parts.

• Experience working across RWHAP Parts.

• Experience working with organizations of various sizes, experiences, service types, and information technology infrastructures.

• Understanding of service systems, operations, and organizational design.

• Knowledge of key RWHAP stakeholders such as Medicaid, SNAP, Healthy

Start, etc.

• Experience in meaningful engagement of people with HIV and improving customer experience.

Project staff should also have the necessary skills to communicate project findings and lessons learned to local communities, state and national stakeholders, and policymakers. Describe the proposed project staff’s (including any partners’, consultants’ and contractors’, if applicable) experience in disseminating project information such as collaborative writing and publishing manuscripts in peer-reviewed journals and in making presentations at conferences. Describe any experience in the development and dissemination of web-based tools and materials.

Discuss any examples of previous projects, materials published, and previous work of a similar nature that reflect the expertise of the proposed staff.

iii. Budget

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

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

Reminder: The total project or program costs are all allowable (direct and indirect) costs used for the HRSA activity or project.