HRSA-24-061 Part D WICY Supplement .pdf

Notice of Funding Opportunity

Application due May 13, 2024

HIV/AIDS Bureau Division of Community HIV/AIDS Programs

Ryan White HIV/AIDS Program Part D - Women, Infants, Children and Youth (WICY) Grant Supplemental Funding Opportunity number: HRSA-24-061

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 8

Step 2: Get Ready to Apply 13

Get registered 14

Find the application package 14

Application writing help 14

Step 3: Prepare Your Application 16

Application contents and format 17

Step 4: Learn About Review and Award 33

Application review 34

Award notices 39

Step 5: Submit Your Application 40

Application submission and deadlines 41

Application checklist 43

Step 6: Learn What Happens After Award 44

Post-award requirements and administration 45

Contacts and Support 48

Contents 2

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

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by May 13, 2024 Applications are due by 11:59 p.m. Eastern Time on May 13, 2024.

Before you begin 3 https://sam.gov/ https://grants.gov/

Jump to a step

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

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Basic information Health Resources and Services Administration

HIV/AIDS Bureau

Division of Community HIV/AIDS Programs

Statutory authority 42 USC §§ 300ff-71 and 300ff-121 (§§ 2671 and 2693 of the Public Health Service Act).

This Notice of Funding Opportunity (NOFO) supplements the work of organizations that currently receive a fiscal year 2024 Ryan White HIV/AIDS Program (RWHAP) Part D WICY grant award.

Have questions?

See Contacts and Support.

Key facts Opportunity Name:

Ryan White HIV/AIDS Program Part D - Women, Infants, Children and Youth (WICY) Grant Supplemental Funding

Opportunity Number:

HRSA-24-061

Federal Assistance Listing:

93.153

Key dates Application deadline:

May 13, 2024

Expected award date:

August 1, 2024

Expected start date:

August 1, 2024

Summary Funding under this program supports current RWHAP Part D recipients to carry out one short-term activity that can be completed by the end of 1 year.

Funding details Type: Competing supplement

Expected total available funding: $4,500,000

Expected number of awards: 25

Funding range per award: Up to $200,000 per organization

We plan to fund awards for one year, known as a 12-month budget period, specifically from August 1, 2024, to July 31, 2025.

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

Step 1: Review the Opportunity 5

Eligibility Who can apply

Eligible applicants Only current recipients funded under the following NOFOs are eligible:

• HRSA-22-037 Ryan White HIV/AIDS Program Part D, Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth (WICY) Existing Geographic Service Areas

• HRSA-22-156 Ryan White HIV/AIDS Program Part D, Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth (WICY) Limited Existing Geographic Service Areas

Only the following types of domestic organizations (see note) may apply:

Institutions of higher education

• Public institutions of higher education

• Private institutions of higher education

Nonprofit entities

• Nonprofits having a 501(c)(3) IRS status

• Nonprofits with an IRS status other than 501(c)(3)

Private for-profit entities

• For-profit organizations

• Small businesses

Public entities

• State governments, including the District of Columbia, domestic territories, and freely associated states

• County governments

• City or township governments

• Special district governments

• Independent school districts

Step 1: Review the Opportunity 6

Tribes and tribal organizations

• Native American tribal governments

• Native American tribal organizations

Note: “Domestic” means the fifty states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau.

Other eligibility requirements None

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

Step 1: Review the Opportunity 7

Program description The purpose of this additional funding is to increase access to high quality family-centered HIV health care services for low-income women, infants, children, and youth, commonly abbreviated as WICY.

Background The Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program has five statutory funding parts that provide a comprehensive system of medical care, support, and medications for low-income people with HIV. The goal is better health results, and lower HIV spread in priority groups.

The HIV care continuum is key to the program. It shows the journey of someone with HIV from diagnosis to effective treatment, leading to viral suppression. Achieving viral suppression boosts the patient’s quality of life and prevents HIV spread.

This continuum also helps programs and planners measure progress and use resources effectively. We require you to assess your outcomes and work with your community and public health partners. To assess your program, use HRSA’s Performance Measure Portfolio.

Strategic frameworks and national objectives To address health challenges faced by low-income people with HIV, using national objectives and strategic frameworks is crucial. These frameworks include:

• Healthy People 2030

• National HIV/AIDS Strategy (NHAS) (2022–2025)

• Sexually Transmitted Infections National Strategic Plan for the United States (2021–2025)

• Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination (2021–2025)

These strategies offer guidance on the main principles, priorities, and steps for our national health response. They serve as a blueprint for collective action.

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

Step 1: Review the Opportunity 8 https://ryanwhite.hrsa.gov/about/parts-and-initiatives https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio https://health.gov/healthypeople 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

Expanding the effort To date, the Ryan White HIV/AIDS Program has made significant progress:

• From 2018 to 2022, HIV viral suppression among RWHAP clients improved from 87.1% to 89.6%. For more information, see the 2022 Ryan White HIV/AIDS Program Services Report (RSR).

• Racial, ethnic, age-based, and regional disparities in HIV viral suppression rates have significantly reduced. For more information, see the Annual Client-Level Data Report 2022.

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

Using data effectively HRSA and the Centers for Disease Control and Prevention (CDC) promote integrated data sharing and use for program planning, quality improvement, and public health action.

We encourage you to:

• Follow the Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs.

• Create data-sharing agreements between surveillance and HIV programs.

• Progress towards NHAS goals through integrated data sharing, analysis, and use of HIV data by health departments.

• Complete CD4, viral load, and HIV nucleotide sequence reporting to the state and territorial health departments’ HIV surveillance systems. CDC mandates the reporting of all such data to the National HIV Surveillance System (NHSS).

• Use HRSA’s interactive RWHAP Compass Dashboard to visualize reach, impact, and outcomes of the RWHAP and to inform planning and decision making.

◦ The dashboard looks at national, state, and metro area data and displays client demographics, services, outcomes, and viral suppression.

◦ It also includes data about clients using the AIDS Drug Assistance Program

(ADAP).

• Develop data-sharing strategies with others to reduce administrative burden.

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

Step 1: Review the Opportunity 9 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2022.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2022.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2022.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-2022.pdf https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf https://data.hrsa.gov/topics/hiv-aids/compass-dashboard

• Use electronic data sources to verify client eligibility when you can. See Policy Clarification Notice 21-02, Determining Client Eligibility and Payor of Last Resort in the Ryan White HIV/AIDS Program.

Program resources and innovative models HRSA offers multiple projects and resources to help you. A full list of resources, including regarding best practices, new innovations, and engaging people with lived experience, is available on TargetHIV.

Funding policies and limitations Policies This program depends on the appropriation of funds. If funds are appropriated for this purpose, we will move forward with the review and award process.

Limitations

• For guidance on some types of costs we do not allow or restrict, see Budget in section 4.1.iv of the Application Guide. You can also see 45 CFR part 75, General Provisions for Selected Items of Cost.

• For-profit organizations cannot earn profit from the federal award. See 45 CFR 75.216(b).

• The General Provisions in Division H that reference the Consolidated Appropriations Act, 2023 (P.L. 117-328) apply to this program. Note that these and other restrictions will apply in fiscal years that follow, as the law requires.

Program-specific restrictions You cannot use funds under this notice for the following:

• Funding restrictions included in PCN 16-02.

• Charges that are billable to third party payors (e.g., private health insurance, prepaid health plans, Medicaid, Medicare, Department of Housing and Urban Development (HUD) funding for housing services, other RWHAP funding including AIDS Drug Assistance Program).

• To directly provide housing or health care services (e.g., HIV care, counseling and testing) that duplicate existing services.

• Payments for clinical research.

• Payments for nursing home care.

• Cash payments to intended clients of RWHAP services.

• Purchase or improvement to land.

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

Step 1: Review the Opportunity 10 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://www.hrsa.gov/sites/default/files/hrsa/grants/sf424-application-guide.pdf#page=20 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75#p-75.216(b) https://www.ecfr.gov/current/title-45/part-75#p-75.216(b) https://www.congress.gov/bill/117th-congress/house-bill/2617/text https://www.congress.gov/bill/117th-congress/house-bill/2617/text https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf

• Purchase, construction, or major alterations or renovations on any building or other facility (see 45 CFR part 75 – subpart A Definitions).

• PrEP or non-occupational Post-Exposure Prophylaxis (nPEP) medications or the related medical services. As outlined in the updated November 16, 2021 RWHAP and PrEP program letter, the RWHAP statute provides grant funds to be used for the care and treatment of people with HIV, thus prohibiting the use of RWHAP funds for PrEP medications or related medical services, such as clinician visits and laboratory costs. RWHAP Part D funds can be used toward psychosocial support services, a component of family-centered care, which may include counseling and testing and information on PrEP to eligible clients’ partners and affected family members, within the context of a comprehensive PrEP program.

• Purchase of sterile needles and syringes for the purpose of hypodermic injection of any illegal drug use. Some aspects of syringe services programs are allowable with HRSA’s prior approval and in compliance with HHS and HRSA policy. See Syringe Services Programs.

• Development of materials designed to directly promote or encourage intravenous drug use or sexual activity, whether homosexual or heterosexual.

• Research.

• Foreign travel.

• Long-term activities; instead, the activities should be short-term in nature with a targeted completion by the end of the one-year period of performance.

You must have policies, procedures, and financial controls in place. Anyone who receives federal funding must comply with legal requirements and restrictions, including those that limit specific uses of funding:

• Follow the list of statutory restrictions on the use of funds in Section 4.1 (Funding Restrictions) of the Application Guide. We may audit the effectiveness of these policies, procedures, and controls.

• 2 CFR § 200.216 prohibits certain telecommunications and video surveillance services or equipment. For details, see the HRSA Grants Policy Bulletin Number:

2021-01E.

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

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

Step 1: Review the Opportunity 11 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.pdf https://www.hiv.gov/federal-response/policies-issues/syringe-services-programs/ https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf https://www.hrsa.gov/grants/manage-your-grant

Indirect costs Indirect costs are those incurred for a common or joint purpose across more than one project and that cannot be easily separated by project (like utilities for a building that supports multiple projects). Learn more at 45 CFR 75.414, Indirect Costs.

You determine indirect costs using one of two methods:

Method 1 – Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency.

Method 2 – De minimis rate. Per 45 CFR 75.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate.

This rate is 10% of modified total direct costs (MTDC). See 45 CFR 75.2 for the definition of MTDC. You can use this rate indefinitely. If you use this rate, you must use it for all federal awards unless you negotiate a rate.

Program income Program income is money earned from your project activities. You will have to use those funds to add to approved project activities. Find more about program income at

45 CFR 75.307.

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

Step 1: Review the Opportunity 12 https://www.ecfr.gov/current/title-45/section-75.414 https://www.ecfr.gov/current/title-45/part-75#p-75.414(f) https://www.ecfr.gov/current/title-45/part-75#p-75.2(Modified%20Total%20Direct%20Cost) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307

Step 2:

Get Ready to Apply

In this step

Get registered 14

Find the application package 14

Application writing help 14

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

To register, go to SAM.gov Entity Registration and click Get Started. From the same page, you can also click on the Entity Registration Checklist for the information you will need to register.

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

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-24-061.

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

Application writing help Visit HHS Tips for Preparing Grant Proposals.

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

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

Step 2: Get Ready to Apply 14 https://sam.gov/content/entity-registration https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/search-grants https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application

Join the webinar For more information about this opportunity, join the webinar on March 19, 2024, at 2 p.m. ET.

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

• Phone number: 833 568 8864 US Toll-free

• Meeting ID: 160 439 4653

• Passcode: 41255177

We will record the webinar. If you are not able to join live, a recording and transcript will be made available on the TargetHIV site within 5 business days.

Need help? See Contacts and Support.

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

Step 2: Get Ready to Apply 15 https://hrsa-gov.zoomgov.com/j/1604394653?pwd=WXhXeUhzNzVBY0xSM0VHV2tNYXBoQT09 tel:+833568-8864 https://targethiv.org/ https://targethiv.org/

Step 3:

Prepare Your Application

In this step

Application contents and format 17

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

There is a 25-page limit for the overall application.

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

Make sure you include each of these:

Component Submission format Included in the page limit?

Project Abstract Use the Project Abstract Summary form No

Project Narrative Use the Project Narrative form Yes

Budget Narrative Use the Budget Narrative form Yes

Attachments Insert each in the Other Attachments form Yes, unless otherwise marked in the next section.

Other Required Forms Upload using each required form. No

Required format

You must format your narratives and attachments using our required formats for fonts, size, margins, etc. See the formatting guidelines in section 4.2 of the Application Guide.

Program requirements and expectations You may submit a proposal for only one of the following two categories:

• HIV Care Innovation

• Infrastructure Development

You must then select only one activity under your selected category. Note that if you choose the Infrastructure Development category, there is only one available activity.

A description of the activities by category is provided here.

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

Step 3: Prepare Your Application 17 https://www.hrsa.gov/sites/default/files/hrsa/grants/sf424-application-guide.pdf#page=37

HIV Care Innovation activities

Activity: Doula services

Background

Improving maternal and infant health are HRSA priorities and are connected to the implementation of the White House Blueprint for Addressing the Maternal Health Crisis, a government-wide strategy to combat maternal mortality and morbidity, as well as the HRSA Enhancing Maternal Health Initiative. This includes supporting programs or activities that result in:

• A more diverse maternal care workforce

• Better access to doulas and midwives to improve outcomes for people with HIV who are pregnant, postpartum or hoping to become pregnant

A doula is a professional trained in childbirth who provides emotional, physical, and educational support to a person who is expecting, is experiencing labor, or has recently given birth.

Additionally, a postpartum doula provides evidence-based information on things such as:

• Infant feeding

• Emotional and physical recovery

• Bonding

• Infant soothing

• Basic newborn care

HRSA’s HIV/AIDS Bureau (HAB) understands the vital role doulas play in not only advancing health equity and reducing disparities in infant mortality, maternal mortality and other adverse perinatal outcomes, but also in achieving the goals of the NHAS by assisting in the improvement of HIV-related health outcomes of birthing people with HIV and reducing HIV-related disparities and health inequities.

Directions

If you select this activity, it must address one of the following two components, which are critical to the provision of doula care for people with HIV and their families, and address at least one or more of the stages of the HIV care continuum:

Funding a doula to provide supportive services before, during, and after pregnancy to:

• Provide effective and culturally responsive pregnancy and childbirth education, early linkage to health care and social services, labor coaching, and encouraging parental attachment.

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

Step 3: Prepare Your Application 18 https://www.whitehouse.gov/wp-content/uploads/2022/06/Maternal-Health-Blueprint.pdf https://www.hrsa.gov/about/news/press-releases/maternal-health-initiative https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/

• Provide patient advocacy and support to clients during the prenatal, birth, and postpartum period (within three months after birth) to ensure their voices, needs, and decisions are being heard.

• Assist in the navigation of the health care system during pregnancy and postpartum by linking clients to support services, including mental health support.

• Assist with infant feeding options, particularly with the 2023 update to the Perinatal HIV Clinical Guidelines.

• Assist in the support and education of pregnant and postpartum clients in the following of their HIV indeterminate infants.

• Provide education and support in the prevention of perinatal transmission during and after pregnancy.

Conducting outreach and building partnerships

• Activities in this category should address how doulas can conduct outreach and build partnerships with community-based organizations to engage and recruit people with HIV to engage with this program.

• Additional activities include educating clients on the role of doulas during the prenatal, birth, and postpartum periods.

Additional notices

• The Ryan White HIV/AIDS Program is the payor of last resort.

• Some states provide partial or full Medicaid reimbursement for doula services.

• It is the responsibility of the applicant to stay up to date on third party payor coverage of doula services and federal, state, and local programs that provide doula services in their service area and state.

• Additionally, some states have qualification standards for doulas (including training and certification requirements) to receive reimbursement from a state’s Medicaid program.

• Applicants can use the National Academy for State Health Policy’s resource on the current state of doula Medicaid Implementation and the HRSA Maternal and Child Health Bureau’s Healthy Start Community-Based Doulas Supplemental Awardees for FY 2021 and FY 2022 as some of the resources for current coverage and training and certification requirements.

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

Step 3: Prepare Your Application 19 https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://healthlaw.org/current-state-of-doula-medicaid-implementation-efforts-in-november-2022/ https://healthlaw.org/current-state-of-doula-medicaid-implementation-efforts-in-november-2022/ https://mchb.hrsa.gov/programs-impact/programs/healthy-start/fy-2021-healthy-start-initiative-awards https://mchb.hrsa.gov/programs-impact/healthy-start/doulas-fy-2022-awards

Activity: Streamlining eligibility for Ryan White Program services

Background

Consistent with the efforts of HRSA HAB to implement best practices for facilitating rapid entry to HIV care and treatment, streamlining Ryan White Program eligibility attempts minimizes client burden by utilizing available data sources before requesting additional information from the client.

Available sources of data that could verify eligibility are:

• Health information exchanges

• Medicaid enrollment

• State tax filings

• Enrollment and eligibility information collected from health care marketplaces

Recent reports indicate some program recipients have begun to streamline their eligibility processes across their respective states, jurisdictions, and participating community-based organizations.

Many HIV programs, including Ryan White Program recipients and subrecipients, could benefit from adopting these best practices.

Directions

For this activity, you should describe the method(s) you will use to conduct a local/ regional systems assessment of:

• Ryan White Program recipient organizations

• Care delivery systems

• Income based federal programs such as:

◦ Health Information Exchanges

◦ Medicaid

◦ Supplemental Nutrition Program for Women, Infants and Children

◦ Healthy Start

This assessment should identify current administrative systems, electronic data sources, and tools utilized to determine and confirm client eligibility, and obtain client consent.

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

Step 3: Prepare Your Application 20

Activity: Inclusive Care for underrepresented communities with disproportionately high rates of HIV

Background

This activity will focus on educating health care professionals and front-line service staff about the health and social needs of underrepresented communities with disproportionately high rates of HIV, such as transgender people with HIV, and how the provision of inclusive care can reduce HIV-related disparities and health inequities in this population. Note: The purchase of hormones and gender-affirming medical procedures is not an allowable activity under this announcement.

Directions

If you select this activity, you should implement inclusive care, education, and training in the clinical setting, and establish collaborative networks with other educational and training programs and community-based social service organizations serving underrepresented communities.

The activity must address at least one of the following two educational and training components critical to inclusive care for underrepresented communities with disproportionately high rates of HIV in at least one or more stages of the HIV care continuum.

Educational and training components (choose one of the two options listed here)

Didactic Training and Education

• Activities in this category should include training and education for clinical and front-line service staff on topics such as cultural competency, stigma, discrimination, and implicit bias, which can affect the quality of care and health outcomes.

• Educational content should address the social determinants of health, medical and pharmacological management of underrepresented communities with disproportionately high rates of HIV, such as transgender people with HIV.

• For mental health and psychosocial service providers, learning activities may also include training and education on trauma-informed, person-centered care.

Model of Care Infrastructure and Clinical Application for underrepresented communities with disproportionately high rates of HIV

• Activities in this category should include activities that facilitate an inclusive infrastructure of care.

• Examples may include modifying existing electronic health records (EHR), medical intake, or registration forms to be more inclusive, tailoring systems and forms to

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

Step 3: Prepare Your Application 21 collect sexual orientation and gender identity (SOGI) data, and integrating social determinants of health (SDOH) data into EHR systems.

• These activities can assist clinicians in providing more precise health and social risk assessments, making predictions about health care utilization and outcomes in underrepresented communities with disproportionately high rates of HIV, and in providing tailored clinical care.

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

• This activity may include strategies that create a more physically inclusive and supportive infrastructure.

Activity: Implementing evidence-informed interventions

Background

The NHAS identifies priority populations to reduce disparities and improve HIV outcomes, specifically to include RWHAP Part D WICY populations.

The NHAS recommends using viral suppression rates as a disparities indicator because increasing and maintaining viral suppression affects HIV-related deaths and transmissions.

Ryan White Program Part D recipients are expected to provide evidence-informed interventions that drive better health outcomes.

Directions

If you select this activity, you must select an evidence-informed intervention that aims to improve outcomes for priority WICY populations with HIV.

This activity may include:

• Training and educating staff on a specific intervention.

• Purchasing materials to implement an intervention.

• Strategic communication activities to promote and raise awareness of an intervention.

• Collecting and tracking performance measures to make continuous quality improvements and adaptations, if necessary.

• Evaluating performance measures and health outcomes.

• Establishing processes and procedures.

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

Step 3: Prepare Your Application 22 https://www.whitehouse.gov/wp-content/uploads/2021/11/National-HIV-AIDS-Strategy.pdf

The proposed intervention must address one or more of the stages of the HIV care continuum for WICY with HIV.

You should choose an intervention from the following resources, which are a library of evidence-informed interventions. Note that you must specify the intervention and resource library used to identify the intervention in the application.

• Best Practices Compilation

• Compendium of Evidence-Informed Approaches to Improving Health Outcomes for People Living with HIV

• Dissemination of Evidence-Informed Interventions

• Evidence-Informed Interventions

• Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention

Activity: Intimate partner violence screening and counseling

Background

There is an intersection between people who experience Intimate Partner Violence (IPV) and HIV risk and barriers to HIV care and treatment.

Addressing IPV’s impact on health requires compassionate patient-centered and trauma-informed services and organizations. These approaches also supplement physical and behavioral health needs and help disrupt cycles of violence and trauma that negatively impact wellness.

Directions

If you select this activity, you should implement IPV screening and counseling in the clinical setting and establish referral networks to community-based social service organizations.

The activity must address 1 or more of the stages of the HIV care continuum.

For resources addressing this topic, access the IPV Toolkit (Intimate Partner Violence Health Partners Toolkit) located on the HRSA Office of Women’s Health website.

Infrastructure Development activity

Activity: Electronic health record and data coordination

Background

Coordination and integration of Electronic Health Record (EHR) systems with HIV data can reduce double entries and improve accuracy of data collection and reporting.

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

Step 3: Prepare Your Application 23 https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://targethiv.org/bestpractices https://targethiv.org/CIE/interventions https://targethiv.org/CIE/interventions https://targethiv.org/deii https://targethiv.org/e2i https://www.cdc.gov/hiv/research/interventionresearch/compendium/lrc/completelist.html https://www.cdc.gov/hiv/research/interventionresearch/compendium/lrc/completelist.html https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://www.hrsa.gov/office-womens-health/addressing-intimate-partner-violence/community-level#ipvtoolkit https://www.hrsa.gov/office-womens-health/addressing-intimate-partner-violence/community-level#ipvtoolkit https://www.hrsa.gov/office-womens-health

Directions

Activities in this category can include the purchase of software to interface CAREWare (or other HIV data collection systems) with existing electronic health records to:

• Improve accuracy and efficiency in data collection and reporting.

• Create mapping and workflows to reduce administrative burden.

• Verify and cleanse data.

• Test and verify historical and new data.

• Integrate oral and primary health EHR systems.

• Secure consultant services on system integration and coordination.

The proposed activities in this category must be used to enhance or expand an organization’s existing EHR system to improve the quality, safety, and efficiency of patient health care for WICY with HIV.

This activity cannot be used for the purchase of an EHR system.

HAB requires that any EHR component purchased, in whole or in part, with federal funds meet the Office of the National Coordinator for Health Information Technology (ONC) requirements for certification.

To improve the quality of clinical data collected, HAB further requires that any EHR or EHR component be configured to report appropriate clinical data electronically for HAB reporting. More information can be found on ONC’s website, HealthIT.gov.

Project abstract Complete the information in the Project Abstract Summary Form. Include a short description of your proposed project. Include the needs you plan to address, the proposed services, and the population groups you plan to serve. For more information, see section 4.1.ix of the Application Guide.

In addition, please name your project title “FY 2024 RWHAP Part D WICY Supplemental Funding” 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 to improve or expand access to HIV primary care or supportive services for low-income WICY with HIV.

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

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

Step 3: Prepare Your Application 24 https://www.healthit.gov/topic/certification-ehrs/certification-health-it https://www.hrsa.gov/sites/default/files/hrsa/grants/sf424-application-guide.pdf#page=36

Project narrative In this section, you will describe all aspects of your project.

Use the section headers and the order that follow.

Introduction See merit review criterion 1: Need

• Briefly describe the purpose of your project.

• Clearly indicate the category under which the proposed activity falls, either:

◦ HIV Care Innovation

◦ Infrastructure Development

• Discuss why your local community and organization needs supplemental funding.

• Discuss how the proposed activity will develop, enhance, or expand access to high quality, family-centered HIV primary care services for low-income WICY with HIV.

• If the proposed activity is an expansion of a previously funded activity, clearly describe how the proposed activity builds upon and furthers the objectives of the previously funded activity in maximizing impact.

Organizational information See merit review criterion 5: Resources and capabilities

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

• Highlight key staff with relevant expertise and experience with similar work. This information should align with the staffing plan provided in Attachment 4 and the biographical sketches of key personnel provided in Attachment 2.

• Describe the organizational resources that you’ll use to sustain, without additional funds from the federal government, the project activities or enhancements supported by this award beyond the 1-year period of performance.

• Describe your experience with the fiscal management of grants and contracts.

Include information on your organization’s experience managing multiple federal grants.

• Discuss the organization’s ability to secure agreements with community-based organizations, health care providers, and consultant services. Additionally, briefly discuss the organization’s ability to recruit and hire staff or contract staff within a reasonable timeframe to compete project activities.

Step 3: Prepare Your Application 25

• If selecting doula services, please provide the following information:

◦ Whether the doula(s) is hired as a full-time employee or as a contractor.

◦ Your organization’s recruitment plan to hire or contract doulas.

Need See merit review criterion 1: Need

For HIV Care Innovation activities only:

• Describe the priority WICY with HIV population(s) in your service area and their unmet health care needs.

◦ More specifically, describe how this priority population(s) is disproportionately affected by the HIV epidemic and has poor health outcomes.

• Describe the service needs based on your assessment of the gaps in the HIV care continuum for WICY with HIV in your community.

• Provide data on the five stages of the HIV care continuum for your priority WICY 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 in the HAB Performance Measure Portfolio.

• Discuss any relevant barriers in the service area that the project hopes to overcome.

• Use and cite demographic data whenever possible.

For the Doula Services activity only: discuss how doula support will be beneficial to your priority population and any anticipated barriers providing doula services to your target population.

For Streamlining RWHAP Eligibility only:

• You should describe the method(s) you will use to conduct a local/regional systems assessment of RWHAP recipient organizations, care delivery systems, and/or income based federal programs, to identify current administrative systems, electronic data sources, and tools utilized to determine client eligibility, confirm eligibility, and obtain client consent.

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

For the Infrastructure Development activity only:

• Outline the community or organization’s needs you plan to address.

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

Step 3: Prepare Your Application 26 https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio

• Describe the gaps in organizational capacity that exist due to current limitations in system infrastructure. Include alterations you have made to the current service delivery system and how lessons learned will be applied to this activity.

• Provide information specific to the selected activity and describe how these gaps or limitations are affecting the optimal provision of quality HIV primary care services and/or affecting your organization’s ability to optimize your response to the changing health care landscape. Discuss any relevant barriers in the service area that the project hopes to overcome.

Approach See merit review criterion 2: Response

Tell us how you’ll address your stated needs and meet the program requirements and expectations described in this NOFO.

• Describe how you will engage WICY with HIV and/or organizations that represent them in the implementation of this activity, including decision-making.

• Discuss how you will carry out your activity

• Include the partners and/or agencies or programs you will work with on your proposed activity, if applicable

• Identify the tasks each partner will perform and the amount of funding, if any

• Include letters of agreement and/or memoranda of understanding from each partner and/or collaborating agency or agencies as Attachment 6

• Describe how you intend to share relevant information, lessons learned, and products developed through your funded activity with other providers in the community or collaborators to your project.

• Propose a plan for continuing the project when federal funding ends. We expect you to keep up key strategies or services and actions that have led to improved practices and outcomes for women, infants, children, and youth with HIV.

• If you chose the evidence-informed interventions, specify the intervention proposed. This requirement does not apply to any other activity.

Work plan See merit review criteria 2: Response and 4: Impact

• Describe how you’ll achieve each of the objectives during the period of performance.

• Provide a timeline that includes each activity and identifies who is responsible for each.

Step 3: Prepare Your Application 27

• Identify how key stakeholders will help plan, design, and carry out all activities, including the application.

• You will also include a more detailed work plan that you will submit as Attachment 5.

Resolving challenges See merit review criterion 2: Response

• Discuss challenges that you are likely to encounter in designing and carrying out the activities in the work plan.

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

Evaluation and technical support capacity See merit review criteria 3: Evaluation measures and 5: Resources and capabilities

• Describe the expected outcomes of the funded activities.

• Describe the systems and processes that you’ll use to track performance outcomes.

• Describe how you’ll collect and manage data in a way that helps you improve the way you carry out your activity.

• Describe the evaluation plan that will be used to monitor ongoing processes and progress toward the goals and objectives. Describe barriers and your plan to overcome them.

• If applicable, describe your plan to evaluate how the project performs and how the results will contribute to your program’s clinical quality management (CQM) program.

• Discuss how CQM of this activity contributes to the CQM goals of your RWHAP Part D WICY program.

For the Doula Services activity only: track at a minimum, the following measures for the period of performance:

• The number of hired or contracted doulas.

• The number of RWHAP Part D clients and affected family members that receive doula services and the type of service received.

• The period(s) of support the services were provided (e.g. prenatal, birth, and/or postpartum).

Step 3: Prepare Your Application 28

Budget and budget narrative See merit review criterion 6: Support requested

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

Reminder: The total project or program costs are all allowable (direct and indirect) costs used for the HRSA activity or project. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement (which may include MOE, if applicable).

Line-Item Budget: In addition to the SF-424 Application Guide requirements, you must also provide the line-item budget and budget narrative according to each object class category (e.g., Personnel, Fringe Benefits, Travel). The budget allocations on the line-item budget must relate to the activities proposed in the project narrative, including the work plan.

In order to evaluate your adherence to RWHAP Part D statutory budget requirements, submit a program-specific line-item budget for the one-year period of performance, and highlight in bold any administrative costs.

Please note, if awarded the supplemental funds, these new funds should be added to the total amount of the RWHAP Part D base awards received, and the 10 percent administrative cost cap recalculated to include these funds.

For further guidance on the classification of administrative costs, see HAB PCN 15-01 Treatment of Costs under the 10% Administrative Cap for Ryan White HIV/AIDS Program Parts A, B, and D.

Review HAB PCN 16-02 Eligible Individuals and Allowable Uses of Funds for allowable uses of RWHAP funds.

The line-item budget submitted must not exceed the total funding ceiling amount. In addition, the total amount requested on the SF-424A and the total amount listed on the line-item budget must match. Please list personnel separately by position title and the name of the individual for each position title or note if the position is vacant. In addition, designate the full-time equivalent (FTE) of each listed personnel. Upload the line-item budget as Attachment 3.

As required by the Consolidated Appropriations Act, 2023 (P.L. 117-328), Division H, § 202, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II.” Effective January 2023, the salary rate limitation is $212,100. As required by law, salary rate limitations may apply in future years and will be updated.

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

Step 3: Prepare Your Application 29 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-15-01.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-15-01.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf https://www.congress.gov/bill/117th-congress/house-bill/2617/text

The budget narrative supports the information you provide in Standard Form 424-A.

See Other required forms. The merit review committee reviews both.

It includes added detail and justifies the costs you ask for. As you develop your budget, consider:

• If the costs are reasonable and consistent with your project’s purpose and activities.

• The restrictions on spending funds. See Funding Restrictions.

To create your budget narrative, see detailed instructions in section 4.1.v of the Application Guide.

Attachments You will upload attachments in Grants.gov in order using the Other Attachments form.

Attachment 1: Federally negotiated indirect cost rate (if applicable) Does not count toward page limit.

Submit a copy of the current agreement.

Attachment 2: Biographical sketches Does not count toward page limit.

Include biographical sketches for people who will hold the key positions you describe in Attachment 2.

For key personnel, include no more than two-page biographical sketches. Do not include personally identifiable information.