hrsa-25-049 FINAL2.pdf

Notice of Funding Opportunity

Application due March 18, 2025

HIV/AIDS Bureau/Office of Program Support Ryan White HIV/AIDS Program Part C Capacity Development Program

Ryan White HIV/AIDS Program Part C Capacity Development Program Opportunity number: HRSA-25-049

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 8

Award information 18

Step 2: Get Ready to Apply 21

Get registered 22

Find the application package 22

Application writing help 22

Step 3: Write Your Application 24

Application contents & format 25

Step 4: Learn About Review & Award 35

Application review 36

Selection process 40

Award notices 41

Step 5: Submit Your Application 42

Application submission & deadlines 43

Application checklist 44

Step 6: Learn What Happens After Award 46

Post-award requirements & administration 47

Contacts & Support 51

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 registrations are active and up-to-date.

SAM.gov registration (this can take several weeks)

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

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days)

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

See Step 2: Get Ready to Apply

Apply by the application due date

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

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

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

Jump to a step

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

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Award information 18

Basic information Health Resources and Services Administration

HIV/AIDS Bureau/Office of Program Support

Ryan White HIV/AIDS Program Part C Capacity Development Program

Have questions?

Go to Contacts and Support.

Key facts

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

Opportunity number:

HRSA-25-049

Announcement version:

New

Federal Assistance Listing Number: 93.918

Statutory authority: 42 USC § 300ff-54(c)(1)(B) (Title XXVI, § 2654(c)(1)(B) of the Public Health Service Act)

Key dates NOFO issue date: January 16, Informational webinar:

January 30, 2025 at 2:00 p.m. ET.

Application deadline: March 18, 2025

Expected award date is by:

September 1, 2025

Expected start date:

September 1, 2025

See other submissions for other time frames that may apply to this NOFO.

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

This notice of funding opportunity (NOFO) supports one short-term activity that can be completed by the end of the one-year period of performance.

Funding detail Application type: New

Expected total available funding in FY 2025: $9,000,000

Expected number and type of awards: 60 grants

Funding range per award: up to $150,000 per organization

We plan to fund awards in one 12-month budget period for a total 1-year period of performance of September 1, 2025 to August 31, 2026.

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

Step 1: Review the Opportunity 5

Eligibility Who can apply You can apply if your organization is in the United States.

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

• Public or non-profit private entity

• Community-based organization

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

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

• Native American tribal governments

• Native American tribal organizations

* “Domestic” means the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

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

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

We will not consider an application that:

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

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

• Is submitted after the deadline.

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

Step 1: Review the Opportunity 6

Cost sharing This program does not have a 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 Purpose The purpose of this program is to strengthen organizational capacity to respond to the changing health care landscape and increase access to high-quality HIV primary health care services for low-income and underserved people with HIV.

Background The Ryan White HIV/AIDS Program The HRSA Ryan White HIV/AIDS Program (RWHAP) 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 transmission 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 transmission.

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 improve outcomes across the HIV care continuum. To assess your program, review 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 and impact.

1. Review 2. Get Ready 3. Write 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://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 There have been significant accomplishments of the RWHAP:

• From 2018 to 2022, HIV viral suppression among Ryan White program patients improved from 87.1% to 89.6%. For more, see the 2022 Ryan White Services Report

(RSR).

• Racial, ethnic, age-based, and regional disparities in viral suppression rates have significantly decreased. For more, 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 transmission by linking people with HIV to the care, treatment, and support services needed to help them reach viral suppression. For the RWHAP, the EHE initiative expands the program’s ability to meet the needs of clients, specifically focusing on linking to care and treatment, people with HIV who are newly diagnosed, diagnosed but currently not in care, or who are in care but not yet virally suppressed.

Using data effectively HRSA and CDC promote integrated data sharing and use for program planning, quality improvement, and public health action.

We encourage you to:

• Follow the CDC’s Data Security and confidentiality guidelines at: 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

• 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 our interactive RWHAP Compass Dashboard to visualize reach, impact, and outcomes of the Ryan White program and to inform planning and decision making. The dashboard gives you a look at national, state, and metro area data and displays client demographics, services, outcomes, and viral suppression. It also includes data about clients in the AIDS Drug Assistance Program (ADAP).

• Develop data-sharing strategies with other RWHAP recipients and relevant entities to reduce administrative burden.

1. Review 2. Get Ready 3. Write 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://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline/ https://www.cdc.gov/program-collaboration-service-integration/php/data-security/index.html https://www.cdc.gov/program-collaboration-service-integration/php/data-security/index.html https://www.cdc.gov/program-collaboration-service-integration/php/data-security/index.html https://www.cdc.gov/program-collaboration-service-integration/php/data-security/index.html 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 & Payor of Last Resort in the Ryan White HIV/AIDS Program.

Program resources and innovative models We offer multiple projects and resources to help you. A full list of resources is available on TargetHIV. We urge you to learn about them and use them in your project. For some examples, see Helpful Websites.

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

• HIV Care Innovation

• Infrastructure Development

In choosing your activities, you are encouraged to review tools and resources developed under RWHAP Part F Special Projects of National Significance (SPNS) Program and HAB Technical Assistance projects. Through each of these programs and funding mechanisms, HRSA has a number of evidence based, evidence informed and emerging strategies that may be useful for you to consider as part of your capacity building efforts.

You are encouraged to review and submit proposals that incorporate one or more of these tools, interventions, or strategies within your organization in accordance with the allowable service categories defined in PCN 16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals and Allowable Uses of Funds as resources permit.

You must then select only one activity under your selected category. You may propose an expansion of an activity previously supported under FY 2023 or FY 2024 RWHAP Part C Capacity Development Program funding (HRSA-23-052; HRSA-24-062) or RWHAP Part D Supplemental (HRSA-23-050; HRSA-24-061) for either category. However, we will not accept applications that propose the same activity in FY 2025 that were funded previously under the NOFOs listed above.

A description of the activities by category is below.

HIV Care Innovation activities

Activity: Strategic partnerships Background

Strategic, non-traditional partnerships are vital for the success of the Ryan White HIV/ AIDS Program in addressing the complex challenges of re-engaging those with HIV who

1. Review 2. Get Ready 3. Write 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://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.hrsa.gov/grants/find-funding/HRSA-23-052 https://www.hrsa.gov/grants/find-funding/HRSA-24-062 https://www.hrsa.gov/grants/find-funding/HRSA-23-050 https://www.hrsa.gov/grants/find-funding/HRSA-24-061 have fallen out of care and early linkage to primary HIV care. By strengthening partnerships with organizations beyond the traditional healthcare setting—such as substance use treatment facilities, Federal and State prison systems, other correctional systems, and community supervision programs, work-release programs, homeless shelters, housing and employment services, mental health, and social service agencies—the program can access hard-to-reach populations and provide a more whole person care support system. These collaborations can help identify and address barriers to care, such as stigma, transportation, childcare, housing, and economic instability, which disproportionately affect people with HIV. By leveraging the trust and reach of these non-traditional partners, the program can create more effective, culturally competent, and sustainable pathways to re-engagement, ensuring that people with HIV receive the comprehensive care they need to achieve optimal health outcomes.

Directions

If you select this activity, it must address at least one of the following components and address at least one or more of the stages of the HIV care continuum:

Partnership Development

• Craft and execute a plan to collaborate with strategic, non-traditional partners (e.g. treatment facilities, homeless shelters, local jail or prison, housing and employment programs, emergency rooms, etc.) that focus on serving people at highest risk of HIV/AIDS with a priority population of hard-to-reach and underserved people with HIV to engage and/or re-engage them into care or provide early linkage to medical and support services. The plan should describe how this partnership will address existing or emerging obstacles to care and how the partnership will strengthen your capacity to meet the continuum of service needs for people with HIV. Develop memoranda of understanding (MOUs) or partnership agreements to outline roles, responsibilities, plans for managing services via referrals and linkage to care, and shared goals with these non-traditional partners.

• Develop and maintain a robust network of culturally responsive referral partnerships that include but are not limited to health care providers, mental health services, substance use treatment facilities, social services programs, education and vocational training programs and organizations addressing housing and food insecurity. The partnerships should focus on identifying shared goals, and executing activities that improve coverage, access, and quality of services for people with HIV.

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

Step 1: Review the Opportunity 11 https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/

Training and Capacity Building

• Train community health workers and/or peer navigators from the community, such as members of faith base organizations with skills to identify and engage those with HIV, emphasizing culturally competent care and confidentiality. You can also train peers, especially those with lived experience, to provide support and navigate care systems, offering mentorship and fostering trust within the community.

• Hire a Strategic Partnerships Lead to meet, engage, and identify health-related partners in the local community, establish partnerships, educate partners on those Ryan White HIV/AIDS Programs in the community, and to oversee and implement the partnership plan.

• Develop and promote tools, trainings, and resources for primary care professionals, behavioral health professionals, treatment facilities, social service organizations providing housing and employment services, and other community organizations serving with those priority populations with HIV and those groups at highest risk for HIV infection.

Activity: Streamlining eligibility for Ryan White HIV/AIDS Program services Background

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

Many data sources are available to verify eligibility. Some examples of available sources of data that could verify eligibility are listed below (Agency names may differ by state or locality):

• Health information exchanges

• Medicaid enrollment

• State tax filings

• Enrollment and eligibility information collected from health care marketplaces

• State or local housing authority

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 RWHAP recipients and subrecipients, could benefit from adopting these best practices.

Step 1: Review the Opportunity 12

Directions

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

• Ryan White HIV/AIDS Program recipient organizations

• Care delivery systems

• Health Information Exchanges

• Income based federal programs such as:

◦ Low Income Home Energy Assistance Programs (LIHEAP)

◦ Medicaid

◦ Supplemental Nutritional Assistance Program (SNAP)

◦ Supplemental Security Income (SSI)

◦ Temporary Assistance for Needy Families (TANF)

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.

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 and how the provision of inclusive care can reduce HIV-related disparities in these populations.

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.

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

Step 1: Review the Opportunity 13

Educational and training components (choose one of the two options below):

1. 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 and stigma, 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.

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

2. Model of Care Infrastructure and Clinical Application 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 includemodifying existing electronic health records (EHR), medical intake, or registration forms to be more inclusive 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.

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

Activity: Coordination or integration of HIV primary care with oral health and/or behavioral health care Background

The NHAS outlines the importance of improved coordination and integration of HIV primary care with other services. Integration between oral health care or behavioral health care services (including mental health services) and primary care can help improve health outcomes for people with HIV and reduce HIV-related disparities.

Directions

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

Step 1: Review the Opportunity 14 https://www.whitehouse.gov/wp-content/uploads/2021/11/National-HIV-AIDS-Strategy.pdf

You may select this activity to coordinate or integrate behavioral health care to support the need and access to behavioral and mental health services for people with HIV.

Applicants can develop strategies, policies, and procedures to improve care coordination and integration of HIV primary care with oral health and/or behavioral health care. Specific activities may include developing policies and procedures to facilitate onsite provision of oral health care or behavioral health services; training staff to understand workflow and processes; and developing policies and procedures to track and coordinate referrals for oral health care or behavioral health services.

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

For resources and further insights into integrating oral health and primary care, please see Integration of Oral Health and Primary Care Technical Assistance Toolkit and other tools for creating innovative oral health care programs available on TargetHIV.org.

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. In addition, pregnant women are more likely to experience IPV throughout the course of their pregnancy; thereby increasing their risk for adverse pregnancy outcomes.

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.

Directions

If you select this activity, you should implement IPV screening, using an evidence-based tool and counseling in the clinical setting and establish referral networks to community-based social service organizations that can facilitate access to safe and stable housing, food, emotional support, and access to legal services.

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

For resources to prevent and address intimate partner violence, see the CDC’s Intimate Partner Violence: Resource for Action, the HRSA-developed Preventing and Responding to IPV: an Implementation Framework for HRSA Supported Settings of Care, Futures without Violence IPV Counseling and Screening Toolkit, and the National Maternal Mental Health Hotline.

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

Step 1: Review the Opportunity 15 https://targethiv.org/library/oral-health-and-hiv-primary-care-integration https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ https://www.cdc.gov/violence-prevention/media/pdf/resources-for-action/IPV-Prevention-Resource_508.pdf https://www.cdc.gov/violence-prevention/media/pdf/resources-for-action/IPV-Prevention-Resource_508.pdf https://www.hrsa.gov/office-womens-health/addressing-intimate-partner-violence/community-level https://www.hrsa.gov/office-womens-health/addressing-intimate-partner-violence/community-level https://ipvhealth.org/ https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline

Infrastructure Development activity

Activity: Emergency preparedness Background

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

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

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

Directions

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

Activity: Telehealth Background

The ability to provide patients access to care remotely though telehealth modalities has increased. Since telehealth allows for care delivery without regard to distance and without the need to travel, this modality can expand access to quality health care for patients in rural or remote areas and, to patients that otherwise may have difficulty accessing in-person care.

HRSA’s Office for the Advancement of Telehealth defines telehealth as “the use of electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, health administration, and public health.” This definition includes patient counseling and case

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

Step 1: Review the Opportunity 16 https://www.phe.gov/about/aspr/Pages/default.aspx https://www.phe.gov/about/aspr/Pages/default.aspx https://home.ecri.org/ https://home.ecri.org/ https://www.hrsa.gov/telehealth management. Telehealth also includes clinical activities such as mHealth, telehomecare, remote monitoring, e-health, and tele-ICUs

Directions

If you select this activity, you must develop and acquire, through lease or purchase, computer hardware and software, audio and video equipment, computer network equipment, interactive equipment, data terminal equipment, and/or other equipment that furthers the objectives of the proposed telehealth activity. You must describe technology requirements and each type of equipment to be employed. Include a concise description of the equipment’s relevance to the project, its cost-effectiveness, timeliness, accuracy of care, and ease of use. Discuss the telehealth reimbursement environment and whether Medicare, Medicaid, and/or private insurance in your state(s) cover telehealth services. For resources addressing this topic, access HRSA’s National Consortium of Telehealth Resource Centers or HRSA Telehealth Programs

Activity: Dental equipment for expanding dental service capacity Background

The American Dental Association recommends that oral health care be a part of all clinical care plans for people with HIV. A large proportion of people with HIV have unmet dental care needs due in part to lack of access or transportation, costs of care, fear, or other barriers. To address these unmet needs, the RWHAP supports a comprehensive approach to oral health care for low-income people with HIV, including the co-location of oral health care services with outpatient ambulatory health care.

Directions

If you select this activity, you must purchase dental equipment for the purpose of developing, enhancing, or expanding oral health care services for people with HIV.

Specifically, this activity involves creating or expanding a dental operatory in a clinic or in a mobile unit (e.g., van) through purchasing such equipment as dental patient chairs, sterilization units, X-ray imaging instruments, dental operating lights, operatory cabinets, hand pieces, etc.). Purchase of a van is not allowable under this activity.

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

Step 1: Review the Opportunity 17 https://digital.ahrq.gov/ahrq-funded-projects/use-mhealth-technology-supporting-symptom-management-underserved-persons-living https://www.telehealthresourcecenter.org/ https://www.telehealthresourcecenter.org/ https://www.hrsa.gov/rural-health/telehealth

Award information Funding policies & limitations Policies

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

General limitations

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

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

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

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

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

• 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

• 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

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

Step 1: Review the Opportunity 18 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf 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 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 C Capacity funds can be used toward risk reduction counseling and targeted testing, a component of primary HIV care, which may include counseling and testing and information on PrEP to eligible clients and their partners, 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 any type of sexual activity.

• 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.

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

Indirect costs are determined using one of two methods:

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

Method 2 – De minimis rate. Per 2 CFR 200.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose

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

Step 1: Review the Opportunity 19 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 https://www.ecfr.gov/current/title-2/section-200.414 this method, costs included in the indirect cost pool must not be charged as direct costs.

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

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

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

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

Step 2:

Get Ready to Apply

In this step

Get registered 22

Find the application package 22

Application writing help 22

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

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

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

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

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-25-049.

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

Application writing help Visit HHS Tips for Preparing Grant Proposals.

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

See Apply for a Grant for other help and resources.

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

Step 2: Get Ready to Apply 22 https://sam.gov/content/entity-registration https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application/assurances-non-construction-programs https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application/assurances-non-construction-programs https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/search-grants https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant

Join the webinar For more information about this opportunity, join the webinar on January 30, 2025 at 2pm ET.

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

• Phone number: 833-568-8864

• Meeting ID: 160 104 7765.

We will record the webinar. If you are not able to join live, you can replay it at TargetHIV.

Have questions? Contacts & Support

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

Step 2: Get Ready to Apply 23 https://hrsa-gov.zoomgov.com/j/1601047765?pwd=mJMtD9Pa3wUz1H8qw5Ph0MzaZoihTC.1 https://targethiv.org/user/login?destination=/calendar/hrsa-25-049

Step 3:

Write Your Application

In this step

Application contents & format 25

Application contents & format Applications include 5 main components. This section includes guidance on each.

Application page limit: 25 pages

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

Make sure you include each of these:

Components Submission format

Project abstract Use the Project Abstract Summary form

Project narrative Use the Project Narrative Attachment form

Budget narrative Use the Budget Narrative Attachment form

Attachments Insert each in the Other Attachments form

Other required forms Upload using each required form

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

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

In addition, please name your project title “FY 2025 RWHAP Part C Capacity Development Program” and include the following information:

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

• A summary of the proposed activity and its intended impact to strengthen organizational infrastructure to respond to the changing health care landscape;

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

Step 3: Write Your Application 25 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=24 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 and/or to increase capacity to develop, enhance, or expand access to high-quality HIV primary health care services for low-income and underserved people with HIV.

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

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

Use the section headers and the order listed.

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/or organization needs capacity development funds and how the proposed activity will develop, enhance, or expand access to high quality HIV primary care services for low income and underserved people with HIV.

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

Need See merit review criterion 1: Need

For HIV Care Innovation activities only:

• Describe and document the priority 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 the priority populations with HIV in your community.

• Provide data on the 5 stages of the HIV care continuum for your priority population(s) with HIV using the most recent 3 calendar years of available data.

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

Step 3: Write Your Application 26

• 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 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.

• 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 people 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 9

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

Step 3: Write Your Application 27 https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio

• 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 people with HIV.

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

High-level work plan See merit review criteria 2: Response & 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.

• 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 7.

Resolving challenges See merit review criterion 2: Response

• Discuss challenges that you are likely to encounter in your work plan and explain approaches that you’ll use to resolve them.

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

Performance reporting and evaluation See merit review criteria 3: Evaluation measures & 5: Resources & capabilities

Outcomes

• Describe the expected outcomes of the funded activities.

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

Performance Measurement and Reporting

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

Step 3: Write Your Application 28

• For the Strategic Partnerships activity only: track at minimum, the following measures for the period of performance:

◦ Partnership Development

▪ The number of strategic partnerships and types of organizations

▪ The number of signed MOUs

◦ Implementation of Evidence-Based Programs – the number of pregnant women with HIV and people with HIV in the Evidence Based Programs

Program Evaluation

• 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 HIV program

Organizational information See merit review criterion 5: Resources & 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 6 and the biographical sketches of key personnel provided in Attachment 4.

• Describe the organizational resources that you’ll use to sustain, without additional funds from the federal government, the project activities or enhancements supported…