HRSA-25-050 Final.pdf

Notice of Funding Opportunity

Application due February 10, 2025

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-25-050

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 7

Award information 17

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 and format 25

Step 4: Learn About Review and Award 35

Application review 36

Selection process 41

Award notices 42

Step 5: Submit Your Application 43

Application submission and deadlines 44

Application checklist 45

Step 6: Learn What Happens After Award 47

Post-award requirements and administration 48

Contacts and Support 52

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 February 10, 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 7

Award information 17

Basic information Health Resources and Services Administration

HIV/AIDS Bureau

Division of Community HIV/AIDS Programs

This program supports current RWHAP Part D recipients to carry out one short-term activity that can be completed by the end of the 1 year period of performance.

Have questions? Go to Contacts & Support

Key facts

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

Opportunity number:

HRSA-25-050

Announcement version:

New

Federal assistance listing:

93.153

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

Key dates

NOFO issue date: December 10, 2024

Informational webinar:

December 17, 2024

Application deadline:

February 10, 2025, at 11:59 p.m. Eastern Time (ET)

Expected award date is by:

August 1, 2025

Expected start date:

August 1, 2025

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

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 the 1 year period of performance.

Funding detail Application type: Competing Supplement

Expected total available FY 2025 funding: $3,000,000

Expected number and type of awards: 25 grants

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

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

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

Step 1: Review the Opportunity 5

Eligibility Who can apply You can apply if you are a current recipient funded under the following:

• 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

Other eligibility criteria None.

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.

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 6

Program description Purpose 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.

HRSA intends funding under this program to support one short-term activity that can be completed by the end of the one-year period of performance. You may propose an expansion of an activity previously supported under the FY2023 or FY2024 RWHAP Part D Supplemental funding (HRSA-23-050; HRSA-24-061) or Part C Capacity Development funding (HRSA-23-052; HRSA-24-062) for either an HIV Care Innovation or Infrastructure Development activity; however, HRSA will not fund the same activity in FY 2025 as HRSA funded previously in FY 2023 or FY 2024. If the proposed project is an expansion of a previously funded activity, you must provide a clear rationale for how the proposed activity builds upon and furthers the objectives of the previously funded activity.

Background 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. Reaching viral suppression boosts the individual’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)

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

Step 1: Review the Opportunity 7 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

• 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.

Expanding the effort There have been significant accomplishments of the RWHAP:

• From 2018 to 2022, HIV viral suppression among Ryan White program clients 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 reduced. For more, see the RWHAP Annual Data Report 2022.

• In 2020, the Ending the HIV Epidemic in the U.S. (EHE) initiative launched to further expand federal efforts to reduce HIV transmission. For the RWHAP, the EHE initiative expands the program’s ability to meet the needs of clients, specifically focusing on linking people with HIV who are either newly diagnosed, diagnosed but currently not in care, or are diagnosed and in care but not yet virally suppressed, to the essential HIV care, treatment, and support services needed to help them reach viral suppression.

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 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 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).

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

Step 1: Review the Opportunity 8 https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/rwhap-annual-client-level-data-report-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

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

• 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 and select one activity under your selected category. Note that if you choose the Infrastructure Development category, there is only one available activity:

• HIV Care Innovation:

◦ Strategic Partnerships

◦ Doula services

◦ Streamlining eligibility for Ryan White Program services

◦ Inclusive care for underrepresented communities with disproportionately high rates of HIV

◦ Implementing evidence-informed interventions

◦ Intimate partner violence screening and counseling

• Infrastructure Development:

◦ Electronic health record and data coordination

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 challenge of re-engaging women with HIV who have fallen out of care and early linkage to prenatal care. By strengthening partnerships with organizations beyond the traditional healthcare setting—such as faith-based groups, fraternities and sororities, housing and employment services, educational institutions, domestic violence and family service organizations, mental

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/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 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, and economic instability, which disproportionately affect women 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 women with HIV receive the comprehensive, family-centered 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. faith-based organizations, OB/GYNs, midwives, emergency rooms, etc.) that focus on maternal health and HIV/AIDS to engage and/or re-engage women with HIV into care or provide early linkage to prenatal 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 maternal health service needs for people with HIV. Develop Memorandums 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 Title V programs, health care providers, mental health services, doulas, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Needy Families (TANF), 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 to women with HIV.

Training and Capacity Building

• Train community health workers and/or peer navigators from the community, such as members of faith based organizations with skills to identify and engage priority populations and women 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.

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

Step 1: Review the Opportunity 10 https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/

• Hire a Strategic Partnerships Lead to meet, discuss, and identify maternal and child health-related partners, establish partnerships, educate partners on the RWHAP Part D, and to oversee and implement the partnership plan.

• Develop and promote tools, trainings, and resources for maternal and child health professionals, community organizations, families, state Title V agencies, Healthy Start Programs, and other maternal and child health programs on working with priority populations with HIV and their affected family members.

Implementation of Evidence-Based Programs

• Establish and implement pregnancy and child-birth evidence-based support groups or programs, focusing on prenatal care, mental health, and coping strategies for people with HIV and their affected family members.

• Establish and implement pregnancy case management models focusing on monitoring and tracking pregnant people throughout the course of their pregnancy, and post-partum to ensure linkage back to primary HIV medical care.

Activity: Doula services Background

Improving maternal and infant health are HRSA priorities and are connected to the implementation of government-wide strategies 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 representative maternal care workforce

• better access to doulas and midwives to improve outcomes for people with HIV before, during, or after pregnancy

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 topics such as:

• Infant feeding

• Emotional and physical recovery

• Bonding

• Infant soothing

• Basic newborn care

Directions

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

Step 1: Review the Opportunity 11 https://www.hrsa.gov/about/news/press-releases/maternal-health-initiative

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.

• Provide patient advocacy and support to clients during the prenatal, birth and postpartum period (within 3 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

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

Step 1: Review the Opportunity 12 https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum/ 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/

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.

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.

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

Step 1: Review the Opportunity 13 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

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 this population.

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 below):

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 and 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.

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 and integrating social determinants of health (SDOH) data into EHR systems.

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

Step 1: Review the Opportunity 14

• 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: 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 such as a curriculum or manual, office supplies necessary to implement the intervention, educational packets or kits, etc.

• 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 such as handling missed visits, recapturing patients lost to care, screening for social determinants of health needs that may inhibit retention in care, or tracking pregnant patients referred out for maternal care and the process for ensuring that those patients return to HIV medical care after delivery, etc.

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

Step 1: Review the Opportunity 15 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. 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.

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 Prevention 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 16 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.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: 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.

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, linked here.

Award information Funding policies and limitations Policies

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

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

Step 1: Review the Opportunity 17 https://www.healthit.gov/topic/certification-ehrs/certification-health-it

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).

• The salary rate limitation imposed by the current appropriations act applies to this program. As of January 2024, the salary rate limitation is $221,900. Note this limitation may apply in future years and will be updated.

Program-specific 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 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

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/subtitle-A/subchapter-A/part-75/subpart-E/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-E/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-45/part-75#p-75.216(b) 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 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.

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

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

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

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

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 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC))

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.

Step 1: Review the Opportunity 20

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. 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-25-050.

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.

Join the webinar For more information about this opportunity, join the webinar on December 17, 2024 at 2:00pm – 4:00pm ET.

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 https://hrsa-gov.zoomgov.com/j/1608709309?pwd=bl7p3EEgsAQq258AWAbcM2o8admnbW.1

If you are not able to join through your computer, you can call in at 1-833-568-8864.

meeting ID: 160 870 9309

Passcode: 03658406.

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

Have questions? Go to Contacts and Support.

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

Step 2: Get Ready to Apply 23 https://targethiv.org/library/hrsa-25-050

Step 3:

Write Your Application

In this step

Application contents and format 25

Application contents and 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 Included in the page limit?

Project abstract Use the Project Abstract Summary form No

Project narrative Use the Project Narrative Attachment form Yes

Budget narrative Use the Budget Narrative Attachment form Yes

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

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, color, format, and margins. See the formatting guidelines in Section 3.2 of the Application Guide.

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

In addition, please name your project title “FY 2025 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.

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=8&zoom=100,93,88

• A statement noting if the proposed project is an expansion of a previously funded activity, if applicable.

• 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

• Clearly state if the proposed project is an expansion of a previously funded activity, if applicable.

• 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.

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 5 stages of the HIV care continuum for your priority WICY 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 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.

• 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.

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

• 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.

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 1.

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.

Step 3: Write Your Application 28

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.

• 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…