HRSA-25-058 Final.pdf

Notice of Funding Opportunity

Application due March 18, 2025

HRSA HIV/AIDS Bureau Division of Policy and Data

Improving Mental Health and Engagement in Care Among People with HIV — Implementation Technical Assistance Provider Opportunity number: HRSA-25-058

Modified on 1/28/25 Updated TA Webinar information

Contents Before you begin 4

Step 1: Review the Opportunity 5

Basic information 6

Eligibility 8

Program description 10

Award information 22

Step 2: Get Ready to Apply 26

Get registered 27

Find the application package 27

Application writing help 27

Step 3: Prepare Your Application 29

Application contents and format 30

Step 4: Learn About Review and Award 40

Application review 41

Selection process 46

Award notices 46

Step 5: Submit Your Application 47

Application submission and deadlines 48

Application checklist 49

Step 6: Learn What Happens After Award 51

Post-award requirements and administration 52

Contacts and Support 56

Contents 2

Endnotes 59

Contents 3

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 4 https://sam.gov/ https://grants.gov/

Jump to a step

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

Step 1:

Review the Opportunity

In this step

Basic information 6

Eligibility 8

Program description 10

Award information 22

Basic information Health Resources and Services Administration (HRSA)

HRSA HIV/AIDS Bureau

Division of Policy and Data

Adapting interventions to better serve people with co-occurring HIV and mental health conditions.

Have questions? Go toContacts and Support.

Key facts Opportunity name:

Improving Mental Health and Engagement in Care Among People with HIV — Implementation Technical Assistance Provider

Opportunity number:

HRSA-25-058

Announcement version:

Modification #1

Federal assistance listing:

93.928

Statutory authority:

42 USC §§ 300ff-54(b) and 300ff-101 (§§ 2654(b) and 2691 of the Public Health Service Act); and Consolidated Appropriations Act, 20242024, Pub. L.

118-47, Division D, t title II.

Key dates NOFO issue date:

January 16, 2025

Informational webinar:

See Webinar Section

Application deadline:

March, 18, 2025

Expected award date is by:

July 1, 2025

Expected start date: August 1, 2025

Summary This four-year funding opportunity is supported by the HRSA Ryan White HIV/AIDS Program (RWHAP) Part F: Special Projects of National Significance (SPNS) Program.

This funding uses implementation science to adapt and evaluate the implementation of interventions that better serve people with co-occurring HIV and mental health conditions. The focus is on people with HIV who are out of care or experiencing barriers to retention in care, and who also have mental health conditions. This initiative is for people who are RWHAP eligible.

This RWHAP SPNS initiative funds one implementation technical assistance provider (ITAP) and one evaluation provider (EP). The ITAP is funded under this opportunity and will be responsible for identifying the intervention strategies and selecting and issuing subawards to the implementation sites. The EP is funded separately under a companion NOFO. The ITAP and EP are required to co-lead the initiative. The HRSA HIV/ AIDS Bureau (HAB) encourages you to read and familiarize yourself with the program expectations of the EP companion NOFO, HRSA-25-059 (EP).

The funded ITAP will:

• Lead the identification of mental health interventions that the implementation sites will then adapt and implement. The ITAP will collaborate with the EP to ensure alignment with the evaluation.

• Lead the process of soliciting and selecting up to 10 implementation sites, in collaboration with the EP.

• Issue subawards to implementation sites and monitor sites in accordance with federal regulations.

• Provide, track, measure, and report implementation of technical assistance (TA) that adheres to the core components of the selected interventions.

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

Step 1: Review the Opportunity 6 https://www.govinfo.gov/content/pkg/USCODE-2011-title42/html/USCODE-2011-title42-chap6A-subchapXXIV.htm https://www.govinfo.gov/content/pkg/USCODE-2011-title42/html/USCODE-2011-title42-chap6A-subchapXXIV.htm https://www.govinfo.gov/content/pkg/USCODE-2011-title42/html/USCODE-2011-title42-chap6A-subchapXXIV.htm https://www.govinfo.gov/content/pkg/USCODE-2011-title42/html/USCODE-2011-title42-chap6A-subchapXXIV.htm https://www.govinfo.gov/app/details/PLAW-117publ328 https://www.govinfo.gov/app/details/PLAW-117publ328 https://www.govinfo.gov/app/details/PLAW-117publ328 https://ryanwhite.hrsa.gov/about/parts-and-initiatives/part-f-spns https://ryanwhite.hrsa.gov/about/parts-and-initiatives/part-f-spns https://targethiv.org/library/topics/eligibility https://grants.gov/search-results-detail/354788

• Coordinate closely with the EP to ensure that implementation TA aligns with the evaluation plan.

• Lead the development and implementation of a communications and dissemination plan for the initiative, including by creating user-friendly multimedia materials.

• Support the EP-led implementation science multisite evaluation of the initiative, as needed.

Funding details Application type: New

Expected total available funding in FY 2025: $2,250,000 (Year 1), $4,000,000 per year (Years 2 and 3), $2,750,000 (Year 4)

Expected number and type of awards: One cooperative agreement

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 four 12-month budget periods for a total four-year period of performance from August 1, 2025, to July 31, 2029.

Step 1: Review the Opportunity 7

Eligibility Who can apply Eligible applicants include domestic entities eligible for funding under Ryan White HIV/ AIDS Program Parts A - D of Title XXVI of the Public Health Service (PHS) Act.

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

• Public and nonprofit private entities.

• State and local governments.

• Academic institutions.

• Local health departments.

• Nonprofit hospitals and outpatient clinics.

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

• Faith-based and community-based organizations.

• Indian tribes or tribal organizations with or without federal recognition.

* “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, or the Republic of Palau.

Individuals are not eligible applicants under this NOFO.

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.

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

Step 1: Review the Opportunity 8 https://ryanwhite.hrsa.gov/about/parts-and-initiatives https://ryanwhite.hrsa.gov/about/parts-and-initiatives

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

Step 1: Review the Opportunity 9

Program description Purpose This initiative has the following three objectives:

• Objective 1: Support a national cohort of implementation sites to adapt and implement culturally responsive interventions to engage and retain people with co-occurring HIV and mental health conditions in HIV primary care and mental health services.

• Objective 2: Evaluate the implementation of interventions using implementation science frameworks. The EP will document and share evaluation findings throughout the initiative to support successful implementation. The evaluation will assess:

◦ Intervention adaptations.

◦ Barriers and facilitators to implementation.

◦ Implementation strategies.

◦ Cost.

◦ Other implementation, client, and service outcomes.

• Objective 3: Create and disseminate user-friendly multimedia materials to help other RWHAP organizations replicate effective interventions.

This RWHAP SPNS initiative funds one ITAP and one EP. The EP is funded separately under a companion NOFO. The ITAP and EP are required to co-lead the initiative. Full information on required activities and roles and responsibilities can be found in the program objectives and requirements section.

This initiative focuses on people with HIV and mental health conditions who are out of care or experiencing barriers to retention in care. You may identify additional priority populations, including those identified by the National HIV/AIDS Strategy (NHAS) [PDF], when you are selecting the implementation sites.

Learnings from this initiative will help the RWHAP determine what implementation strategies work to engage people with HIV in care and improve mental health and HIV outcomes in different settings among different priority populations. The ITAP and EP will document and widely share lessons learned with the RWHAP community and beyond to help other organizations replicate these interventions to improve mental health and quality of life among people with HIV in their own settings.

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

Step 1: Review the Opportunity 10 https://files.hiv.gov/s3fs-public/NHAS-2022-2025.pdf

Mental health and HIV People with HIV are more likely to have one or more occurring mental health conditions, compared to people without HIV. These mental health conditions include depression, anxiety, and post-traumatic stress disorder. Some populations who are disproportionately impacted by HIV also experience increased mental health disparities, including priority populations as defined by the National HIV/AIDS Strategy (2022–2025). Untreated mental health conditions among people with HIV result in reduced quality of life and poorer health outcomes, including lower rates of viral suppression and higher rates of mortality.

Untreated mental health conditions also contribute to lower engagement in HIV care.

Approximately 21 percent of people with HIV in the United States were out of care between 2018 and 2020. Compared to people with HIV in care, those who are out of care are more likely to report mental health symptoms as a barrier to HIV care. They also self-report poorer health and more unmet non-HIV medical and mental health needs. It is estimated that 60 percent of HIV transmissions result from people with HIV who are out of care.

Although this initiative focuses on mental health, it is important to highlight the complex relationship between mental health, substance use, stigma, and the social determinants of health. Mental health and substance use conditions often reinforce each other, resulting in poorer health outcomes such as lower rates of viral suppression and increased rates of hospitalization. Many factors can contribute to the prevalence of mental health conditions among people with HIV at the biological, individual, social, and structural levels.

Key definitions For this initiative, the following definitions will be used:

• Implementation science is the study of methods to promote or improve the systematic uptake of effective intervention strategies by public health practice, program, and policy. Intervention strategies may occur at the system, community, organization, and individual levels. At HRSA HAB, successful intervention strategies positively impact health and quality of life for people with HIV.

• Intervention strategies: HRSA HAB categorizes interventions into three levels, based on evidence of demonstrated effectiveness. The three levels are collectively known as “intervention strategies” and include:

◦ Evidence-based interventions: Interventions that are demonstrated to effectively improve health and/or quality of life, based on published research.

These interventions meet the CDC criteria for being evidence-based.

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

Step 1: Review the Opportunity 11 https://journals.lww.com/aidsonline/fulltext/2023/02010/the_prevalence_of_mental_health_disorders_in.5.aspx https://journals.lww.com/aidsonline/fulltext/2023/02010/the_prevalence_of_mental_health_disorders_in.5.aspx https://journals.lww.com/aidsonline/fulltext/2019/07150/Mental_health_and_HIV_AIDS__the_need_for_an.1.aspx https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666642/ https://www.kff.org/hivaids/issue-brief/what-do-we-know-about-people-with-hiv-who-are-not-engaged-in-regular-hiv-care/ https://www.kff.org/hivaids/issue-brief/what-do-we-know-about-people-with-hiv-who-are-not-engaged-in-regular-hiv-care/ https://pubmed.ncbi.nlm.nih.gov/26973741/ https://journals.lww.com/aidsonline/fulltext/2019/07150/Mental_health_and_HIV_AIDS__the_need_for_an.1.aspx https://journals.lww.com/aidsonline/fulltext/2019/07150/Mental_health_and_HIV_AIDS__the_need_for_an.1.aspx https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003128 https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003128

◦ Evidence-informed interventions: Interventions that are demonstrated to effectively show promise, based on published research. Evidence-informed interventions may demonstrate impact and strength of evidence without meeting CDC criteria for being evidence-based.

◦ Emerging interventions: Innovative practices that have not yet been published or do not have extensive evaluation data but have effectively improved health and/or quality of life.

• Implementation strategies: Methods to enhance the adoption or uptake of interventions in specific settings.

• Culturally responsive care: Services that are culturally grounded, attuned, and sensitive to the unique needs of each client and their cultural background.

• Flexible service delivery: The ability to quickly adjust services to meet the unique and evolving needs of clients—such as low-barrier care, street medicine, and nontraditional clinic hours.

• Integrated care: Clinicians’ careful coordination of HIV primary care, mental health care, and supportive services. Clinicians work together systematically and use a multidisciplinary approach to ensure clients receive one consistent message about care and treatment and are included in planning their treatment. See the Substance Abuse and Mental Health Services Administration’s 2023-2026 Strategic Plan.

• Mental health: The Substance Abuse and Mental Health Services Administration (SAHMSA) includes our emotional, psychological, and social well-being in its definition of mental health. Mental health affects how we think, feel, and act, and helps determine how we handle stress, relate to others, and make choices.

• Out of care or experiencing barriers to retention in care:

◦ Newly diagnosed with HIV within the past 12 months, or

◦ Diagnosed with HIV more than 12 months ago but not fully engaged in care, either by:

▪ Not attending at least two HIV medical care encounters at least 90 days apart within a 12-month measurement year (see HAB performance measure).

▪ Being at risk of disconnecting from care by missing their last appointment in the last six months, leaving incarceration, or having another high-risk factor.

▪ Not being virally suppressed—defined as having a viral load of 200 copies/mL or more—at the time of enrollment (see HAB performance measure).

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

Step 1: Review the Opportunity 12 https://www.samhsa.gov/about-us/strategic-plan https://www.samhsa.gov/about-us/strategic-plan https://www.samhsa.gov/mental-health https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio/core-measures/annual-retention-in-care https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio/core-measures/annual-retention-in-care https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio/core-measures/hiv-viral-load-suppression https://ryanwhite.hrsa.gov/grants/performance-measure-portfolio/core-measures/hiv-viral-load-suppression

• Recovery: SAMHSA’s working definition of recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery signals a dramatic shift to expecting positive outcomes for individuals who experience mental health and substance use conditions or both.

Background The HRSA Ryan White HIV/AIDS Program has five statutory funding parts that provide a comprehensive system of medical care, support, and medications for low-income people with HIV. The goal is better health results, and lower HIV 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)

• SAMHSA Strategic Plan (2023–2026)

• 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.

Expanding the effort There have been significant accomplishments:

• From 2018 to 2023, HIV viral suppression among RWHAP patients improved from 87.1% to 90.6%. For more, see the 2023 Ryan White Services Report (RSR).

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

Step 1: Review the Opportunity 13 https://www.samhsa.gov/find-help/recovery 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.samhsa.gov/about-us/strategic-plan https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/programs/topic-sites/sexually-transmitted-infections/plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://www.hhs.gov/hepatitis/viral-hepatitis-national-strategic-plan/national-viral-hepatitis-action-plan-overview/index.html https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/2023-ryan-white-annual-data-report.pdf

• Racial, ethnic, age-based, and regional disparities in viral suppression rates have significantly reduced. For more, see the 2023 Ryan White Services Report (RSR).

• 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).

• 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.

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

Step 1: Review the Opportunity 14 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/data/2023-ryan-white-annual-data-report.pdf https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview/ending-epidemic-timeline/ https://data.hrsa.gov/topics/hiv-aids/compass-dashboard 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

Program objectives and requirements Overview The ITAP and EP are co-leaders of this initiative. You are required to continuously collaborate and communicate with the EP, as well as with HRSA HAB, to achieve the goals of this program.

The table below shows the requirements for the ITAP and EP for initiative activities.

Details about the ITAP’s lead activities follow. In consultation with HRSA HAB, the ITAP and EP must collaboratively refine their roles and responsibilities within the first 90 days of the award and develop a comprehensive joint work plan.

Program Objectives (O) and Requirements (R) ITAP EP

O1 Support a national cohort of implementation sites to adapt and implement culturally responsive interventions to engage and retain people with co-occurring HIV and mental health conditions in HIV primary care and mental health services.

Lead Support

R1.1 Select and adapt interventions to engage and retain the priority population in HIV primary care and mental health services.

Lead Support

R1.2 Select and issue subawards to up to 10 implementation sites. Lead Support

R1.3 Train and monitor implementation sites on adhering to and adapting the intervention. Monitor compliance with federal regulations.

Lead Limited support [1]

R1.4 Coordinate and facilitate multisite meetings. Lead Support

O2 Evaluate the implementation of interventions using implementation science frameworks.

Support Lead

R2.1 Develop and implement a multisite evaluation plan grounded in implementation science.

Support Lead

R2.2 Develop and implement a process and digital platform for collecting and reporting implementation, service, client, and cost data.

Support Lead

R2.3 Provide implementation science and evaluation-related TA to implementation sites.

Limited support

Lead

O3 Create and disseminate user-friendly multimedia materials to help other RWHAP organizations replicate effective interventions from the initiative.

Lead Support

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

Step 1: Review the Opportunity 15

R3.1 Develop a communications and dissemination plan and produce user-friendly multimedia replication materials.

Lead Support

Details of the ITAP requirements The objectives and program requirements are based on the overarching initiative. This section provides details on objectives and program requirements that the ITAP will lead or support.

Objective 1 Requirement 1.1, Lead: Select and adapt interventions designed to engage and retain the priority population in HIV primary care and mental health services.

In consultation with HRSA HAB, you must complete the following tasks within the first six months of award:

• Research and identify relevant interventions as defined by requirement 1.1 of this NOFO. You will scan existing interventions that are not in the peer-reviewed literature and consult subject matter experts, including people with lived experience.

• Develop criteria and select interventions. Interventions may occur at the individual, community, and systems level, as long as they have a measurable impact on clients within the initiative period. The selection criteria must consider whether the interventions:

◦ Are appropriate for people who are out of care or experiencing barriers to retention in care.

◦ Prioritize HIV and mental health care and treatment.

◦ Are replicable.

◦ Are feasible.

◦ Address one or more of SAMHSA’s 10 Guiding Principles of Recovery.

◦ Incorporate accessible service models such as integrated care or flexible service delivery.

• Create an intervention inventory of resources to help sites implement the selected interventions.

Requirement 1.2, Lead: Select and issue subawards to up to 10 implementation sites.

By the end of the first year of the initiative, you will issue subawards for implementation sites to adapt and implement the selected interventions.

In collaboration with HRSA HAB and the EP, you will develop and implement a competitive application process to select implementation sites. You must ensure

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

Step 1: Review the Opportunity 16 https://store.samhsa.gov/product/samhsas-working-definition-recovery/pep12-recdef funding is accessible to organizations that are rooted in the community and led by people with lived experience.

Consider the following when establishing the selection criteria:

• Site eligibility: Implementation sites must be eligible for RWHAP funding. Sites must directly provide mental health services or partner with a mental health service organization.

• Organizational impact. The sites must be able to have an impact on HIV and mental health disparities and respond to community needs. This impact could be based in site locations and staffing structures.

• Geographic distribution. Sites must be located in a variety of geographic areas to respond to diverse community needs.

• Cultural responsiveness. Sites must be able to adapt and implement the selected interventions to be culturally responsive to the communities they serve.

• Organizational capacity: Sites must be able to participate in an RWHAP SPNS initiative, including:

◦ Dissemination activities, such as documenting and writing procedures and processes.

◦ The multisite evaluation, including data reporting, data security, data analysis, and IRB processes.

You should consider the following funding structure for implementation site subawards, based on the four-year life cycle of RWHAP SPNS initiatives:

• Year 1: $100,000 per site

• Years 2 and 3: $275,000 per site per year

• Year 4: $150,000 per site

Requirement 1.3, Lead: Provide training and monitoring to implementation sites on intervention fidelity and adaptations. Monitor compliance with federal regulations.

• Based on the needs of the implementation sites, you will collect resources and develop new materials to help them successfully adapt and implement the interventions you’ve selected.

• You will ensure that implementation sites are implementing the interventions and complying with federal regulations.

• You will monitor the implementation sites to ensure fidelity to the core elements of the selected interventions. When new staff members are hired at implementation sites, you will make sure there is a process to train them on implementing the interventions.

• In collaboration with the EP, you will lead and collaborate with the implementation sites to develop logic models for each site’s approach. These

Step 1: Review the Opportunity 17 models will outline the core elements, implementation strategies, and potential barriers and facilitators to successful implementation. The logic models will guide you in monitoring ongoing fidelity to the intervention. They can be adjusted as needed to reflect mid-implementation adjustments.

• In consultation with HRSA HAB, you will develop a TA tracking system to record all identified or requested TA needs and the actions you took in response.

• You will develop a TA data reporting plan, which will include easy-to-understand analyses and visualizations. Your TA data reporting plan must support TA data tracking updates, which you must provide to HAB each quarter.

• In coordination with the EP and HRSA HAB (as needed), you will monitor each implementation site, including by making annual site visits to ensure compliance with federal requirements, monitor implementation progress, and provide TA.

◦ You will develop a site visit protocol to guide the content and focus of the site visits, with input from the EP on evaluation-related items.

◦ Site visit protocols should address TA needs related to intervention planning, implementation, and data submission and quality.

• You will provide TA to help sites sustain interventions after the federally funded program ends.

Requirement 1.4, Lead: Coordinate and facilitate multisite meetings.

In collaboration with HRSA HAB and the EP, you will coordinate and facilitate at least two multisite meetings per year. The meetings must include at least two representatives from the ITAP, EP, HRSA HAB, and each implementation site.

• These meetings are peer focused, with the goal of fostering knowledge sharing, learning, and innovation across the initiative.

• You should plan to hold these meetings at HRSA headquarters or in the Washington, DC, metropolitan area.

• You will submit and present a final report to HRSA and HAB after the meetings, reporting on their major activities.

• You will coordinate at least two work planning meetings per year with the EP and HRSA HAB, where you will assess progress and adjust plans as needed to ensure success. You could hold these in person immediately after the multisite meetings.

• Note that you may also require routine coordination and monitoring meetings to effectively coordinate and collaborate.

Objective 2 You will provide support or limited support for the requirements within Objective 2.

This will include supporting the EP’s evaluation of how interventions are implemented, using an implementation science framework.

Step 1: Review the Opportunity 18

For full information on the activities the EP will conduct and that you will support, please see the companion NOFO focusing on the EP.

Objective 3 Requirement 3.1, Lead: Develop a communications and dissemination plan and create user-friendly multimedia replication materials.

• In coordination with the EP and HRSA HAB, you will develop and implement a communication and dissemination work plan and timeline for disseminating evaluation findings and replication materials. This plan will outline how you will create, review, and promote materials and strategies that will help other organizations replicate successful interventions from this initiative.

• You will create user-friendly multimedia dissemination products, including practical guidance to help other organizations replicate the approaches implemented by the sites. You will support the EP in collaborating with implementation sites and HRSA HAB to create manuscripts that describe the design and outcomes of the project.

• Along with the EP, you will review all draft dissemination products to ensure rigor, quality, and consistency before they are submitted to HRSA HAB for review.

• Along with the EP, you will manage the completion of all dissemination products through the HRSA clearance process in collaboration with your HRSA project officer.

• Your communication and dissemination plan must include:

◦ Publication and dissemination committee: You will form a committee consisting of EP staff, HRSA HAB staff, and implementation site representatives. The committee will generate study questions, topics for presentations and publications, concept sheets and analyses, and a dissemination plan for the initiative’s products.

◦ Dissemination products and strategies: These will include user-friendly multimedia materials that describe findings from the initiative. They should include materials aligned with RWHAP service categories [PDF] so they can easily be replicated. You will work with the EP to ensure that evaluation findings are included in the dissemination products.

◦ Priority audiences: You must ensure that products and strategies are culturally responsive and accessible to all priority audiences. These include HIV care and treatment providers, support service providers, and communities impacted by HIV and mental health disparities. Other audiences may include clinicians, program administrators, RWHAP program leaders, and policymakers.

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

Step 1: Review the Opportunity 19 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf#page=4

▪ You should tailor your dissemination mechanisms based on the needs of the priority audiences. You will use TargetHIV and the RWHAP Best Practices Compilation to share all products from this initiative with RWHAP recipients and providers, HIV service delivery staff, and other partners. Other mechanisms may include websites, social media, webinars, conferences, and academic journals.

◦ Dissemination timeline: You should develop and disseminate materials throughout the initiative, not just at the end. The purpose is to promote real-time learning and dissemination of best practices within the RWHAP. Your timeline should incorporate HRSA HAB review and review by subject matter experts, as needed.

◦ Project websites: You will collaborate with the EP and HRSA HAB to develop and maintain a public, project-specific page on TargetHIV.org to communicate about the project. In addition to the public website, you must create and maintain a secure, password-protected site (such as on Sharepoint) to host the initiative’s files. This site will be shared with you, the implementation sites, the EP, and HRSA HAB staff.

◦ Promoting replication: You will collaborate with national and regional RWHAP Part F AIDS Education and Training Centers (AETC) programs to make it easier to replicate successful interventions.[2] The network of RWHAP AETC programs is uniquely positioned to help increase the capacity of HIV service providers to implement mental health interventions to improve health outcomes of people with HIV.

◦ Conferences: You will plan and coordinate a presentation with the implementation sites, in collaboration with the EP and HRSA HAB, at the National Ryan White HIV/AIDS Conferences in 2026 and 2028. For the NRWC, each implementation site is responsible for its own travel costs, ground transportation, per diem, and hotel accommodations.

Key personnel HIV and mental health expertise are critical to this initiative. People with lived experience, mental health professionals, and other key partners must be a part of the ITAP, EP, and implementation site teams.

When possible, consider hiring individuals with lived experience into key roles. Lived experience includes people living with HIV, people in recovery with mental health and/ or substance use conditions, or people who have changed their behaviors to reduce the risk of HIV. Lived experience, along with other relevant personal or professional expertise, is acceptable instead of education, as appropriate.

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

Step 1: Review the Opportunity 20 https://targethiv.org/ https://targethiv.org/bestpractices https://targethiv.org/bestpractices https://targethiv.org/

Timeline of lead activities This chart shows a high-level anticipated timeline of lead activities for this project.

Year Lead: ITAP Lead: EP

Year 1 • Develop joint work plan with

EP.

• Coordinate and co-facilitate project planning meetings.

• Conduct a comprehensive search to select mental health interventions.

• Develop a technical assistance plan, including a process for TA tracking.

• Select and issue subawards to implementation sites.

• Develop a communications and dissemination plan.

• Develop joint work plan with

ITAP.

• Co-facilitate project planning meetings.

• Support selection of mental health interventions.

• Support selection of implementation sites.

• Support development of the communications and dissemination plan.

• Develop a multisite evaluation plan grounded in implementation science.

• Submit evaluation protocol for Institutional Review Board (IRB) review and approval.

• Support sites with IRB applications and submissions, as needed.

Years 2 and 3 • Train sites on implementing their selected interventions (year 2 only).

• Coordinate and co-facilitate multisite and project planning meetings.

• Monitor subrecipients, including through an annual site visit.

• Provide TA to sites on adapting and implementing the interventions.

• Develop replication materials and begin disseminating as appropriate.

• Train sites on all aspects of the evaluation.

• Co-facilitate multisite and project planning meetings.

• Lead data collection and, in year 3, analysis for the multisite evaluation.

• Attend annual subrecipient site visits.

• Provide TA to sites on the evaluation.

• Work on publications.

Step 1: Review the Opportunity 21

Year Lead: ITAP Lead: EP

Year 4 • Continue to coordinate and co-facilitate multisite and project planning meetings.

• Continue to monitor subrecipients, including through an annual site visit.

• Provide TA to sites on sustaining the interventions.

• Finalize replication materials and other dissemination products.

• Continue to co-facilitate multisite and project planning meetings.

• Complete data collection for the multisite evaluation.

• Continue to attend the annual subrecipient site visits.

• Continue to provide TA to sites on the evaluation.

• Finalize data analysis and integrate evaluation findings into dissemination products.

• Finalize any publications.

Award information Cooperative agreement terms Our responsibilities Aside from monitoring and technical assistance, we also get involved in these ways:

• Facilitate the availability and expertise of key federal partners in planning, developing, and implementing the project, including staff from SAMHSA, the National Institute of Mental Health (NIMH), and other relevant agencies.

• Facilitate effective collaborative relationships with the ITAP, EP, and other relevant partners.

• Provide relevant project information and resources, including TA resource centers.

• On an ongoing basis, review activities, procedures, measures, and tools to accomplish the goals and objectives of this initiative.

• Participate in designing and implementing evaluation tools, evaluation plans, and other project materials.

Review and participate in disseminating project activities, products, findings, best practices, evaluation data, and other information developed as part of this project to RWHAP providers and the broader health care community.

• Coauthor and publish technical manuscripts describing project design, implementation, outcomes, and other topics in scientific journals.

Step 1: Review the Opportunity 22

Your responsibilities You must follow all relevant laws and policies. In addition to the requirements and activities mentioned in the program objectives and requirements section, you must also:

• Complete all reporting requirements, developing and sharing replication resources and tools—including step-by-step implementation guidance, manuscripts for publication, and communications about project design and outcomes—at various venues throughout the project.

• Help HRSA share information with constituencies upon request.

• Collaborate with the assigned HRSA HAB project officer and other HRSA HAB staff as necessary to plan and execute TA and implementation activities.

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.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting the project’s objectives.

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

• If we receive more funding for this program, we may:

◦ Fund more applicants from the rank order list.

◦ Extend the period of performance.

◦ Award supplemental funding.

General limitations

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

• 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.

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

Step 1: Review the Opportunity 23 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

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

• Charges that are billable to third-party payers such as private health insurance, prepaid health plans, Medicaid, or Medicare.

• To directly provide medical or support services (for example, HIV care, counseling, and testing) that supplant existing services.

• Cash payments to intended recipients of RWHAP services.

• Purchase or construction of new facilities, or capital improvements to existing facilities.

• Purchase or improvement to land.

• Fundraising expenses or lobbying activities and expenses.

• Syringe Services Programs that have not received HRSA’s prior approval or do not comply with HHS and HRSA policy.

• To develop materials designed to directly promote or encourage intravenous drug use or sexual activity.

• Pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) medications or related medical services. (Please note that RWHAP recipients and subrecipient providers may provide prevention counseling and information to eligible clients’ partners—see RWHAP and PrEP Program Letter, November 16, 2021.)

• International travel.

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 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 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. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 24 https://www.aids.gov/federal-resources/policies/syringe-services-programs/ https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.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.

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

Step 1: Review the Opportunity 25 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 27

Find the application package 27

Application writing help 27

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-25-058.

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. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 27 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 More information on this NOFO's webinar will be posted at a later date to the related documents tab here.

We recommend you “Subscribe” to the NOFO on Grants.gov to receive updates when documents are posted.

The Webinar will be recorded.

Have questions? Got to Contacts and Support.

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

Step 2: Get Ready to Apply 28 https://grants.gov/search-results-detail/354787

Step 3:

Prepare Your Application

In this step

Application contents and format 30

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

Application page limit: 60 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, margins, etc. 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.

Inclu…