hrsa-26-067_Final.pdf

Notice of Funding Opportunity

Application due 07/13/2026

HIV/AIDS Bureau

Division of Community HIV/AIDS Programs

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

Opportunity number: HRSA-26-067

Contents

Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 7

Program description 9

Award information 18

Step 2: Get Ready to Apply 22

Get registered 23

Find the application package 23

Application writing help 24

Step 3: Build Your Application 25

Application checklist 26

Application contents and format 28

Step 4: Understand Review, Selection, and Award 54

Application review 55

Selection process 61

Award notices 61

Step 5: Submit Your Application 62

Application submission and deadlines 63

Other submissions 64

Step 6: Learn What Happens After Award 65

Post-award requirements and administration 66

Reporting 68

Contacts and Support 69

Appendices 72

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 007/13/2026.

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

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.

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

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 7

Program description 9

Award information 18

Basic information Health Resources Services Administration

HIV/AIDS Bureau

Division of Community HIV/AIDS Programs

Funding family-centered HIV medical care and support services for low-income women, infants, children, youth with HIV, and their affected families.

Summary The Ryan White HIV/AIDS Program (RWHAP) provides a comprehensive system of HIV care that improves health outcomes and supports viral suppression. Through its Part D program, RWHAP funds local, community-based organizations to provide family-centered medical and specialty care for low-income women, infants, children, and youth with HIV (WICY). Overall, the RWHAP’s goal is to improve health outcomes and reduce HIV transmission, especially for people not yet in regular medical care.

Funding details Application Types: Competing continuation, New

Expected total available funding in FY 2026: $69,000,000

Expected number and type of awards: 111 Grants

Funding range per award: $115,000 to $2,000,000

We plan to fund awards in four 12-month budget periods for a total four-year period of performance from 08/01/2026 to 07/31/2030.

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

Have questions?

Go to Contacts and

Support.

Key facts

Opportunity name:

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

Opportunity number:

HRSA-26-067

version:

Initial

93.153

Key dates

06/11/2026 deadline:

07/13/2026

08/01/2026

08/01/2026

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

RWHAP Part D funding methodology

In fiscal year (FY) 2022, the Health Resources and Services Administration (HRSA) initiated the first phase of a Ryan White HIV/AIDS Program (RWHAP) funding methodology for Part D to strategically target RWHAP Part D resources to maximize national impact. The process included an analysis of the Ryan White Services Report

(RSR), allocation, and Centers for Disease Control and Prevention (CDC) surveillance data. It also included a review of evidence-informed interventions for women, infants, children, and youth (WICY) and stakeholder input.

To minimize service disruptions and burden on recipients, HRSA implemented an incremental approach, beginning with 22% in 2022. In FY 2026, HRSA will increase implementation to 50%.

The methodology includes:

• Base funding: A minimum award of $115,000 per service area to support program operations.

• WICY clients served: Additional funding based on the number of eligible Part D clients reported in the most recent RSR data (2023 for this competition).

◦ Approximately 85% of funding was allocated through base funding and client volume.

• Absence of RWHAP Part A resources: Additional funding for service areas outside

Part A jurisdictions, primarily rural areas.

◦ Approximately 15% of funding was based on this factor.

The methodology ensured baseline operational support, minimized funding disruptions by limiting decreases (approximately 20%) and increases (approximately

25%) compared to FY 2025 levels, and maintained continuity of care. HRSA used this approach to establish funding ceilings under the NOFO, which remained a competitive, discretionary opportunity.

Eligibility You can apply if you are a public or nonprofit private entity (including a health facility operated by or pursuant to a contract with the Indian Health Service, Tribal governments and organizations, and faith based organizations) that provides family-centered care involving outpatient or ambulatory care (directly or through contracts or memoranda of understanding) for women, infants, children and youth (WICY) with HIV/AIDS.

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

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Public and State controlled institutions of higher education.

• Native American tribal governments (Federally recognized).

• Native American tribal organizations (other than Federally recognized tribal governments).

• Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education.

• Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education.

• Private institutions of higher education.

• For profit organizations other than small businesses.

• Small businesses.

• Faith-based organizations.

*“Domestic” means the 50 states, the District of Columbia, the Commonwealth of

Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin

Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria

• All applicants must meet the basic requirements of a RWHAP Part D Program as outlined in this NOFO and as established in section 2671 of the Public Health

Service (PHS) Act.

• This competition is open to current RWHAP Part D recipients and to new organizations proposing to provide RWHAP Part D–funded services, and your application must cover the entire geographic service area specified in Appendix B.

• If you apply for more than one service area listed in Appendix B, you must submit a separate application for each. Applications that propose to serve more than one service area in a single application will be deemed ineligible.

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.

• Does not include all required attachments.

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

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. Recipients agree that once committed, cost sharing amounts are enforceable and subject to reporting and auditing requirements under 2 CFR 200.

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

Program description

Purpose This program funds family-centered HIV care and support services in outpatient or ambulatory settings. It serves low-income women, infants, children and youth with HIV, and their affected family members.

Types of services

• HIV family-centered care includes outpatient or ambulatory care such as:

◦ Behavioral health.

◦ Nutrition services.

◦ Oral health services.

• Specialty care includes, but is not limited to:

◦ HIV specialty care.

◦ Obstetrics and gynecology.

◦ Hepatology.

◦ Neurology.

• Support services may include, but are not limited to the following:

◦ Family-centered care services such as non-medical case management, child care, housing and other services described in Policy Clarification Notice (PCN)

16-02: Ryan White HIV/AIDS Program Services: Eligible Individuals &

Allowable Uses of Funds [PDF] that address the health care needs of people with HIV to achieve optimal health outcomes.

◦ Referrals for:

▪ Inpatient hospital services.

▪ Other social and support services, as needed.

◦ Activities for participation such as:

▪ Helping people with HIV and affected individuals participate in the established program, including activities designed to retain youth with

HIV.

◦ Lastly, information and education about opportunities to participate in HIV/

AIDS-related clinical research.

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

For additional information, please refer to PCN 16-02 [PDF] for a list of RWHAP allowable services and use of funds.

For more details, see program requirements and expectations.

Background

The Ryan White HIV/AIDS Program

The Ryan White HIV/AIDS Program (RWHAP) has five statutorily defined Parts that provide grants to states, cities, counties, local clinics, and community-based organizations. The grants fund medical care, medication, and essential support services, to meet the needs of people with HIV and family members affected by HIV.

Together these grants provide a comprehensive system of care to ensure low-income people with HIV have access to services for early diagnosis of HIV, linkage to care, medically appropriate treatment, retention in care, and sustained viral suppression (a very low or undetectable amount of HIV in the blood).

For nearly four decades, the RWHAP has funded services to provide HIV primary health care, medication, and essential support services, including mental health care, transportation, case management, nutrition, and housing. These services support clients to enter and remain in care, access medications, and reach viral suppression, reducing transmission and lowering health care costs.

Ending the HIV epidemic

Launched in 2020, the Ending the HIV Epidemic in the U.S. (EHE) initiative further expands 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.

Making America Healthy Again

The Ryan White HIV/AIDS Program helps advance the Making America Healthy Again

(MAHA) priorities by:

• Expanding access to primary care for people with HIV, particularly those with low incomes, and by

• Strengthening the health workforce.

• Fighting the chronic disease epidemic by providing HIV medical care, treatment, and support services to people with HIV.

• Supporting improved nutrition by providing patient-centered focused medical nutrition therapy and food services.

• Supporting disease prevention through HIV care and treatment services that help people reach viral suppression, so they live longer, healthier lives and do not transmit HIV.

https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf https://ryanwhite.hrsa.gov/about/parts-and-initiatives https://www.hhs.gov/maha/index.html https://www.hhs.gov/maha/index.html

Key accomplishments

• Nearly 602,000 people with HIV in the U.S. received life-saving care, medication, and essential support services through the RWHAP, representing over half of all diagnosed with HIV in the U.S. This is an increase of nearly 26,000 clients.

• More than 91% of Ryan White HIV/AIDS Program patients receiving HIV medical care were virally suppressed in 2024. This is up from 69.5% of patients virally suppressed in 2010 and significantly higher than the 67.2% virally suppressed nationally among all people with diagnosed HIV.

• More than 47% of Ryan White HIV/AIDS Program clients are aged 50 years and older, demonstrating the program’s success in supporting older clients and its commitment to addressing the unique needs of people aging with HIV.

Program requirements and expectations You must provide or coordinate services for all the following populations to meet the program’s requirements and expectations:

• Family-centered outpatient or ambulatory care and support services for:

◦ Low-income women with HIV.

◦ Infants (up to two years old) exposed to or with HIV.

◦ Children (ages 2 to 12) with HIV.

◦ Youth (ages 13 to 24) with HIV.

• Affected individuals in limited situations per PCN 16-02 [PDF].

Family-centered outpatient ambulatory health services may be delivered directly, or through contracts or memoranda of understandings (MOUs).

RWHAP Part D recipients must create a comprehensive and coordinated system of family-centered care and support services for low-income WICY with HIV in their entire service area as listed in Appendix B. Programs should:

• Focus on populations who have the greatest unmet need.

• Improve health outcomes related to:

◦ Testing and linkage to care.

◦ Retention in medical care.

◦ Viral suppression.

◦ Reducing new HIV infections in the community.

https://hab.hrsa.gov/sites/default/files/hab/Global/service_category_pcn_16-02_final.pdf

Ryan White Program 2030

Ryan White Program 2030 (RWP 2030) builds on the foundation of the RWHAP and innovative, low-barrier strategies employed in the Ending the HIV Epidemic in the U.S.

initiative. This framework is designed to sustain high-quality care and treatment for people currently receiving services through the RWHAP while expanding efforts to identify and engage individuals with HIV who are undiagnosed or out-of-care.

Achieving this goal requires a comprehensive, collaborative approach that builds upon existing successes and resources while fostering innovation.

In alignment with RWP 2030, recipients are expected to implement interventions that are evidence-based, evidence-informed, or emerging strategies that are grounded in data and responsive to the lived experiences of the communities they serve. These approaches are critical for improving health outcomes, reducing HIV-related deaths, and preventing new HIV transmissions. RWHAP Part D programs are expected to select and implement interventions that meet the needs of WICY and WICY populations with greatest need while advancing the goals of RWP 2030.

Minority AIDS Initiative (MAI)

Under section 2693 of the PHS Act, the Minority AIDS Initiative (MAI) addresses the challenges in access, treatment, care, and outcomes for racial and ethnic minorities, including African Americans, Alaska Natives, Hispanic/Latinos, American Indians, Asian

Americans, and Native Hawaiians or Pacific Islanders.

MAI funds are granted to health care organizations that provide patient-centered care and services tailored to the needs of racial and ethnic minorities.

HRSA assigns MAI funds to RWHAP Part D WICY recipients based on the percentage of the RWHAP Part D WICY populations served from racial and ethnic minority communities as reported in the most recent Ryan White HIV/AIDS Program Services

Report (RSR).

Clinical requirements

Prevention of HIV transmission

Programs are required to follow the HHS Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV.

Providers should share information that reflects recent advances in HIV prevention, including:

• Viral suppression.

• Pre-exposure Prophylaxis (PrEP).

https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/whats-new https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/whats-new

◦ RWHAP funds cannot be used for PrEP medications or related medical services, such as clinician visits and laboratory costs. However, RWHAP recipients must refer people who could benefit from PrEP to appropriate HIV prevention service providers in their area.

• Non-occupational Post-Exposure Prophylaxis (nPEP).

◦ RWHAP funds cannot be used to pay for nPEP medications or related medical services. However, RWHAP recipients may educate and counsel clients on health and HIV prevention issues, including nPEP. See Updated guidelines for antiretroviral post-exposure prophylaxis after sexual, injection drug use, or other non-occupational exposure to HIV [PDF].

Medical services

• You must develop a comprehensive and coordinated system of family-centered care and support services in an outpatient or ambulatory care setting.

◦ This should happen either directly or through contracts or MOUs throughout their entire designated service area (see Appendix B).

Clinical guidelines

• All clinical care must be provided in accordance with HHS Clinical Practice

Guidelines for HIV/AIDS.

• You are strongly encouraged to require continuing education, as updates are made available. This ensures that staff remain knowledgeable of advances in the treatment of HIV and are familiar with the most recent HHS Clinical Practice

Guidelines.

Referral systems

• Programs must have a referral process for allowable services, as outlined in PCN

16-02 [PDF], that are not directly supported by your RWHAP Part D funding, such as:

◦ Oral health.

◦ Specialty care.

◦ Medical case management.

• Referrals, including referral outcomes, should be tracked and monitored in the patient’s medical record so follow-up can happen.

Linkage to clinical trials

Section 2671 of the PHS Act requires RWHAP Part D recipients to have a plan to refer patients to biomedical research facilities or community-based organizations that conduct HIV-related clinical trials.

https://www.cdc.gov/mmwr/volumes/74/rr/pdfs/rr7401a1-H.pdf https://www.cdc.gov/mmwr/volumes/74/rr/pdfs/rr7401a1-H.pdf https://www.cdc.gov/mmwr/volumes/74/rr/pdfs/rr7401a1-H.pdf https://clinicalinfo.hiv.gov/en/guidelines https://clinicalinfo.hiv.gov/en/guidelines https://clinicalinfo.hiv.gov/en/guidelines https://clinicalinfo.hiv.gov/en/guidelines

See the NIH HIV Clinical Trials Network website for protocol details.

Clinical Quality Management (CQM)

Section 2671 of the PHS Act requires RWHAP Part D recipients to:

• Assess the extent to which HIV health services provided to patients under the grant are consistent with HHS Guidelines for the treatment of HIV and related opportunistic infections.

• Develop strategies for ensuring such services are consistent with the guidelines for improvement in the access to and quality of HIV health services.

Please see PCN 15-02 : Clinical Quality Management [PDF] for information on CQM program requirements.

Coordination/linkages to other programs

Required activities

• Recipients must coordinate with all available and accessible community resources, including federally-funded and non-federally-funded programs.

• Recipients must also coordinate with other health care services under the Title V of the Social Security Act, including programs that promote the reduction and elimination of risk of HIV for youth.

• Recipients must participate in the development of the statewide coordinated statement of need required under the RWHAP Part B.

• Recipients must submit audits every two years to the lead state agency under

RWHAP Part B regarding funds spent under RWHAP Part D.

Examples of programs to coordinate with:

• Support service programs such as substance use disorder treatment and housing services.

• Mental health services.

Medicaid provider status and clinic licensure

All applicants, including proposed subrecipients and MOU funded organizations, must:

• Have Medicaid provider status for all primary medical care providers and case management agencies.

• Be fully licensed to provide clinical and case management services, as required by state and local jurisdiction (see Attachment 12).

https://www.niaid.nih.gov/clinical-trials https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-15-02-cqm.pdf https://www.ssa.gov/OP_Home/ssact/title05/0500.htm https://www.ssa.gov/OP_Home/ssact/title05/0500.htm

Administrative and fiscal requirements

Rapid service delivery

• To comply with PCN 21-02 : Determining Client Eligibility & Payor of Last Resort in the Ryan White HIV/AIDS Program [PDF], RWHAP recipients and subrecipients must develop protocols to facilitate the rapid delivery of RWHAP services.

◦ This includes providing antiretrovirals to people who are newly diagnosed or re-engaged in care.

• If services begin before formal eligibility or payer source verification, recipients must determine eligibility within a reasonable timeframe.

◦ Recipients must also reconcile RWHAP funds to ensure they were only used for allowable costs for eligible people.

Confirming RWHAP eligibility

RWHAP recipients and subrecipients must establish, implement, and monitor policies and procedures to determine eligibility for each client based on:

• HIV status.

• Low income.

• Residency.

We do not require documentation to be provided in-person nor be notarized.

See eligibility requirements (PCN 21-02 [PDF]).

Information systems

Recipients must have an information system that manages and reports, at a minimum, the following administrative, fiscal, and clinical data:

• Client demographic/clinical data and service provision data as required by the

Ryan White HIV/AIDS Program Services Report (RSR).

◦ See the most recent Annual RSR Instruction Manual [PDF].

• Source and use of program income.

• Services according to funding source.

• Time and effort supported by grant funds.

• Number of people with HIV served.

https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/about-program/2025-rsr-manual.pdf

Service availability

HIV medical services should be available to clients no later than 90 days from the

RWHAP D award issuance date.

The ability to provide family-centered HIV care includes hiring clinical staff and having the ability to bill for services.

When services are provided through contracts or through an MOU, subawards

(contracts or MOU signed by both parties) must be finalized within 60 days of the award.

Subawarded services

In addition to the information included in 2 CFR 200.332, subrecipient agreements must include:

• The total number of WICY to be served.

• Eligibility for Medicaid certification of the medical providers and ambulatory care facilities.

• Details of the services to be provided.

• Assurance that providers will comply with RWHAP Part D legislative and program requirements, including:

◦ Data sharing.

◦ Submission of the RSR.

◦ Participation in the CQM program.

Per 2 CFR 200.331–.333, recipients must monitor the activities of their subrecipients as necessary to ensure that the subaward is:

• Used for authorized purposes.

• In compliance with federal statutes, RWHAP legislative and programmatic requirements, regulations, and the terms and conditions of the subaward.

Recipients must also track that subaward performance goals are achieved.

• Recipients must ensure that subrecipients track, appropriately use, and report program income generated by the subaward.

• Recipients must also ensure that subrecipient expenditures adhere to legislative mandates regarding the distribution of funds.

Medication discounts

• HRSA expects RWHAP grant recipients that purchase, are reimbursed for, or provide reimbursement to other entities for outpatient prescription drugs to secure the best prices available for such products.

• They should also maximize results for their organization and patients (see 42 CFR part 50, subpart E).

• Eligible health care organizations and covered entities that enroll in the 340B Drug

Pricing Program must comply with all 340B Program requirements.

◦ They will also be subject to audit regarding 340B Program compliance.

• See more details regarding program requirements and eligibility.

Program income

All program income generated from awarded funds is additive and must be added to the grant amount and used for otherwise allowable costs. This means it should further the objectives of the RWHAP Part D grant program.

Please see PCN 15-03: Clarifications Regarding the Ryan White HIV/AIDS Program and

Program Income [PDF] for more information on the RWHAP and program income.

Financial tracking

Programs must have internal financial controls to:

• Safeguard assets.

• Ensure stewardship of federal funds.

• Manage cash flow to meet daily operations.

• Maximize revenue from non-federal sources.

If patients who need medications are eligible for state drug reimbursement programs funded under RWHAP Part B or other pharmaceutical programs, Part D program recipients should assist them in accessing these resources prior to using RWHAP Part D grant funds for such purposes.

RWHAP Part D funds also may be used to support co-pays and deductibles in cases where other RWHAP funds (Part A, B, or C) are not available.

Statutory authority 42 U.S.C. §§ 300ff-71 and 300ff-121 (§§ 2671 and 2693 of the Public Health Service Act) https://www.hrsa.gov/opa https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-15-03-program-income.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-15-03-program-income.pdf

Award information

Funding policies and limitations

Changes in HHS regulations

As of October 1, 2025, HHS has adopted 2 CFR Part 200, with some modifications included in 2 CFR Part 300. These regulations replace those in 45 CFR Part 75.

Policies

• To make an award, funding must be available and allocated for this program and purpose, at which point we will move forward with the review and award process.

• Have clear policies and good financial practices to avoid spending HRSA funds on unallowable activities. Like other award rules, we may audit your policies, procedures, and controls.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Your 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:

◦ Project Budget Information in the Application Guide [PDF].

◦ 2 CFR Part 200 Subpart E — General Provisions for Selected Items of Cost.

◦ Allowable and Unallowable Costs and Activities in the HHS Grants Policy

Statement.

• All costs must be reasonable, necessary, allocable to the award, and adequately documented (2 CFR 200.403).

• You cannot earn profit from the federal award. See 2 CFR § 200.400(g).

• To promote objectivity in research, you cannot have a financial conflict of interest. See 42 CFR 50.

• Current appropriations law includes a salary limit of $228,000 as of January 2026 that applies to this program. You may pay salaries at a higher rate if the rate beyond the salary rate limit (Executive Level II) is paid with non-HHS funds. For https://www.ecfr.gov/current/title-2/part-200 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.404 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.405 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.403 https://www.ecfr.gov/current/title-2/part-200#p-200.400(g) https://www.ecfr.gov/current/title-42/chapter-I/subchapter-D/part-50/subpart-F#subpart-F help calculating salaries under this limit, read more at “salary rate limitation” in the Application Guide [PDF] .

Program-specific statutory or regulatory limitations You cannot use funds under this notice for the following unallowable costs (this list is not exhaustive):

• Funding restrictions included in PCN 16-02 [PDF].

• Services that must be paid for by other sources, when available, consistent with the RWHAP payor of last resort requirement in PCN 21-02 [PDF].

• Payments for clinical research.

• Payments for inpatient hospitals, nursing homes, and other long-term care facilities.

• Cash payments to intended clients of RWHAP services.

• Purchase of, or improvement to land.

• Purchase, construction, or major alterations or renovations on any building or other facility (see 2 CFR 200 – subpart A Definitions).

• PrEP or nPEP medications or the related medical services. As outlined in the updated November 16, 2021 RWHAP and PrEP program letter [PDF].

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

Syringe Services Programs.

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

• Research.

• Foreign travel.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf https://hab.hrsa.gov/sites/default/files/hab/Global/service_category_pcn_16-02_final.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200 https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.pdf https://www.hiv.gov/federal-response/policies-issues/syringe-services-programs/

RWHAP Part D funds cannot be used to:

• Supplement the maximum cost allowance for services reimbursed by third party payers such as Medicaid, Medicare, or other insurance programs.

◦ Please note that recipients cannot use direct or indirect federal funds such as

RWHAP Parts A, B, C, and F-Dental to duplicate reimbursement for services funded under Part D.

• Bill services reimbursed by RWHAP Part D to RWHAP Parts A, B, C, or F-Dental.

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 [PDF].

◦ 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 [PDF].

Payor of last resort

With the exception of programs administered by or providing the services of the Indian

Health Service, the RWHAP is the payor of last resort.

Funds may not be used for services already paid for, or that could reasonably be paid for by:

• A state compensation program.

• An insurance policy.

• A federal or state health care program.

• An entity that provides health services on a pre-paid basis.

To comply with PCN 21-02 [PDF], recipients and subrecipients must:

• Establish, implement, and monitor written policies and procedures to identify any other payer sources.

• Vigorously pursue enrollment into health care coverage for which clients may be eligible, starting with, and in the order of employer-sponsored coverage, other private insurance, marketplace insurance, Medicare, and Medicaid.

• Maintain clear documentation of those efforts.

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

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/manage/grants-policy-bulletin-2021.pdf https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/pcn-21-02-determining-eligibility-polr.pdf https://www.hrsa.gov/grants/manage-your-grant

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 the time of award.

Method 2 – De minimis rate. Per 2 CFR § 200.414(f), if you don’t have a current 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 up to 15% of modified total direct costs (MTDC). See 2 CFR § 200.1 for the definition of MTDC. You can use this rate indefinitely for all your federal awards or until you choose to receive a negotiated rate.

Consider your indirect costs when developing your budget.

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 2 CFR 200.307.

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)) https://www.ecfr.gov/current/title-2/section-200.307

Step 2:

Get Ready to Apply

Get registered 23

Find the application package 23

Application writing help 24

Get registered

SAM.gov You must have an active account with SAM.gov to apply. 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 for the information you will need to register.

• You must agree to the financial assistance general certifications and representations [PDF] specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier (UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

If you need additional information about user roles in SAM.gov, see “Get registered:

SAM.gov user roles” in the Application Guide [PDF].

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 and How to Apply for Grants.

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-26-067.

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

https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/search-grants

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.

FAQs will be posted on our TA webpage after the webinar.

Join the webinar Webinar information will be posted to the Related Documents tab on Grants.gov. We recommend you

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

Have questions? Go to Contacts and Support.

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

Step 3:

Build Your Application

Application checklist 26

Application contents and format 28

Application checklist There are two types of forms in Grants.gov.

• Some forms allow you to upload components of your application to the form.

These include components like your project narrative, budget and budget narrative, and attachments.

• Other forms are more typical, fill-in-the-blank forms.

Make sure that you have everything you need to apply.

Narratives

Attachments Insert each in the Attachments Form in this order.

Component

1. Proof of nonprofit status

2. Program-specific line-item budget

3. Federally negotiated indirect cost rate

4. Staffing plan and biographical sketches

5. Job descriptions for key vacant positions

6. Project organizational chart

7. Work plan

8. Signed and scanned RWHAP Part D additional agreements and assurances

9. Map of service area

10. List of provider organizations with contracts and/or MOUs

11. Letter(s) from RWHAP Part A and/or Part B recipient of record

Included in page limit*?

No

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes form

Project Narrative Attachment form. Yes

Budget Narrative Attachment form. Yes

Component

12. Table of provider Medicaid and Medicare numbers (National Provider

Identifiers) and clinic licensure status

13. – 15. Other relevant documents

Other required forms Upload using each required form in Grants.gov.

Included in page limit*?

*Only what you attach in these forms counts toward the page limit. The forms themselves do not count.

Application for Federal Assistance (SF-424) No

Project Abstract Summary form No

Budget Information for Non-Construction Programs (SF-424A) No

Disclosure of Lobbying Activities (SF-LLL) No

Budget Narrative Attachment form No

Project/Performance Site Location(s) No

Grants.gov Lobbying form No

Key Contacts No

Application contents and format This section includes guidance on each component found in the application checklist.

Application page limit: 80 pages

Submit your information in English and express whole number budget figures using

U.S. dollars.

Required format for project summary, project narrative, budget narrative, and attachments Font: A readable font like Arial, Courier, CG Times, or Times New Roman

File format: We only accept the following document formats:

• .PDF - Adobe Portable Document Format

• .DOC/.DOCX - Microsoft Word

• .RTF - Rich Text Format

• .TXT - Text

• .WPD - Word Perfect Document

• .XLS/.XLSX - Microsoft Excel

• .VSD - Microsoft Visio

Size: 12-point font

Footnotes, charts, graphics, and budget tables may be 10-point or higher.

Ink color: Black

Spacing: Single-spaced, including all text and tables

Alignment: Left

Headings: Bold all headings and align left.

Size: 8.5 x 11 (Make sure the print area is set and allows printing to 8.5 x 11.)

Margins: 1-inch on all sides

Footer: On each page as the footer, include your organization’s name and page numbers. If a competing continuation or competing supplement, also include your

10-digit award number.

Page numbering:

• Do not number the standard OMB-approved forms.

• Number each attachment page sequentially (that is, 1, 2, 3).

• Reset the numbering for each attachment.

• Treat each attachment as a separate section.

File names: You can find guidance for naming our files in the Application Guide [PDF].

Project narrative

Introduction

In this section, you will describe all aspects of your project. Use the section headers and the order listed.

See merit review criterion 1: Need

• Clearly state the entire service area you plan to serve, as designated in Appendix

B, and, if applicable, specify the current recipient for that service area whom you are proposing to replace.

◦ Be specific about the geographic boundaries.

Please note:

• All applicants must demonstrate the capacity and readiness to provide comprehensive, family-centered HIV primary care and support services consistent with RWHAP Part D requirements to ensure continuity of care for WICY.

• New applicants are not expected to replicate the current recipient’s exact service model.

In your response, include the following:

• Your organization’s experience with health care delivery.

• Your organization’s experience with the administration of federal funds.

• Your organization’s mission statement, a description of your organization’s model of care and how you will address access barriers across the entire service areas for

WICY with HIV.

• Provide a list of the services you propose to provide for all of the WICY populations with HIV either directly or through referrals, contracts, or memoranda of understanding (MOUs) across the entire service area.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf

• A description of your organization’s readiness to deliver the proposed services across the entire service area, including the infrastructure in place to begin or continue service delivery with minimal disruption.

Need

See merit review criterion 1: Need

This section must include the following three components:

• Overview of epidemiologic and socio-demographic data.

• Unmet needs.

• Description of the local HIV service delivery system and any recent changes.

Use clear, quantifiable data to show why RWHAP Part D funding is needed in your community.

• Focus specifically on the needs of women, infants, children, and youth (WICY) with HIV.

Component 1: Overview of epidemiologic and socio-demographic data

Present and explain the latest epidemiologic and socio-demographic data that shows the burden of HIV on WICY populations, and any significant changes to these populations in your service area.

• This section should use the most recent three years of HIV surveillance data for the full service area from your organization’s patient population:

◦ Calendar year (CY) data for:

▪ 2022 (January 1 – December 31, 2022).

▪ 2023 (January 1 – December 31, 2023).

▪ 2024 (January 1 – December 31, 2024).

• For each of the three most recent years, provide the following data for the WICY populations, showing the total number of WICY with HIV and numbers for each population separately:

◦ Women.

◦ Infants (under 2 years old).

◦ Children (ages 2–12).

◦ Youth (ages 13–24).

• Where applicable, break down the data further (disaggregate) to highlight gaps in health outcomes based on factors such as:

◦ Race and ethnicity.

◦ Age.

◦ Sex.

◦ HIV transmission category.

◦ Income level (as a percentage of the federal poverty level).

◦ Housing status.

◦ Health insurance coverage.

◦ Education level.

• Use both tables and narrative explanations to present the data and clearly cite all sources.

◦ Official data from reliable sources (e.g., state health departments or the CDC) should be used and referenced. Your data must include:

▪ The number of newly diagnosed WICY with HIV.

▪ The total number of WICY with HIV (prevalence).

▪ WICY-specific rates of diseases such as syphilis, gonorrhea, tuberculosis, and Hepatitis C, which may indicate high-risk behaviors associated with

HIV transmission.

Note: In this section, give both baseline numbers and percent change (e.g., “From 2022 to 2024, the number of women with HIV increased by 50%, from 100 to 150”).

Component 2: Unmet needs

• Describe the unmet needs by analyzing gaps at each stage of the HIV care continuum for WICY populations with HIV served by your organization.

• Use data to show where individuals have been diagnosed with HIV, but are not actively in care or not receiving necessary services.

• Include estimates from RWHAP Part A or Part B for the entire service area (as defined in Appendix B), specifically:

◦ The number of WICY who are unaware of their HIV status.

◦ The number of WICY who are aware of their status but not receiving HIV care.

• Clearly define both the numerator and the denominator for each stage of the continuum.

◦ Use the same definitions as those outlined in the HHS Common HIV Core

Indicators, including:

▪ The HAB Performance Measure Portfolio.

https://ryanwhite.hrsa.gov/about/performance-measures

◦ It is recommended that you present this information in a table format. The left-hand column of the table should list each stage of the care continuum:

▪ Total number of WICY with HIV in care.

▪ Number of WICY newly diagnosed with HIV (HIV diagnosis).

▪ Number of WICY linked to HIV care within 90 days of diagnosis (linkage to care).

▪ Number of WICY retained in HIV medical care (retention in care).

▪ Number of WICY prescribed antiretroviral therapy (use of ART).

▪ Number of WICY who are virally suppressed.

◦ Across the top row of the table, include separate columns for each calendar year of data you are reporting (e.g., CY 2022, CY 2023, CY 2024).

Sample table: HIV care continuum and related outcomes for WICY, by calendar year

HIV care continuum stage

CY 2022

January 1 –

December 31, CY 2023

January 1 –

December 31, CY 2024

January 1 –

December 31, Total number of WICY with HIV in care

Number of WICY newly diagnosed with HIV

Number linked to HIV care within 90 days of diagnosis

Number retained in HIV medical care

Number prescribed antiretroviral therapy

(ART)

Number virally suppressed

Component 3: Description of the local HIV service delivery system and any recent changes

Describe the HIV care and prevention services available to WICY populations throughout the entire service area. Also include any recent changes in the local service delivery system.

Your description should address the following four areas:

1. HIV service providers in the entire service area as listed in Appendix B

• List all public and private organizations that provide HIV services to WICY populations in the target area, including your own organization.

• For each provider, describe:

◦ The specific services offered.

◦ People and communities disproportionately impacted by HIV served.

◦ If available, the annual number of unduplicated WICY clients or patients served.

• RWHAP Part A and Part B Programs may serve as resources for this section.

• You may present this information in a table format.

Sample table: HIV service providers in the entire service area

Organization

Services provided

Populations served

Annual number of unduplicated WICY clients/patients served

If you are a current RWHAP Part D or a new applicant applying for a service area designated as being “statewide” in Appendix B, please describe the following:

• Your model of care, specifying whether services are delivered:

◦ Through a network of satellite clinics, or

◦ Via contracts or memoranda of understanding (MOUs) with other providers across the state.

• Any access to care challenges, such as:

◦ Transportation barriers for patients or staff

◦ Difficulty reaching rural or remote regions

• How your organization provides consultative and telehealth services across the statewide service area for WICY with HIV.

https://ryanwhite.hrsa.gov/about/parts-and-initiatives

2. Public funding in support of HIV services in the service area

• Identify all federal, state, and local funding sources that support HIV prevention and care services for WICY populations across your entire service area.

• You can include this information in a table for clarity.

◦ Additional information about HHS awards is available on the HHS website, Tracking Accountability in Government Grants System.

• In your description, you must state all RWHAP funding sources for your organization, including whether it receives both RWHAP Part C and Part D funding

(i.e., you are dually funded), and whether it is a subrecipient of RWHAP Part A and/ or Part B.

◦ If you receive funding from both Part C and Part D, explain whether the two programs are either:

▪ Integrated (for example,…