OGH HRSA-21-099 (UL1) CLM-HIV-Sierra Leone_Final.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of Global Health Division of Global Programs

Community-Led Monitoring (CLM) of HIV Services in Sierra Leone

Funding Opportunity Number: HRSA-21-099

Funding Opportunity Type(s): New

Assistance Listings (CFDA) Number: 93.266

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2021

Application Due Date: July 19, 2021

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: May 20, 2021

Carolyn Hall Nurse Consultant PEPFAR Program Implementation Team Division of Global Programs Office of Global Health Telephone: (301) 443-2175 Email: CHall@hrsa.gov

Authority: Public Law 108-25 (the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) [22 U.S.C. 7601 et seq.], Public Law 110-293 (the Tom Lantos and Henry Hyde United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008), and Public Law 113-56 (PEPFAR Stewardship and Oversight Act of 2013).

https://www.hrsa.gov/office-global-health https://www.state.gov/community-led-monitoring/ https://www.state.gov/countries-areas/sierra-leone/ https://www.state.gov/pepfar/ https://www.hrsa.gov/office-global-health mailto:CHall@hrsa.gov https://www.state.gov/pepfar/

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2021 Community-Led Monitoring (CLM) of HIV Services in Sierra Leone. The purpose of this program is to use standardized data collection tools to conduct CLM of HIV services in 30 PEPFAR service sites in Sierra Leone for dissemination throughout the country to promote improvements in the national HIV response.

Funding Opportunity Title: Community-Led Monitoring (CLM) of HIV

Services in Sierra Leone

Funding Opportunity Number: HRSA-21-099 Due Date for Applications: July 19, 2021

Anticipated Total Annual Available FY 2022 Funding:

$100,000

Estimated Number and Type of Award(s): One (1) cooperative agreement Estimated Award Amount: $100,000 per year, subject to the availability of appropriated funds.

Cost Sharing/Match Required: No Period of Performance: September 30, 2021 through

September 29, 2024 three (3) years Eligible Applicants: Domestic or foreign public or non-profit private entities, including schools of medicine, nursing, public health, management and public administration, and academic health centers, community based organizations, faith-based organizations, and consortia consisting of such organizations.

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

https://www.hrsa.gov/about/index.html https://www.state.gov/community-led-monitoring/ https://www.state.gov/countries-areas/sierra-leone/ https://www.state.gov/countries-areas/sierra-leone/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/pepfar/ https://www.state.gov/countries-areas/sierra-leone/ https://www.state.gov/countries-areas/sierra-leone/

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Application Guide

You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance

HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Tuesday, June 8, 2021 Time: 9 a.m. – 10:30 a.m. EST Call-In Number: +1-833-568-8864 Participant Code: 160 258 6740

Weblink: https://hrsa-gov.zoomgov.com/j/1602586740 https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa-gov.zoomgov.com/j/1602586740

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER TRANSITION

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the President’s Emergency Plan for AIDS Relief (PEPFAR) Community-Led Monitoring (CLM) of HIV Services in Sierra Leone. The purpose of this program is to use standardized data collection tools to conduct CLM of HIV services in approximately 30 PEPFAR service sites in Sierra Leone for dissemination throughout the country to promote improvements in the national HIV response. This CLM program will use client feedback collected by trained community members in order to improve performance of PEPFAR service delivery.

Areas of focus include HIV prevention services, testing services, treatment services (including linkage, retention, and viral load testing), service provider perceptions, attitudes, practices, and client satisfaction with services provided. The recipient will present and analyze data in close collaboration with community representatives, healthcare providers, clients, government stakeholders, and facility managers to ensure dialogue and participation in identifying improvement opportunities, and implementing and monitoring solutions. Specifically, PEPFAR intends to utilize this program to focus on getting input from recipients of HIV services, especially key populations and underserved groups, in a routine and systematic manner that will translate into action and change.

The goal of this program is to improve HIV care and services for a better client experience, and, ultimately, improve health outcomes through PEPFAR site and service monitoring.

The objective of the program is to develop and conduct an assessment and reporting CLM system that reflects clients’ experience in receiving quality HIV services in Sierra Leone and support stakeholder analysis with actionable insights.

Given the low overall national prevalence of HIV in Sierra Leone, the PEPFAR program focuses on key and priority Populations. At sites where PEPFAR is providing support, CLM extends to all people living with HIV (PLHIV) and for any individual seeking HIV prevention and testing services. The CLM program in Sierra Leone will give voice to those individual community members PEPFAR serves, to strengthen the quality of service provision by ensuring feedback from PLHIV is captured and used to enhance program quality.

The CLM program will provide a clear description of challenges using quantitative and qualitative data to identify areas that need improvement across the HIV continuum of care, as well as areas that are of good quality. Monitoring efforts will include PEPFAR’s minimum program requirements (MPR) as applicable. Collection of monitoring data should be triangulated with, but not duplicative of, other PEPFAR data streams. Per PEPFAR, CLM data should reflect an ‘added value’ and not duplicate collection of routine data already available to PEPFAR. ‘Added value’ monitoring data includes:

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information from beneficiaries about their experience with the health facility, information about barriers and enablers to access and retention in services, etc.

Finally, this program will engage with in-country stakeholders to identify and support sustainable solutions that improve client care. Engagement will include discussions with government and non-government stakeholders at all levels to promote improvement of the patient experience.

2. Background

This program is authorized by Public Law 108-25 (the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) [22 U.S.C. 7601 et seq.], Public Law 110-293 (the Tom Lantos and Henry Hyde United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008), and Public Law 113-56 (PEPFAR Stewardship and Oversight Act of 2013).

Since its inception, PEPFAR has invested over $85 billion in the global HIV/AIDS response, saving over 18 million lives, preventing millions of HIV infections, and accelerating progress toward controlling the global HIV/AIDS epidemic.

PEPFAR’s investments continue to strengthen the systems that drive client-centered and sustainable health care. These investments create a lasting health system for partner countries to confront other current and future health challenges, enhance global health security, and protect America’s borders. The HIV/AIDS pandemic constantly evolves in every community and country and PEPFAR continually adapts to address new risk groups, new health challenges and persistent gaps.

Under the leadership of the Office of the U.S. Global AIDS Coordinator (OGAC), as part of the U.S. Government’s global HIV response, HRSA has been a significant contributor to PEPFAR’s achievements. HRSA’s work builds on the agency’s domestic and international experience and expertise by improving outcomes along the HIV care continuum for PLHIV. Domestically, HRSA’s programming includes integrations with other bureaus in the agency, such as the HIV/AIDS Bureau (HAB) and Bureau of Primary Health Care (BPHC). HAB provides a comprehensive system of HIV primary medical care, essential support services, and medications for low-income PLHIV who are uninsured and underserved. More than half of PLHIV receive services through the Ryan White HIV/AIDS Program each year. This means more than half a million people received services through the program. BHPC oversees the Health Center Program, a national network of health centers that provide comprehensive primary health care services to more than 27 million people nationwide, regardless of a patient’s ability to pay, charging for services on a sliding fee scale. These health centers play an important role in “Ending the HIV Epidemic,” by serving as a key point of entry for medical care for people previously undiagnosed with HIV. Integrating HIV services into primary care delivery is critical for success, both for health centers and for patients living with HIV.

They emphasize coordinated and comprehensive care, and have the ability to manage patients with multiple health care needs.

HRSA continues to work with host countries and with other key partners to assess the needs of each country and design a customized program of assistance that fits within https://www.congress.gov/bill/108th-congress/house-bill/1298 https://www.congress.gov/bill/110th-congress/house-bill/5501 https://www.congress.gov/bill/110th-congress/house-bill/5501 https://www.congress.gov/bill/113th-congress/senate-bill/1545 https://www.state.gov/pepfar/ https://www.state.gov/pepfar/ https://2009-2017.state.gov/s/gac/index.htm https://www.hrsa.gov/about/organization/bureaus/hab https://www.hrsa.gov/about/organization/bureaus/bphc/index.html https://www.hrsa.gov/about/organization/bureaus/bphc/index.html

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the host country’s strategic plan. PEPFAR guidance changes regularly; therefore recipients will consistently monitor, adapt, and align their program activities with current PEPFAR guidelines.

For project success, the ideal applicant will be community-based organizations (CBOs) or other civil society groups, or networks of Key Populations (KP), PLHIV, people with disabilities, or other affected groups or community entities. Organizations would be registered and based in Sierra Leone. These types of organizations will have the capacity to gather quantitative and qualitative data about HIV service delivery, and have missions and activities that focus on HIV programming. A consortium of qualifying organizations with these characteristics could also be successful. See further information in Section IV Organizational Information and V. Resources and Capabilities.

Sierra Leone has well developed civil society organizations, many supported through the Global Fund, with one or more supporting the overall national HIV response and others supporting key and priority populations. PEPFAR is supporting CLM for the first time in the U.S. Fiscal Year 2021.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New

HRSA will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where HRSA anticipates substantial involvement with the recipient during performance of the contemplated project.

HRSA program involvement will include:

• Participate in discussions for planning, implementing, and evaluating program activities, including the identification and selection of additional in-country impact partners.

• Assist in the coordination and collaboration among program partners, such as the Office of the U.S. Global AIDS Coordinator and Health Diplomacy (OGAC), other HHS agencies, the USAID, foreign governments, international donors, and other key stakeholders.

• Participate, as appropriate, in planning and producing meetings or workgroups conducted during the period of performance.

• Maintain an ongoing dialogue with the recipients of this cooperative agreement concerning program plans, policies, and other issues that have major implications for any activities under the cooperative agreement.

• Review and provide comments and recommendations for documents, curricula, program plans, budgets, contracts, personnel (including consultants), revisions of work plans, etc., prior to printing, dissemination, or implementation.

• Support the engagement of relevant stakeholders and assist in developing and periodically reviewing the recipients’ three-year monitoring and evaluation plan (M&E), ensuring compliance with the strategic information guidance established by

OGAC.

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• Provide technical assistance, as mutually agreed upon, and revise annually during validation of the first ad subsequent annual work plans. This could include expert technical assistance and targeted training activities in specialized areas, such as strategic information, project management, confidential counseling and testing, palliative care, treatment literacy, and adult learning techniques.

• Support access to the expertise of HRSA personnel and other relevant resources to the project.

• Participate in the dissemination of project findings, best practices, and lessons learned across the initiative.

The cooperative agreement recipient’s responsibilities will include:

• Close collaboration with HRSA, the government of Sierra Leone, in-country U.S.

Government (USG) teams, and other key stakeholders to gain a greater understanding of the historical context of the country, health system and other factors that affect HIV service delivery and the state of the nation. Identified priorities will build consensus, and efficiently plan and coordinate successful interventions for the highest impact.

• Consultation with HRSA and field teams as applicable, to inform HRSA on program progress and barriers encountered, identify jointly planned activities, and discuss matters that require HRSA input and approval.

• Implementation of strategies for facilitating scale-up and sustainability of activities supported under this agreement that include building on and strengthening previous and/or existing efforts by governments, local networks, and institutions that benefit the populations served. Strategies should strengthen indigenous capacity in all aspects of the agreement.

• Development and execution of a final monitoring and evaluation (M&E) plan within the first six months of the period of performance, in consultation with HRSA and key stakeholders.

• Support for evidenced based interventions that address stigma and other social barriers of HIV service delivery.

• A recognition of the HIV service needs of the people of Sierra Leone with their unique history and national context. Activities will identify post-conflict, resource-poor, or policy-poor considerations that possess uniquely complicated characteristics and will require a customized approach.

2. Summary of Funding

HRSA estimates approximately $100,000 to be available annually to fund one recipient.

You may apply for a ceiling amount of up to $100,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. The period of performance is September 30, 2021 through September 29, 2024 (three years). Funding beyond the first fiscal year is subject to the availability of appropriated funds for CLM in Sierra Leone in subsequent fiscal years, satisfactory recipient performance and a decision that continued funding is in the best interest of the Federal Government.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

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Grants to foreign organizations and foreign public entities that implement fully outside of the territorial limits of the U.S. may be paid to support the costs of compliance with federal requirements at a fixed rate of 8 percent of Modified Total Direct Cost (MTDC) exclusive of tuition and related fees, direct expenditures for equipment, and subawards in excess of $25,000.

III. Eligibility Information

1. Eligible Applicants

Domestic or foreign public or non-profit private entities, including schools of medicine, nursing, public health, management and public administration, and academic health centers, community based organizations, faith-based organizations, and consortia consisting of such organizations are eligible to apply.

2. Cost Sharing/Matching

Cost sharing is not required for this program.

3. Other

PEPFAR-funded implementing partners or sub-awardees who currently work on service delivery at the site level are not eligible for CLM funding.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 as non-responsive and will not consider it for funding under this notice.

NOTE: Multiple applications from an organization are not allowable.

If, for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html

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The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for each NOFO you are reviewing or preparing in the workspace application package in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov. You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this NOFO.

2. Content and Form of Application Submission

Section 4 of HRSA’s SF-424 Application Guide provides instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract. You must submit the information outlined in the Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

See Section 8.5 of the Application Guide for the Application Completeness Checklist.

Application Page Limit The total size of all uploaded files included in the page limit may not exceed the equivalent of 60 pages when printed by HRSA. The page limit includes the project and budget narratives, attachments, and letters of commitment and support required in the Application Guide and this NOFO. Please note: Effective April 22, 2021, the abstract is no longer an attachment that counts in the page limit. The abstract is the standard form "Project_Abstract Summary.” Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important to respond appropriately to ensure your application does not exceed the specified page limit.

Applications must be complete, within the specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3321).

3) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 11: Other Relevant Documents.

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See Section 4.1 viii of HRSA’s SF-424 Application Guide for additional information on all certifications.

Program-Specific Instructions In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 Application Guide (including the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

Project Level Activities CLM is key to ensuring availability, access, and delivery of high quality HIV prevention, testing, care and treatment services. CLM empowers patients and communities to seek services, increase health literacy, expand engagement with health service delivery, and demand accountability from the health system. CLM is essential for surfacing stigma and discrimination, intimate partner violence and other forces affecting safe, ethical, and effective HIV prevention, testing, and treatment services.

The primary activity of this cooperative agreement is to conduct CLM of HIV services in Sierra Leone. This includes prevention, testing and treatment (linkage, retention and viral load testing) services, as well as monitoring of service provider perceptions, attitudes, practices, and client satisfaction. PEPFAR requires that services be client-friendly, including such differentiated service delivery options as appointment spacing and multi-month medication dispensing. CLM provides an opportunity to ensure these services meet the needs of the clients. To ensure dialogue and participation in identifying improvement opportunities, and implementing and monitoring solutions, you will present results for analysis in collaboration with community representatives, providers, and facility managers.

CLM is a technique initiated and implemented by local community-based organizations and other civil society groups, networks of key populations (KP), PLHIV, and other affected groups, or other community entities that gather quantitative and qualitative data about HIV services. The focus is on getting input from recipients of HIV services in a routine and systematic manner that will translate into action and change.

You will be responsible for the following activities:

1. A protocol and tools for administering CLM, covering the provision of high-quality HIV prevention services, testing services, HIV treatment services (including linkage, retention, and viral load testing), service provider perceptions, attitudes and practices, patient satisfaction, stigma and discrimination. The protocol and tools must support a community-informed systematic approach to collecting actionable information and will ultimately support timely course-corrective improvement in service delivery and client satisfaction. Information collected should support analysis among sub-populations such as specific KP, adolescents, etc. to facilitate customized solutions.

2. Assessment of site-level activities to assure compliance with PEPFAR Minimum Program Requirements such as the prohibition on user fees for any HIV-related services.

3. A systematic process for analyzing CLM information and formulating recommendations. You should include a description of the frequency of http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.state.gov/community-led-monitoring/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/community-led-monitoring/ https://www.state.gov/wp-content/uploads/2020/12/PEPFAR-COP21-Guidance-Final.pdf

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data collection, analysis, and dissemination. You should also identify stakeholders to be included in these processes. Allow for community and host country government development of the specific metrics, measures, or tools to be used for CLM. Metrics or measures should be tailored to a given context and address the specific needs and concerns of community members. A CLM Technical Working Group (TWG), with representation from the joint United Nations Programme on HIV/AIDS, Key Populations (KP) Civil Society Organizations (CSOs), and government stakeholders is an example of possible stakeholder engagement, but this is an example and not as a specific requirement.

4. Communication and collaboration that includes:

A. System for sharing lessons-learned and solutions, prioritizing all

PEPFAR-supported sites.

B. In collaboration with HRSA, establishment of site-level or district-level feedback meetings where none exists.

C. Participation in any meetings with a PEPFAR CLM Task Force or other National CLM Steering Committee to provide in-depth discussion of work and results at both the national and district levels.

D. Options for supporting victims of intimate partner violence such as by linked referrals and follow-up.

E. Options for reporting and following up on reports of stigma and discrimination associated with HIV testing and treatment services.

F. Participation in any site-level or district-level structured feedback meetings.

5. A monitoring and evaluation plan to show outcomes and impact. This might include periodic case studies showing the issues identified, the solutions, and the follow-up information to confirm that the solution was maintained and has resulted in improved client satisfaction or service outcomes that are defined and measurable. This is included here as an example and not as a specific requirement.

You should keep in mind and incorporate the following guidance:

• The unique needs of key and priority populations need to be accommodated and advanced in the implementation of this program.

• CLM supports activities to assure consistent achievement of results and to support further progress through advocacy and use of additional ideas for continuous improvement.

• CLM data must be collected using standardized tools and synthesized through a variety of methods that reveal actionable insights from communities about challenges and/or issues identified with HIV service delivery.

• You may not use data collected for research purposes, and the protocol and tools may be subject to review for non-research determination.

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You must have the capability to collaborate at the national level with PEPFAR, Sierra Leone officials, and key community-focused stakeholders, and at the local level with health facility staff and clients receiving PEPFAR-supported services.

You must be able to implement a monitoring program to promote cooperation in addressing HIV service delivery related issues, encourage constituencies to share their experiences, and facilitate joint action that improves the quality, efficiency, and effectiveness of HIV services in Sierra Leone.

The PEPFAR Guidance for the 2022 U.S. Federal Fiscal Year (FY22), which begins October 1, 2021, offers additional information on PEPFAR’s description and expectations for CLM.

More information and tools on PEPFAR’s approach to CLM are available at the following websites:

• https://www.state.gov/wp-content/uploads/2020/07/PEPFAR_ Community-Led-

Monitoring_Fact-Sheet_2020.pdf

• https://www.pepfarsolutions.org/tools-2/2020/3/12/community-led-monitoring-implementation-tools

You are encouraged to consult these sources in developing your application.

PEPFAR currently supports sites in Western Area Urban and Rural, Port Loko and Kambia Districts, with plans to expand to Bo District in October 2021. The PEPFAR program will be supporting approximately 30 PEPFAR supported sites.

Given the low overall national prevalence, the PEPFAR program in Sierra Leone focuses on key and priority populations, though that the sites where PEPFAR is providing support, support extends to all PLHIV and for any individual seeking HIV prevention and testing services.

While this initiative focuses on PEPFAR-supported districts and sites, the data, insights, and solutions are to be shared broadly to promote improvements across the entire national HIV response in Sierra Leone.

You are encouraged to use the following models and tools to carry out monitoring activities:

• Community scoping tool

• Community treatment observatory model and associated tools

• Digital app with scorecard and dashboard functionality

• Dashboard (generated on the back end of app)

You may include activities and associated costs to strengthen internal capacity to administer USG funds and implement the program.

You should describe actions to achieve rapid introduction and scale-up of activities following award including details of timeline and scale of activities.

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You should also describe approaches to reaching any sub-populations such as pediatrics, adolescent girls and young women, and key and priority populations.

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment. For the information content required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 Application Guide.

ii. Project Narrative

INTRODUCTION -- Corresponds to Section V’s Review Criterion 1 : NEED Briefly describe the purpose of the proposed project.

NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion 1: NEED Outline the needs of the community. Describe and document the HIV population and priority sub-populations in Sierra Leone and their unmet health needs. Use and cite demographic data whenever possible to support the information provided.

Discuss any relevant barriers in the service area that the project hopes to overcome. This section will help reviewers understand the community and that you will serve with the proposed project.

METHODOLOGY -- Corresponds to Section V’s Review Criterion 2: RESPONSE

Propose methods that you will use to address the stated needs and meet each of the previously described program requirements and expectations in this NOFO:

1 A protocol and tools for administering CLM, covering the provision of high-quality HIV prevention services, testing services, HIV treatment services (including linkage, retention, and viral load testing), service provider perceptions, attitudes and practices, patient satisfaction, stigma and discrimination. The protocol and tools must support a systematic, client-informed approach to collecting actionable information and will ultimately support course-corrective improvement in service delivery and client satisfaction. Information collected should support analysis among sub-populations such as specific KP, adolescents, etc. to facilitate customized solutions. Please label your response as M1.

2 Assessment of site-level activities to assure compliance with PEPFAR Minimum Program Requirements (MPRs) such as the prohibition on user fees for any HIV-related services. https://www.state.gov/wp-content/uploads/2021/02/PEPFAR-COP21-Guidance-Final.pdf Please label your response as M2.

3 A systematic process for analyzing CLM information and formulating recommendations. You should include a description of the frequency of data collection, analysis, and dissemination. You should also identify stakeholders to be included in these processes. A CLM Technical Working Group (TWG), with representation from the UNAIDS, Sierra Leone’s NACP, KPs CSOs, are examples of possible stakeholder engagement, but this is offered here as an example and not as a specific requirement. Please label your response as M3.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.state.gov/community-led-monitoring/ https://www.state.gov/wp-content/uploads/2020/12/PEPFAR-COP21-Guidance-Final.pdf https://www.state.gov/wp-content/uploads/2021/02/PEPFAR-COP21-Guidance-Final.pdf https://www.state.gov/wp-content/uploads/2021/02/PEPFAR-COP21-Guidance-Final.pdf https://www.state.gov/community-led-monitoring/ https://www.unaids.org/en https://www.nas.gov.sl/nacp#:%7E:text=The%20National%20HIV%2FAIDS%20control,Ministry%20of%20Health%20and%20Sanitation.&text=The%20national%20HIV%2FAIDS%20control%20programme%20(NACP)%20is%20involved,to%20the%20National%20AIDS%20secretariat

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4 Communication and collaboration that includes:

G. System for sharing lessons-learned and solutions across all

PEPFAR supported sites.

H. In collaboration with HRSA, establishment of site-level or district-level feedback meetings where none exists.

I. Participation in any meetings with a PEPFAR CLM Task Force or other National CLM Steering Committee to provide in-depth discussion of work and results at both the national and district levels.

J. Options for supporting victims of intimate partner violence such as by linked referrals and follow-up.

K. Options for reporting and following up on reports of stigma and discrimination associated with HIV testing and treatment services.

L. Participation in any site-level or district-level structured feedback meetings

Please label your response for these communication and collaboration activities as M4.

Propose a plan for project sustainability after the period of federal funding ends.

HRSA expects recipients to sustain key elements of their projects, e.g., strategies or services and interventions, which have been effective in improving practices and those that have led to improved outcomes for the target population. Please label your response as M5.

As appropriate, include development of effective tools and strategies for ongoing staff training, outreach, collaborations, clear communication, and information sharing/dissemination with efforts to involve patients, families, and communities.

Include a plan to disseminate reports, products, and/or project outputs so key target audiences receive the project information. Include a description of any innovative methods that you will use to address the stated needs.

WORK PLAN -- Corresponds to Section V’s Review Criteria 2: RESPONSE and 4:

IMPACT

Describe the activities or steps that you will use to achieve each of the objectives proposed during the entire period of performance in the Methodology section. Use a time line that includes each activity and identifies responsible staff. As appropriate, identify meaningful support and collaboration with key stakeholders (including clients) in planning, designing, and implementing all activities, including developing the application.

Discuss how goals and objectives directly relate to the requirements and expectations of this initiative. Provide a work plan that demonstrates how the outcomes, strategies, and activities will take place over the course of the award.

Include a detailed work plan for the first year of the project and a high-level plan for the two subsequent years.

The work plan should include goals, objectives, and outcomes that are SMART (specific, measurable, achievable, realistic, and time-measured). Include all aspects of planning, implementation, and evaluation. The work plan should relate

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to the needs identified in the needs assessment and to the activities described in the project narrative with a minimum of the following:

o Interventions for each goal.

o Activities for each intervention.

o Responsible staff to complete or monitor each activity.

o Anticipated timeline for activity, intervention, and completion.

The work plan should include sufficient detail to support understanding while recognizing that you will revise the work plan after the cooperative agreement is awarded and after initial consultations with HRSA and in-country stakeholders.

Include the project’s work plan as Attachment 1.

RESOLUTION OF CHALLENGES-Corresponds to Section V’s Review Criterion 2:

RESPONSE

Discuss challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve such challenges. Discuss the strength of your methodology in identifying and responding to these challenges. Describe how the five districts will be covered in your work plan, implementation and reporting.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criteria 3: EVALUATIVE MEASURES and 5:

RESOURCES/CAPABILITIES

Describe the plan for the program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation should monitor ongoing processes and the progress towards the goals and objectives of the project. Include descriptions of the inputs (e.g., organizational profile, collaborative partners, key personnel, budget, and other resources), key processes, and expected outcomes of the funded activities.

Describe the systems and processes that will support your organization's performance management requirements through effective tracking of performance outcomes, including a description of how the organization will collect and manage data (e.g., assigned skilled staff, data management software) in a way that allows for accurate and timely reporting of performance outcomes. Describe current experience, skills, and knowledge, including individuals on staff, materials published, and previous work of a similar nature. As appropriate, describe the data collection strategy to collect, analyze and track data to measure process and impact/outcomes, and explain how the data will be used to inform program development and service delivery. Describe any potential obstacles for implementing the program performance evaluation and your plan to address those obstacles.

The monitoring and evaluation plan must show outcomes and impact. This might include periodic case studies showing the issues identified, the solutions, and the follow-up information to confirm that the results were sustained and improved client satisfaction or service outcomes that are defined and measurable. This is included here as an example and not as a specific requirement.

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ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion 5: RESOURCES/CAPABILITIES

Provide information demonstrating that the applicant is a community-based organization (CBOs) or other civil society group; a network of KP, PLHIV, people with disabilities, other affected groups or community entities; or a consortium of such organizations; is registered and based in Sierra Leone; and has the capacity to gather quantitative and qualitative data about HIV service delivery and whose mission and activities focus on HIV programming.

Succinctly describe your organization’s mission, structure, and scope of current activities; its familiarity with the community and its needs based on interactions and observations obtained through community-based, immersive experience; and how these elements all contribute to the organization’s ability to implement the program requirements and meet program expectations. Include an organizational chart. Discuss how the organization and each personnel will follow the approved plan, as outlined in the application, properly account for the federal funds, and document all costs to avoid audit findings. Describe how you will routinely assess and improve the unique needs of target populations of the communities served.

Describe the previous projects in Sierra Leone that reflect the expertise of proposed personnel in working collaboratively with Ministerial, education institutions, regulatory bodies, health management teams, other USG-funded programs, and stakeholders. Explain how your activities at nation, district and site and community levels have demonstrated effective results and relationships.

Describe how you assessed, developed and implemented aspects of the HIV care continuum and international best practices for HIV service delivery at site and community levels in Sierra Leone. It may be helpful to present in chart form the partners and Government of Sierra Leone timeframes, inputs, outputs and results.

Describe your networks of CSOs throughout Sierra Leone, including a description of the diversity of populations and geographic area. Explain how you utilize, contribute and sustain existing relationships with KPs and Civil Society Organizations (CSOs) in Sierra Leone.

iii. Budget The directions offered in the SF-424 Application Guide may differ from those offered by Grants.gov. Follow the instructions in Section 4.1.iv of HRSA’s SF-424 Application Guide and the additional budget instructions provided below. A budget that follows the Application Guide will ensure that, if HRSA selects the application for funding, you will have a well-organized plan and, by carefully following the approved plan, may avoid audit issues during the implementation phase.

Reminder: The Total Project or Program Costs are the total allowable costs (inclusive of direct and indirect costs) you incur to carry out a HRSA-supported project or activity. Total project or program costs include costs charged to the award and costs borne by you to satisfy a matching or cost-sharing requirement, as applicable.

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In addition, the Community-Led Monitoring (CLM) of HIV Services in Sierra Leone Program requires the following:

• Provide a program-specific line item budget for each year of the three-year period of performance using the object class categories in the SF-424A. List personnel separately by position title and the name of the individual for each position title, or note if position is vacant. You should upload the line item budget for each of the three years as an attachment to the application as Attachment 6. The budget allocations on the line item must relate to the activities proposed in the project narrative, including the work plan. The line item budget requested for each year must not exceed the total funding ceiling amount. In addition, the amounts requested on the SF-424A and the amounts listed on the line item budget must match.

• Indirect costs on grants awarded to foreign organizations and performed outside of the territorial limits of the United States may support the costs of compliance with federal requirements at a fixed rate of eight (8) percent of modified total direct costs. These costs exclude tuition and related fees, direct expenditures for equipment, and sub-awards and contracts under the grant in excess of $25,000.

• Allocation of multiple indirect cost rates: For institutions of higher education and nonprofits that have indirect costs benefitting major programs disproportionately, indirect rates will vary.

The Further Consolidated Appropriations Act, 2021 (P.L. 116-260), Division H, § 202 Salary Limitation does not apply to this program.

iv. Budget Narrative

See Section 4.1.v. of HRSA’s SF-424 Application Guide.

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria. Any attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria Introduction (1) Need

Needs Assessment (1) Need

Methodology (2) Response

Work Plan (2) Response and (4) Impact

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures and

(5) Resources/Capabilities

Organizational Information (5) Resources/Capabilities

Budget and Budget Narrative (6) Support Requested

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v. Attachments Provide the following items in the order specified below to complete the content of the application. Unless otherwise noted, attachments count toward the application page limit. Indirect cost rate agreements and proof of non-profit status (if applicable) will not count toward the page limit. Clearly label each attachment.

Attachment 1: Work Plan, required

Attach the work plan for the project that includes all information detailed in Section IV.2.ii. Project Narrative. If you will make subawards or expend funds on contracts, describe how your organization will ensure proper documentation of funds.

Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (see Section

4.1. of HRSA’s SF-424 Application Guide), required

Keep each job description to one page in length as much as is possible. Include the role, responsibilities, and qualifications of proposed project staff. Also, please include a description of your organization’s timekeeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 3: Biographical Sketches of Key Personnel, required

Include biographical sketches for persons occupying the key positions described in Attachment 2, not to exceed two pages in length per person. In the event that a biographical sketch is included for an identified individual not yet hired, include a letter of commitment from that person with the biographical sketch.

Attachment 4: Letters of Agreement, Memoranda of Understanding, and/or Description(s) of Proposed/Existing Contracts (project-specific), required

Provide any documents that describe working relationships between your organization and other…