PKG00238547-instructions.docx

DEPARTMENT OF HEALTH AND HUMAN SERVICES

AGENCY: Office of the Assistant Secretary for Health, Office of Population Affairs FUNDING OPPORTUNITY TITLE: Announcement of Anticipated Availability of Funds for Family Planning Services Grants ACTION: Notice

ANNOUNCEMENT TYPE: INITIAL COMPETITIVE GRANT

FUNDING OPPORTUNITY NUMBER: PA-FPH-18–001

CFDA NUMBER: 93.217

CFDA PROGRAM: Family Planning Services

DATES:

Non-binding Letters of Intent: We are requesting non-binding letters of intent. Your letter of intent is due within 45 days of the date of this FOA.

Technical Assistance: A technical assistance webinar will take place within 30 days of the date of this FOA. Please visit www.hhs.gov/opa for more information.

Please be sure to review the entire announcement promptly so you can have any questions answered well in advance of the application due date.

Applications: Your application is due May 24, 2018 by 6 p.m. Eastern Time. To receive consideration, you must submit your application electronically via Grants.gov no later than this due date and time. If you do not submit your application by the specified deadline, we will return it to you unread. You must submit electronically via Grants.gov unless you obtain a written exemption from this requirement 2 business days in advance of the deadline from the Director, HHS/Office of the Assistant Secretary for Health (OASH) Office of Grants Management (OGM). To obtain an exemption, you must request one via email from the HHS/OASH OGM, and provide details as to why you are technologically unable to submit electronically through Grants.gov. Your request should be submitted at least 4 business days prior to the application deadline to ensure your request can be considered prior to 2 business days in advance of the deadline. If you request an exemption, include the following in your e-mail request: the HHS/OASH announcement number; your organization's DUNS number; your organization’s name, address and telephone number; the name and telephone number of your Authorizing Official; the Grants.gov Tracking Number (for example, GRANT####) assigned to your submission; and a copy of the "Rejected with Errors" notification from Grants.gov. Send the request with supporting documentation to ogm.oash@hhs.gov. Note: failure to have an active System for Account Management (SAM) registration prior to the application due date will not be grounds for receiving an exemption to the electronic submission requirement. Failure to follow Grants.gov instructions to ensure software compatibility will not be grounds for receiving an exemption to the electronic submission requirement.

The HHS/OASH OGM will only accept applications via alternate methods (hardcopy paper via U.S. mail or other provider or PDF via email) from applicants obtaining prior written approval. If you receive an exemption, you must still submit your application by the deadline. Only applications submitted through the Grants.gov portal or alternate format (hardcopy paper via U.S. mail or other service or PDF via email) with an approved written exemption will be accepted. See Section D.7 (“Other Submission Requirements”) for information on application submission mechanisms.

Executive Order 12372 comment due date: The State Single Point of Contact (SPOC) has 60 days from the application due date to submit any comments. For more information on the SPOC see section D.4 Intergovernmental Review.

To ensure adequate time to successfully submit your application, HHS/OASH recommends that you register as early as possible in Grants.gov since the registration process can take up to one month. For information on registering for Grants.gov, refer to http://www.grants.gov or contact the Grants.gov Contact Center 24 hours a day, 7 days a week (excluding Federal holidays) at 1-800-518-4726 or support@grants.gov.

Your organization is strongly encouraged to register multiple authorized organization representatives in Grants.gov to ensure someone is available to submit your application.

EXECUTIVE SUMMARY: The Office of Population Affairs announces the anticipated availability of funds for Fiscal Year 2018 grant awards under the authority of Title X of the Public Health Service Act. This notice solicits applications from entities to provide Title X family planning services throughout the service areas identified in Table I. The Office of Population Affairs intends to make available approximately $260 million for competing grants in 60 service areas and/or populations. The actual amount available will not be determined until enactment of the FY 2018 federal budget. While there is not a fixed cost-sharing percentage or amount, entities must have financial support from sources other than Title X. The proposed budget should reflect financial support in addition to Title X funds on both the Standard Form (SF) 424A, Budget Information for Non-Construction Programs, and in the budget narrative.

This notice solicits applications from public and private nonprofit entities, including comprehensive primary care providers, hospitals, health collaboratives, and women’s health centers to establish and operate voluntary family planning projects to serve the areas and/or populations listed in Table I. We encourage all qualified applicants, especially those proposing innovative strategies to increase the number of clients served or the quality of services, to apply. HHS seeks a broad competition for Title X grant awards to provide a diversity of options for clients with the intention of improving overall service provision, increasing the number of clients served, and expanding the breadth of services available in the states, territories and throughout the regions. Family planning services include services for both men and women as they plan their families. Such services include postponing, preventing, achieving, or facilitating the spacing of pregnancy. Family planning services also include infertility services, health screenings and exams, lab tests and related health services which are important to family planning and male and female reproductive health, improving the likelihood of a healthy pregnancy and birth, should conception occur. Family planning services also include information, education, and counseling related to family planning; and referral services as indicated.

All activities funded under this announcement must be in compliance with the Title X statute, as well as the program regulations and legislative mandates, as applicable. Copies of the Title X statute, regulations, and legislative mandates may be downloaded from the Office of Population Affairs web site at http://www.hhs.gov/opa.

HHS/OASH encourages applicants to review all program requirements, eligibility information, application format and submission information, evaluation criteria and other information in this funding announcement to ensure that their applications comply with all requirements and instructions.

A. PROGRAM DESCRIPTION:

This announcement seeks applications from public and private nonprofit entities to establish and operate voluntary family planning services projects, which includes family planning services for both men and women as they plan their families. Such services include postponing, preventing, achieving, or facilitating the spacing of pregnancy. Family planning services also include infertility services, health screenings and exams, lab tests and related health services which are important to family planning and male and female reproductive health, improving the likelihood of a healthy pregnancy and birth, should conception occur. Family planning services also include information, education, and counseling related to family planning; and referral services as indicated. Family planning services under this grant will give priority to those from low-income families. An applicant may propose a family planning service project that either is comprised of a single provider or a group of partnering providers who deliver coordinated and comprehensive family planning services. If not providing all services directly, the applicant must have documented the process and selection criteria it will use for providing an opportunity to receive subawards to qualified entities eligible to receive federal funds in providing services throughout the service area to meet the needs of project beneficiaries. Single providers who have developed expertise in one family planning approach or method may be partners in a broader proposal that offers a broad range of family planning methods. The application shall ensure that if family planning services are provided by contract or other similar arrangements with actual providers of services, services will be provided in accordance with a plan which establishes rates and method of payment for medical care. These payments must be made under agreements with a schedule of rates and payment procedures maintained by the grantee. The grantee must be prepared to substantiate, that these rates are reasonable and necessary. Each project should offer core family planning services that include:

· A Sexual health assessment which ascertains current risk in light of sexual history and current behavioral practices. A sample is available at the CDC website. https://npin.cdc.gov/publication/guide-taking-sexual-history.

· Introduction and access to tools for a personal family planning, fertility, and reproductive life plan, which informs decision-making and is important to client- provider communication. A reproductive life plan outlines personal goals about becoming pregnant: https://www.cdc.gov/preconception/planning.html.

· Family planning services which offer a broad range of acceptable and effective family planning methods and services (including natural family planning methods - also called fertility awareness), and which includes pregnancy testing and counseling, as indicated. The broad range of services does not include abortion as a method of family planning.

· Health screenings which are preventive and/or diagnostic in nature and which help clients achieve preconception health; offering at least STD screenings and treatment and cervical and breast cancer screenings; and may also include other services including, but not limited to preventive health, mental health assessments, and risk behavior screenings.

· Health information, education, and counseling with an optimal health outcome as the desired goal for the client. Optimal health refers to the best possible outcomes for an individual’s physical, emotional, and social health.

· Referral services available to clients from a network of formalized linkages among community partners, as indicated.

Program Statute, Regulations, Legislative Mandates, , Program Priorities, and Key Issues Title X Statute and Regulations: Requirements regarding the provision of family planning services under Title X can be found in the statute (Title X of the Public Health Service Act, 42 U.S.C. 300 et seq.). Applicants must comply with these requirements. Applicants must also comply with the regulations which govern grants for family planning services (42 CFR part 59, subpart A), as applicable. In addition, sterilization of clients as part of the Title X program must be consistent with 42 CFR part 50, subpart B (“Sterilization of Persons in Federally Assisted Family Planning Projects”). Title X of the Public Health Service Act authorizes the Secretary of Health and Human Services (HHS) to award grants to entities to provide family planning services to those desiring such services, with priority given to persons from low-income families. Therefore, in order to ensure that all prospective low income clients are able to access services, no charge will be made for services to persons from a low-income family except to the extent that payment will be made by a third party, including a government agency, which is authorized to or is under legal obligation to pay this charge.

In addition, family planning medical services will be performed under the direction of a physician with special training or experience in family planning and each family planning project must refer to other medical facilities when medically indicated, including in medical emergencies.

Section 1001 of the Act, as amended, authorizes grants “to assist in the establishment and operation of voluntary family planning projects which shall offer a broad range of acceptable and effective family planning methods and services (including natural family planning methods, infertility services, and services for adolescents.)” (Natural family planning methods are also now known as Fertility Awareness Based Methods.) We encourage applications for all methods, especially those that add to the breadth and variety of methods offered in a service area, in particular those with a holistic vision of health and those historically underrepresented in the Title X program.

An important part of family planning includes supporting the overall health of clients who may seek to become parents in the future. Therefore, each Title X project should ensure that family planning is contextualized within a holistic conversation of health, with the project optimally offering primary health services onsite, or having robust referral linkages to primary health providers in close proximity to the Title X site. Section 1001 of the statute requires that, to the extent practicable, Title X entities which receive grants or contracts under this subsection shall encourage family participation in family planning services projects. This requirement applies throughout the program, extending to all individuals, couples and families seeking Title X services, as practicable, always being mindful of the health, safety, and best interest of the client.

Finally, section 1001 (b) assures the right of local and regional entities to apply directly to the Secretary for Title X grant funds. Section 1008 of the Act, as amended, stipulates, “None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning.”

Legislative Mandates: The following legislative mandates have been part of the Title X appropriations language for the last several years. This funding opportunity announcement assumes these provisions will be carried forward in FY 2018. Title X family planning services should include administrative, clinical, counseling, and referral services as well as training of staff necessary to ensure adherence to these requirements.

· “None of the funds appropriated in this Act may be made available to any entity under Title X of the PHS Act unless the applicant for the award certifies to the Secretary of Health and Human Services that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities;” and

· “Notwithstanding any other provision of law, no provider of services under Title X of the PHS Act shall be exempt from any State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.”

OPA expects every project shall comply with applicable state laws in the proposed service area and will have project-wide monitoring and reporting policies related to child abuse, child molestation, sexual abuse, rape, incest, intimate partner violence, and human trafficking. These policies will include details related to annual staff training on policy and protocols, how policies will be implemented and monitored, always ensuring a clear understanding of the reporting process. In addition, any teen who presents with an STD, pregnancy, or any suspicion of abuse will be subject to preliminary screening to rule out victimization of a minor. Such screening is required for any individual who is under the age of consent in the state of the proposed service area.

Copies of the Title X statute, regulations, and legislative mandates may be downloaded from the Office of Population Affairs web site at http://www.hhs.gov/opa. All activities funded under this announcement must be in compliance with the Title X statute, as well as the program regulations and legislative mandates, as applicable.

Program Priorities: Each year the OPA establishes program priorities that represent overarching goals for the Title X program. Program priorities derive from the Department of Health and Human Services (HHS) priorities. Applicants should provide evidence of their capacity to address program priorities. The FY 2018 program priorities are as follows:

1. Assuring innovative high quality family planning and related health services that will improve the overall health of individuals, couples and families, with priority for services to those of low-income families, offering, at a minimum, core family planning services enumerated earlier in this Funding Announcement. Assuring that projects offer a broad range of family planning and related health services that are tailored to the unique needs of the individual, that include natural family planning methods (also known as fertility awareness based methods) which ensure breadth and variety among family planning methods offered, infertility services, and services for adolescents; breast and cervical cancer screening and prevention of STDs as well as HIV prevention education, counseling, testing, and referrals;

2. Assuring activities that promote positive family relationships for the purpose of increasing family participation in family planning and healthy decision-making; education and counseling that prioritize optimal health and life outcomes for every individual and couple; and other related health services, contextualizing Title X services within a model that promotes optimal health outcomes for the client.

3. Ensuring that all clients are provided services in a voluntary, client-centered and non-coercive manner in accordance with Title X regulations.

4. Promoting provision of comprehensive primary health care services to make it easier for individuals to receive both primary health care and family planning services preferably in the same location, or through nearby referral providers, and increase incentive for those individuals in need of care choosing a Title X provider.

5. Assuring compliance with State laws requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, incest, intimate partner violence, and human trafficking;

6. Encouraging participation of families, parents, and/or legal guardians in the decision of minors to seek family planning services; and providing counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities; and

7. Demonstrating that Title X activities are separate and clearly distinct from non-Title X activities, ensuring that abortion is not a method of family planning for this grant

8. Use of OPA performance metrics to regularly perform quality assurance and quality improvement activities.

Key Issues: In addition to program priorities, the following key issues should be considered in developing the project plan:

1. Efficiency and effectiveness in program management and operations;

2. Management and decision-making and accountability for outcomes;

3. Cooperation with community-based and faith-based organizations;

4. Meaningful collaboration with subrecipients and documented partners in order to demonstrate a seamless continuum of care for clients;

5. A meaningful emphasis on education and counseling that communicates the social science research and practical application of topics related to healthy relationships, to committed, safe, stable, healthy marriages, and the benefits of avoiding sexual risk or returning to a sexually risk-free status, especially (but not only) when communicating with adolescents;

6. Activities for adolescents that do not normalize sexual risk behaviors, but instead clearly communicate the research informed benefits of delaying sex or returning to a sexually risk-free status.

7. Emphasis on the voluntary nature of family planning services;

8. Data collection (such as the Family Planning Annual Report (FPAR) for use in monitoring performance and improving family planning services.

AUTHORITY: Section 1001 of the Public Health Service Act

B. FEDERAL AWARD INFORMATION

The Office of Population Affairs intends to make available approximately $260 million for competing grants. HHS intends to provide broad and expanded service coverage throughout all of the service areas listed below, with special emphasis on removing current gaps in service. Applicants may propose in a single application to serve any combination of service areas or subset of a single service area listed. Applicants should use Table I – Estimated Funds Available as a guide when developing proposals. The final funding amount will not be determined until enactment of the FY 2018 federal budget. This program announcement is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, applications can be processed, and funds can be awarded in a timely manner.

Award Information We will fund grants in annual increments (budget periods) and generally for a project period of up to 3 years, although we may approve shorter project periods. Funding for all approved budget periods beyond the first year of the grant is generally level with the initial award amount however, applicants may propose up to a 2% increase for each budget year beyond the proposed year 1 budget amount, and is contingent upon the availability of funds, satisfactory progress of the project, adequate stewardship of Federal funds, and the best interests of the Government.

Award Information Estimated Federal Funds Available: $260,000,000 (see Table 1 below) Anticipated Number of Awards: 100 Award Ceiling (Federal Funds including indirect costs): $22,000,000 per budget period (See Table 1 below) Award Floor (Federal Funds including indirect costs): $150,000 (See Table 1 below) Anticipated Start Date: 9/1/2018 Period of Performance: Not to exceed 3 years, 9 months Budget Period Length: 9 to 12 months Type of Award: Grant Type of Application Accepted: Electronic via Grants.gov ONLY unless an exemption is granted Funds Available by Service Area (Note: HHS intends to fund services in all areas listed. Award decisions will be based on the quality of applications received (as stated in the Application Review Information section starting on pg. 43) and eligibility of applicants (as stated in the Eligibility Information section starting on pg. 15).

Local and regional entities are assured the right to apply.)

Table 1

US States and the District of Columbia

US Territories and the Pacific Jurisdictions

C. ELIGIBILITY INFORMATION

1. Eligible Applicants Any public or private nonprofit entity located in a State (which includes one of the 50 United States, District of Columbia, Commonwealth of Puerto Rico, U.S. Virgin Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of the Marshall Islands) is eligible to apply for a grant under this announcement. Faith-based organizations and American Indian/Alaska Native/Native American (AI/AN/NA) organizations are eligible to apply for Title X family planning services grants.

2. Cost Sharing or Matching Program regulations stipulate that projects must identify additional sources of funding and not rely solely upon Title X grant funds.

While there is not a fixed cost-sharing percentage or amount, projects must include financial support from sources other than Title X. The proposed project’s budgets should reflect financial support in addition to Title X funds on both the Standard Form (SF) 424A, Budget Information, and in the budget justification. The amount and source(s) of these funds must be clearly identified separately from the requested Title X support as indicated on the SF 424A, as well as on the SF 424, Application for Federal Assistance. The OASH Office of Grants Management will review applications to ensure that the requested amount of Title X funding is in compliance with this business requirement.

The cost sharing requirements outlined above are waived for any grant made to the U.S. Virgin Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of the Marshall Islands.

3. Other Eligibility Information Application Responsiveness Criteria We will review your application to determine whether it meets the following responsiveness criteria. If your application does not meet the responsiveness criteria, we will remove it from the competition and it will not be reviewed.

The applicant appears to have demonstrated:

· evidence that a broad range of acceptable and effective family planning methods and services (including natural family planning methods, infertility services, and services for adolescents), informational, educational, social, and referral services related to family planning will be provided as stipulated in 42 CFR 59.5;

· evidence of cost-sharing as described in this announcement; if applicable; and

· evidence that, if not providing all services directly, the applicant has documented the process and selection criteria it will use for providing an opportunity to receive subawards to qualified entities eligible to receive federal funds in providing services throughout the service area to meet the needs of project beneficiaries.

Application Disqualification Criteria If you successfully submit an application, we will screen it to assure a level playing field for all applicants. If we determine your application fails to meet the criteria described below we will disqualify it, that is, it will not be reviewed and will receive no further consideration.

a) You must submit your application electronically via www.grants.gov (unless an exemption was granted 2 business days prior to the deadline) by the date and time indicated in the DATES section of this announcement.

b) If you successfully submit multiple applications from the same organization for the same project, we will only review the last application received by the deadline.

c) HHS/OASH/OGM deems your application eligible according to section C.1 Eligible Applicants.

d) Your Project Narrative section of the application must be double-spaced, on the equivalent of 8 ½ ” x 11” inch page size, with 1” margins on all sides (top, bottom, left and right) and font size not less than 12 points.

e) Your Project Narrative must not exceed 65 pages. NOTE: The following items do not count toward the page limit: all required forms, including SF-424, SF-424A, SF-424B, SF-LLL, Project Abstract Summary, and Budget Narrative (including budget tables).

f) Your total application, including the Project Narrative plus Appendices, must not exceed 150 pages. NOTE: items listed in “e” immediately above do not count toward total page limit.

g) Your application meets the Application Responsiveness Criteria outlined above.

D. APPLICATION AND SUBMISSION INFORMATION

1. Address to Request Application Package You may obtain an application package electronically by accessing Grants.gov at http://www.grants.gov/. You can find it by searching on the CFDA number shown on page 1 of this funding opportunity announcement. If you have problems accessing the application or difficulty downloading, contact:

Office of Grants Management Phone: 240-453-8822 Email: ogm.oash@hhs.gov

2. Content and Form of Application Submission

i. Letter of Intent We are requesting non-binding letters of intent. Your letter of intent is due within 45 days of the date of this FOA and should be directed to the program office: DASPA, Office of Population Affairs, 1101 Wooton Parkway, Ste 700, Rockville, MD 20852.

If you plan to apply for this funding opportunity, you should submit a letter of intent as early as possible, but no later than the deadline indicated in the DATES section of this announcement. Although you are not required to submit a letter of intent, the information that it contains allows HHS/OASH to estimate the potential review workload and plan the review. A letter of intent is not binding, and is not part of the review of a subsequent application. Your letter of intent should include a descriptive title of your proposed project, the name, street address, email address, and telephone number for the designated authorized representative of your organization, and the FOA number and title of this announcement.

ii. Application Format Your application must be prepared using the forms and information provided in the online application package.

The Project Narrative, and total application including appendices, must adhere to the page limit indicated in Application Disqualification Criteria listed in Section C.

You must double-space the Project Narrative pages.

You should use an easily readable typeface, such as Times New Roman or Arial. You must use 12-point font. You may single-space tables or use alternate fonts but you must ensure the tables are easy to read. The page limit does not include the Budget Narrative (including budget tables), required forms, assurances, and certifications as described in the Application Disqualification Criteria. Please do not number pages or include a table of contents. Our grants management system will generate page numbers once your application is complete.

If your application exceeds the specified page limits for the Project Narrative or Project Narrative plus Appendices when printed on 8.5” X 11” paper by HHS/OASH/OGM, we will not review it. We recommend you print out your application before submitting electronically to ensure that it is within the page limits and is easy to read.

Appendices Submit all appendix content as a single acceptable file. Your Appendices should include any specific documents under the heading “Appendices” in the Application Content section of this funding opportunity announcement. Your documents should be easy to read. You should use the same formatting specified for the Project Narrative. However, documents such as resumes/CVs, organizational charts, tables, or letters of commitment may use formatting common to those documents, but the pages must be easy to read. All of your appendices must be uploaded as a single, consolidated file in the Attachments section of your Grants.gov application.

Project Abstract Summary You must complete the Project Abstract Summary form provided in the application package. The abstract will be used to provide reviewers with an overview of the application and will form the basis for the application summary in grants management and program summary documents. If your project is funded, HHS may publish information from your form; therefore, do not include sensitive or proprietary information.

Budget Narrative The Budget Narrative should use the formatting required of the Project Narrative for the explanatory text. Budget tables may be single-spaced but should be laid out in an easily-readable format and within the printable margins of the page.

iii. Application Content Successful applications will contain the following information:

Project Narrative The Project Narrative is the most important part of the application, since it will be used as the primary basis to determine whether or not your project meets the minimum requirements for an award under this announcement. The Project Narrative should provide a clear and concise description of your project. HHS/OASH recommends that your project narrative include the following components:

Successful applicants will clearly describe the administrative, management, and clinical capability of the applicant organization. All services to be provided, should be included as part of the plan.

Your narrative should address how you will comply with the Title X statute, as well as the Title X program regulations, regulations regarding sterilization of persons in federally-assisted family planning projects, and legislative mandates, as applicable. Your narrative should discuss processes in place to ensure those from low-income families, with incomes that fall at or below 100% of the current Federal Poverty Guidelines (Federal Poverty Level, FPL), will not be charged except where third parties are authorized or legally obligated to pay. Where there is legal obligation or authorization for third party reimbursement, including public or private sources, all reasonable efforts you will employ to obtain third party payment without the application of any discounts.

The Project Narrative of successful applicants will also address or provide:

1. A clear description of the need for the services provided and a detailed description of the geographic area and population to be served;

2. Evidence that proposed projects will address the family planning needs of the full population in the service area to be covered;

3. Evidence of experience in the particular service area and with the particular community to be served;

4. Evidence that proposed projects have experience in providing clinical health services, are qualified to deliver family planning services, and have the capacity to undertake family planning and related health services required in statute and regulation, including a broad range of acceptable and effective family planning methods, natural family planning methods, infertility services and services for adolescents. A complete list of the family planning methods offered as part of the project should be included. Projects may consist of a single provider or a group of partnering providers who deliver coordinated and comprehensive family planning services. Each project should offer core family planning services as described earlier in this Funding Announcement. Each project must provide the full array of required services under this grant.

5. Evidence of familiarity with, and ability to provide services that include the following:

· family planning and related health issues;

· services that are consistent with standards of care related to family planning, adolescent health, and general preventive health measures for HIV, STDs, etc.;

· compliance with State laws applicable in the proposed service area requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, intimate partner violence, human trafficking, or incest;

· counseling techniques that encourage family participation in the decision of minors to seek family planning services, and incorporate resistance skills for minors to resist/avoid exploitation and/or sexual coercion; and

· counseling techniques that encourage family participation for all clients, including the involvement of parents, spouses or family where practicable, mindful of the health, safety, and best interest of the client.

6. For the proposed schedule of discounts provided in the Appendices, a description of how the schedule of discounts was developed; or for applicants with multiple subrecipients, a policy that is applicable to sub-recipients which meets the criteria set out in the Title X regulations at 42 CFR §59.5(a)(7)-(9). (Title X regulations require that the schedule of discounts be applied to all services provided to individuals with family income between 101-250% of the Federal Poverty Level (directly by the grantee and/or through the subrecipient) as part of the proposed projects as described in the application).

7. Evidence that the proposed services are consistent with the Title X statute, as well as the program regulations, and regulations regarding sterilization of persons in federally assisted family planning services projects, and legislative mandates, as applicable;

8. Evidence that Title X funds will not be used in programs where abortion is a method of family planning;

9. Evidence that Title X activities are separate and distinct from non-Title X activities;

10. A plan for providing community information and education programs which promote understanding about the availability of services. The plan should include a strategy for maintaining records of information and education activities;

11. A plan for an information and education advisory committee that is consistent with the Title X statute and regulations and that ensures that all information and education materials are current, factual, and medically accurate, as well as suitable for the population or community to which they will be made available;

12. Evidence that the Title X program priorities and key issues outlined above in this announcement are addressed in the project plan;

13. To the extent that the applicant will not provide all services directly, a description of the process and selection criteria used or to be used to select service sites and providers, including a description of eligible entities for funding as subrecipients.

14. A staffing plan which is reasonable and adheres to the Title X regulatory requirement that family planning medical services be performed under the direction of a physician with special training or experience in family planning. Evidence that staff providing clinical services (e.g., physicians, State-recognized advanced practice nurses, physician assistants) will be licensed and function within the applicable professional practice acts for the State in which they practice.

15. Goal statement(s) and related outcome objectives that are specific, measurable, achievable, realistic and time-framed (S.-M.-A-.R.-T);

16. Evidence, including signed referral agreements with relevant referral agencies, that the applicant has a plan to facilitate access to the following:

· all required clinical services, provided according to a schedule of rates that are reasonable and necessary as required by 42 CFR 59.5;

· comprehensive primary care services, if not provided by the project, and

· other needed health and social services for clients served in the Title X funded family planning projects, such as HIV care and treatment services.

17. Evidence of the capability to collect and report the required program data for the Title X annual data collection system, the Family Planning Annual Report (FPAR),

18. Evidence of a system for ensuring quality family planning services, including:

· a process for ensuring compliance with program requirements;

· defined performance measures, including an agreement to measure those provided to successful grantees upon notification of award, and a process for systematically assessing the quality of services provided throughout the defined projects; and a methodology for ensuring that health care practitioners have the knowledge, skills, and attitudes necessary to provide effective, quality family planning and related preventive health services that are consistent with current, evidence-based national standards of care and which include core family planning services, as enumerated early in this Funding Announcement. This will include training of select health care practitioners by OPA, and may utilize other clinical training opportunities available through OPA.

19. Evidence that the applicant has ability to bill third party commercial insurance carriers and Medicaid in accordance with Title X requirements; and the ability to facilitate enrollment of clients into Medicaid.

Budget Narrative You must complete the required budget forms and submit a budget narrative with detailed justification as part of your application. You must enter the project budget on the Budget Information Non-construction Programs standard form (SF 424A) according to the directions provided with this standard form. The budget narrative consists of a detailed line-item budget that includes calculations for all costs and activities by "object class categories" identified on the SF-424A and justification of the costs. You must indicate the method you are selecting for your indirect cost rate. See Indirect Costs below for further information.

Project budget calculations must include estimation methods, quantities, unit costs, and other similar quantitative detail sufficient to verify the calculations. If matching or cost sharing is required, you must include a detailed listing of any funding sources identified in box 18 of the SF-424 (Application for Federal Assistance).

Please be sure to carefully review section D.6 Funding Restrictions for specific information regarding allowable, unallowable, and restricted costs.

You must provide an object class category budget using Section B, box 6 of the SF 424A for the first year of the proposed project. Provide a budget justification, which includes explanatory text and line-item detail, for the first year of the proposed project. The budget narrative should describe how the categorical costs are derived. Discuss the necessity, reasonableness, and allocation of the proposed costs.

For subsequent budget years, provide a summary narrative and line item budget. For categories or items that differ significantly from the first budget year, provide a detailed justification explaining these changes. Note, do not include costs beyond the first budget year in the object class budget in box 6 of the SF- 424A or box 18 of the SF-424; the amounts entered in these sections should only reflect the first budget year.

Your budget narrative should justify the overall cost of the project as well as the proposed cost per activity, service delivered, and/or product. For example, the budget narrative should define the amount of work you have planned and expect to perform, what it will cost, and an explanation of how the result is cost effective. For example, if you are proposing to provide services to clients, you should describe how many clients are you expecting to serve, the unit cost of serving each client, and how this is cost effective.

Use the following guidelines for preparing the detailed object class budget required by box 6 of the SF-424A. The object class budget organizes your proposed costs into a set of defined categories outlined below. Both federal and non-federal resources (when required) must be detailed and justified in the budget narrative. "Federal resources" refers only to the HHS/OASH funds for which you are applying. "Non-federal resources" are all other non- HHS/OASH federal and non-federal resources. We recommend you present budget amounts and computations in a columnar format: first column, object class categories; second column, federal funds requested; third column, non-federal resources; and last column, total budget.

Sample Budget Table

Note, subrecipient/contract and consultant detailed costs should all be included in those specific line items, not in the overall project object class line items, i.e., subrecipient travel should be included in the Contractual line item not in Travel.

Object Class Descriptions and Required Justifications Personnel Description: Costs of staff salaries and wages, excluding benefits.

Personnel Justification: Clearly identify the project director or principal investigator, if known at the time of application. Provide a separate table for personnel costs detailing for each proposed staff person: the title; full name (if known at time of application), time commitment to the project as a percentage or full-time equivalent: annual salary and/or annual wage rate; federally funded award salary; non-federal award salary, if applicable; and total salary. No salary rate may exceed the statutory limitation in effect at the time you submit your application (see D.6 Funding Restrictions, Salary Limitation for details). Do not include the costs of consultants, personnel costs of delegate agencies, or of specific project(s) and/or businesses to be financed by the applicant. Contractors and consultants should not be placed under this category.

Sample Personnel Table

Fringe Benefits Description: Costs of employee fringe benefits unless treated as part of an approved indirect cost rate.

Fringe Benefits Justification: Provide a breakdown of the amounts and percentages that comprise fringe benefit costs such as health insurance, Federal Insurance Contributions Act (FICA) taxes, retirement insurance, and taxes.

Travel Description: Costs of travel by staff of the applicant organization only.

Travel Justification: For each trip proposed for applicant organization staff only, show the date of the proposed travel, total number of traveler(s); travel destination; duration of trip; per diem; mileage allowances, if privately owned vehicles will be used; and other transportation costs and subsistence allowances. Do not include travel costs for subrecipients or contractors.

Equipment Description: "Equipment" means an article of nonexpendable, tangible personal property having a useful life of more than one year per unit and an acquisition cost that equals or exceeds the lesser of: (a) the capitalization level established by the organization for the financial statement purposes, or (b) $5,000. (Note: Acquisition cost means the net invoice unit price of an item of equipment, including the cost of any modifications, attachments, accessories, or auxiliary apparatus necessary to make it usable for the purpose for which it is acquired.

Ancillary charges, such as taxes, duty, protective in-transit insurance, freight, and installation, shall be included in or excluded from acquisition cost in accordance with your organization's regular written accounting practices.)

Equipment Justification: For each type of equipment requested you must provide a description of the equipment; the cost per unit; the number of units; the total cost; and a plan for use of the equipment in the project; as well as a plan for the use, and/or disposal of, the equipment after the project ends. An applicant organization that uses its own definition for equipment should provide a copy of its policy, or section of its policy, that includes the equipment definition; include this with your Budget Narrative file. Reference the policy in this justification and include the policy copy in your Budget Narrative file (not your appendices).

Supplies Description: Costs of all tangible personal property other than those included under the equipment category. This includes office and other consumable supplies with a per- unit cost of less than $5,000.

Supplies Justification: Specify general categories of supplies and their costs. Show computations and provide other information that supports the amount requested.

Contractual Description: Costs of all contracts or subawards for services and goods except for those that belong under other categories such as equipment, supplies, construction, etc. Include third-party evaluation contracts, if applicable, and contracts or subawards with subrecipient organizations (with budget detail), including delegate agencies and specific project(s) and/or businesses to be financed by the applicant. This line item is not for individual consultants.

Contractual Justification: Demonstrate that all procurement transactions will be conducted in a manner to provide, to the maximum extent practical, open, and free competition.

Recipients and subrecipients are required to use 45 CFR § 75.329 procedures and must justify any anticipated procurement action that is expected to be awarded without competition and exceeds the simplified acquisition threshold fixed by 41 U.S.C. § 134, as amended by 2 CFR § 200.88, and currently set at $150,000.