PKG00245477-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

HIV/AIDS Bureau Office of Training and Capacity Development

Regional AIDS Education and Training Centers

Funding Opportunity Number: HRSA-19-035 Funding Opportunity Type(s): New and Competing Continuation

Catalog of Federal Domestic Assistance (CFDA) Number: 93.145

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2019

Application Due Date: December 10, 2018

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: October 12, 2018 Modification Date: November 23, 2018

Modification 1: Table 2 on page(s) 10-11 moves the state of Missouri from the Southeast Regional AETC to the Midwest Regional AETC.

Modification 2: Section IV.2.ii. p.18 (1) - Practice Transformation Project (PT) eligibility has been clarified.

Modification 3: a reference and link to the FAQs has been added on pages ii and 46.

Sherrillyn Crooks, PA-C Chief, HIV Education Branch Office of Training and Capacity Development Telephone: (301) 443-7662 Email: scrooks@hrsa.gov

Authority: Section 2692(a) (42 U.S.C. §300ff-111(a)) and section 2693 (42 U.S.C. § 300ff-121) of the Public Health Service Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009.

Funds for the CDC Expanded Testing Initiative are authorized under Sections 301 and 318 of the Public Health Service Act (42 U.S.C. Section 241 and 247c), as amended. Secretary’s Minority AIDS Funds are authorized Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (P.L. 115-245), Division B, Title II. Funds for the Practice Transformation Expansion Project are authorized under Section 330 of the Public Health Service Act (42 U.S.C. 254b), as amended.

mailto:scrooks@hrsa.gov i

HRSA-19-035

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for fiscal year (FY) 2019 Regional AIDS Education and Training Centers (AETC) Program, a component of the Ryan White HIV/AIDS Part F AETC Program. The purpose of this program is to provide funding for targeted, multidisciplinary education and training for health care professionals to provide health care services to people living with HIV (PLWH). The overarching goal of the AETC Program is to increase the number of health care providers who are educated and motivated to counsel, diagnose, treat, and medically manage PLWH and to help prevent HIV transmission.

Funding Opportunity Title: Regional AETC Program Funding Opportunity Number: HRSA-19-035 Due Date for Applications: December 10, 2018

Anticipated Total Annual Available FY 2019 Funding:

$29,100,000

Estimated Number and Type of Award(s): Up to eight (8) cooperative agreements

Estimated Award Amount: Varies per region, subject to the availability of funds.

Cost Sharing/Match Required: No Period of Performance: July 1, 2019 through

June 30, 2024 (5 years)

Eligible Applicants: Eligible applicants include public and nonprofit private entities and schools and academic health science centers.

Faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply.

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

Application Guide

You (the applicant organization/agency) 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.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf ii

Technical Assistance

HRSA has scheduled the following technical assistance webinar:

Day and Date: Tuesday, November 13, 2018 Time: 3 – 4:30 p.m. ET Call-In Number: 1-888-989-6490 Participant Code: 6692465 Weblink: https://hrsa.connectsolutions.com/fy19_rae_tc/

HAB will record the TA webinar and make it available on the TargetHIV website. Also available will be a Frequently Asked Questions document, which will be continuously updated, on:

https://targethiv.org/library/funding-opportunity-part-f-aetc-regional-training-centers-hrsa-19-035 https://hrsa.connectsolutions.com/fy19_rae_tc/ https://targethiv.org/library/funding-opportunity-part-f-aetc-regional-training-centers-hrsa-19-035 iii iv

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 AND

SYSTEM FOR AWARD MANAGEMENT

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 AND OTHER PRE-AWARD ACTIVITIES

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Regional AIDS Education and Training Centers (AETC), a component of the Ryan White HIV/AIDS Part F AETC Program. The AETC Program consists of the Regional AETC Program, two (2) National AETCs, and an AETC National Evaluation Contractor (NEC). The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB), Office of Training and Capacity Development administers this program.

The Regional AIDS Education and Training Center (AETC) Program has been a cornerstone of HRSA's HIV/AIDS program for nearly three decades. Funding under this announcement will support a network of eight (8) regional AETCs. Each regional AETC will increase the number of health care providers who are trained and intend to counsel, diagnose, treat, and medically manage people living with HIV (PLWH) and help prevent high-risk behaviors that lead to HIV transmission.

You are encouraged to consider how your proposed regional AETC activities will provide innovative, tailored, data-driven training strategies, training and technical assistance, consultation, and clinical decision support at the local and regional levels to health care professionals who provide health care services for PLWH.

Each of the eight (8) regional AETCs covers a designated geographic area. Combined, the regions include all 50 States, the District of Columbia, the U.S. Virgin Islands, Puerto Rico and the six (6) U.S. Pacific Jurisdictions (Guam, American Samoa, the Commonwealth of the Northern Marians Islands, The Republic of Palau, the Federated States of Micronesia and the Republic of the Marshall Islands).

Successful applicants funded under this funding opportunity will be required to collaborate with RWHAP Part A – D and other health care systems and work with other Regional and the National AETCs. The National Coordinating Resource Center (NCRC) and the National Clinician Consultation Center (NCCC) serve as the National AETCs that collaborate with the Regional AETC Program. They must provide training, education, consultation, and clinical decision support to diverse health care providers, allied health professionals, and health care support staff through the following four Regional AETC Program components:

1. Core Training

This program component aims to increase the number of HIV providers who intend to counsel, diagnose, treat, and medically manage PLWH, particularly by reaching novice and low-volume HIV clinics and providers in an effort to increase the size of the HIV workforce and patient access to quality HIV care.

2. Minority AIDS Initiative (MAI) Activities (At least 20 percent of funding may cut across multiple programmatic components (Practice Transformation (PT), Interprofessional Education (IPE), and Core training) AETCs dedicate approximately 20 percent of their funding to education, training, and technical assistance to increase the capacity of minority providers and minority-serving providers to provide HIV care, increase access to HIV care, and decrease disparities in outcomes along the HIV care continuum among minority PLWH.

3. Practice Transformation (PT) Project (at least 40 percent of funding)

In this AETC program component, each regional AETC works with a minimum of six eligible HRSA-funded community health centers (CHCs), of which three (3) must be Ryan White funded and three (3) must be non-Ryan White funded. Practice transformation activities are derived from the principles of the Patient Centered Medical Home (PCMH) model. Through coaching and practice facilitation, the goal is for the AETCs to assist the selected CHCs in enhancing outcomes along the HIV care continuum.

4. Interprofessional Education Project (IPE) Project (at least 10 percent of funding)

Through training and curriculum support by the AETCs, faculty of health professions schools and graduate departments or programs are able to teach students how to provide high quality HIV care to PLWH incorporating a hands-on, team-based learning approach based on principles derived from the Core Competencies for Interprofessional Collaborative Practice: 2016 Update.

The goal of this initiative is to increase and strengthen the HIV workforce, thus contributing to improved outcomes along the HIV care continuum.

AETCs may provide additional services through the following optional programmatic components:

5. Optional Practice Transformation Expansion (PTE) Project

As part of this funding opportunity, you may apply for funds to assist primary health care facilities to increase the capacity of providers to enhance organizational HIV integration within primary care health systems and to effectively manage PLWH who have substance use disorders (e.g., opioid use disorders, Hepatitis C Virus, and Sexually Transmitted Infections (STIs).

6. Optional Centers for Disease Control and Prevention (CDC) Expanded HIV

Testing for Disproportionately Affected Populations

As part of this funding opportunity, you may apply for funds to assist health care facilities and health departments to implement routine HIV testing in accordance with CDC’s HIV Testing Recommendations in CDC’s jurisdictions.

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2. Background

This program is authorized by Section 2692(a) (42 U.S.C. §300ff-111(a)) and section 2693 (42 U.S.C. § 300ff-121) of the PHS Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87). Secretary’s Minority AIDS Funds (SMAIF) are authorized under the Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (P.L. 115-245), Division B, Title II. Funds for the CDC Expanded Testing Initiative are authorized under Section 310 and 318 of the PHS Act (42 U.S.C. Section 251 and 241c), as amended. Funds for the Practice Transformation Expansion Project are authorized under Section 330 of the Public Health Service Act (42 U.S.C. 254b), as amended.

The AETC Program consists of the Regional AETC Program, two (2) National Centers, and the NEC. The Regional AETC Program provides targeted, multidisciplinary education and training for health care professionals to provide health care services to PLWH. The NCCC and the NCRC are the national centers for the AETC program. The NCCC serves as a national resource to provide healthcare providers with HIV clinical consultation services. The NCRC serves as the central convener, coordinator, and disseminator of the Regional AETC Program and the NCCC. The NEC assesses the regional and national impact of the AETC program.

The mission of the AETC Program is to increase the number of health care professionals who are educated to counsel, diagnose, treat, and medically manage PLWH, and to help prevent high-risk behaviors that lead to HIV transmission.

Achieving this mission includes providing training, education, consultation, and clinical decision support to diverse health care providers, allied health professionals, and health care support staff on the prevention and treatment of HIV/AIDS. Health care providers who are able to provide high quality HIV care and prevention services are needed to help achieve the goals of the AETC Program. The AETC Program goals are to:

• Increase the size and strengthen the skills of the current and novice HIV clinical workforce in the United States.

• Improve outcomes along the HIV care continuum, including diagnosis, linkage to care, retention, and viral suppression, in alignment with the National HIV/AIDS Strategy, through training and technical assistance.

• Reduce HIV transmission and incidence of new infections by improving the rates of viral load suppression and retention in care of PLWH through training and technical assistance.

Regional AETCs are required to incorporate the following when developing educational training programs:

• Adult learning principles.

• Cultural competency, including culturally competent materials, techniques and trainers.

• Opportunities for trainees to participate in longitudinal training.

• Distance-based learning opportunities.

Health care providers, including HIV specialists and primary care providers, need to obtain the knowledge and skills necessary to ensure that HIV care is consistent with established guidelines and reflects current research.

The Regional AETC Program, in collaboration with the other National AETC Programs, serves as a comprehensive training and educational resource for health care providers in the treatment and prevention of HIV/AIDS. National AETCs and the Regional AETCs are required to work together to enhance their individual roles and performance and reduce and eliminate duplication of efforts across the Program.

Examples include the development of joint needs assessments, curricula, training programs, marketing activities, and national evaluation tools. For information on components of the current AETC Provider Training Network, please refer to the HRSA/HAB website: http://hab.hrsa.gov/abouthab/partfeducation.html.

In addition to the National and Regional AETC Programs, several other organizations work in partnership with AETCs to provide training and HIV/AIDS health professions education. One example is HRSA’s Ryan White HIV/AIDS Program Center for Quality Improvement and Innovation (CQII), the primary technical assistance resource for RWHAP recipients on issues related to quality improvement and quality management

(QI/QM).

MAI funds awarded to the AETCs to expand the number of health care professionals with treatment expertise and knowledge about the most appropriate standards of HIV disease-related treatments and medical care for racial and ethnic minority adults, adolescents, and children with HIV. This includes African Americans, Alaska Natives, Latinos, American Indians, Asian Americans, Native Hawaiians, and Pacific Islanders (see Section 2693(a) of the PHS Act). Note that while MAI funds are for innovative projects, they are not limited solely to new projects. These funds may complement current activities involving training and/or capacity building that target racial and ethnic minorities.

National HIV/AIDS Strategy: Updated to 2020 The National HIV/AIDS Strategy for the United States: Updated to 2020 (NHAS 2020) is a five-year plan that details principles, priorities, and actions to guide the national response to the HIV epidemic. The RWHAP promotes robust advances and innovations in HIV health care using the National HIV/AIDS Strategy to end the epidemic as its framework. Therefore, to the extent possible, activities funded by RWHAP focus on addressing these four goals:

1) Reduce new HIV infections;

2) Increase access to care and improve health outcomes for PLWH;

3) Reduce HIV-related health disparities and health inequities; and

4) Achieve a more coordinated national response.

To achieve these shared goals, recipients should align their organization’s efforts, within the parameters of the RWHAP statute and program guidance, to ensure that PLWH are http://hab.hrsa.gov/abouthab/partfeducation.html linked to and retained in care, and have timely access to HIV treatment and the supports needed (e.g., mental health and substance use disorder services) to achieve HIV viral suppression.

HIV Care Continuum Diagnosing PLWH, linking PLWH to HIV primary care, and PLWH achieving viral suppression are important public health steps toward ending the HIV epidemic in the U.S. The HIV care continuum has five main “steps” or stages that include HIV diagnosis, linkage to care, retention in care, antiretroviral use, and viral suppression.

The HIV care continuum provides a framework that depicts the series of stages a person with HIV engages in from initial diagnosis through their successful treatment with HIV medication. It shows the proportion of individuals living with HIV or individuals diagnosed with HIV who are engaged at each stage. The HIV care continuum allows recipients and planning groups to measure progress and to direct HIV resources most effectively.

According to recent data from the 2016 Ryan White Services Report (RSR), the RWHAP has made tremendous progress toward ending the HIV epidemic in the U. S.

From 2010 to 2016, HIV viral suppression among RWHAP patients who have had one or more medical visits during the calendar year and at least one viral load with a result of <200 copies/mL reported, has increased from 69.5 percent to 84.9 percent, and racial/ethnic, age-based, and regional disparities have decreased.1 These improved outcomes mean more PLWH in the U.S. will live near normal lifespans and have a reduced risk of transmitting HIV to others.2 In a September 27, 2017, Dear Colleague letter, CDC notes that scientific advances have shown that antiretroviral therapy (ART) preserves the health of PLWH. There is also strong evidence of the prevention effectiveness of ART. When ART results in viral suppression, it prevents sexual HIV transmission. This means that people who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner. Such findings underscore the importance of supporting effective interventions for linking PLWH into care, retaining them in care, and helping them adhere to their ART.

RWHAP recipients are encouraged to assess the outcomes of their programs along this continuum of care. Recipients should work with their community and public health partners to improve outcomes across the HIV care continuum. HRSA encourages recipients to use the performance measures developed for the RWHAP at their local level to assess the efficacy of their programs and to analyze and improve the gaps along the HIV care continuum.

Integrated Data Sharing and Use HRSA and CDC’s Division of HIV/AIDS Prevention support integrated data sharing, analysis, and utilization for the purposes of program planning, needs assessments, 1 Health Resources and Services Administration. Ryan White HIV/AIDS Program Annual Client-Level Data Report 2016. http://hab.hrsa.gov/data/data-reports. Published December 2017. Accessed December 1, 2017.

2 National Institute of Allergy and Infectious Diseases (NIAID). Preventing Sexual Transmission of HIV with Anti-HIV Drugs. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US).

2000- [cited 2016 Mar 29]. Available from: https://clinicaltrials.gov/ NCT00074581 NLM Identifier:

NCT00074581.

https://hab.hrsa.gov/sites/default/files/hab/data/datareports/RWHAP-annual-client-level-data-report-2016.pdf https://docs.wixstatic.com/ugd/de0404_fab89a3aaeeb406bbd7898d0e90d5dac.pdf https://docs.wixstatic.com/ugd/de0404_fab89a3aaeeb406bbd7898d0e90d5dac.pdf http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html http://hab.hrsa.gov/data/data-reports https://clinicaltrials.gov/ unmet need estimates, reporting, quality improvement, the development of your HIV care continuum, and public health action. HRSA strongly encourages RWHAP Part F recipients to:

• Follow the principles and standards in the Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs: Standards to Facilitate Sharing and Use of Surveillance Data for Public Health Action.

• Establish data sharing agreements between surveillance and HIV programs to ensure clarity about the process and purpose of the data sharing and utilization.

Integrated HIV data sharing, analysis, and utilization approaches by state and territorial health departments can help further progress toward reaching the NHAS 2020 goals and improve outcomes on the HIV care continuum.

To fully benefit from integrated data sharing, analysis, and utilization, HRSA strongly encourages complete CD4/viral load (VL) reporting to the state and territorial health departments’ surveillance systems. CD4 and VL data can be used to identify cases, classify stage of disease at diagnosis, and monitor disease progression. These data can also be used to evaluate HIV testing and prevention efforts, determine entry into care and retention in care, measure viral suppression, and assess unmet health care needs. Analyses at the national level to monitor progress against HIV can only occur if all HIV-related CD4 and VL test results are reported by all jurisdictions. CDC recommends the reporting of all HIV-related CD4 results (counts and percentages) and all VL results (undetectable and specific values). Where laws, regulations, or policies are not aligned with these recommendations, AETC’ s might consider strategies to best implement these recommendations within current parameters or consider steps to resolve conflicts with these recommendations. In addition, consider reporting HIV-1 nucleotide sequences from genotypic resistance testing to monitor prevalence of antiretroviral drug resistance and HIV genetic diversity subtypes and transmission patterns.

Special Projects of National Significance (SPNS) Program Through its SPNS Program, HRSA’s HAB funds demonstration project initiatives focused on the development of effective interventions to quickly respond to emerging needs of PLWH receiving assistance under the RWHAP. Through these demonstration projects, SPNS evaluates the design, implementation, utilization, cost, and health related outcomes of innovative treatment models, while promoting dissemination, replication and uptake of successful interventions. SPNS findings have demonstrated promising new approaches to linking and retaining into care underserved and marginalized populations living with HIV. All RWHAP recipients are encouraged to review and integrate a variety of SPNS evidence-informed tools within their HIV system of care in accordance with the allowable service categories defined in PCN 16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals and Allowable Uses of Funds as resources permit. You can find the SPNS related tools at the following locations:

• Integrating HIV Innovative Practices (IHIP) (https://careacttarget.org/ihip) Resources on the IHIP website include easy-to-use training manuals, curricula, case studies, pocket guides, monographs, and handbooks, as well as http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf http://www.cdc.gov/nchhstp/programintegration/docs/pcsidatasecurityguidelines.pdf https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf https://careacttarget.org/ihip informational handouts and infographics about SPNS generally. IHIP also hosts technical assistance (TA) training webinars designed to provide a more interactive experience with experts, and a TA help desk exists for you to submit additional questions and share your own lessons learned.

• Replication Resources from the SPNS Systems Linkages and Access to

Care (https://careacttarget.org/library/replication-resources-spns-systems-linkages-and-access-care)

There are intervention manuals for patient navigation, care coordination, state bridge counselors, data to care, and other interventions developed for use at the state and regional levels to address specific HIV care continuum outcomes among hard-to-reach populations living with HIV.

• Dissemination of Evidence Informed Interventions

(https://nextlevel.careacttarget.org/) The Dissemination of Evidence-Informed Interventions initiative runs from 2015- 2020 and disseminates four adapted linkage and retention interventions from prior SPNS and the Secretary’s Minority AIDS Initiative Fund (SMAIF) initiatives to improve health outcomes along the HIV care continuum. The end goal of the initiative is to produce four evidence-informed care and treatment interventions (CATIs) that are replicable, cost-effective, capable of producing optimal HIV care continuum outcomes, and easily adaptable to the changing healthcare environment. Manuals are currently available at the link provided and will be updated on an ongoing basis.

II. Award Information

1. Type of Application and Award

Types of applications sought: New and Competing Continuation

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

HRSA Program involvement will include:

• Participating in the design of models and tools as described in the project narrative;

• Reviewing and providing recommendations (on an as needed basis), including training curriculum, publications, and other resources;

• Providing assistance in the management and technical performance of activities;

• Participating in the planning and coordination of meetings;

• Assisting the recipient in establishing linkages between this project and other

AETC and HAB-supported projects to enhance collaboration;

• Ensuring integration into the HAB programmatic and data reporting efforts;

https://careacttarget.org/library/replication-resources-spns-systems-linkages-and-access-care https://careacttarget.org/library/replication-resources-spns-systems-linkages-and-access-care https://nextlevel.careacttarget.org/

• Reviewing all project information prior to dissemination; and

• Reviewing conference presentations (oral, poster, roundtable, etc.) where cooperative agreement data activities, work products, and/or best practices and lessons learned are presented.

The cooperative agreement recipient’s responsibilities will include:

• Collaborating with HAB, NCCC, NCRC, the national evaluation contractor (NEC) and other Regional AETCs, to achieve the expectations as outlined in the project narrative;

• Participating in the national evaluation of the AETC Program;

• Identifying activities to be planned jointly, including with HAB input and approval, and informing HAB of project activities with ample time to receive input and/or technical assistance;

• Identifying and responding to training and educational development needs of faculty and staff;

• Collaborating with HRSA as necessary to plan, execute and deliver technical assistance and training activities;

• Working with HRSA and its national evaluation contractor to analyze and modify activities as necessary in keeping with the changing trends and needs of the RWHAP recipients and the health care environment;

• Submitting data to HRSA and its national evaluation contractor to support evaluation of the AETC Program;

• Submitting training and informational materials to the NCRC for inclusion on the NCRC website, https://aidsetc.org/;

• Attending biennial RWHAP recipient meetings in the Washington, D.C. area;

• Attending the biennial AETC program recipients’ administrative reverse site visit meetings;

• Attending the annual RWHAP clinical conference meetings.

2. Summary of Funding

HRSA expects approximately $29,100,000 to be available annually to fund eight (8) recipients. The period of performance is July 1, 2019 through June 30, 2024 (5 years).

Funding beyond the first year is subject to the availability of appropriated funds for the Regional AIDS Education and Training Centers Program (i.e., Core, PT, IPE), the MAI SMAIF, PTE Project, and the CDC HIV Testing Initiative in subsequent fiscal years, recipient satisfactory performance, and a decision that continued funding is in the best interest of the Federal Government.

You may apply for a total cost ceiling amount for each of the five budget periods based upon the region for which you are applying. The table below identifies the maximum amounts that you can request for each Regional AETC (includes both direct and indirect, facilities and administrative costs). The ceiling amount includes funds for the AETC program, MAI activities, SMAIF, PTE Project, and funds for the CDC HIV Testing Initiative, should these funds be available.

HRSA will award funds to the Regional AETCs to ensure all 50 states, the District of https://aidsetc.org/

Columbia, and the U.S. territories have the opportunity to provide HIV clinical training to support the overall mission and objectives of the RWHAP. HRSA intends to have one award in each of the eight (8) AETC designated regions.

HRSA has determined funding levels for each of the eight (8) regional AETCs based on factors that contribute to the training needs of the HIV workforce in each region.

These factors are considered in the following order of priority: AIDS death rates, viral suppression rate of PLWH, number of persons living with HIV, rate of new HIV infections, number of health care delivery sites, number of RWHAP outpatient ambulatory medical care providers, total primary care health profession shortage area (HPSA) designations, number of RWHAP Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs), number of states and territories, and area (square miles) of the region.

HRSA will consider each of the eight (8) regional AETCs independently from each other. The HRSA Division of Independent Review (DIR) will not consider scoring or applications across regions in making funding decisions. Each successful applicant will be considered for the amount requested, but will receive no more than the amount available for AETC, MAI, SMAIF, PTE, and CDC HIV Testing Initiative funding as listed for the region in which they applied.

Table 1: AETC Regions, States, and Funding Ceilings

Regional AETC Name

Alignment with U.S.

Department of Health and Human Services

States Included in Regional AETC area

Total Cost Funding ceiling for each budget period

New England

AETC

Region 1 Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont

$2,400,000

Northeast/ Caribbean

AETC

Region 2 New York, New Jersey, Puerto Rico, U.S.Virgin Islands

$4,400,000

MidAtlantic

AETC

Region 3 Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia

$3,300,000

Southeast

AETC

Region 4 Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee

$4,800,000

Midwest

AETC

Region 5 and Region

Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin

$3,600,000

South Central

AETC

Region 6 Arkansas, Louisiana, New Mexico, Oklahoma, Texas

$3,600,000

Mountain West

AETC

Region 8 and Region

Alaska, Colorado, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming

$3,300,000

Pacific AETC Region 9 Arizona, California, Hawai’i, Nevada, and the 6 U.S.-affiliated Pacific Jurisdictions (Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Republic of the Marshall Islands, Republic of Palau)

$3,700,000

MAI and SMAIF

If awarded, the actual MAI and SMAIF amounts are on the Notice of Award (NOA).

Recipients are required to submit a revised budget and work plan to reflect the MAI and SMAIF amounts provided in the NOA. Funded applicants will be responsible for tracking, spending, and reporting of MAI funds.

Optional CDC Expanded HIV Testing for Disproportionately Affected Populations

Funding for the optional CDC Expanded HIV Testing for Disproportionately Affected Populations Project depends on availability of funds from CDC and on the number and size of jurisdictions (listed below) within each Regional AETC coverage area. If available, the award amount will range from approximately $9,800 to $80,000 per Regional AETC. HRSA and CDC will work together to determine the funding amount for each regional AETC.

Table 2: Jurisdictions Eligible for CDC Expanded HIV Testing Program

Regional AETC Name Alignment with HHS

Regions Jurisdictions eligible for CDC Expansion

New England AETC Region 1 Connecticut;

Massachusetts

Northeast/Caribbean

AETC

Region 2

New Jersey; New York City; New York State;

Puerto Rico

Mid Atlantic AETC Region 3 Baltimore, Maryland;

District of Columbia;

Maryland; Pennsylvania;

Philadelphia, Pennsylvania; Virginia

Southeast AETC Region 4 Alabama; Atlanta, Georgia; Florida;

Georgia; Mississippi;

North Carolina; South

Carolina; Tennessee Midwest AETC Region 5 & Region 7 Chicago, Illinois; Indiana;

Michigan; Missouri; Ohio South Central AETC Region 6 Houston, Texas;

Louisiana; Texas Mountain West AETC Region 8 & 10 Colorado Pacific AETC Region 9 Arizona; California; Los

Angeles, California; San Francisco, California

These CDC jurisdictions may be subject to change in subsequent Federal fiscal years of funding, based on changes in HIV epidemiology, over the project period.

If awarded, the actual funding for the CDC Expanded Testing for Disproportionately Affected Populations is on the NOA. Recipients are required to submit a revised budget and work plan to reflect the CDC Expanded Testing for Disproportionately Affected Populations amount provided in the NOA.

PTE Project

Funding for the PTE project depends on the availability of funds from HRSA’s Bureau of Primary Health Care. If available, the award amount per clinic will range from approximately $267,000 to $408,000. If you chose to apply, you must identify at least two (2) additional non-RWHAP HRSA-funded health centers. If awarded, the actual PTE amount will be on the NOA. Recipients will be required to submit a revised budget and work plan to reflect the PTE award.

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

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include public and nonprofit private entities, schools, and academic health science centers. Faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply.

In order to ensure that areas with the greatest prevalence of HIV/AIDS, but with relative shortages of HIV care and treatment professionals receive adequate support, HRSA has divided the US into eight (8) regions in alignment with the HHS Regions, as identified in Table 1 above.

You must select only one region to support in your application, and you must agree to support the HIV/AIDS training and education needs across the entire region selected.

You must be physically located in the region you intend to serve.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA will consider any application that exceeds the funding ceiling amount non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 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 NOFO following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

If you are reading this notice of funding opportunity (NOFO) (also known as “Instructions” on Grants.gov) and reviewing or preparing the workspace application package, you will automatically be notified in the event HRSA changes and/or republishes the NOFO on Grants.gov before its closing date. Responding to an earlier version of a modified notice may result in a less competitive or ineligible application.

Please note you are ultimately responsible for reviewing the For Applicants page for all information relevant to desired opportunities.

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)).

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

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

Application Page Limit The total size of all uploaded files may not exceed the equivalent of 80 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support required in the Application Guide and this NOFO. Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. We strongly urge you 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 to be considered under this notice.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) The prospective recipient certifies, by submission of this proposal, that neither it nor its principals is 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 the prospective recipient is unable to attest to the statements in this certification, an explanation shall be included in Attachment 10: Other Relevant Documents.

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:

i. Project Abstract See Section 4.1.ix of HRSA’s SF-424 Application Guide.

In addition to the information required in the Guide, provide an abstract for the Regional AETC Program including information on all key components of the project (i.e., Core Training, Practice Transformation Project, HIV Interprofessional Education Project, MAI, PTE, and the HRSA/CDC HIV Testing Training Initiative Project). The abstract must include the following information:

• Briefly describe the proposed project. Identify the region and outline the approach to address the HIV workforce training needs in the identified region.

Include the activities that you plan to implement;

• Describe the collaborative process used to obtain RWHAP Part A and B review and concurrence on proposed core training and practice transformation work http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf plans with submission of letters of agreement from RWHAP Part A and B;

• Identify the key organizations that are collaborating on the project (in terms of the special projects, these will be the direct care sites and the health professions programs).

ii. Project Narrative

This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and well organized so that reviewers can understand the proposed

Successful applications will contain the information below. Please use the following section headers for the narrative:

• INTRODUCTION -- Corresponds to Section V’s Review Criterion 1 (Need)

You should articulate the key issues and challenges addressed with AETC Program funds. This section should include a description of the proposed geographical region served and should demonstrate an understanding of the HIV/AIDS epidemic and HIV service delivery system in the proposed region, the evolving HIV treatment options and associated challenges, and their impact on the education and training needs of the region’s health care professionals. This section should include a discussion of the problems associated with increasing clinical care capacity in general, and specifically among clinical health care providers practicing at the community level. This section should include a discussion of the challenges for the proposed targeted populations identified for training and should be inclusive of urban, rural, and suburban communities.

A preliminary statement of need, described below, should reflect your program plan, associated work plans, and budgets.

• NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion 1

(Need)

• Please describe the gaps and needs in your region with regard to knowledge and ability of health care professionals to counsel, diagnose, treat, and medically manage PLWH, and to help prevent high-risk behaviors that lead to HIV transmission.

• Please describe HIV workforce shortages in the region, particularly in medically underserved areas. This includes shortages among pre-service, novice, and experienced HIV providers.

• Please describe HIV workforce needs regarding cultural competency in the region.

• Please describe the target training population. This should include specific language regarding recruitment and training of minority health care professionals and health care professionals who care for minority PLWH. Please describe how your organization will identify training needs among Historically Black Colleges and Universities (HBCU), Hispanic Serving Institutions (HSI), and/or Tribal Colleges and Universities (TCU) in the region.

• Please provide a succinct summary of the literature that demonstrates a comprehensive understanding of the issues related to strategic planning for health care system-level change; the methods for practice transformation that increase capacity; and adherence to standardized or evidence-based quality metrics to demonstrate ability to implement the Practice Transformation Project (described in Section IV.

Methodology).

• METHODOLOGY -- Corresponds to Section V’s Review Criteria #2 (Response) and #3 (Evaluative Measures ) Please describe the training modalities that your organization will use to improve the knowledge, skills, and behaviors of HIV health care professionals that will ultimately affect client outcomes. Describe training modalities within each programmatic component.

Describe the development and implementation of a plan to market the services of the AETC throughout the region to health care professionals including but not limited to health care professionals in community-based organizations, local health departments, federally qualified health centers, interprofessional health care teams in rural settings, and those who are serving minority populations.

Core Training Please describe the project’s plan to develop and implement HIV training for novice health care professionals (those not currently providing HIV care) and low-volume HIV clinics and providers. Components of the project’s plan should describe:

• A process to work with RWHAP Parts A and B recipients to:

a) Identify those clinics and clinicians providing care to few or no

PLWH in order to increase workforce capacity.

b) Develop and implement the core training work plan. Applicants must obtain annually the RWHAP Parts A and B Program Director letters of agreement (Attachment 4) on AETC proposed core training work plans prior to implementation.

• How you will increase awareness and uptake of replicable HIV service delivery models. Models include: SPNS Health Information Technology (HIT) Capacity Building for Monitoring and Improving Health Outcomes along the HIV Care Continuum, SPNS Replication of a Public Health Information Exchange to Support Engagement in HIV Care, SPNS System-level Workforce Capacity Building for Integrating HIV Primary Care in Community Health Care Settings - Demonstration Sites, and other SPNS and non-SPNS evidence-based/informed interventions (e.g., CDC and the National Institute of Mental Health (NIMH)) to meet the needs of staff training and HIV education.

• How you will collaborate with other federal training programs and stakeholders (e.g., NCCC, NCRC, SAMHSA’s Addiction Technology Transfer Centers, CDC’s Capacity Building Assistance programs HIV/STD Prevention Training Centers, Title X National Training Centers, Primary Care Associations, Telehealth Resource Centers, Viral Hepatitis Education and Training Projects, the Center for Rural Development, and other Regional AETCs). Collaborations should describe a plan for the counseling, diagnosis, and treatment of people with HIV disease, opportunistic infections and co-morbid conditions (e.g., opioid use disorder, STIs, mental health disorders, intimate partner violence, trauma-informed care, and getting to zero HIV transmission).

• How your training program will promote and implement innovative training techniques to engage rural or clinically isolated health care professionals. Discuss your region’s distance-based learning capabilities and needs. Include descriptions of a distance-based learning infrastructure to include broadband bandwidth; a secure network by which to broadcast videoconferencing; relevant hardware and equipment (e.g., webcams, microphones, speakers, monitors/screens); and videoconferencing software able to operate with any browser, computer, or mobile device. Existence of distance-based learning infrastructure may reside in the Regional AETC’s Central Office or through a written agreement with a local partner or Telehealth Resource Center.

• How your training program will support the cultural and ethnic diversity among trainees and patients served. Describe processes by which trainees will receive skill-appropriate longitudinal support and ongoing training and consultation; include those individuals referred by the NCCC. Also, include how the AETC will provide updated information to individuals who have been trained. Describe a process to identify technical assistance opportunities for health care professionals and agencies/organizations providing direct care for

PLWH.

• How you will align training plans with the National HIV/AIDS Strategy and the HIV care continuum, correspond to the work plan and budget, and address the need for training of the HIV workforce in your region with

• A process to collect data on the impact of core training activities on:

• Provider intent to provide clinical skills in HIV practice

• Impact of skills applied in HIV practice

• System adoption of policies or procedures in practice setting

(e.g., adoption of SPNS innovative models of care)

Minority AIDS Initiative (MAI) Please describe your proposed plan for MAI funding to provide education, training and technical assistance to increase the capacity of minority and minority-serving providers to provide HIV care, increase access to HIV care, and decrease disparities in outcomes along the HIV care continuum among minority PLWH.

Successful applicants will be required to include the following performance measures in their evaluation of MAI efforts:

• Number of clinical and program staff who provide HIV-related training through the MAI funds in one or more of the following areas: (1) HIV testing and risk…