PKG00251962-instructions.pdf

Centers for Disease Control

National Center for HIV-AIDS, Viral Hepatitis, STD, and TB Prevention

Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States

CDC-RFA-PS19-1906

Application Due Date: 07/12/2019

Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Assistance Listings (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Application and Submission Information E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-PS19-1906. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR)

B. Notice of Funding Opportunity (NOFO) Title:

Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

E. Assistance Listings (CFDA) Number:

93.118 Additional CFDA Number: 93.940 F. Dates:

1. Due Date for Letter of Intent (LOI): 06/19/2019

2. Due Date for Applications: 07/12/2019, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

Component A: June 14, 2019 at 1:00 pm (Eastern Standard Time)

Call Information o Toll-free Number: 800-857-5950 o Participant Passcode: 2436104 o Access https://adobeconnect.cdc.gov/rg8be8x4ljxd/ to view the presentation.

Component B: June 14, 2019 at 2:45 pm (Eastern Standard Time)

Call Information o Toll-free Number: 800-857-5950 o Participant Passcode: 2436104

Access https://adobeconnect.cdc.gov/rg8be8x4ljxd/ to view the presentation.

https://www.grants.gov https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov https://adobeconnect.cdc.gov/rg8be8x4ljxd/ https://adobeconnect.cdc.gov/rg8be8x4ljxd/

G. Executive Summary:

1. Summary Paragraph:

The Centers for Disease Control and Prevention (CDC) is committed to working with public health systems, hospitals, and healthcare providers to ensure that planners, developers, and implementers of public health initiatives possess the skills and resources needed to better address HIV in the U.S. and its territories. CDC announces the availability of fiscal year 2019 funds for a Notice of Funding Opportunity (NOFO) to support CDC human immunodeficiency virus (HIV) related policies and programs. This program will support strategic partnerships;

communication; peer-to-peer technical assistance (TA) for all CDC-funded state and local health departments; and jurisdictional planning efforts to address emerging needs of targeted jurisdictions through CDC-funded state and local health departments and their ability to end the HIV epidemic in the U.S. Despite many treatment and prevention advances, reducing HIV infections and improving health outcome for people with HIV in the U.S. remains a challenge.

In February 2019, the Ending the HIV Epidemic in America initiative was announced. The initiative will leverage powerful data, tools and resources to reduce all new HIV infections by 75% during the first 5 years of the initiative and by 90% in 10 years.

a. Eligible Applicants: Limited

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 33

Component A: National Network to Enhance Strategic Communications, Partnerships, Policy Analysis and Interpretation- 1 award

Component B: Accelerating State and Local HIV Planning to End the HIV Epidemic- 32 awards

d. Total Period of Performance Funding: $19,500,000

Component A: National Network to Enhance Strategic Communications, Partnerships, Policy Analysis and Interpretation- $7,500,000 (5 years)

$12,000,000 (1 year)

e. Average One Year Award Amount: $0

Component A: National Network to Enhance Strategic Communications, Partnerships, Policy Analysis and Interpretation- $1,500,000 Per Budget Period

$375,000 Per Budget Period

f. Total Period of Performance Length: 5

g. Estimated Award Date: 09/30/2019

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview For over 30 years, the human immunodeficiency virus (HIV) has affected millions throughout the United States. In recent years, deaths among persons living with HIV have declined, while the number of people living with HIV has increased. An estimated 1.1 million persons are living with HIV and approximately 162,500 (15%) are unaware of their infection.[1] Persons living with HIV who use antiretroviral therapy (ART) and achieve undetectable levels of the virus (suppressed viral load) can have a nearly normal life expectancy and have effectively no risk of transmitting HIV to others.[2] If untreated, HIV infection leads to illness, premature death, and potential transmission to others.

To reduce new HIV infections in the United States, it is critical to ensure that everyone with HIV is aware of their infection, linked to and retained in HIV medical care, and maintains viral suppression.[3] CDC's approach to reducing HIV infections in the United States, High Impact Prevention (HIP), supports the ultimate national HIV prevention goals to achieve and sustain viral suppression and reduce new infections. Viral suppression is the central tenet of these national HIV prevention efforts and is associated with improved health outcomes and longer lifespans for persons living with HIV and greatly reduces the likelihood of transmitting HIV to others. In 2016, 76% of persons living with diagnosed HIV were linked to care within one month, 57% were retained in care, and 60% had evidence of viral suppression.[4] While the nation has made progress overall, further efforts are necessary. Each step along the HIV care continuum (HIV diagnosis, prompt and sustained HIV medical care, and continuous use of ART) is essential for achieving a suppressed viral load.[2] Behavioral strategies (e.g., use of condoms and reduction in number of partners) are effective in reducing risk of HIV infection.[5] Targeted HIV prevention efforts to HIV-negative persons at risk for infection are also important. These efforts supplement prevention efforts among persons living with HIV to help prevent new HIV infections as well as other sexually transmitted infections not protected by ART. This includes support for community-level HIV prevention activities, pre-exposure prophylaxis (PrEP), and other targeted prevention strategies. PrEP is a highly effective intervention that can reduce the number of new HIV infections when supported by behavioral and structural strategies.[6] A high-impact prevention approach to achieving national HIV prevention goals requires a strategic combination of scientifically proven, cost-effective, and scalable structural, behavioral, and biomedical interventions. These interventions should target persons living with HIV and populations at risk for infection in geographic areas highly affected by HIV.

Since the late 1980s, CDC has formally partnered with state and local health departments to conduct HIV surveillance and expand the impact and reach of HIV prevention in affected communities. State and local health departments remain important partners in providing comprehensive high-impact HIV prevention services. Building individual competencies and technical expertise among health department staff, and improving organizational capacities and supportive structural environments, are key operational and foundational activities for HIV prevention programs and services.

b. Statutory Authorities Section 318 of the Public Health Service Act [42 U.S.C. § Section 247c], as amended and the Consolidated Appropriation Act of 2016 (Pub. L. 114-113).

c. Healthy People 2030 This NOFO addresses the Healthy People 2020 focus on HIV: http://www.healthypeople.gov /2020/topicsobjectives2020/overview.aspx?topicid=22

d. Other National Public Health Priorities and Strategies Ending the HIV Epidemic: A Plan for America: https://www.hiv.gov/federal-response/ending-the -hiv-epidemic/overview The HHS Strategic Plan, FY 2018-2022: https://www.hhs.gov/about/strategic-plan/strategic-goal- 2/index.html National HIV/AIDS Strategy: Update 2020: https://www.hiv.gov/federal-response/national-hiv-aids-strategy/nhas-update CDC Division of HIV/AIDS Prevention Strategic Plan 2017-2020: https://www.cdc.gov/hiv/pdf /dhap/cdc-hiv-dhap-external-strategic-plan.pdf CDC National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Strategic Plan Through 2020: https://www.cdc.gov/nchhstp/docs/NCHHSTP-Strategic-Plan-through-2020- 508.pdf HIV Care Continuum:https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-conti nuum

e. Relevant Work This NOFO builds upon previous and current programs, including:

PS14-1405: Technical Assistance to Support AIDS Directors and HIV Prevention Program Managers in the 50 States, District of Columbia, the Commonwealth of Puerto Rico, the US Virgin Islands, and the Pacific Islands PS14-1409: Assisting Directly Funded AIDS Directors in Urban Jurisdictions and Other HIV Prevention Partners in Meeting the Changes in the Public Healthcare Systems and HIV Prevention Landscape PS18-1802: Integrated HIV Surveillance and Preventions Programs for Health Departments

2. CDC Project Description http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22 http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22 https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview https://www.hhs.gov/about/strategic-plan/strategic-goal-2/index.html https://www.hhs.gov/about/strategic-plan/strategic-goal-2/index.html https://www.hiv.gov/federal-response/national-hiv-aids-strategy/nhas-update https://www.hiv.gov/federal-response/national-hiv-aids-strategy/nhas-update https://www.cdc.gov/hiv/pdf/dhap/cdc-hiv-dhap-external-strategic-plan.pdf https://www.cdc.gov/hiv/pdf/dhap/cdc-hiv-dhap-external-strategic-plan.pdf https://www.cdc.gov/nchhstp/docs/NCHHSTP-Strategic-Plan-through-2020-508.pdf https://www.cdc.gov/nchhstp/docs/NCHHSTP-Strategic-Plan-through-2020-508.pdf https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum

a. Approach

Bold indicates period of performance outcome.

i. Purpose The purpose of this NOFO is to fund:

A national organization to enhance the health departments' capacity to support integrated HIV programs; ensure development and maintenance of strategic communication channels and partnerships that advance national HIV prevention goals and contribute to ending the HIV epidemic in the U.S.

Eligible health departments to conduct a rapid planning process that engages the community, HIV planning bodies, HIV prevention and care providers, and other partners in aligning resources and activities to develop jurisdictional End the HIV Epidemic plans.

ii. Outcomes The program is expected to demonstrate measurable progress toward addressing the short-term outcomes that appear in bold in the NOFO logic model. Indicators that quantify these outcomes are described in the section entitled CDC Evaluation and Performance Measurement Strategy.

The Component A expected short-term outcomes of the award include:

o Increased awareness and knowledge of integrated HIV programs, including activities related to ending the HIV epidemic, among relevant national partners o Increased integration of procedures to interpret and share data o Increased assistance to CDC in identifying and addressing emerging issues o Increased development and strengthening of partnerships with private and public entities to sustain effective integrated HIV programs o Increased technical assistance (TA) provided to health departments to support implementation of integrated HIV programs o Increased awareness and knowledge about the policy environment and the impact of state and local policies and laws on integrated HIV programs among HIV program staff

The Component A expected intermediate outcomes of the award include:

o Increase sharing of program successes and challenges among HIV program staff o Increased awareness and knowledge about integrated HIV programs among policy stakeholders o Increased support for development and implementation of procedures to share data within health department units and between health departments and community partners o Increased opportunities for HIV program staff to effectively communicate with policy stakeholders about the importance of their HIV program work

The Component B expected short-term outcomes of the award include:

o Increased engagement of HIV service partners, including local care and prevention planning bodies, local providers, persons with HIV, and other community members impacted by HIV o Increased understanding of epidemiological profile of the relevant jurisdictions o Increased understanding of the HIV care and Prevention context/situational for the relevant jurisdictions

The Component B expected intermediate outcomes of the award include:

o Improved ability to rapidly implement activities to meet the HIV care and prevention needs of the local jurisdictions consistent with the goals of the Ending the HIV Epidemic Initiative

iii. Strategies and Activities Component A of this cooperative agreement will fund a national organization, and its selected partners, to assist CDC in supporting HIV programs in a changing health care environment through the development of strategic national partnerships and enhanced communication efforts.

CDC recognizes the benefit of collaborating with a national organization that can assist with the critical and complex functions of bridging programs with national partners and cutting-edge communications.

Component B of this cooperative agreement will fund select health departments to engage local partners in an accelerated ending the HIV epidemic planning process. Such efforts are essential to the goals of both CDC and the HIV programs it supports. HIV programs, together with other national, state, and local programs, can maximize their reach and advance HIV prevention efforts at all levels. Moreover, the network of HIV programs that CDC supports directly is diverse in its geography, epidemiology, and organizational context.

The broad goals of this program are to achieve maximum impact in ending HIV in the U.S.;

enhancing the quality and performance of the HIV workforce; and improving organizational structures to address changes in the HIV prevention landscape. The program will also support the enhancement of healthcare systems for integrated HIV prevention and surveillance programs in support of a high-impact prevention approach focused on reducing HIV-related disparities and health inequities within the US and its territories.

To successfully implement strategies supported in this NOFO, applicants must propose the development of programs that support all of the activities listed under the Component for which they are applying, Component A: National Network to Enhance Strategic Communications, Partnerships, Policy Analysis and Interpretation or Component B: Accelerating HIV Planning to End the HIV Epidemic.

Component A: National Network to Enhance Strategic Partnerships, Communication, Policy Analysis and Interpretation This cooperative agreement requires the recipient to actively assist participants in CDC-supported multi-sectoral national and state partnerships, support communication channels, and provide peer-to-peer TA to participants that include state and local HIV prevention, care, and treatment programs, national partners, the community, and other stakeholders. It is important for HIV program staff to understand how policies affect the work they do, and how to effectively communicate their work to others. Moreover, staff in HIV programs need support to better promote the important work being done to prevent new HIV infections. Applicants must propose a program that describes how they will collaborate with CDC and other partners to implement the following strategies and activities.

A1. Strategic Partnerships and Communication

1. Collaborate and engage with a broad spectrum of national organizations, including organizations that represent sexually transmitted infection (STI) programs, that have common interests and that represent state, territorial, and local health department HIV prevention and surveillance programs.

2. Establish, cultivate, and maintain collaborative strategic partnership(s) with other national partner(s) to carry out the requirements of the NOFO in support of HIV prevention and surveillance programs.

a. In an effort to maximize the reach of this program, recipients should establish contractual partnerships(s) with other national partner(s) to strengthen their ability to support the required strategies and activities of this NOFO.

b. Applicants may propose to execute contractual partnerships with up to two national partners to support the implementation of the NOFO requirements.

3. Develop and disseminate timely and relevant information on key HIV-related issues and topics, to include the integration of HIV and STI prevention and treatment, surveillance, science, policy (e.g., data sharing), and education to HIV program staff, national partners and community partners.

a. Support the development and rollout of guidance documents intended to support the implementation of HIV prevention and surveillance activities at state and local levels.

b. Support the dissemination of information on strategies that address disparities among specific populations.

4. Use established partnerships and communication channels to assist CDC with addressing emerging issues and special projects that affect HIV prevention and surveillance programs nationwide.

a. Establish partnerships and communication channels with CDC-funded state and local health departments to assist CDC in addressing emerging issues, policies, and new and innovative biomedical breakthroughs.

5. Facilitate and host national stakeholder planning and collaboration meetings.

a. Provide educational advancement opportunities on topics relevant to advancements in HIV and STI prevention, such as PrEP, mathematical modeling (e.g., financing models), Data-to-Care (D2C) models, etc.

This activity includes supporting the dissemination of CDC social marketing campaign messaging, materials, and resources that support HIV prevention, care, and treatment at the state and local levels.

6. Work with partners to increase visibility of HIV prevention and surveillance programs among stakeholders.

7. Support and facilitate active communication and consultation between the national organizations and CDC, as well as between CDC and the health department HIV prevention and surveillance program staff (i.e., AIDS directors, managers and surveillance coordinators), via the development and utilization of various communication strategies to support the implementation of high impact HIV prevention and surveillance programs.

a. Identify and establish mechanisms to promote and facilitate active and increased communication between national partners, federal partners, state and local health departments, community-based organizations (CBO), and other relevant agencies.

Focus should be on: 1) obtaining input in the development and implementation of HIV prevention activities; 2) educating state and local health departments on policies that are relevant to HIV programs; and 3) addressing health inequities.

b. Maintain and enhance processes that allow for peer-to-peer collaboration, communication, and information exchange between state and local health department AIDS directors, HIV prevention program managers, and epidemiologists about relevant issues (e.g., data sharing).

8. Collaborate with appropriate CDC-funded capacity building assistance providers in the dissemination of information and the provision of TA to health departments, as appropriate.

a. Examples of collaboration and coordination include, but are not limited to, facilitating peer-to-peer technical assistance opportunities to support the development of an End the Epidemic plan, participation on capacity building assistance (CBA) specific webinars, presentations at CDC meetings and professional conferences.

Examples of ways the recipient may implement these strategies include (but are not limited to):

representing HIV program interests at relevant national meetings and workgroups; and engaging in strategic partnerships with other agencies working in the areas of STI, family planning, maternal and child health, adolescent health, school health, violence prevention, substance abuse, mental health, Lesbian, Gay, Bisexual and Transgender (LGBT) health, correctional health, and primary care. To foster communication, the recipient may produce regular updates and other periodic communications to HIV programs, as well as maintain a strong social media and web presence to serve HIV programs, its partner agencies, and the community. The recipient will produce communication materials such as press releases, fact sheets, and other educational materials as part of this program. To assist CDC with addressing emerging issues, the recipient may establish a mechanism to help CDC respond to urgent information needs related to pressing HIV program issues and sharing of critical HIV prevention and surveillance information.

A2. Policy Analysis and Interpretation

1. Track state and local level activity on policies and laws relevant to HIV programs.

a. Disseminate state level activity on policies and reporting laws relevant to the implementation of HIV prevention and surveillance programs.

2. Develop and disseminate policy-related educational and informational products in support of the above-referenced Strategy A1 activities.

3. Analyze, and interpret national and jurisdictional-level data in areas of HIV prevention and surveillance policies and programs.

a. Analyze health department policies nationally to support programmatic activities.

b. Gather information nationally on the Integrated Planning process to inform the development of future guidance.

4. Provide support and technical assistance to health departments on ways to effectively communicate with and educate policymakers about jurisdictions' HIV prevention, surveillance, care, and treatment programs.

a. Work with jurisdictions, as needed, to develop comprehensive policies that support the development and implementation of jurisdictional End the Epidemic plans.

Examples of ways the recipient may implement these strategies include (but are not limited to):

developing briefs, fact sheets, program impact reports, investment strategies, professional judgements, etc., and/or success stories for HIV program staff and their key stakeholders for the purpose of educating policy makers and informing policy setting. Activities may also include forging new partnerships to help advance HIV program interests, speaking at conferences and meetings attended by decision makers and key stakeholders about HIV programs, and providing information and guidance on policy issues and education to individual HIV programs.

Component B: Accelerating State and Local HIV Planning to End the HIV Epidemic This cooperative agreement requires participating Phase 1 health departments (refer to the Additional Information on Eligibility section) to engage local partners in an accelerated and collaborative planning process to develop ending the HIV epidemic plans tailored for the local jurisdictions. This collaborative planning process will allow health departments to address local needs and provide flexibility to address local challenges that vary from one community to another, consistent with the HIV integrated planning process. Recipients will be expected to engage in the following activities to support the purpose and outcomes of the NOFO. Note that additional guidance regarding these activities will be issued post-award.

1. Engage with existing local prevention and care integrated planning bodies. Recipients will engage with existing local HIV prevention and care integrated planning bodies as key participants in the planning process. These planning bodies have experience representing key local populations and stakeholders in the discussion about local HIV prevention and care strategies. These groups also have existing and ongoing relationships with multiple community and service provider partners in the jurisdiction and are the groups that will provide concurrence to any new or realigned local HIV prevention and care integrated plan. If not already included, these bodies should be expanded to include participants from the Phase 1 counties to ensure adequate representation and inclusion in the planning process. These efforts should also include working with the relevant HRSA-funded Ryan White Part A and B recipients. Planning should occur at the local level and planning bodies should have representation from the affected counties.

2. Prepare current epidemiologic profile for jurisdiction. To prepare or update a current epidemiologic profile, recipients should use the most current local data available to synthesize a comprehensive overview of the local HIV epidemic. As this tool will be critical to local planning activities it should be shared with local planning bodies and partners.

3. Prepare a brief situational analysis for jurisdiction. Recipients will develop (or update) and submit a brief situational analysis that provides an overview of strengths, challenges and identified needs with respect to several key aspects of HIV prevention and care activities. This analysis should synthesize information from the local epidemiologic profile, from the engagement with local planning bodies, and from other local partners and local community engagement efforts. The situational analysis should be informed by and include consultation of other federally- and state/locally-funded implementation partners (e.g., Community-based Organizations, HRSA-funded Ryan White HIV/AIDS Program Clinics and Community Health Centers, SAMHSA or HUD recipients, CMS, Local Education Agencies supported under PS18-1807, etc.). Previously developed Integrated HIV Prevention and Care plans, as well as any locally-relevant "Getting to Zero", "Ending the Epidemic" plans, or "Fast Track City" commitments should also be considered.

4. Engage with local community partners. To produce the outcomes expected from this NOFO, recipients will engage directly with local community partners. Local communities most heavily impacted by HIV are crucial partners in the process to develop or refine an HIV prevention and care plan. Their participation in the planning process and input to the final plan will ensure the proposed programmatic activities are conducted in ways that are acceptable to the local population. This aspect of the planning process is critical for successfully increasing reach to people in communities experiencing health disparities, and that have either not had access to prevention and care programs or who have not felt included as part of the intended audience for such programs.

5. Engage with local HIV service provider partners. Local HIV service providers are another segment of key partners in planning for local HIV prevention and care programs.

Recipients are expected to engage with local partners who provide prevention, care and other essential services for people with HIV. Some jurisdictions may have an existing network of providers to engage and others may need to develop or expand one. As a group that interacts with and provides so many services to key local populations with HIV, the input on planning from these partners is critical in developing a feasible and potentially sustainable plan.

6. Reach concurrence on an Ending the HIV Epidemic plan with local HIV planning groups.

Many jurisdictions have an existing HIV prevention and care integrated plan for which local planning groups have provided concurrence. Any newly developed, updated or realigned plan consistent with the Ending the HIV Epidemic initiative must go through the same process to reach concurrence.

7. Prepare a final/revised Ending the HIV Epidemic plan for jurisdiction. This planning document will describe the justification for specific strategies to achieve the objectives outlined in the Ending the HIV Epidemic initiative, and will be used to guide future funding of Ending the HIV Epidemic programmatic activities.

1. Collaborations

a. With other CDC programs and CDC-funded organizations:

Component A and B recipients must establish, build, and/or maintain working partnerships with CDC and other CDC-funded organizations (e.g., national partner organizations, state and local health departments, directly funded CBOs, STI programs- including STD clinics, health centers) to ensure communication, collaboration, and coordination for the national delivery of a comprehensive and integrated HIV surveillance and prevention program for Component A and an End the HIV Epidemic plan for Component B. Both should be consistent with CDC standards and guidance. If necessary, memoranda of agreements/memoranda of understandings (MOAs/MOUs) should be established.

Component B recipients are encouraged to include the local education agencies (LEA) within their county in the planning efforts to address primary prevention activities for school-age youth.

Where multiple school districts exist, recipients are encouraged to align with school districts of highest disease burden. In counties where CDC currently provides funding support through CDC- RFA-PS18-1807 to promote adolescent health through school-based HIV prevention, recipients should include the LEAs in the planning process.

b. With organizations not funded by CDC:

The recipient should establish, build, and/or maintain collaborative relationships with organizations not funded by CDC that will support the implementation of the proposed program for Component A and an End the Epidemic plan for Component B. Consideration should be given to developing strategic partnerships with the following types of organizations: federal agencies (e.g., the Health Resources and Services Administration, the Centers for Medicaid and Medicare Services, Substance Abuse and Mental Health Services Administration) and their recipients; public health departments; tribal governments and/or tribally designated organizations;

local and state education agencies; colleges and universities; non-CDC funded CBOs; capacity building assistance organizations; faith-based organizations; for-profit organizations; clinics and hospitals; non-governmental organizations; state and local governments; community advocates;

community members; and other stakeholders that may have a vested interest in promoting health through HIV prevention, care, and treatment. If necessary, memoranda of agreements/memoranda of understandings (MOAs/MOUs) should be established.

2. Target Populations The Component A recipient must provide support to and collaborate with state and local health department HIV program staff (e.g., HIV/AIDS directors, HIV prevention managers, HIV surveillance coordinators). The Component B recipients must engage in planning activities that focus on HIV care and prevention programming for persons with HIV and at risk of acquiring HIV in Phase 1 geographical hotspots identified in the Ending the HIV Epidemic Initiative.

a. Health Disparities Health disparities in HIV are inextricably linked to a complex blend of social determinants that influence populations most severely affected by this disease. Health equity is a desirable goal that entails special efforts to improve the health of those who have experienced social or economic disadvantage. Social determinants of health affect disparities in HIV, viral hepatitis, STD and TB.

Environmental factors such as housing conditions, social networks, and social support are also key drivers for acquisition and transmission of HIV, viral hepatitis, STDs, and TB. This NOFO supports efforts to improve the health of populations disproportionately affected by HIV by maximizing the health impact of public health services, reducing disease prevalence, and promoting health equity.

Where applicable, the recipient should assist the jurisdictions with the use of epidemiologic and social determinants data to identify communities within their jurisdictions disproportionately affected by HIV and related diseases and conditions. Likewise, the recipient should use data describing the social determinants of diseases in their coverage areas to accurately focus activities for reducing health disparities and to identify strategies to promote health equity. In collaboration with partners and appropriate sectors of the community, the recipient should consider social determinants of health in the development, implementation, and evaluation of program-specific efforts and use culturally appropriate prevention messages, strategies, and interventions that are tailored for the communities for which they are intended. For additional resources to identify disability social determinants of health, visit the Disability and Health Data System website (http ://dhds.cdc.gov ).

http://dhds.cdc.gov http://dhds.cdc.gov

Details of the health equity strategy and approach are outlined in the NCHHSTP Social Determinants of Health White Paper (https://www.cdc.gov/nchhstp/socialdeterminants/docs/SDH -White-Paper-2010.pdf) and updates on the approach are described in Public Health Reports special supplement (Dean HD, Williams KM, Fenton KA. From Theory to Action: Applying Social Determinants of Health to Public Health Practice. Public Health Reports. 2013;128(Suppl 3):1-4.).

iv. Funding Strategy Not applicable.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy CDC's approach to evaluation and performance measurement strategy involves assessing the performance of the awardee, to ensure quality of product development and dissemination, effective program implementation, and accountability of funds. Program evaluation includes collection and analysis of program implementation and performance data submitted by recipients, tracking of key performance indicators and process and outcome standards, review of required reports, conference calls with awardees, and site visits. During the period of performance, CDC may partner with recipients on evaluation activities.

Evaluation and performance measurements help demonstrate achievement of program outcomes;

build a stronger evidence base for specific program interventions; clarify applicability of the evidence base to different populations, settings, and contexts; and drive continuous program improvement. Collection of key data that can show the impact of these funds toward the intended outcomes is a critical component of this award. CDC will work with the Component A recipient in the first quarter of the award, and periodically throughout the five-year period of performance, to determine what information will be collected and how it will be used to demonstrate program impact through process evaluation, and short and intermediate-term outcome evaluation. Process and outcome evaluation methods will be used to assess the extent to which planned program activities have been implemented and have led to desired programmatic outcomes, and to demonstrate the feasibility and sustainability of the strategies. Short-term and intermediate outcome evaluation will assess when Ending the HIV Epidemic CDC-funded activities are leading to intended long-term outcomes. The indicators and method used to assess the outcomes below will be determined with CDC after award.

Data collected are used for program accountability, monitoring, evaluation, and improvement.

Findings will be systematically reviewed by CDC to identify challenges encountered by recipients, identify capacity-building assistance needs and actions needed to improve overall project performance, demonstrate the value of the NOFO, and contribute to the evidence base for NOFO strategies and activities. Data will also be used to produce reports on project accomplishments, project feedback reports, fact sheets, and other monitoring and evaluation reports.

Component A: National Network to Enhance Strategic Communications, Partnerships, Policy Analysis and Interpretation Strategy A1. Strategic Partnerships and Communication https://www.cdc.gov/nchhstp/socialdeterminants/docs/SDH-White-Paper-2010.pdf https://www.cdc.gov/nchhstp/socialdeterminants/docs/SDH-White-Paper-2010.pdf

Activity 1: Collaborate and engage with a broad spectrum of national organizations, including organizations that represent sexually transmitted infection (STI) programs, that have common interests and that represent state, territorial, and local health department integrated HIV programs.

Outputs:

Engagement plan/protocol developed Collaborative meetings/conference calls held Number of organizations and health department involved Collaboration as reflected by signed MOU/MOA

Outcomes:

Increased awareness and knowledge of integrated HIV programs, including activities related to ending the HIV epidemic, among relevant national partners

Enhanced representation of integrated HIV programs in relevant national discussions

Activity 2: Establish, cultivate, and maintain collaborative strategic partnership(s) with other national partner(s) to carry out the requirements of the NOFO in support of integrated HIV programs Outputs:

Efforts (e.g., joint meetings, calls, consultations) to establish, cultivate, and maintain partnerships with other national partners Number of other national partners engaged in partnerships

Outcomes:

Increased awareness and knowledge of integrated HIV programs among relevant national partners

Activity 3: Develop and disseminate timely and relevant information on key HIV-related issues and topics Outputs:

Dissemination plan/protocol developed Development and distribution of informational materials Coverage of key HIV-rated issues Reach of people, health departments, and other organizations

Outcome:

Increased sharing of program successes and challenges among HIV program staff

Activity 4: Use established partnerships and communication channels to assist CDC with addressing emerging issues that affect integrated HIV programs

Outputs:

Communication plan/protocol developed Type and number of communication channels identified and utilized Frequency and amount of technical assistance provided to CDC

Outcomes:

Increased identification and addressing of emerging issues Increased ability for CDC to respond effectively to emerging issues

Activity 5: Facilitate and host national stakeholder planning and collaboration meetings Outputs:

Meeting plans developed Number of meetings hosted and facilitated Number and type of stakeholders engaged in meetings

Outcomes:

Increased development and strengthening of partnerships with private and public entities to sustain effective integrated HIV programs

Enhanced representation of integrated HIV programs in relevant national discussions

Activity 6: Work with partners to increase visibility of integrated HIV programs among stakeholders Outputs:

Number of events held to improve visibility of HIV prevention and surveillance programs Development and distribution of materials to increase visibility of HIV prevention and surveillance programs Number and type of stakeholders reached through events and materials designed to increase visibility of HIV prevention and surveillance programs

Outcomes:

Increased awareness and knowledge of integrated HIV programs among relevant national partners

Activity 7: Support and facilitate active communication and consultation between the national organizations and CDC, as well as between CDC and the health department integrated HIV program staff Outputs:

Communication/consultation plan/protocol developed Communication/consultation events between CDC and health departments

Communication/consultation events between CDC and national organizations

Outcomes:

Increased communication and consultation about integrated HIV programs between CDC, health departments and national partner organizations

Increased support for development and implementation of procedures to share data within health department units and between health departments and community partners

Activity 8: Collaborate with appropriate CDC-funded capacity building assistance providers in the dissemination of information and provision of technical assistance to health departments, as appropriate.

Outputs:

Efforts (e.g., joint meetings, calls, material exchanges) to collaborate with CDC-funded capacity building assistance providers

Technical assistance (TA) provided to health departments to support the implementation of integrated HIV programs

Outcome:

Increased capacity of health departments to support the implementation of their integrated HIV programs

Strategy A2. Policy Analysis and Interpretation Activity 9. Track state and territory level activity on policies and laws relevant to HIV programs.

Outputs:

Policy tracking protocol/tool developed Number of policy briefs or reports developed/shared Number of persons/organizations/Health Departments reached

Outcome:

Increased awareness and knowledge about the policy environment and the impact of state and local policies on HIV programs among HIV program staff

Increased opportunities for HIV program staff to effectively communicate with policy stakeholders about the important work of their programs

Activity 10. Develop and disseminate educational and informational products Outputs:

Number and type of educational/informational materials developed Distribution of educational/informational materials

Number of persons, health departments, and partner organizations reached

Outcome:

Increased awareness and knowledge about the policy environment and the impact of state and local policies on HIV programs among HIV program staff

Increased opportunities for HIV program staff to effectively communicate with policy stakeholders about the important work of their programs

Activity 11. Analyze and interpret national and jurisdictional-level data in areas of HIV prevention and surveillance policies and programs Outputs:

Data analysis plan/protocol developed Analysis of HIV prevention and surveillance programs and policies Production of analytic products (e.g., briefs, reports) Discussions, interpretation, dissemination of analytic findings

Outcome:

Increased awareness and knowledge about the policy environment and the impact of state and local policies on HIV programs among HIV program staff

Increased ability of HIV program staff to effectively communicate with policy stakeholders about the important work of their programs

Activity 12. Provide support and technical assistance to health departments on ways to effectively communicate with and educate policymakers about their HIV prevention, surveillance, care, and treatment programs Outputs:

Technical assistance plan/protocol developed Number of organizations and health department provided technical assistance Number and type of strategies or tools developed to educate policymakers about integrated HIV programs

Outcome:

Increased awareness and knowledge about the policy environment and the impact of state and local policies and laws on HIV programs among HIV program staff

Increased opportunities for HIV program staff to effectively communicate with policy stakeholders about the important work of their programs

Component B: Accelerating State and Local HIV Planning to End the HIV Epidemic To monitor progress on recipient implementation of planning activities, recipients will submit performance measures to CDC. These will include a detailed planning timeline with associated milestone and draft documents describing results and/or outcome for each activity. These outcomes will demonstrate the result of accelerated planning efforts supported by this NOFO.

Existing information already available to the state and local award recipients will be used to generate or update the resulting local plan.

CDC will use findings from this NOFO to support implementation of Ending the HIV Epidemic activities and to support planning for Phase 2 jurisdictions in the future. Since this NOFO does not involve the generation or collection of public health data, a Data Management Plan is not required for this NOFO.

Activity 1: Engage with existing local prevention and care integrated planning bodies.

Outcome:

Increased engagement of partners, including local care and prevention planning bodies, local HIV service providers, persons with HIV, and other community members impacted by HIV

Activity 2: Prepare current epidemiologic profile for jurisdiction Output:

Updated (current) epidemiological profile for the relevant jurisdiction(s)

Outcome:

Increase understanding of epidemiologic profile of the relevant jurisdictions

Activity 3: Prepare a brief situational analysis for jurisdiction Output:

Completed current situational analysis for the relevant jurisdiction(s)

Outcome:

Increase understanding of the HIV care and prevention context/situation for the relevant jurisdictions

Activity 4: Engage with local community partners Outcome:

Increased engagement of partners, including local care and prevention planning bodies, local HIV service providers, persons with HIV, and other community members impacted by HIV

Activity 5: Engage with local HIV service provider partners Outcome:

Increased engagement of partners, including local care and prevention planning bodies, local HIV service providers, persons with HIV, and other community members impacted by HIV

Activity 6: Reach concurrence on an Ending the HIV Epidemic plan with local HIV planning groups Outcome:

Increased engagement of partners, including local care and prevention planning bodies, local HIV service providers, persons with HIV, and other community members impacted by HIV

Activity 7: Prepare a final/revised Ending the HIV Epidemic plan for jurisdiction Output

Completed final (revised) implementation plan aligned with the goals of the Ending the HIV Epidemic initiative and that reflects the HIV prevention and care needs of the community, implementation partners, and planning bodies

Outcome:

Improved ability to rapidly implement activities to meet the HIV care and prevention needs of the local jurisdictions consistent with the goals of the Ending the HIV Epidemic Initiative.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should https://www.cdc.gov/grants/additionalrequirements/ar-25.html be directed to:

Describe the type of evaluations (i.e., process, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach Applicants must demonstrate their existing or forthcoming capacity to successfully execute all proposed strategies and activities to meet the program requirements. Applicants must demonstrate expertise, experience, and/or capacity to develop, implement, and evaluate the required program strategies and activities.