PS15-1502 AMENDMENT II 10 27 14 FINAL.pdf

Funding Opportunity Announcement (FOA)

PS15-1502 – New, Non-research, Domestic

Comprehensive High-Impact HIV Prevention

Projects for Community-Based Organizations

CDC-RFA-PS15-1502

National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis

Prevention

Centers for Disease Control and Prevention

Effective date: September 3, 2014

Version 2.0

Issued 08/30/2013

Page i

Amendment I is made September 29, 2014 to the following:

Part II: Section A. Funding Opportunity Description; 2. CDC Project Description:

“newly identified” is revised to “newly diagnosed” (pages 10, 16, 23, and 31)

Part II: Section A. Funding Opportunity Description; 2. CDC Project Description: “must be referred to or provided required and recommended prevention and essential support services.” is revised to “must be provided or referred to one or more of the required and recommended prevention and essential support services.” (pages 11 and 32)

Part II: Section A. Funding Opportunity Description; 2. CDC Project Description:

“health department jurisdiction’s Comprehensive HIV Prevention Plan…” is revised to

“health department’s Jurisdictional HIV Prevention Plan…” (pages 13 and 29)

Part II: Section A. Funding Opportunity Description; 2. CDC Project Description:

“each FOA performance target described…” is revised to “each FOA performance measure described…” (page 15)

Part II: Section A. Funding Opportunity Description; 2. CDC Project Description:

“meet and/or exceed all FOA performance targets” is revised to “meet and/or exceed all FOA performance measures.” (page 15)

Part II: Section C. Eligibility Information; 1. Eligible Applicants: New York, NY-NJ-

PA MSA was revised to include the Newark Division (page 39)

Part II: Section C. Eligibility Information; 1. Eligible Applicants: “San Juan-Caguas-

Guaynabo, PR” was revised to “Puerto Rico*” (page 39)

Part II: Section C. Eligibility Information; 1. Eligible Applicants: the footnote “*U.S.

dependent area not considered an MSA” was revised to “*Area not considered to be an

MSA, but eligible for funding under PS15-1502” (page 39)

Part II: Section C. Eligibility Information; 1. Eligible Applicants: hyperlink updated to http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_Surveillance_Report_vol_23.pdf#Page

=75. (page 40)

Part II: Section D. Application and Submission Information; 12. Budget Narrative:

“itemized budget narrative reflective of the integrated screening activities to be provided” revised to “itemized budget to support these activities...” (page 48)

Part II: Section F. Award Administration Information; 2. Administrative and National

Policy Requirements: deleted AR-7: Executive Order 12372

Amendment II is made October 28, 2014 to the following:

Part II Section C. Eligibility Information; 1. Clarification on required 501(c)(3) documents. The following sentence was added “If applying as a CBO HIV Prevention

Partnership, the lead applicant organizations must submit a Federal 501(c)(3) Internal

Revenue Service tax exemption certificate for the lead applicant organization and each of the CBO HIV Prevention Partnership members.”

Part II Section E. Application Review Information; b. Phase II Review: scoring section revised for clarification and assigning of point values.

Part II Section H. Other Information: the following was added “(required for lead applicant organization only”) http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_Surveillance_Report_vol_23.pdf#Page=75 http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_Surveillance_Report_vol_23.pdf#Page=75

Template for all FOAs (new, non-research, domestic) Page 1

Contents

Part I. Overview Information

A. Federal Agency Name

B. Funding Opportunity Title

C. Announcement Type

D. Agency Funding Opportunity Number

E. Catalog of Federal Domestic Assistance (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. Application Review Information

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 PS15-1502. Applicants also must provide an email address to www.grants.gov to receive notifications of changes.

Federal Agency Name: A.

Centers for Disease Control and Prevention (CDC)

Funding Opportunity Title: B.

Comprehensive High-Impact HIV Prevention Projects for Community-Based Organizations

Announcement Type: New—Type 1 C.

This announcement is only for non-research domestic activities supported by CDC. If research is proposed, the application will not be considered. Research for this purpose is defined at http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf.

Agency Funding Opportunity Number: D.

CDC-RFA-PS15-1502

Catalog of Federal Domestic Assistance (CFDA) Number: E.

93.939 HIV Prevention Activities --Non-Governmental Organization Based

Dates: F.

1. Letter of Intent (LOI) Deadline: September 17, 2014

2. Application Deadline: November 14, 2014, 11:59 p.m. U.S. Eastern Standard Time, on www.grants.gov

Informational conference call for potential applicants: To obtain a schedule of the pre-application and technical assistance activities or additional information related to this funding opportunity announcement, please visit http://www.cdc.gov/hiv/policies/funding/announcements/ps15-1502/index.html.

Executive Summary: G.

1. Summary Paragraph:

The Centers for Disease Control and Prevention announces the availability of fiscal year 2015 funds for a cooperative agreement program for community-based organizations (CBOs) to develop and implement High-Impact Human Immunodeficiency Virus (HIV) Prevention Programs in the following two categories:

Category A: HIV prevention services for members of racial/ethnic minority communities. These services must focus on members at greatest risk of acquiring and transmitting HIV infection.

Examples of these minority communities include, but are not limited to, Black/African Americans, Hispanics/Latinos, American Indians/Alaskan Natives, Asian, and Native Hawaiian/Other Pacific Islanders.

Category B: HIV prevention services for members of groups at greatest risk for acquiring and transmitting HIV infection, regardless of race/ethnicity. Examples include, but are not limited to, HIV-positive persons, men who have sex with men (MSM), injection drug users (IDUs), and http://www.grants.gov/ http://www.grants.gov/ http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://intranet.cdc.gov/od/oadpg/docs/Www.Grants.gov http://www.cdc.gov/hiv/policies/funding/announcements/ps15-1502/index.html transgender persons.

Community-based organizations are uniquely positioned to complement and extend the reach of HIV prevention efforts implemented by state and local health departments and education agencies to support the optimization of services across public, private, and other community-based organizations to achieve objectives of increased identification of HIV infection, referral for pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) services, earlier entry to HIV care, and increased consistency of care. The High-Impact HIV Prevention Program model for HIV-positive and high-risk HIV-negative persons will consist of the following required program components: (1) formalized collaborations; (2) program promotion, outreach, and recruitment; (3) targeted HIV testing; (4) HIV prevention for HIV-positive persons; (5) HIV prevention for high-risk HIV-negative persons; (6) condom distribution;

and (7) HIV and organizational planning.

The purpose of this program is to implement comprehensive HIV prevention programs to reduce morbidity, mortality, and related health disparities. In accordance with the National HIV/AIDS Strategy (http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf) and CDC’s High-Impact HIV Prevention (HIP) approach (http://www.cdc.gov/hiv/strategy/hihp/index.htm), this FOA focuses on HIV in the nation by reducing new infections, increasing access to care, and promoting health equity. These goals will be achieved by enhancing community-based organizations’ capacities to increase HIV testing, link HIV-positive persons to HIV medical care, increase referrals to Partner Services (PS), provide prevention and essential support services for HIV-positive persons and high-risk persons with unknown/negative serostatus, and increase program monitoring and accountability. Standard performance measures for HIV prevention programs that are consistent with the focus of the National HIV/AIDS Strategy on improving performance and accountability are included in this FOA.

Eligible Applicants (select one): Limited competition

a. FOA Type (select one): Cooperative agreement

b. Approximate Number of Awards: up to 100

c. Total Project Period Funding: $210,000,000

d. Average One Year Award Amount: $400,000

e. Number of Years of Award: 5 years

f. Approximate Date When Awards will be Announced: June 1, 2015

g. Cost Sharing and /or Matching Requirements: N/A http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf http://www.cdc.gov/hiv/strategy/hihp/index.htm

Part II. Full Text

Funding Opportunity Description A.

1. Background For over 30 years, Human Immunodeficiency Virus (HIV) has been an epidemic, affecting millions globally. According to the CDC, by the end of 2010 an estimated 1,144,500 persons aged 13 years and older were living with HIV infection in the U.S., including 180,900 (15.8%) persons who are unaware of their infection.1 Over the past 10 years, deaths among persons in the U.S. living with HIV have declined, the number of people living with HIV has increased, and the number of new HIV infections has remained stable with approximately 50,000 new infections annually.2

Since the late 1980s, CDC has formally partnered with community-based organizations (CBOs) to expand the impact and reach of HIV prevention in affected communities. Because of their accessibility, history, and credibility in the community, CBOs are recognized and remain important partners in providing comprehensive high-impact HIV prevention services to people living with and at greatest risk for HIV infection.

Through this new funding cycle, CDC is seeking to develop new and enhance existing strategies for community-based HIV prevention programs. In addition, the CDC seeks to enhance programming to achieve the goals and milestones of the National HIV/AIDS Strategy (NHAS) and CDC’s High-Impact Prevention (HIP) approach.

a. Statutory Authorities: This program is authorized under sections 317(k)(2) and 318 of the Public Health Service Act, 42 U.S.C. sections 241(a) and 247(c), as amended.

b. Healthy People 2020:

This FOA addresses the “Healthy People 2020” focus area of HIV.

http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22

c. Other National Public Health Priorities and Strategies:

The National HIV/AIDS Strategy and CDC Division of HIV/AIDS Prevention (DHAP) Strategic Plan: This FOA aligns with the National HIV/AIDS Strategy and CDC DHAP Strategic Plan to (1) reduce the number of people who become infected with HIV; (2) increase access to care and optimize health outcomes for people living with HIV; and (3) reduce HIV-related health disparities.

Minority AIDS Initiative (MAI): This FOA is supported in part with MAI base funds included in the CDC appropriation. This FOA will support the development of community-based comprehensive high-impact HIV prevention services for people living with and at greatest risk of HIV infection, including African Americans/Blacks;

Latinos/Hispanics; all races/ethnicities of gay, bisexual, and other MSM; injection drug users (IDUs); and transgender persons.

http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22

CDC Winnable Battles: This FOA supports CDC’s efforts to keep pace with emerging public health challenges and address the leading causes of death and disability through Winnable Battles. These are public health priorities with large-scale impact on health and with known, effective strategies to address them. HIV Prevention is one of six Winnable Battles that have been chosen based on the magnitude of the health problem and our ability to make significant progress in improving outcomes.

The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) is committed to a future free of these diseases. NCHHSTP accomplishes its mission by working with a diverse range of community, local, state, and national partners to increase access to, and uptake of, effective prevention interventions; promote healthy living; and support improved quality of life throughout one’s lifespan. For more information regarding NCHHSTP’s mission and core values, see the Other Information section. The FOA activities support the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention in achieving its overarching goals as defined in the NCHHSTP Strategic Plan 2010-2015 (http://www.cdc.gov/nchhstp), including reducing health disparities http://healthypeople.gov/2020/about/DisparitiesAbout.aspx), implementing program collaboration and service integration (PCSI) (http://www.cdc.gov/nchhstp/programintegration/docs/207181- C_NCHHSTP_PCSI%20WhitePaper-508c.pdf, and Prevention Through Health Care (http://www.cdc.gov/nchhstp/PreventionThroughHealthCare/index.htm).

All FOA activities must also be consistent with current and future CDC-supported programmatic guidance and recommendations. See the Other Information section for more detailed information.

d. Relevant Work:

This FOA builds upon previous and current HIV prevention programs for community-based organizations, including:

CDC-RFA-PS10-1003, “HIV Prevention Projects for Community-Based Organizations” http://www.cdc.gov/hiv/policies/funding/announcements/PS10-1003/index.html CDC-RFA-PS13-1310, “HIV Prevention Projects for the Commonwealth of Puerto Rico and the United States Virgin Islands” http://www.cdc.gov/hiv/policies/funding/announcements/PS13-1310/index.html CDC-RFA-PS11-1113, “HIV Prevention Projects for Young Men of Color Who Have Sex with Men and Young Transgender Persons of Color” http://www.cdc.gov/hiv/policies/funding/announcements/PS11-1113/index.html FOA activities will support current and future CDC HIV prevention programs and initiatives. See the Other Information section for additional detail.

http://www.cdc.gov/nchhstp http://healthypeople.gov/2020/about/DisparitiesAbout.aspx http://www.cdc.gov/nchhstp/programintegration/docs/207181-C_NCHHSTP_PCSI%20WhitePaper-508c.pdf http://www.cdc.gov/nchhstp/programintegration/docs/207181-C_NCHHSTP_PCSI%20WhitePaper-508c.pdf http://www.cdc.gov/nchhstp/PreventionThroughHealthCare/index.htm http://www.cdc.gov/hiv/policies/funding/announcements/PS10-1003/index.html http://www.cdc.gov/hiv/policies/funding/announcements/PS13-1310/index.html http://www.cdc.gov/hiv/policies/funding/announcements/PS11-1113/index.html

2. CDC Project Description

a. Approach:

The following logic model provides a high-level visual depiction of CDC’s programmatic approach, including relationships between program strategies and outcomes. For more information, see the Evaluation and Performance Measurement section. To further understand the contextual factors influencing this programmatic approach, see CDC’s Imperatives for High- Impact HIV Prevention in the Other Information section of this FOA.

CDC-RFA-PS15-1502 Program Logic Model: Comprehensive High-Impact HIV Prevention Projects for Community-Based Organizations (CBOs)

Strategies and Activities Short-term Outcomes Long-term Outcomes

Project Overview

Provide an overview describing how the proposed program complements the jurisdiction’s Comprehensive HIV Prevention Plan and meets the needs of the target population

Formalized Collaborations Establish service agreements with medical care providers and prevention and essential support services providers to maximize reach, increase coordination and collaboration, and support provision of comprehensive HIV prevention and treatment services and prevention and essential support services providers

Program Promotion, Outreach, and Recruitment Promote the program to the target population

Conduct outreach to recruit the target population into the program

Targeted HIV Testing Conduct HIV testing among persons at high risk for HIV infection

Complementary Services o Conduct Couples HIV Testing and Counseling (CHTC) o Conduct integrated screening for STDs, viral hepatitis, and TB

Comprehensive HIV Prevention with HIV-positive Persons Linkage to HIV Medical Care Link newly diagnosed HIV-positive persons to HIV medical care

Re-engage previously diagnosed, out-of-care HIV-positive persons in HIV medical care

Promote retention of HIV-positive persons in HIV medical care

Promote use of antiretroviral therapy (ART) Navigation and Prevention and Essential Support Services Train navigators (e.g., community health workers, peer advocates, outreach workers) to provide referrals to (or provide) prevention and essential support services

Refer HIV-positive persons to required and recommended prevention and essential support services (e.g., medication adherence support, Partner Services [PS], High-Impact Prevention [HIP] behavioral intervention, STD screening, housing services) or provide these services

Comprehensive HIV Prevention with High-risk HIV-negative (HRN) Persons Navigation and Prevention and Essential Support Services Train navigators (e.g., community health workers, peer advocates, outreach workers) to provide referrals to (or provide) prevention and essential support services

Refer HRN persons to required and recommended prevention and essential support service providers (e.g., STD screening, housing services, PrEP and/or nPEP, as appropriate) or provide these services

Condom Distribution Offer condoms to HIV-positive and HRN persons

HIV and Organizational Planning Develop or revise an organizational strategic plan that incorporates the proposed program to provide a continuum of HIV prevention and care services

Participate in the jurisdiction’s HIV planning process

Targeted HIV Testing

Increase in number of target population members tested for

HIV

Increase in HIV-positive persons who are aware of their infection

HIV Prevention with HIV-positive Persons

Increase in HIV-positive persons who receive HIV medical care

Increase in HIV-positive persons who receive medication adherence services

Increase in HIV-positive persons who receive Partner Services

Increase in HIV-positive persons who are provided or referred to a HIP behavioral intervention that reduces sexual or drug-related risks related to the transmission of HIV infection

Increase in HIV-positive persons who receive required and recommended prevention and essential support services facilitated through trained navigators

HIV Prevention with High-risk HIV-negative

Increase in HRN persons who are aware of their risk for HIV infection

Increase in HRN persons who receive required and recommended prevention and essential support services facilitated through trained navigators

Increase in HRN persons who are referred to Pre-Exposure Prophylaxis (PrEP) and/or Non- Occupational Post-Exposure Prophylaxis (nPEP), as appropriate

HIV Prevention with HIV-positive and HRN

Increase in HIV-positive and HRN persons who are offered condoms

Reduce HIV transmission from PLWH

Increase the number of HIV-positive persons with suppressed viral load

Reduce HIV incidence among HRN persons partners of HIV-positive persons who are aware of their risk for HIV and are tested for HIV

HRN persons who receive and use PrEP and/or nPEP, as appropriate

Increase HIV-positive and HRN persons’ access to care and improved health outcomes

HIV-positive and HRN persons who use condoms consistently and correctly

Impacts: Reduced HIV transmission, Increased access to care and improved health outcomes for people living with HIV/AIDS (PLWHA)

Italicized components of the logic model will be measured in the program.

i. Problem Statement:

In 2011, an estimated 49,273 people were diagnosed with HIV infection in the United States.

Overall, an estimated 1,155,792 people in the United States have been diagnosed with HIV and AIDS.3 HIV and AIDS disproportionally affects some populations, especially persons identified as gay, bisexual, and other men who have sex with men (MSM) of all races and ethnicities. In 2010, the estimated number of new HIV infections among MSM was 29,800, a 12% increase from the 26,700 new infections among MSM in 2008.2

In addition, despite ongoing targeted HIV prevention programs, racial and ethnic minority groups continue to experience the most severe burden of HIV. Blacks/African Americans and Hispanics/Latinos represent a small percentage of the U.S. population, but accounted for 44% and 21% respectively of new infections in 2010.1,2

Toward the successful implementation of the National HIV/AIDS Strategy, CDC’s Division of HIV/AIDS Prevention works in partnership with other federal operating divisions; state, tribal, local, and territorial health departments; community-based organizations; health care organizations; and other stakeholders to better coordinate and implement state and local responses to HIV and AIDS. Building individual competencies, organizational capacities, and supportive structural environments among these partners are key strategies for the effective promotion, delivery, and sustainability of HIV prevention programs and services, particularly for people living with and at greatest risk of HIV infection including African Americans/Blacks;

Latinos/Hispanics; all races/ethnicities of gay, bisexual, and other MSM; IDUs; and transgender persons.

ii. Purpose:

The purpose of this program is to implement comprehensive HIV prevention programs to reduce morbidity, mortality, and related health disparities in accordance with the National HIV/AIDS Strategy (http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf) and CDC’s High-Impact HIV Prevention approach (http://www.cdc.gov/hiv/strategy/hihp/index.htm). This FOA focuses on addressing the national HIV epidemic by reducing new infections, increasing access to care, and promoting health equity. The aforementioned will be achieved by enhancing community-based organizations’ capacities to increase HIV testing, link HIV-positive persons to HIV medical care, increase referrals to Partner Services (PS), provide prevention and essential support services for HIV-positive persons and high-risk persons with unknown/negative serostatus, and increase program monitoring and accountability. Standard performance measures for HIV prevention programs that are consistent with the focus of the National HIV/AIDS Strategy on improving performance and accountability are included in this FOA.

iii. Outcomes:

The program is expected to demonstrate measurable progress among its target populations toward addressing the short-term outcomes depicted in the FOA logic model. Potential indicators that quantify these outcomes are described in the section entitled CDC Evaluation http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf http://www.cdc.gov/hiv/strategy/hihp/index.htm and Performance Measurement Strategy.

Expected short-term outcomes include the following:

Outcomes

1. Targeted HIV Testing

Outcome: Increase in number of target population members tested for HIV (at least 75% of those tested must be in the target population[s]).

o Indicator: Number of HIV tests conducted.

Outcome: Increase in HIV-positive persons who are aware of their infection.

o Indicators: Number and percentage of newly diagnosed HIV-positive persons identified; number and percentage of previously diagnosed HIV-positive persons identified.

Organizations must annually identify a minimum of six (6) new HIV infections per every $50,000 allocated to support the HIV testing component of the proposed program.

Organizations are expected to establish their annual HIV testing objectives (e.g., number of HIV tests to be conducted, number of new HIV infections diagnosed) based upon the size of the service area where services will be provided, the capacity of the organization to provide HIV testing, and the organization’s access to the target population(s).

2. HIV Prevention with HIV-positive Persons

Outcome: Increase in HIV-positive persons who receive HIV medical care. A minimum of 90% of all newly diagnosed HIV-positive persons must be linked to HIV medical care within three months (90 days) of diagnosis.

o Indicators: Number and percentage of newly diagnosed HIV-positive persons linked to HIV medical care; number and percentage of previously diagnosed, out of care HIV-positive persons re-engaged in HIV medical care.

Outcome: Increase in HIV-positive persons who receive medication adherence services.

o Indicator: Number and percentage of HIV-positive persons referred to medication adherence support.

Outcome: Increase in HIV-positive persons who receive Partner Services. A minimum of 90% of all newly diagnosed HIV positive persons must be referred for Partner Services, in accordance with state and local regulations.

o Indicator: Number and percentage of HIV-positive persons referred for Partner

Services, in accordance with state and local regulations.

Outcomes: Increase in HIV-positive persons who are provided or referred to a High Impact Prevention behavioral intervention that reduces sexual or drug-related risks related to the transmission of HIV infection.

o Indicator: Number and percentage of HIV-positive persons provided or referred to a HIP behavioral intervention that reduces sexual or drug risks related to the transmission of HIV infection.

o Indicator: Number and percentage of HIV-positive persons who enrolled in a HIP behavioral intervention funded by this FOA that reduces sexual or drug risks related to the transmission of HIV infection.

o Indicator: Number and percentage of HIV-positive persons who completed a HIP behavioral intervention funded by this FOA that reduces sexual or drug risks related to the transmission of HIV infection.

Outcome: Increase in HIV-positive persons who receive required and recommended prevention and essential support services facilitated through trained navigators (see the Strategies and Activities: HIV Prevention with HIV-Positive Persons section for a listing of these services). A minimum of 90% of all newly diagnosed HIV-positive persons must be provided or referred to one or more of the required and recommended prevention and essential support services.

o Indicator: Number and percentage of HIV-positive persons provided or referred to required and recommended prevention and essential support services.

o Indicator: Number of HIV-positive persons who enrolled in high-impact HIV prevention interventions or strategies.

o Indicator: Number and percentage of HIV-positive persons who completed high-impact HIV prevention interventions or strategies.

3. HIV Prevention with High-risk HIV-negative Persons

Outcome: Increase in high-risk HIV-negative persons who are aware of their risk for HIV infection.

Outcome: Increase in HRN persons who receive the required and recommended prevention and essential support services facilitated through trained navigators (see the Strategies and Activities: HIV Prevention with High Risk HIV-Negative Persons section for a listing of these services). A minimum of 90% of HRN must be provided or referred to one or more of the required and recommended prevention and essential support services.

o Indicator: Number and percentage of HRN persons provided or referred to required and recommended prevention and essential support services.

o Indicator: Number of HRN persons who enrolled in HIP interventions funded by this FOA.

o Indicator: Number and percentage of HRN persons who completed HIP interventions funded by this FOA.

Outcome: Increase in HRN persons who are referred to PrEP and/or nPEP, as appropriate.

o Indicator: Number and percentage of HRN persons who were referred to PrEP and/or nPEP.

4. HIV Prevention with HIV-positive and HRN Persons

Outcome: Increase in HIV-positive and HRN persons who are offered condoms. 100% of all clients must be offered condoms.

o Indicator: Number of HIV-positive and HRN persons offered condoms.

Expected long-term outcomes include the following:

Outcome: Reduce HIV transmission from persons living with HIV/AIDS (PLWH).

Outcome: Increase the number of HIV-positive persons with suppressed viral load.

Outcome: Reduce HIV incidence among HRN persons.

Outcome: Increase the number of partners of HIV-positive persons who are aware of their risk for HIV and are tested for HIV.

Outcome: Increase in HRN persons who receive and use PrEP and/or nPEP, as appropriate.

Outcome: Increase HIV-positive and HRN persons’ access to care and improved health outcomes.

Outcome: Increase the number of HIV-positive and HRN persons who use condoms consistently and correctly.

iv. Funding Strategy:

There are two possible funding strategies under this FOA.

1. An organization applying as a single recipient of these funds under Category A or B will be considered for the following:

a. Approximate average award: $400,000

b. Floor of Individual Award range: $350,000

c. Ceiling of Individual Award range: $450,000

2. An organization applying as the lead (applicant) agency of a CBO HIV Prevention Partnership under Category A or B will be considered for the following:

a. Approximate average award: $850,000

b. Floor of Partnership Award range: $700,000 (dependent on the total number of

Partnership members)

c. Ceiling of Partnership Award range: $1,000,000 (dependent on the total number of Partnership members)

d. Please see the Strategies and Activities: Establishing Formalized Collaborations section for detailed information.

v. Strategies and Activities:

Applicant organizations are required to provide comprehensive HIV prevention services for HIV-positive persons and high-risk HIV-negative persons. The applicant organization’s High-Impact HIV Prevention Program model for HIV-positive and high-risk HIV-negative persons must consist of the following program components:

1. Project overview

2. Formalized collaborations

3. Program promotion, outreach, and recruitment

4. Targeted HIV testing

5. HIV prevention with HIV-positive persons

6. HIV prevention with high-risk HIV-negative persons

7. Condom distribution

8. HIV and organizational planning

Because there is no one singular approach that will work effectively to address the overarching goals of the project, applicants should evaluate approaches that include the required components and additional components that will, when combined, have the greatest public health impact. These combined activities should also have the greatest potential to address the social and structural determinants of health that are known to create the most significant barriers to testing; linkage to, retention in, and re-engagement with care; and prevention and essential support services in the organization’s jurisdiction. This framework acknowledges that prevention and care/treatment together contribute to reducing HIV-related morbidity, mortality, and related health disparities among racial and ethnic minorities in the United States, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands.

This program will support the national implementation of high-impact HIV prevention programs by community-based organizations under the two core funding categories previously described.

Applicants may apply for funding under only one of the above referenced categories.

Additionally, applicants applying under Category A or B must address all strategies and activities including, but not limited to, all those delineated below, unless otherwise indicated.

*Applicants are required to provide HIV prevention services for both HIV-positive persons and high-risk HIV-negative persons, regardless of the category for which funding is being provided.

Project Overview General All applicants must incorporate the following general program requirements into their proposed programs:

1. Applicants should refer to their health department’s Jurisdictional HIV Prevention Plan for relevant data to assist with selecting the proposed target population(s).

2. Applicants must use state and/or local HIV epidemiologic and surveillance data, Health Resources and Services Administration (HRSA) Ryan White program data, and/or HIV needs assessment data to provide the information requested in this section. CDC recommends that applicants use the local and/or state health department as their primary source of this data whenever possible.

a. To describe the social and environmental characteristics of the affected populations, data from research studies and other valid data sources may also be used if health department data are not available or to complement data obtained from the health department.

Justification of Need Applicant organizations must describe the factors that place the target population(s) at high risk for acquiring or transmitting HIV infection, including concurrent risk transmission with other diseases (i.e., STDs, viral hepatitis, and TB) and social and environmental characteristics.

Applicants should also provide an overview of how the proposed target population(s) and the community at large have been affected by the HIV epidemic (e.g., HIV incidence or prevalence;

AIDS incidence or prevalence; AIDS mortality; HIV co-infection rates with hepatitis, STDs, or TB).

The applicant should ensure the proposed program meets the needs of the health department’s Jurisdictional HIV Prevention Plan. More specifically, the applicant must:

1. Define the specific service area in which they plan to deliver their program. Local surveillance and epidemiologic data, when available, should be used to identify the service areas within the eligible metropolitan statistical area (MSA) that are disproportionately affected by HIV and where people living with and at greatest risk for HIV infection reside and/or frequent.

2. Enhance existing and develop new strategies to identify and collaborate with organizations that currently provide similar and/or complementary services in the proposed service area.

3. Describe how these funds will augment existing HIV prevention services and provide an assurance that the funds being requested will not duplicate or supplant funds received from any other federal or non-federal entity.

Consumer Advisory Board (CAB) Applicants must establish a new or enhance the existing CAB to assist with programmatic decision-making (e.g., program recruitment, planning, and implementation). Members of the target population(s) must comprise at least 75% of the CAB. Remaining members must have experience working in HIV prevention and/or care and a history of working with the target population(s). The CAB must be used throughout the project period to ensure services are responsive to the needs of the target population(s).

Cultural Competence and Sensitivity Applicants must have a strategy to ensure that the development and delivery of their Comprehensive High-Impact HIV Prevention Program are culturally, linguistically, and educationally appropriate to meet the needs of their selected target population(s), which may include people living with and at greatest risk of HIV infection, including African Americans/Blacks; Latinos/Hispanics; all races/ethnicities of gay, bisexual, and other MSM;

IDUs; and transgender persons.

Appropriate Staffing Applicants must have a plan to ensure competent staff (e.g., accessing capacity building assistance to support workforce development), inclusive of subcontractors and consultants if applicable, throughout the duration of the 5-year project. Staff must have the breadth of subject matter expertise and experience required to conduct all proposed work. Additionally, applicants must develop a staffing plan designed to promote and sustain peer leadership from within the target population(s). When feasible, applicants should consider hiring direct service staff reflective of the target population(s), with a minimum of 12 months’ experience working with the target population(s).

Structure of the Project There will be two phases of the project: a development phase lasting up to 6 months from the start of Year 1 (July 1-December 31, 2015), followed by ongoing program implementation, monitoring, and evaluation.

1. Development Phase: Awardees will collaborate with CDC as well as community, local, and state partners to finalize the components of their project. During this time, awardees are expected to complete staff hiring processes and attend all required trainings that support the effective implementation of their programs. During the Development Phase:

a. Awardees must work with CDC directly-funded capacity building assistance (CBA) providers to develop and implement a Strategic Plan for Enhanced CBO Capacity.

Please see the CDC Monitoring and Accountability Approach, CDC Program Support to Awardees section for detailed information.

b. Awardees must work with CDC/DHAP to make the necessary adjustments to their work plan and detailed evaluation plan, as described later in the Applicant Evaluation and Performance Measurement Plan section of the FOA.

2. Implementation Phase: It is expected that each awardee will begin programmatic implementation (excluding “development activities” as described above) by January 1, 2016.

a. During the Implementation Phase of Year 1 (July 1, 2015 – June 30, 2016) only, each awardee will be expected to achieve at least 75% of each FOA performance measure described throughout the FOA and approved by CDC. Beginning in Year 2, and for all subsequent years (Years 3, 4, and 5), the awardee is expected to meet and/or exceed all FOA performance measures.

b. Awardees will be expected to attend a Grantee Orientation meeting in Atlanta, Georgia, during Year 1 and should allocate funds to support the travel of up to three staff persons to attend the 3- to 5-day meeting.

c. Awardees must also allocate sufficient funds to enable appropriate program staff to attend all required CDC meetings and trainings that support the prevention approaches described in this FOA, as communicated by CDC in advance of the meetings.

Formalized Collaborations The success of this FOA hinges upon community-based organizations’ ability to increase coordination and collaboration among community, local, and state HIV prevention and care service providers. This can be achieved by the CBO providing HIV prevention services required by the FOA either directly or through enhancing existing or establishing new formalized collaborations.

Service Agreements and Memorandums of Agreement/Understanding (MOAs/MOUs) (required) Applicants will be required to enhance existing and establish new formalized collaborative partnerships, supported by detail-specific service agreements, with HIV medical care providers and prevention and essential social support service providers (housing, substance abuse counseling and services, mental health services, schools, etc.) to maximize reach, increase coordination and collaboration, and support the provision of comprehensive HIV prevention services.

When establishing a service agreement with an HIV medical care provider, applicants should consider the following:

1. Proximity of the medical provider to the applicant organization’s service area.

2. The provider’s capacity and history to care for and treat HIV-positive persons (including, as needed, the capacity and history to care for and treat HIV-positive adolescents).

3. Additional services available for HIV-positive persons to be accessed via referrals (e.g., medication education and adherence, essential support services).

Additionally, the service agreement must include, but is not limited to the following:

1. Name and address of the provider(s).

2. Name, title, and contact information (i.e., primary work address, email, and phone number) for the primary point of contact for the medical care provider.

3. Description of the agreed-upon processes that will be used to link newly diagnosed HIV-positive persons to medical care within 90 days of HIV diagnosis and previously diagnosed HIV-positive persons who are out of care, including:

a. Scheduling of first medical appointment.

b. Process for confirming the individual’s attendance at the first medical appointment, in accordance with federal, state, and local policies.

4. Signatures from the Business Official for the applicant organization and the HIV medical care provider.

The applicant organization must have at least one established service agreement with an HIV medical care provider (internal and/or external to organization) at the time the application is submitted.

When establishing prevention and essential support services MOAs/MOUs or service agreements, the applicant organization should consider the following:

1. Proximity of the provider to the applicant organization’s service area.

2. The provider’s capacity and history to serve the target population(s).

3. Payment requirements for services rendered (e.g., Ryan White provider, type of health insurance accepted).

4. Types of services available for HIV-positive and high-risk HIV-negative persons to access.

Additionally, the service agreement must include, but is not limited to the following:

1. Name and address of the provider(s).

2. Name, title, and contact information (i.e., primary work address, email, and phone number) for the primary point of contact for the provider.

3. Description of the agreed upon referral process for prevention and essential support services between the applicant organization and the prevention and essential support service provider.

a. Process for confirming that the individual accessed the service, in accordance with federal, state, and local policies.

4. Signatures from the Business Official for the applicant organizations and the prevention and essential support services provider.

The applicant organization must have at least one established MOA/MOU or service agreement (internal and/or external to organization) with a prevention and essential support services provider at the time the application is submitted. The agreement(s) should be reflective of the services most commonly requested by the target population(s). The applicant organization is encouraged to establish additional collaborations supported by service agreements over the course of the 5-year project period.

CBO HIV Prevention Partnership (optional) As previously mentioned in the Funding Strategy section, applicant organizations may opt to establish a CBO HIV Prevention Partnership, hereafter referred to as Partnership, with other organizations in the proposed service area(s) to facilitate the provision of a comprehensive high-impact HIV prevention program, provide a continuum of HIV care and prevention services, and maximize the reach of the program into the community. The requirements for establishing a Partnership are listed below:

1. A maximum of three CBOs per Partnership is permitted.

2. CBOs may participate in a maximum of two Partnerships, but may serve as the lead applicant organization for only one Partnership.

a. If an organization is a member of more than one Partnership, this must be stated in the Establishing Formalized Collaborations section of each program proposal in which they are associated.

3. CBOs may apply for funding as an individual applicant and may also participate as a member (not the lead applicant organization) of one Partnership.

a. If an organization applies as an individual applicant and as a member of one Partnership, this must be clearly stated in the Establishing Formalized Collaborations section of each program proposal in which the organization is associated.

4. Each organization applying as a member of a Partnership must meet all of the eligibility requirements as outlined in the section entitled Eligibility Information and must submit all required eligibility documentation with the application.

5. Formalized service agreements for all members of the Partnership must be submitted with the application. The service agreements must include, but are not limited to, the following:

a. Name and address of each participating organization.

b. Name, title, and contact information (i.e., primary work address, email, and phone number) for the primary point of contact for each member of the Partnership.

c. Description of the strategies and activities each participating organization will deliver, including annual deliverables, the mechanism that will be used for data submission and reporting program strategies and activities to the lead (applicant) organization, and the frequency of reporting and data submission.

The lead applicant is responsible for ensuring that performance measures for the entire program are met and/or exceeded.

d. Processes to be followed in the event inadequate program performance or voluntary withdrawal dictates the removal of a Partnership member. When a Partnership member is removed, the lead organization, in collaboration with the remaining Partnership member, must submit a plan to the CDC Project Officer (PO) and PGO Grants Management Specialist (GMS) describing the processes that will be used to continue providing services and the timeline associated with the identification of a replacement Partnership member, if applicable. The lead organization is expected to develop a plan to ensure all deliverables associated with the core program components are met, regardless of the number of members remaining in the Partnership.

e. Signatures from the Business Official of each Partnership member.

6. An itemized budget narrative reflective of the strategies and activities to be provided must be submitted for each Partnership member as a part of the overall Comprehensive High-Impact HIV Prevention program budget. For additional information related to the development of the budget, see the section entitled Application Submission Information, Budget Narrative and visit http://www.cdc.gov/od/pgo/funding/grants/foamain.shtm.

Failure to comply with the above guidance will result in the application being deemed non-responsive; the application will not be considered for funding. Applicant organizations should complete and submit the CBO HIV Prevention Partnership form with the application, if applicable. (See Attachment A: CBO HIV Prevention Partnership Form.)

Program Promotion, Outreach, and Recruitment All funded organizations must deliver strategic, culturally competent, community-based program marketing campaigns to increase public awareness of services available via the proposed program; destigmatize HIV and HIV medical care; empower disproportionately affected populations; promote HIV testing, linkage to, retention in, and re-engagement in HIV medical care; and promote navigation to prevention and essential support services, including PrEP and nPEP.

Organizations should collaborate with other organizations that have an established history of working with and recruiting members of the target population(s) at greatest risk for HIV acquisition or transmission. The program must seek input from the CAB and community stakeholders to select the most appropriate program promotion and recruitment strategies to determine the appropriate use of incentives (i.e., monetary and non-monetary) in the program.

Client recruitment is essential to the success of a comprehensive high-impact HIV prevention program. Moreover, new outreach and recruitment strategies to promote awareness of the HIV prevention program, specifically within the social networks of people living with and at greatest risk for HIV infection, are required. Organizations will utilize cutting edge and innovative strategies, as well as traditional outreach, Internet and social media, and surveillance data to support mapping of areas of highest morbidity to establish a comprehensive program promotion, outreach, and recruitment plan. Additionally, the applicant organization should http://www.cdc.gov/od/pgo/funding/grants/foamain.shtm consider development of the program promotion, outreach, and recruitment component to address participation by members of the target population through multiple points of entry into the program. For information about resources available to increase organizational capacity to develop and deliver effective and appropriate program promotion, outreach, and recruitment, please visit www.effectiveinterventions.org.

Organizations should prioritize existing social media efforts that can be tailored to their jurisdiction’s specific requirements from CDC’s Act Against AIDS and other social marketing campaigns (http://www.cdc.gov/actagainstaids/).

Targeted HIV Testing HIV testing is an essential part of a comprehensive high-impact HIV prevention program.

Applicant organizations will be required to develop new or enhance existing targeted HIV testing programs aimed at reaching persons who are at greatest risk for HIV infections and who are unaware of their HIV status. As a part of the HIV testing session, applicant organizations are expected to:

1. Complete a brief risk assessment.

2. Provide brief risk reduction education messaging when appropriate.

a. Brief risk reduction education messaging should provide persons with their HIV test results and include factual HIV education (e.g., transmission, window period, risk reduction methods).

3. After HIV testing is completed, offer clients a variety of HIP interventions and services, as appropriate.

a. For persons with a non-reactive test result and who are at high-risk for infection, referrals to PrEP and nPEP services; STD, viral hepatitis, and/or TB screenings;

and other prevention and essential support services as described in the HIV Prevention with HIV-Positive Persons section.

The targeted…