21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 1

RFP DUE DATE AND TIME: Thursday, August 19, 2021 at 11:00 AM (ET)

RFP ISSUANCE DATE: Thursday, July 15, 2021

PRE-PROPOSAL CONFERENCE

DATE:

Thursday, July 29, 2021 10:00 AM Eastern Time (US and Canada) Join Zoom Meeting https://zoom.us/j/95839608673

Meeting ID: 958 3960 8673 One tap mobile +16465588656,,95839608673# US (New York) +13017158592,,95839608673# US (Washington DC)

Dial by your location +1 646 558 8656 US (New York) +1 301 715 8592 US (Washington DC) +1 312 626 6799 US (Chicago) +1 669 900 9128 US (San Jose) +1 253 215 8782 US (Tacoma) +1 346 248 7799 US (Houston) Meeting ID: 958 3960 8673 Find your local number: https://zoom.us/u/acn9efSGme Join by SIP 95839608673@zoomcrc.com

Join by H.323

162.255.37.11 (US West)

162.255.36.11 (US East)

115.114.131.7 (India Mumbai)

115.114.115.7 (India Hyderabad)

213.19.144.110 (Amsterdam Netherlands)

213.244.140.110 (Germany)

103.122.166.55 (Australia Sydney)

FY 2021 APPLICATION GUIDANCE

ENDING THE HIV EPIDEMIC: A PLAN FOR AMERICA

Phase III https://www.bidnetdirect.com/georgia/fultoncounty

REQUEST FOR PROPOSAL NUMBER: 21RFPRW0708B-EC

https://zoom.us/j/95839608673

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 2

103.122.167.55 (Australia Melbourne)

149.137.40.110 (Singapore)

64.211.144.160 (Brazil)

149.137.68.253 (Mexico)

69.174.57.160 (Canada Toronto)

65.39.152.160 (Canada Vancouver)

207.226.132.110 (Japan Tokyo)

149.137.24.110 (Japan Osaka) Meeting ID: 958 3960 8673

The Pre-Proposal Conference will be recorded and stored on the Ryan White website: www.ryanwhiteatl.org

Please remember to have a copy of this guidance and related documents with you during the Pre-Proposal Conference

PURCHASING CONTACT: Elsa D. Castro, (404) 612-4216

LOCATION: FULTON COUNTY DEPARTMENT OF PURCHASING & CONTRACT

COMPLIANCE

130 PEACHTREE STREET, SW, SUITE 1168

ATLANTA, GA 30303

FOR FURTHER INFORMATION Elsa.Castro@FultonCountyGa.gov

TABLE OF CONTENTS

SECTION # TITLE PAGE #

1.0 INTRODUCTION 6

1.1 PROJECT DESCRIPTION 6

1.2 SERVICE CATEGORIES ELIGIBLE FOR FUNDING 7

1.3 METHOD OF SOURCE SELECTION 14

1.4 BACKGROUND 14

1.4.1 ENDING THE HIV EPIDEMIC: A PLAN FOR AMERICA 14

1.4.2 HIV CARE CONTINUUM 16

1.4.3 GOALS AND OBJECTIVES 18

1.5 OBTAINING THE RFP 19

1.6 PRE-PROPOSAL CONFERENCES 19

1.7 PROPOSAL DUE DATE AND TIME 20

1.8 SUBMITTAL REQUIREMENTS 20

1.9 CONTACT PERSON AND INQUIRIES 20

1.10 PROCUREMENT SCHEDULE 20

2.0 INSTRUCTIONS TO PROPOSERS 20

To meet the deadline, a complete application packet must be electronically submitted before the 11:00 AM deadline on Thursday, August 12, 2021. NO EXTENSIONS WILL BE GRANTED.

http://www.ryanwhiteatl.org/ mailto:Elsa.Castro@FultonCountyGa.gov

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 3

2.1 PROCUREMENT PROCESS 20

2.2 DEFINITIONS 21

2.3 NO CONTACT DURING PROCUREMENT PROCESS 24

2.4 CLARIFICATION AND ADDENDA 25

2.5 TERM OF CONTRACT 26

2.6 RFP SUBMITTAL CHECKLIST 27

2.7 PROPOSAL EVALUATION 27

2.8 RESERVED RIGHTS 27

2.9 APPLICABLE LAWS 28

2.10 INSURANCE AND RISK MANAGEMENT PROVISIONS 28

2.11 ACCURACY OF RFP AND RELATED DOCUMENTS 28

2.12 RESPONSIBILITY OF PROPOSER 28

2.13 CONFIDENTIAL INFORMATION 28

2.14 COUNTY RIGHTS AND OPTIONS 29

2.15 COST OF PROPOSAL PREPARATION AND SELECTION PROCESS 30

2.16 TERMINATION OF NEGOTIATIONS 30

2.17 WAGE CLAUSE 30

2.18 ADDITIONAL OR SUPPLEMENTAL INFORMATION 30

2.19 REPORTING RESPONSIBILITIES 30

2.20 AUTHORIZATION TO TRANSACT BUSINESS 30

2.21 RIGHT TO PROTEST 31

2.22 NON-COLLUSION 31

2.23 CERTIFICATE OF ACCEPTANCE 31

2.24 EXCEPTIONS TO THE COUNTY CONTRACT 32

2.25 CERTIFICATION REGARDING DEBARMENT 32

2.26 GENERAL REQUIREMENTS 32

2.27 PREPARATION AND WRITING TIPS 33

2.28 CLIENT ELIGIBILITY 34

2.29 REPORTING REQUIREMENTS 34

2.30 PROGRAM AND FISCAL MONITORING STANDARDS 35

2.31 BUSINESS AGREEMENTS 35

2.32 PROGRAM INCOME 35

2.33 CULTURAL AND LINGUISTIC COMPETENCE 36

2.34 CONDOM AVAILABILITY 37

2.35 PEERS 37

2.36 INCLUSION 37

2.37 COLLABORATIONS 38

2.38 PROFESSIONAL LICENSE 39

2.39 FUNDING EXCLUSIONS 39

2.40 FEDERAL REQUIREMENTS 41

2.41 LOCAL POLICIES AFFECTING FUNDING 42

2.42 OTHER DOCUMENTS TO BE PROVIDED PRIOR TO ENTERING INTO CONTRACT 43

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 4

3.0 PROPOSAL REQUIREMENTS 45

3.1 PROPOSAL SUBMITTAL FORMAT 45

3.2 FORMAT AND PROPOSAL SUBMISSION INSTRUCTIONS 45

3.2.1 FORMAT 45

3.2.2 NUMBER OF COPIES 46

3.2.3 DEFINITION OF A “COMPLETE” SUBMISSION PACKET 46

3.2.4 FORMATTING REQUIREMENTS 46

4.0 TECHNICAL PROPOSAL GUIDELINES 47

4.1 TECHNICAL GUIDANCE 47

4.2 OVERVIEW 47

4.3 TECHNICAL NARRATIVE GUIDANCE 47

T-O TECHNICAL OPENING MATERIALS 47

T-O-I COVER PAGES 47

1 GENERAL INFORMATION 47

2 ORGANIZATIONAL INFORMATION TABLE 48

3 PROPOSED PRIORITY SERVICE AREA(S), FUNDING AMOUNT REQUESTED PER

SERVICE PRIORITY AREA, AND NUMBER OF UNDUPLICATED CLIENTS TO BE SERVED

BY SERVICE PRIORITY AREA

4 AGENCY DEMOGRAPHIC OVERVIEW 48

5 LITIGATION DISCLOSURE 48

T-O-II TABLE OF CONTENTS 48

TN TECHNICAL APPLICATION NARRATIVE 49

T-N-I HIV CARE CONTINUUM 49

T-N-II AGENCY OVERVIEW 50

T-N-III DESCRIPTION OF ACTIVITIES 50

T-N-IV WORK PLAN 51

T-N-V CULTURAL COMPETENCE/HUMILITY 52

T-N-VI REGULATORY PROCEDURES 53

T-N-VII CLIENT ELIGIBILITY 54

5.0 COST PROPOSAL 55

5.1 COST NARRATIVE 55

CN COST PROPOSAL GUIDELINES 55

C-N-I FINANCIAL MANAGEMENT AND FISCAL PROCEDURES 55

C-N-II PAYER OF LAST RESORT/THIRD PARTY PAYERS 56

C-N-III COLLECTION OF FEES 57

5.2 C-BR BUDGET REQUEST GUIDANCE 57

C-BR

OVERVIEW 57

GUIDELINES FOR DETERMINING TYPES OF COSTS 58

PRINCIPLES FOR THE PROPER ALLOCATION OF ADMINISTRATIVE VS. PROGRAM

COSTS, AND UNALLOWABLE COSTS

BUDGET CATEGORIES 60

C-BR- BUDGET REQUEST AND BUDGET TABLES 63

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 5

EtHE FY21 BUDGET REQUEST C-BR FY21 BUDGET REQUEST.XLS 63

5.3 C-J COST JUSTIFICATION GUIDANCE 67

C-J COST JUSTIFICATION TABLES AND NARRATIVE 67

6.0 EVALUATION PROCESS 69

6.1 EVALUATION COMMITTEE 69

6.2 EVALUATION & SELECTION PROCESS 69

6.3 RESPONSIVENESS REVIEW 69

6.4 EVALUATION SELECTION CRITERIA 69

6.4.1 TECHNICAL PROPOSAL SCORING RUBRIC 70

6.4.2 COST PROPOSAL SCORING RUBRIC 73

6.4.3 EXHIBIT SCORING RUBRIC 74

6.5 AWARD SELECTION 74

6.6 NOTIFICATION OF SELECTION 74

7.0 CONTRACT COMPLIANCE REQUIREMENTS 75

7.1 NON-DISCRIMINATION IN PURCHASING AND CONTRACTING 75

8.0 INSURANCE AND RISK MANAGEMENT PROVISIONS 75

8.1 INSURANCE 75

8.2 PROTECTION OF PROPERTY 77

8.3 INDEMNIFICATION AND HOLD HARMLESS PROVISIONS 78

9.0 CONTRACT INFORMATION AND SAMPLE CONTRACT 78

9.1 FULTON COUNTY CONTRACTUAL REQUIREMENTS - BACKGROUND 78

9.2 CONTRACT TERMS AND CONDITIONS 78

9.3 CONTRACT TERMS AND CONDITIONS – NO MATERIAL CHANGES 79

9.3.1 INDEMNIFICATION AND INSURANCE 79

9.3.2 LIMITATION OF LIABILITY 79

9.3.3 WAIVERS OF JURISDICTION AND VENUE 79

9.3.4 ALTERNATIVE DISPUTE RESOLUTION/MEDIATION 79

9.3.5 CONFIDENTIALITY 80

9.4 EXCEPTIONS TO THE COUNTY’S CONTRACT 80

9.5 SAMPLE CONTRACT 80

10.0 APPENDICES TO REVIEW ON BIDNETDIRECT.COM 80

APPENDIX I: PRIORITY SERVICE DEFINITIONS

APPENDIX II: SF-424B NON-CONSTRUCTION PROGRAMS

APPENDIX III: PHS 5161-1 FEDERAL ASSURANCES

APPENDIX IV: EMPLOYMENT REPORT

APPENDIX V: OAHS EXPECTATIONS

APPENDIX VI: SAMPLE CONTRACT

APPENDIX VII: LEGISLATIVE MANDATES

11.0 ELECTRONIC FORMS TO DOWNLOAD FROM BIDNETDIRECT.COM

AND COMPLETE

T-N TECHNICAL PROPOSAL NARRATIVE TEMPLATE

80 C-N COST PROPOSAL NARRATIVE TEMPLATE

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 6

C-BR ETHE BUDGET REQUEST

12.0 EXHIBITS TO DOWNLOAD FROM BIDNETDIRECT.COM AND

COMPLETE

Exhibit 1 REQUIRED SUBMITTAL CHECKLIST

Exhibit 2 CERTIFICATE OF ACCEPTANCE OF REQUEST FOR PROPOSAL REQUIREMENTS

Exhibit 3 ACKNOWLEDGEMENT OF ADDENDA

Exhibit 4 CERTIFICATION REGARDING DEBARMENT

Exhibit 5 PROMISE OF NON-DISCRIMINATION

Exhibit 6 EVIDENCE OF TAX EXEMPT STATUS

Exhibit 7 BOARD OF DIRECTORS

Exhibit 8 LITIGATION DISCLOSURE

Exhibit 9 INDIRECT COST RATE LETTER

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 7

1.0 INTRODUCTION

1.1 PROJECT DESCRIPTION

Fulton County, Georgia (“County”) is seeking proposals from qualified entities providing HIV services in Cobb, DeKalb, Fulton, or Gwinnett Counties to provide HIV services for Persons Living with HIV (PLWH) in these targeted jurisdictions.

Through the issuance of this Request for Proposals (“RFP”), the County is soliciting proposals from qualified Proposers/Offerors for the Ending the HIV Epidemic: A Plan for America (EtHE) – Ryan White HIV/AIDS Programs (RWHAP) Parts A & B (CFDA 93.686) – the purpose of which is to implement strategies, interventions, approaches, and core medical and support services to reduce new HIV infections in the United States. The overarching goal for this initiative is to reduce new HIV infections in the United States to less than 3,000 per year by 2030.

https://www.hhs.gov/blog/2019/02/05/ending-the-hiv-epidemic-a-plan-for-america.html

In working towards this goal, our department is focused on care and treatment services for people living with HIV, to help them reach and maintain viral suppression. By increasing the number of clients that maintain viral suppression, we can contain the spread of the virus and in turn, reduce the number of new HIV cases. In our targeted jurisdictions, most new HIV cases are among the African American population. If we are going to change the course of the HIV epidemic, we must rethink the ways our systems seek to serve Black Americans. We must find ways to adapt our systems to address HIV-related stigma, social/structural influencers of health, and barriers in order to make services available for all, and not just some. This will require disruptive innovation of the care system to change the way in which we respond to service needs.

Funding is not limited to entities currently funded via RWHAP Part A. Any organization that meets the eligibility criteria, as detailed in this RFP, may apply for these funds.

Funds will be awarded to organizations that have demonstrated success in improving the health outcomes of clients. It is expected that funds will contribute to the replication or expansion of an existing program or HIV services.

To be eligible to apply, an organization must:

1. Operate a physical site and/or deliver services with no physical site in at least one of the following EtHE jurisdictions: Cobb, DeKalb, Fulton, or Gwinnett Counties.

2. Be governed by a Board of Directors.

3. Be a community-based organization, community health center, Federally Qualified Health

Center, hospital, health department, mental health center, substance abuse treatment center, university, migrant health center, faith-based organization, housing provider, tribal government, nonprofit organization or private for-profit organization.1 Complete EXHIBIT 6:

EVIDENCE OF TAX EXEMPT STATUS

4. Have a functioning accounting system that is operated in accordance with generally accepted

1 Private for-profit entities may apply for these funds if they can adequately demonstrate that they are the only provider of quality HIV services for a specific category in the geographic area they intend to serve.

https://www.hhs.gov/blog/2019/02/05/ending-the-hiv-epidemic-a-plan-for-america.html

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 8 accounting principles or an agreement with a designated eligible entity that maintains such information and acts as the respondent’s fiscal agent.

5. Be Medicaid-certified if providing services that are Medicaid-eligible.

6. Have all required licenses and certifications required by appropriate government agencies to perform the proposed services and procure all permits and pay all charges, taxes and fees.

Proposals provided in response to this RFP that comply with the submittal requirements set forth in Sections 4.0 and 5.0, including all forms and certifications, will be evaluated in accordance with the criteria and procedures described in Section 6.0. Based on the results of the evaluation, the County will award the EtHE funds to the most advantageous Proposers based on the cost and the evaluation factors set forth in the RFP. The County reserves the right to award any service in whole or in part, if proposals suggest that doing so would benefit the County.

1.2 SERVICE CATEGORIES ELIGIBLE FOR FUNDING:

Funding will be awarded for the following purposes:

Provide access to HIV care for priority populations including African Americans (Black Men and Women), Black Men who have Sex with Men (BMSM)/ Same Gender Loving Men (SGL), Hispanics/Latinx, Transgender Persons, and Young Adults 18-44.

Increase capacity for established programs with demonstrated outcomes to further the reach of their work in the community or to expand their services to a larger population.

Increase the number of clients able to reach and maintain viral suppression.

Implement innovative projects to address HIV-related stigma, social/structural influencers of health, gaps in the health care delivery system and barriers in order to make services available for all.

Annual funding estimates are not included – applicants should request such sums as necessary to perform the activities described in this application to serve the number of clients proposed in this application.

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 9

Funding Cycle Project Period One Year July 1, 2021 – February 28, 2022

Multi-Year July 1, 2021 – February 28, 2025

For each category, applicants may choose to apply for either one year or multi-year funding. The selected funding cycle should be specified in the narrative and budget justification.

Agencies are encouraged to request funds for multiple service categories and to demonstrate a coordinated continuum of core medical and support services that meet the needs of the clients served.

All services must be consistent with Public Health Service (PHS) Treatment Guidelines and all other applicable professional regulations and licensure requirements. For the PHS treatment guidelines see: https://aidsinfo.nih.gov/guidelines. Definitions of the RWHAP service activities within each category and subcategory that are eligible for funding may be found in APPENDIX I:

PRIORITY SERVICE DEFINITIONS.

The following priorities represent categories eligible for funding under this RFP: Arts, Media, Culture; Capacity Building; Effective Behavioral Interventions; Innovative Project Support; Non- Traditional Hours; Non-Traditional Services; Telehealth Services, Telecare Tablets.

Examples provided for each category are not exhaustive. Applicants with unique programs are encouraged to apply under the innovative project support category.

Arts, Media, Culture

This category will focus on projects that blend visual art, media and marketing with messages of empowerment and advocacy, which seek to influence social norms.

Examples of projects that could be funded in this category include but are not limited to:

Media campaigns which seek to challenge social norms or engage/re-engage clients that have been lost to care.

Marketing campaigns which increase awareness of HIV services provided in jurisdiction.

Arts-based approaches that promote engagement in HIV care and treatment, including o Artivism campaigns o Theatre-based approaches o Storytelling

ARTS, MEDIA, CULTURE

Arts, Media, Culture (AMC) – EtHE Initiatives https://aidsinfo.nih.gov/guidelines

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 10

Capacity Building

Capacity building encompasses quality, effectiveness, efficiency, patient-centeredness, safety, accessibility, equity, and sustainability of all HIV clinical services and related non-clinical support. In order to improve health outcomes for PLWH we must have sustainable programs and health systems. This category will support capacity building efforts of emerging programs, sustainability for developed programs and provide funding for organizations that wish to provide community mini-grants for HIV services.

Grant sponsorship - applicant is requesting funds to subaward to other agencies

Emerging Programs - newly formed organizations with a 501 (c) 3 status less than three-years old are eligible to apply for up to $75,000 for their first year funding request. The age of the organization is determined by the effective date for the 501 (c) 3 as designated by the IRS and identified on the Letter of Designation.

Program sustainability

Program expansion to better service women, heterosexual males, families, and persons of transgender experience

Hiring of case managers to support clients that are newly linked to care or returning to care.

CAPACITY BUILDING

CORE SERVICES

Health Insurance Premium and Cost-sharing Assistance (HIPCA) EtHE

Medical Nutrition Therapy (MNT) EtHE

Medical Case Management (MCM) EtHE

Mental Health Services (MH) EtHE

Oral Health Services (OH) EtHE

Outpatient/Ambulatory Health Services (OAHS) EtHE

Substance Abuse Treatment Services – Outpatient (SA-O) EtHE

SUPPORT SERVICES

Child Care Services (CCS) EtHE

Emergency Financial Assistance- Housing (EFA-H) EtHE

Food Bank/Home-Delivered Meals – Food Vouchers EtHE

Housing- Rental Assistance (RA) EtHE

Linguistics Services (LING) EtHE

Medical Transportation (TRANSP) EtHE

Non-Medical Case Management (N-MCM) EtHE

Other Professional Services (OPS) – Legal EtHE

Psychosocial Support (PS) EtHE

Referral for Health Care and Support Services (REF) EtHE

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 11

Effective Behavioral Interventions

Behavioral interventions are interventions designed to affect the actions that individuals take with regard to their health. Behavioral interventions can be implemented on three levels- the individual level, community level and systems level. Individual level interventions aim to change knowledge, attitudes, beliefs, practices, and behaviors of individuals. Community level interventions seek to change community norms, community attitudes, community awareness, community practices, and community behaviors. System level interventions changes organizations, policies, laws, and power structures. The focus is not directly on individuals and communities but on the systems that impact health. Effective behavioral interventions use a continuum of integrated policies, strategies, activities, and services whose effectiveness has been proven or informed by research and evaluation.

Examples of projects that could be funded in this category include but are not limited to:

Replication of evidence informed interventions o Compendium of Evidence-based Interventions and Best Practices for HIV Prevention.

Applicants should identify an intervention from one of the compendium chapters:

Structural Interventions; Linkage to, Retention in, and Re-Engagement in HIV Care (LRC); Medication Adherence; or Risk Reduction:

https://www.cdc.gov/hiv/research/interventionresearch/compendium/index.html o Care and Treatment Interventions: https://targethiv.org/deii/deii-resources o Special Projects of National Significance (SPNS): https://targethiv.org/library/hiv-care-innovations-replication-resources

EFFECTIVE BEHAVIORAL INTERVENTIONS (EBI)

EBI – Linkage to HIV Care

EBI – Retention in HIV Care

EBI – Re-Engagement in HIV

EBI – Medication Adherence

EBI – Risk Reduction

EBI – People in care, but not Virally Suppressed

Innovative Project Support

Projects that focus on care and treatment services for people living with HIV, to help them reach and maintain viral suppression. Projects which utilize novel approaches to transform the current system of care.

Examples of projects that could be funded in this category include but are not limited to:

Community Summit

Viral Suppression Awards/Incentives

Emergency Room Patient Navigation

Black Barbershop Physician Network https://www.cdc.gov/hiv/research/interventionresearch/compendium/index.html https://targethiv.org/deii/deii-resources https://targethiv.org/library/hiv-care-innovations-replication-resources https://targethiv.org/library/hiv-care-innovations-replication-resources

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 12

Faith-Based Projects

Emergency Access to Medications for Individuals with Expired Prescriptions

INNOVATIVE PROJECT SUPPORT (IPS)

IPS – Linkage to HIV Care

IPS – Retention in HIV Care

IPS – Re-Engagement in HIV

IPS – Medication Adherence

IPS – Risk Reduction

IPS – People in care, but not Virally Suppressed

Non-Traditional Hours

It is expected that funded entities will provide a reasonable level of services in early morning, evening, and weekend hours to facilitate access by PLWH. Services must be available in early morning (before 8:00 am) and/or evening (until at least 8:00 pm) two nights per week and at least one-half day every other weekend.

Core medical and support service delivery to clients that are HIV positive

NON-TRADITIONAL HOURS (NTH)

CORE MEDICAL SERVICES

NTH - Health Insurance Premium and Cost-sharing Assistance (HIPCA) EtHE

NTH - Medical Nutrition Therapy (MNT) EtHE

NTH - Medical Case Management (MCM) EtHE

NTH - Mental Health Services (MH) EtHE

NTH - Oral Health Services (OH) EtHE

NTH - Outpatient/Ambulatory Health Services (OAHS) EtHE

NTH - Substance Abuse Treatment Services – Outpatient (SA-O) EtHE

SUPPORT SERVICES

NTH - Child Care Services (CCS) EtHE

NTH - Emergency Financial Assistance- Housing (EFA-H) EtHE

NTH - Food Bank/Home-Delivered Meals – Food Vouchers EtHE

NTH - Housing- Rental Assistance (RA) EtHE

NTH - Linguistics Services (LING) EtHE

NTH - Medical Transportation (TRANSP) EtHE

NTH - Non-Medical Case Management (N-MCM) EtHE

NTH - Other Professional Services (OPS) – Legal EtHE

NTH - Psychosocial Support (PS) EtHE

NTH - Referral for Health Care and Support Services (REF) EtHE

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 13

Non-Traditional Services

Provides a means for clients to access HIV services outside of the traditional clinical setting. Non-traditional services are client centered and focus on meeting clients where they are. Services provided in this category should center on the convenience of care for clients.

Examples of projects that could be funded in this category include but are not limited to:

Mobile Units

Drop-in / Walk-in Services

Home Health Delivery

Multi-Month ART Dispensing

ART starter packs for new clients; ART gap packs for existing clients

Online Support Group

NON-TRADITIONAL SERVICES (NTS)

NTS - Health Insurance Premium and Cost-sharing Assistance (HIPCA) EtHE

NTS - Medical Nutrition Therapy (MNT) EtHE

NTS - Medical Case Management (MCM) EtHE

NTS - Mental Health Services (MH) EtHE

NTS - Oral Health Services (OH) EtHE

NTS - Outpatient/Ambulatory Health Services (OAHS) EtHE

NTS - Substance Abuse Treatment Services – Outpatient (SA-O) EtHE

SUPPORT SERVICES

NTS - Child Care Services (CCS) EtHE

NTS - Emergency Financial Assistance- Housing (EFA-H) EtHE

NTS - Food Bank/Home-Delivered Meals – Food Vouchers EtHE

NTS - Housing- Rental Assistance (RA) EtHE

NTS - Linguistics Services (LING) EtHE

NTS - Medical Transportation (TRANSP) EtHE

NTS - Non-Medical Case Management (N-MCM) EtHE

NTS - Other Professional Services (OPS) – Legal EtHE

NTS - Psychosocial Support (PS) EtHE

NTS - Referral for Health Care and Support Services (REF) EtHE

Telehealth Services, Telecare Tablets

Telehealth refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance. Telecare refers to the idea of enabling people to remain independent in their own homes by providing person-centered technologies to support the individual or their caregivers. Mobile health intervention greatly improves retention in care

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 14 benchmarks and viral load suppression rates in PLWH. Telecare is a proven strategy to improve health outcomes, but it is only effective if it is accessible.

Telecare Tablets are available to provide access to 8-inch tablets with an unlimited data connection for clients. Each device ships with a secured environment and limited functionality customized by the service provider to include the tools that clients need to access care. The platform supports client-by-client interface customizations, so each client’s experience is tailored to their unique treatment plan. The vendor provides device insurance and same-day replacement built into the program to account for loss, theft, and damaged devices, so organizations will always have access to the inventory they need to serve their clients.

The following amounts should be considered when requesting funds for Telecare Tablets:

Initial Cost/Unit: $944.00 Redistribution Cost/Unit for lost or stolen tablets: $136.00 Recurring Annual Cost/Unit: $524.00

Examples of projects that could be funded in this category include but are not limited to:

Telehealth equipment, licensing, supplies

Telecare Tablets

Medical Case Management (MCM) EtHE – Tablets

Medical Case Management (MCM) EtHE – Telehealth

Medical Nutrition Therapy (MNT) EtHE – Tablets

Medical Nutrition Therapy (MNT) EtHE – Telehealth

Mental Health Services (MH) EtHE – Tablets

Mental Health Services (MH) EtHE – Telehealth

Oral Health Services (OH) EtHE – Tablets

Oral Health Services (OH) EtHE – Telehealth

Outpatient/Ambulatory Health Services (OAHS) EtHE – Tablets

Outpatient/Ambulatory Health Services (OAHS) EtHE – Telehealth

Substance Abuse Treatment Services – Outpatient (SA-O) EtHE – Tablets

Substance Abuse Treatment Services – Outpatient (SA-O) EtHE – Telehealth

SUPPORT SERVICES

Linguistics Services (LING) EtHE – Tablets

Linguistics Services (LING) EtHE – Telehealth

Non-Medical Case Management (N-MCM) EtHE – Tablets

Non-Medical Case Management (N-MCM) EtHE – Telehealth

Other Professional Services (OPS) – Legal EtHE – Tablets

Other Professional Services (OPS) – Legal EtHE – Telehealth

Psychosocial Support (PS) EtHE – Tablets

Psychosocial Support (PS) EtHE – Telehealth

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 15

Referral for Health Care and Support Services (REF) EtHE – Tablets

Referral for Health Care and Support Services (REF) EtHE – Telehealth

1.3 METHOD OF SOURCE SELECTION

This procurement is being conducted in accordance with all applicable provisions of the Fulton County Code of Ordinances and the specific method of source selection for the services required in this Proposal is Code Section 102-375, Competitive Selection Procedures for Professional and Consultant Services.

1.4 BACKGROUND

1.4.1 ENDING THE HIV EPIDEMIC: A PLAN FOR AMERICA

The Ending the HIV Epidemic: A Plan for America (hereafter referred to as “EtHE” or “initiative”) has four pillars, or key strategies:

The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC), along with the National Institutes of Health (NIH) Centers for AIDS Research (CFARs), the Indian Health Service (IHS), and the Substance Abuse and Mental Health Services Administration (SAMHSA) are collaborating on the implementation of each of these Pillars. At the most general level:

Pillar One is led by CDC and, among many activities, includes working with the HRSA Health

Center Program to increase testing among Health Center Program patients;

Pillar Two is led by HRSA and focuses on providing access to HIV care and treatment through the RWHAP and the Health Center Program, including working with CDC funded organizations and/or CDC staff to link people with HIV, newly diagnosed or re-identified through testing programs, to care;

Pillar Three is co-led by CDC and HRSA with the HRSA Health Center Program focusing on providing Pre-Exposure Prophylaxis (PrEP) related outreach, care coordination, medical services and medications supported by CDC efforts to promote PrEP among populations needing PrEP services as well as other prevention activities, such as syringe services programs (SSPs); and, Pillar Four is led by CDC to rapidly detect HIV clusters and networks with support from the HRSA RWHAP and Health Center Program to provide HIV care and treatment or PrEP services through the Health Center Program, as applicable.

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 16

The HRSA HIV/AIDS Bureaus (HAB) initiative is authorized under Section 311(c) of the Public Health Service Act, (42 U.S.C. § 243(c)) and title XXVI, (42 U.S.C. § 300ff-11 et seq.), with the funding to be used in conjunction with the Ryan White HIV/AIDS Program (RWHAP).

Fulton County is issuing this competitive Request for Proposal to fund EtHE programs in the four target jurisdictions Cobb, DeKalb, Fulton, and Gwinnett Counties that demonstrate proficiency working with PLWH to achieve positive health outcomes ultimately leading to viral suppression.

As part of this RFP process, Fulton County will fund culturally-appropriate programs offering an array of Ryan White HIV/AIDS Program (RWHAP) eligible core medical and support services that directly address the needs of PLWH in the target area. These programs will exist within a continuum of care network that provides services in a consistent, cost-effective manner;

coordinates effectively with other service providers; and minimizes duplication of effort.

Funded programs must augment and interact with the RWHAP Part A Continuum of CARE in place to serve eligible low-income PLWH in the 20-county Atlanta Eligible Metropolitan Area (EMA).2

Funding under this announcement is through the Ending the HIV Epidemic: A Plan for America— RWHAP Parts A and B Grant administered and provided by the United States Department of Health and Human Services, HRSA, HAB, Division of Metropolitan HIV/AIDS Programs.

Funds under this RFP are designed to support activities that will support Pillar Two (Treat people with HIV rapidly and effectively to reach sustained viral suppression) including:

Expanding access to HIV care and treatment in the focus jurisdictions for people with HIV, both those who are newly diagnosed and those who are not engaged in care, and/or not virally suppressed; and

Addressing unmet needs and improving client-level health outcomes

This project is 100% supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). The actual amount available will not be determined until enactment of the Final FY2021 Federal budget. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.”

This program announcement is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, applications can be processed and funds can be awarded in a timely manner.

The amount awarded to each successful applicant will be based on the merits of the proposal.

2 The Atlanta EMA service area includes the following counties: Barrow, Bartow, Carroll, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding, Pickens, Rockdale, Spalding, and Walton.

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 17

Proposals will be evaluated according to the evaluation criteria outlined in this RFP. Ranked proposals will typically be funded in order; however, proposals may be funded outside of rank order to ensure geographic coverage.

Allocation of funds will be made in a fair and equitable manner that does not discriminate on the basis of race, ethnicity, color, creed, national origin, gender, sexual orientation, or religion of clientele served by an agency, community-based organization or institution requesting funds.

Ryan White Part A funds provide direct financial assistance to EMAs that have been the most severely affected by the HIV epidemic to assist in developing or enhancing access to a comprehensive continuum of high quality, community-based care for low-income individuals and families with HIV disease. As defined by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB), a comprehensive continuum of care consists of core medical services including: 1) Outpatient/Ambulatory Health Services (primary care); 2) Medical Case Management; 3) Medical Nutrition Therapy; 4) Mental Health Services; 5) Oral Health Services;

6) Substance Abuse Services – Outpatient; 7) Early Intervention Services; and, 8) Health Insurance Premium and Cost Sharing Assistance for Low-Income Individuals. Such care must include access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections as well as combination antiretroviral therapies. Comprehensive HIV/AIDS care beyond core medical services must include only those essential support services that enable individuals to access and remain in primary medical care and improve their medical outcomes. Support services include 1) Non-Medical Case Management; 2) Child care; 3) Food Bank/Home Delivered Meals; 4) Referral for Health Care and Support Services; 5) Other Professional Services; 6) Linguistics Services; 7) Medical Transportation; 8) Psychosocial Support; 9) Housing; 10) Outreach; and, Substance Abuse – Residential.

1.4.2 HIV Care Continuum

Identifying people living with HIV and linking them to HIV primary care with initiation and long-term maintenance of life-saving antiretroviral treatment (ART) are important public health steps toward the elimination of HIV in the United States. The continuum of interventions that begins with outreach and testing and concludes with HIV viral load suppression is generally referred to as the HIV Care Continuum. Ryan White funds are intended to address gaps in the HIV care system. The HIV Care Continuum can be used to highlight unmet needs of PLWHA in the EMA. In the HIV Care Continuum, population needs are categorized across demographic groups based on health outcomes as follows: 1) Individuals living with HIV who are diagnosed; 2) Individuals not linked to HIV care; 3) Individuals not currently engaged in HIV care; 4) Individuals that never started on antiretroviral medications (ARVs); and 5) Individuals who are not currently virally suppressed.

The main stages of the HIV Care Continuum are:

1. Diagnosed - Number and percentage of people in the EMA living with HIV.

2. Linked to Care - Number and percentage of people living with HIV in the EMA connected to an HIV healthcare provider.

3. Engaged and Retained in Care - Number and percentage of people living with HIV in the EMA, 21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 18 receiving regular HIV medical care.

4. Prescribed Antiretroviral Therapy (ART) - Number and percentage of people living with HIV in the EMA, prescribed a combination of three or more antiretroviral drugs from at least two different HIV drug classes every day to control the virus.

5. Virally Suppressed - Number and percentage of people living with HIV in the EMA with a viral load below 200.

The difficult challenge of executing these lifesaving steps is demonstrated by data from the CDC, which estimate that only 30 percent of individuals living with HIV in the United States have complete HIV viral suppression. Data from the Ryan White Service Report (RSR) indicate that there are better outcomes in Ryan White HIV/AIDS Program (RWHAP) funded agencies with approximately 79% of individuals who received RHWAP-funded medical care being virally suppressed. Such findings underscore the importance of supporting effective interventions for linking PLWH into care, retaining them in care, and helping them adhere to their combination antiretroviral regimens.

The National HIV/AIDS Strategy (NHAS) 2020 states that efforts must be directed towards improving outcomes at every step of the HIV Care Continuum, from testing to diagnosis, linkage and engagement in care, treatment, and ultimately, viral suppression. Key to this effort will be the identification and re-engagement of people who have been lost to care. Further, the NHAS recognizes the importance of developing models of competent care to getting people with HIV into care early after exposure, optimizing the continuum of care and making access to lifesaving antiretroviral therapy a right, eliminating stigma and discrimination to diminish barriers to HIV prevention, testing and care.

In this RFP, greater emphasis has been placed on the HIV Care Continuum. Applicants must also describe how they ensure that the services they provide are aligned with the NHAS.

The HIV/AIDS Bureau (HAB) has worked with other agencies within the Department of Health and Human Services (HHS) to develop performance measures to assist in assessing outcomes along the continuum. HAB encourages recipients to use these performance measures at their local level to assess the efficacy of their programs and to analyze and address the gaps along the HIV Care Continuum to improve the care outcomes provided. These efforts are in alignment with the support and goals and objectives of the National HIV/AIDS Strategy.

The HIV Care Continuum measures also align with the HHS Common HIV Core Indicators approved by the before Secretary and announced in August 2012. RWHAP grantees and providers are required to submit data through the Ryan White Services Report (RSR). Through the RSR submission, HAB currently collects the data elements to produce the HHS Common HIV Core Indicators. HAB will calculate the HHS Core Indicators for the entire RWHAP. HAB will use these data to report six of the seven HHS Common HIV Core Indicators to the Department of Health and Human Services, Office of the Secretary for Health.

The Executive Order on the HIV Care Continuum Initiative that was released on July 15, 2013, is http://hab.hrsa.gov/data/reports/continuumofcare/viralloadsuppression.html http://blog.aids.gov/2012/08/secretary-sebelius-approves-indicators-for-monitoring-hhs-funded-hiv-services.html http://blog.aids.gov/2012/08/secretary-sebelius-approves-indicators-for-monitoring-hhs-funded-hiv-services.html http://blog.aids.gov/2012/08/secretary-sebelius-approves-indicators-for-monitoring-hhs-funded-hiv-services.html http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 19 available at http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order-hiv-care-continuum-initiative.

1.4.3 Goals and Objectives

This funding opportunity strives to create a network of services and service providers by enhancing activities and services through collaborations and models of HIV care designed to provide access to life-saving high quality HIV ambulatory outpatient care and treatment. Support services must be designed to address needs and reduce and eliminate barriers to ambulatory outpatient health services. This can only be accomplished by working to ensure clients access and remain in medical care with appropriate medication therapies in accordance with HIV treatment guidelines. Therefore, the overall goals of are to:

1. Provide access to core medical and support services for those who are aware of their HIV status as they are guided through all five stages of the HIV Care Continuum with an emphasis in achieving viral load suppression in individuals with HIV and to improve the community viral load for the Atlanta EMA. Services will be designed for PLWH who have never entered care, PLWH who have left care, and PLWH who are in care, but not virally suppressed.

2. Collaborate with HIV counseling and testing programs to ensure those who are newly aware of their HIV status (previously unaware) are not lost to care or late to care.

3. Reduce and eliminate barriers to medical care through the provision of support services that are culturally and linguistically appropriate.

4. Improve the health outcomes of minority populations disproportionately impacted by HIV in the targeted jurisdictions.

5. Deliver high quality HIV services that meet or exceed national and professionally accepted guidelines and standards.

Funded recipients will use these initiative resources in conjunction with the RWHAP Parts A and B systems of HIV care and treatment to develop, implement, and/or enhance innovative approaches to engaging people with HIV who are newly diagnosed, not in care, and/or not virally suppressed. In addition, the recipients will provide rapid access to a comprehensive continuum of high quality care and treatment services.

There are several guiding tenets that apply to this funding opportunity:

All services, policies, and programs should be client-centered.

All programs must be built upon a foundation of cultural humility. There must be universal understanding of how we define cultural humility and a standard approach to on-going staff training.

All programs must recognize the impact implicit bias has on the ability to effectively serve diverse populations. There should be a mindfulness of understanding both conscious and subconscious bias. To counter this effect, organizations must institute clear procedures for decision-making and encourage all employees and volunteers to be mindful of the presence of implicit bias and how to avoid acting on these biases.

http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order-hiv-care-continuum-initiative http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order-hiv-care-continuum-initiative http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order-hiv-care-continuum-initiative http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order-hiv-care-continuum-initiative

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 20

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes trauma as events or circumstances experienced by an individual as physically or emotionally harmful or life-threatening, which result in adverse effects on the individual’s functioning and mental, physical, social, emotional, and spiritual well-being. Persons we seek to serve are more likely than not to have experienced trauma. In recognition of this, our care systems must acknowledge the role trauma may have played in a person’s life and change the organizational structure to emphasize appropriately responding to the effects of trauma. We must be cognizant that trauma comes in a variety of forms including: physical, sexual and emotional abuse, stigma, acute stress, etc.

The language we use has the ability to empower individuals and communities or to cause further stigmatization; therefore, we support the use of People First Language. People First

Language honors the individuality, equality and dignity of people by placing a places a person before a diagnosis – describing what a person “has” rather than asserting what a person “is”.

1.5 OBTAINING THE RFP

This document and supporting documents can be accessed at https://www.bidnetdirect.com/georgia/fultoncounty.

1.6 PRE-PROPOSAL CONFERENCE

The County will hold a Pre-Proposal Conference via Zoom on Thursday, August 29, 2021 @ 10:00

AM (ET).

Join Zoom Meeting https://zoom.us/j/95839608673

Meeting ID: 958 3960 8673 One tap mobile +16465588656,,95839608673# US (New York) +13017158592,,95839608673# US (Washington DC)

Dial by your location +1 646 558 8656 US (New York) +1 301 715 8592 US (Washington DC) +1 312 626 6799 US (Chicago) +1 669 900 9128 US (San Jose) +1 253 215 8782 US (Tacoma) +1 346 248 7799 US (Houston) Meeting ID: 958 3960 8673 Find your local number: https://zoom.us/u/acn9efSGme Join by SIP 95839608673@zoomcrc.com

Join by H.323

162.255.37.11 (US West) https://zoom.us/j/95839608673

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 21

162.255.36.11 (US East)

115.114.131.7 (India Mumbai)

115.114.115.7 (India Hyderabad)

213.19.144.110 (Amsterdam Netherlands)

213.244.140.110 (Germany)

103.122.166.55 (Australia Sydney) The session will be recorded and posted on the Ryan White website: www.ryanwhiteatl.org

Attendance at the Pre-Proposal Conference is voluntary for responding to this RFP, however Proposers are encouraged to attend. The purpose of the Pre-Proposal Conference is to provide information regarding the project and to address any questions and concerns regarding the services sought by the County through this RFP.

Fulton County does not discriminate on the basis of disability in the admission or access to its programs or activities. Any requests for reasonable accommodations required by individuals to fully participate in any open meeting, program or activity of Fulton County Government should be directed to Mario Avery, Contract Compliance Administrator at (404) 612-6307 or email:

mario.avery@fultoncountyga.gov.

1.7 PROPOSAL DUE DATE AND TIME

All Electronic Bid Submissions are due on or before Thursday, August 19, 2021 at 11:00 A.M., legal prevailing time. The Proposal due date can be changed only by addendum from the County.

1.8 SUBMITTAL REQUIREMENTS

It shall be the sole responsibility of the Proposer/Offeror to have his/her Proposal electronically submitted in bidnetdirect.com on or before the above stipulated due date and time.

1.9 CONTACT PERSON AND INQUIRIES

Any questions or suggestions regarding this RFP shall be submitted in writing to the Purchasing Department contact person: Elsa D. Castro, CPPB, CPM, Chief Assistant Purchasing Agent, Elsa,Castro@FultonCountyGa.gov, 404-612-4216. Any response made by the County shall be provided in writing to all Proposers/Offerors by addendum. No verbal responses shall be authoritative.

1.10 PROCUREMENT SCHEDULE

The following is the procurement schedule for this project and will be strictly adhered to.

EVENT DATE

RFP Issued Thursday, July 15, 2021

Pre-Proposal Conference Thursday, July 29, 2021

Deadline for Submission of Questions and Requests for Clarification by 2:00 PM.

Thursday, August 12, 2021

Proposal Due Date by 11:00 am ET Thursday, August 19, 2021

Tentative Dates for Oral Interviews/Presentations if Required

Thursday August 26, 2021 http://www.ryanwhiteatl.org/ mailto:mario.avery@fultoncountyga.gov mailto:mark.hawks@fultoncountyga.gov

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 22

2.0 INSTRUCTIONS TO PROPOSERS

2.1 PROCUREMENT PROCESS

The procurement will be on a formally advertised basis. All technical requirements, unless otherwise specified, must be met, or be capable of being met by the Proposer or their proposal will be disqualified as being non-responsive.

2.2 DEFINITIONS:

In addition to any other terms that may be defined in this solicitation, the following terms have the following meaning:

Acronym or Term Name or Definition Addendum Revision to the RFP documents issued by the County prior to the receipt of

Proposals.

Agreement Refers to the executed contract between the County and Contracting Entity.

AIDS Drug Assistance Program (ADAP)

State-administered program authorized under Part B of RWHAP that provides FDA-approved medications to low-income people with HIV/AIDS disease who have limited or no coverage from private insurance, Medicaid, or Medicare. Program funds may also be used to purchase health insurance for eligible clients and for services that enhance access to, adherence to, and monitoring of drug treatments.

Applicant Means the same as Proposer.

Award Financial assistance that provides support or stimulation to accomplish a public purpose. Awards include grants and other agreements (e.g., cooperative agreements) in the form of money, or property in lieu of money, by the government to an eligible applicant.

Business Associate Agreement

Is a person or entity, other than a member of the workforce of a covered entity, who performs functions or activities on behalf of, or provides certain services to, a covered entity that involve access by the business associate to protected health information. A “business associate” also is a subcontractor that creates, receives, maintains, or transmits protected health information on behalf of another business associate.

Budget Period or Budget Year

The duration of each individual funding period within the project period.

Charges The imposition of fees upon payers for the delivery of billable services.

Compliance Criteria Minimum standards or requirements that are dictated by the funding source or the recipient.

Confidential Information Information, such as name, gender, age, and HIV status, that is collected on the client and the unauthorized disclosure of which could cause the client unwelcome exposure, discrimination, and/or abuse.

Consumer/Client An individual with HIV/AIDS who receives at least one EtHE eligible service.

Contact Person Purchasing staff designated by the Fulton County Department of Purchasing and Contract Compliance to submit any questions and suggestions.

Core Medical Services A set of essential, direct health care services provided to people with HIV/AIDS and specified in the Ryan White HIV/AIDS Treatment Extension Act. Terms are defined in Sections 2604(c)(3) and 2604(d) of Title XXVI of the Public Health Service Act and the HIV/AIDS Bureau (HAB) Ryan White HIV/AIDS Program Annual Data Report.

Costs The accrued expenditures incurred by the recipient /sub-recipient during a given period requiring the provision of funds for: (1) goods and other tangible property received; (2) services performed by employees, contractors, sub-recipient, subcontractors, and other payees.

County Fulton County Government and its authorized representatives.

21RFPRW0708B-EC, Ending the HIV Epidemic Phase III 23

Culturally Appropriate Conforming to a culture's acceptable expressions and standards of behavior and thought. Interventions and educational materials are more likely to be culturally appropriate when representatives of the intended target audience are involved in planning, developing, and pilot testing them.

Data Universal Numbering System (DUNS)

A nine-digit number, issued by Dun & Bradstreet (D&B), assigned to each business location in the D&B database, having a unique, separate, and distinct operation for the purpose of identifying them. The DUNS number is random, and the digits have no apparent significance.

Eastern Standard Time

(ET)

(UTC- 05:00) Eastern Time (US & Canada).

Eligible Metropolitan Area

(EMA)

The geographic area eligible to receive Ryan White Program Part A funds. The Office of Management and Budget (OMB) define metropolitan areas based on Census Bureau data. AIDS cases reported to the CDC determines eligibility. Some EMA include just one city and others are composed of several cities and/or counties.

Ending the HIV Epidemic (EtHE)

The part of the Ending the HIV Epidemic: A Plan for America that provides direct financial assistance via HRSA to designated EMAs that have jurisdictions identified by HRSA as eligible for such funding.

Engaged in Care The number…