Ryan White HIV/AIDS ProgramPart C Capacity Development Program(HRSA-19-031)Pre-Application Technical Assistance Conference CallJanuary 24, 2019

Mahyar Mofidi, DMD, Ph.D.Director, Division of Community HIV/AIDS Programs (DCHAP)HIV/AIDS Bureau (HAB)Health Resources and Services Administration (HRSA)

Agenda

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• HAB Vision and Mission• Purpose of Funding Opportunity• Award Information • Eligibility Information• Application and Submission Information • Application Review Information • Application Submission Tips• Question and Answer

Acronyms

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• Application Guide – SF-424 Application Guide

• CQM – Clinical Quality Management• DUNS – Data Universal Numbering

System• EHB – Electronic Handbooks• EHR – Electronic Health Records• HRSA – Health Resources and

Services Administration• HAB – HIV/AIDS Bureau• GMS – Grants Management

Specialist

• MIS – Management Information System

• MOE – Maintenance of Efforts• NOFO – Notice of Funding

Opportunity (formerly FOA)• PLWH – People Living with HIV• PO – Project Officer • RWHAP – Ryan White HIV/AIDS

Program• SAM – System for Award

Management

HIV/AIDS Bureau Vision and Mission

VisionOptimal HIV/AIDS care and treatment for all

MissionProvide leadership and resources to assure access to and retention in high quality, integrated care,

and treatment services for vulnerable people living with HIV and their families

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Purpose

The purpose of this program is to strengthen organizational capacity to respond to the changing health care landscape and increase access to high quality HIV primary health care services for low income, uninsured, and underserved people living with HIV (PLWH).

Applicants may submit proposals for only one activity under one of the following two categories:

1) HIV Care Innovation

2) Infrastructure Development

Please refer to pages 1 to 2 of the NOFO

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Award Information

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• Approximately $4,000,000 is available to fund up to 26 recipients.

• HRSA will only fund one activity per recipient under one category: HIV Care Innovation or Infrastructure Development.

• Applicants may request funding amounts of up to $150,000 for the one year period of performance (9/1/19 - 8/31/20).

• HRSA will not fund the same activity in FY 2019 that was funded in FY 2018; however, an expansion of activities currently supported with RWHAP Part C Capacity Development or Part D Supplemental funding will be considered with a clear rationale for how the proposed activity builds upon and furthers the objectives of the previously funded activity.

Please refer to pages 5 to 6 of the NOFO

Eligibility Information

• Public and nonprofit private entities, faith-based and community-based organizations, and Tribes and tribal organizations are eligible to apply. Foreign entities are not eligible for this award.

• Cost sharing and matching is not required.• HRSA will consider any application that exceeds the ceiling

amount of $150,000 non-responsive and will not consider it for funding under this notice.

• Maintenance of Effort (MOE) information is required under the HIV Care Innovation category.

• NOTE: Multiple applications from an organization are not allowable.

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Please refer to pages 6 to 7 of the NOFO

Application and Submission Information

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Two Components of the NOFO:

1) RWHAP Part C Capacity Development Program NOFO HRSA-19-031 focuses on the program-specific content, including goals, expectations, and requirements of the program

2) HRSA’s General Instructions• SF 424 Application Guide (“Application

Guide”)• Links are found throughout the NOFO

Application Package

Applicants must include the following:• SF-424 Application for Federal Assistance• Project Abstract (uploaded in box 15 of the SF-424)• Project/Performance Site Location Form• Project Narrative (uploaded to the Project Narrative

Attachment Form)• SF-424A Budget• Budget Narrative (uploaded to the Budget Narrative

Attachment Form)• Attachments (Section IV 2. v. of NOFO)• Grants.gov Lobbying Form• SF-424B Assurances• Key Contacts

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Project Abstract

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• Indicate the project title as “FY 2019 RWHAP Part C Capacity Development Program” and include the following:

• Identification of the selected category (HIV Care Innovation or Infrastructure Development) and activity.

• A summary of the proposed activity and its intended impact.

• The funding amount requested for the one-year period of performance.

• Identification of the statutory preference requested, if applicable.

See page 8 in the NOFO and Section 4.1 in the SF424 Application Guide

Project Narrative

Sections:• Introduction• Needs Assessment• Methodology• Work Plan• Resolution of Challenges• Evaluation and Technical Support Capacity• Organizational Information

Please refer to pages 8 to 14 in the NOFO

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HIV Care Innovation: Choose Only One Activity

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HIV Care Innovation:• HIV Case Finding• Patient-Based Treatment Adherence• Motivational Interviewing• Chronic Disease Self-Management• Transitioning Youth into Adult HIV Care• Integration of HIV Primary Care with Oral Health

and/or Behavioral Health

Please refer to pages 10 and 11 in the NOFO

HIV Care Innovation: HIV Case Finding

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• Train designated staff:

• To implement specific HIV outreach and collaborative case finding and develop policies and procedures to link PLWH into care after testing to address one or more stages of the HIV care continuum.

• In HIV case finding techniques through local health departments and/or through Centers for Disease Control and Prevention (CDC)-funded training centers https://www.cdc.gov/learning/index.html

• Develop policies and procedures to apply these skills in the clinical setting to link PLWH into care after HIV testing to address one or more stages of the HIV care continuum.

Please refer to page 9 in the NOFO

HIV Care Innovation: Patient-Based Treatment Adherence

• Implement an innovative patient-based treatment adherence program supported by policies and procedures to provide long-term adherence support for chronically non-adherent patients, in particular patients with co-occurring mental health, substance use disorder, and opioid use disorder issues, to address one or more stages of the HIV care continuum.

• For resources addressing this topic, access the Knowledge Network (https://knowledge.samhsa.gov/) located on the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

Please refer to page 9 in the NOFO

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HIV Care Innovation: Motivational Interviewing

• Train staff to conduct motivational interviewing for PLWH who are also dealing with co-occurring mental health, substance use, and opioid use disorder issues.

• Applicants must train direct care staff on how to assess clients for mental health and substance abuse and for treatment readiness.

• Policies and procedures in the clinical setting must address one or more stages of the HIV care continuum.

• For resources addressing this topic, access the SAMHSA-HRSA Center for Integrated Health Solutions https://www.integration.samhsa.gov/clinical-practice/motivational-interviewing located on the SAMHSA website.

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Please refer to page 9 in the NOFO

HIV Care Innovation: Chronic Disease Self-Management

• Institute a clinic-wide chronic disease management program for HIV/AIDS based on the Stanford program or other resources for patient self-management (e.g., http://www.ahrq.gov/research/findings/final-reports/ptmgmt/index.html) to engage patients in long-term disease control to address one or more stages of the HIV care continuum.

• Develop policies and procedures to apply the program.

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Please refer to page 10 in the NOFO

HIV Care Innovation: Transitioning Youth into Adult HIV Care

• Implement transition planning activities that include, but are not limited to, written policies, procedures, and staff training to assist youth in transitioning from pediatric to adult HIV medical care.

• Transition planning is a RWHAP Part C requirement; therefore, this activity should focus on innovative approaches that build organizational capacity to effectively implement and manage the transition for the youth population (ages 13 - 24) and minimize negative impacts.

• The activity must address one or more of the stages of the HIV care continuum.

Please refer to page 10 in the NOFO

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HIV Care Innovation: Integration of HIV Primary Care with Oral Health and/or Behavioral Health

• Develop strategies, policies, and procedures to improve care coordination and integration of HIV primary care with oral health care and/or behavioral health services.

• Develop policies and procedures to facilitate onsite provision of oral health care and/or behavioral health services.

• Organize primary care and oral health and/or behavioral health teams and train staff to understand workflow and processes.

• Develop policies and procedures for coordinating and tracking referrals for oral health care and/or behavioral health.

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Please refer to page 10 in the NOFO

Infrastructure Development: Choose Only OneActivity

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Infrastructure Development:• Electronic Health Records (EHR)• Management Information System • Dental Equipment for Expanding Dental Service

Capacity• Emergency Preparedness

Please refer to pages 10 and 11 of the NOFO

Infrastructure Development: Electronic Health Records (EHR)

• Implement enhancements to or an expansion of existing EHRs to improve the quality, safety, and efficiency of patient health care.

• Describe the plan to enhance or expand the EHR and describe how this will expand the capacity of the organization to support increased quality of care for PLWH.

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Please refer to page 10 of the NOFO

Infrastructure Development: Management Information System (MIS)

• Identify, establish, and strengthen administrative, managerial, and MIS structures to offer, enhance, or expand comprehensive HIV primary health care.

• This activity may include enhancements to interface with existing EHRs specifically to improve data collection, reporting, and quality improvement activities.

• Describe how this activity will increase the capacity of the organization to respond to changes in the health care environment and support increased quality of care for PLWH.

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Please refer to page 11 of the NOFO

Infrastructure Development: Dental Equipment for Expanding Dental Service Capacity

• Purchase dental equipment for the purpose of developing, enhancing, or expanding oral health care services to people living with HIV.

• For Example: Creating or expanding an HIV dental operatory or clinic.

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Please refer to page 11 in the NOFO

Infrastructure Development: Emergency Preparedness

• The areas of focus for this activity are to address the development of organizational assessments of:

• vulnerability • creation of an emergency preparedness plan• staff training and evaluation through drills and exercises • identification and collaboration with local emergency

management planners

• The activity should result in the development of an implementation plan/toolkit and/or policies and procedures for effective preparation and response to natural disasters and public health emergencies resulting in minimal interruption to PLWH HIV care and treatment.

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Please refer to page 11 in the NOFO

Project Narrative: Introduction

• Clearly indicate the proposed activity. • Briefly describe the purpose of the proposed activity. • Clearly indicate the category under which the proposed

activity falls: 1) HIV Care Innovation or 2) Infrastructure Development.

• Discuss why your local community and/or organization is in need of capacity development funds.

• If the proposed activity is an expansion of a previously funded activity, clearly describe how the proposed activity builds upon and furthers the objectives of the previously funded activity in maximizing impact.

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Please refer to page 11 in the NOFO

Project Narrative: Needs Assessment

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Please refer to pages 11 to 12 in the NOFO

HIV Care Innovation Activities:• Clearly describe and document the target

population(s) and their unmet health care needs. • Describe the service needs based on your

evaluation of the gaps in the HIV care continuum for your target population(s) living with HIV your organization serves.

• Provide data on the five stages of the HIV care continuum for your target population(s) living with HIV using the most recent three calendar years of available data.

Project Narrative: Needs Assessment

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Please refer to pages 11 to 12 in the NOFO

Infrastructure Development Activities:• Clearly describe the gaps in organizational capacity that

exist due to current limitations in system infrastructure. • Provide information specific to the selected activity and

describe how these gaps or limitations are affecting the optimal provision of quality HIV primary care services and/or affecting your organization’s ability to optimize your response to the changing health care landscape.

Project Narrative: Methodology

• PLWH Involvement: Describe how you will engage PLWH and/or organizations that represent them in the implementation of this activity, including decision-making.

• Collaboration and Coordination: Outline the partners needed for this proposed activity, if applicable. Identify the tasks each partner proposes to perform and the amount of funding, if any, you expect to allocate to the partner.

• Sustainability: Describe how you will maintain the efforts set forth in this activity after the period of federal funding ends. Describe how you intend to share or disseminate relevant information and/or products developed through the funded activity and lessons learned with other providers in the community and/or collaborators to this project.

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Please refer to page 12 of the NOFO

Project Narrative: Work Plan

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• Describe the activity’s goal, specify the objectives, and identify the key action steps that will be used to achieve the proposed activity for the 12-month period of performance of September 1, 2019 -August 31, 2020.

• Use a timeline that includes each step of the proposed activity, target date for completion, and identifies staff responsible for the activities.

• Identify the measures you will use to evaluate success.• Identify meaningful support and collaboration with key partners in

planning, designing, and implementing all activities.• Provide the above information in a table format and submit in the

application as Attachment 3.

Please refer to pages 12 to 13 in the NOFO

Project Narrative: Work Plan

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SPECIFICMEASURABLE

ACHIEVABLEREALISTIC &

TIME FRAMED!

Your work plan should include objectives and key action steps that are:

Project Narrative: Resolution of Challenges

• Discuss challenges you are likely to encounter in the planning and implementation of your proposed HIV Care Innovation or Infrastructure Development project.

• Describe the specific activities or strategies you will use to mitigate or resolve anticipated challenges.

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Please refer to page 13 of the NOFO

Project Narrative: Evaluation and Technical Support Capacity

• Data Collection and Management: • Describe the systems and processes that will support your

organization’s monitoring of the proposed activity.• Include a description of how your organization will collect,

manage, and analyze data.• Project Evaluation:

• Describe the evaluation plan that will monitor ongoing processes and progress toward the goals and objectives of the proposed activity.

• Describe the plan for the program performance evaluation that will contribute to continuous quality improvement.

• Describe how you will share evaluation results internally with program staff and externally with key stakeholders to improve program implementation and outcomes.

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Project Narrative: Organizational Information

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Please refer to pages 13 to 14 of the NOFO

• Describe specific organizational capabilities that will contribute to successfully implementing the proposed activity.

• Describe the organizational skills, capabilities, and resources, including staff that will contribute to your organization’s ability to carry out the proposed activity.

• Highlight key staff with relevant expertise and past experience with similar work.

• In addition, describe your experience with fiscal management of grants and contracts. Include information on your organization’s past experience managing multiple federal grants.

Budget Requirements

Budget information consists of three parts:

1. SF-424A Budget Information for Non-Construction Programs (included in the application package)

2. Program-specific line item budget (Attachment 1)

3. Budget justification narrative

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See pages 14 to 15 in the NOFO, and 16 to 18 in the SF424 Application Guide

Budget Requirements: SF-424A

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Budget Requirements: SF-424A

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Salary Limitation

Please note that effective January 8, 2018, the salary rate limitation applicable to RWHAP domestic grants and cooperative agreements increased from $187,000 to $189,600. • The Consolidated Appropriations Act, 2018 (P.L. 115-141),

Division H, § 202, states “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II.”

• As a reminder, RWHAP funds and program income generated by RWHAP awards may not be used to pay salaries in excess of the rate limitation.

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Salary Rate Limitation Example

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• Individual’s full time salary: $255,000

• Amount that may be claimed on the federal RWHAP award due to the legislative salary limitation

• Individual’s base full time salary adjusted to Executive Level II: $189,600

Attachments

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• List of Attachments can be found in Section IV. 2. v. of the NOFO

• Upload attachments in the order specified to the Attachments Form in the application package.

• Label each attachment clearly.• Unless otherwise noted, attachments count toward

the page limit.

Please refer to pages 16 to 18 of the NOFO

Attachments: Sample Staffing Plan

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Attachments: Maintenance of Effort (MOE)

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Please refer to pages 6 and 17 of the NOFO

Funding Restrictions

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Please refer to pages 19 to 20 of the NOFO

• Charges that are billable to third party payors

• Directly provide health care services that duplicate existing services

• Clinical research

• Nursing home care

• Cash payments to intended recipients of RWHAP services

• Purchase of or improvement to land

• Purchase, construction, or major alterations or renovations on any building or other facility

• PrEP medications and related medical services

• Purchase of sterile needles or syringes for the purposes of hypodermic injection of any illegal drug

• Development of materials designed to promote or encourage intravenous drug use or sexual activity

• Research• Foreign travel • Long-term activities

Application Review Information

• The independent review process provides an objective evaluation to the individuals responsible for making award decisions. The highest ranked applications receive consideration for award within available funding ranges.

• Applications will be reviewed and rated based on the review criteria in Section V of the NOFO if they:

• are submitted by the published deadline

• do not exceed the 30-page limit

• do not request more than the ceiling amount, and

• pass the initial HRSA eligibility and completeness screening

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Application Review Information

• Review Criteria are used to review and rank applications. For this opportunity, there are 6 review criteria:

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Criteria PointsCriterion 1: Need 20Criterion 2: Response 25Criterion 3: Evaluative Measures 10Criterion 4: Impact 15Criterion 5: Resources/Capabilities 10Criterion 6: Support Requested 20Total Points 100

Please refer to pages 20 to 22 of the NOFO

Funding Preferences

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• Applicants receiving funding preference will be placed in a more competitive position among applicants that can be funded.

• The funding preference request is considered and reviewed as part of the objective review process.

• Applications that do not receive a funding preference will be given full and equitable consideration during the review process.

• Funding preference will be granted to any qualified applicant that justifies their qualification for the funding preference by demonstrating that they meet the criteria for preference(s)

• If requesting funding preference(s), include a narrative justification as Attachment 7.

Please refer to page 23 of the NOFO

Funding Preferences

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Qualification 1: Rural Areas• Rural communities are NOT designated a metropolitan statistical

area (MSA).• Rural communities may exist within the broad geographic

boundaries of MSAs.• For additional information, please review:

• https://www.hrsa.gov/rural-health/about-us/definition/index.html• https://datawarehouse.hrsa.gov/tools/analyzers/geo/Rural.aspx

Qualification 2: Underserved Populations• Applicants may request funding preference if they provide primary

care services to an underserved population. • Gaps in HIV related health services must be defined and

documented in the application and may include inadequate and/or unavailable services.

Please refer to page 23 of the NOFO

Reporting Requirements

• Recipients must submit a progress report to HRSA on a semi-annual basis:

• The first progress report is due 6 months after the period of performance start date.

• A final report is due within 90 days after the period of performance ends.

• Recipients currently funded under the RWHAP Part C and/or Part D programs who are successfully awarded through this NOFO will be required to provide updated progress on the impact of capacity funded activities.

• Updates will be provided through routine monitoring and progress reports.

• These updates will be requested for up to one year following the completion of the funded project period.

Please refer to pages 24 and 25 of the NOFO

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Application Package: Where is it?

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• On HRSA’s website at www.hrsa.gov/grants• Click on the NOFO “apply at Grants.gov” link

• At www.grants.gov• Search by opportunity number, HRSA-19-031 or• CFDA 93.918

• The Application Guide is available at https://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf or click the links in the NOFO

Application Submission Tips

• Read the NOFO and the SF-424 Application Guide carefully and follow instructions.

• Include your agency name and the name of this program on all pages (RWHAP Part C Capacity Development Program)

• Refer to section 4.7 of the Application Guide for additional Tips for Writing a Strong Application.

• Apply early; do not wait until the last minute in case you run into challenges!

• Make sure the person who can submit for your organization will be available.

• Ensure SAM.gov and Grants.gov registration and passwords are current immediately!

• Have all your PIN numbers and passwords handy!

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Grants.gov Contact Information

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• When to contact Grants.gov Helpdesk• Error messages• Other technical issues• Application did NOT transmit to HRSA• If you have any submission problems, please contact

Grants.gov immediately!

• Grants.gov Contact Center (24/7 except Federal holidays): • 1-800-518-4726, or• support@grants.gov, or • https://grants-portal.psc.gov/Welcome.aspx?pt=Grants

Tracking Grants.gov Submissions

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SF424 Application Guide, section 8.2.5

Reminders

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• Your application must be electronically submitted through and successfully validated by Grants.gov no later than March 22, 2019, 11:59 pm ET.

• We recommend submission of the application at least four business days before the due date.

• Grants.gov Contact Center: • 1-800-518-4726 or support@grants.gov• (24/7 except Federal holidays)

HRSA Contacts

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Applicants who need additional information may contact:

Mindy Golatt, MPH, MA, RN, CPNPBranch Chief, DCHAP

Email: mgolatt@hrsa.govPhone: 301.443.0717Web: hab.hrsa.gov

Potie PettwayGrants Management Specialist, Division Grant Management Operations

Office of Federal Assistance Management (OFAM)Email: ppettway@hrsa.govPhone: 301.443.1014

Web: hab.hrsa.gov

Q&A: Your Questions are Welcome!

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HAB TargetHIV Websitehttps://targethiv.org/calendar/webinar-and-call-archives

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