Pa Part t C HIV IV Ea Early ly In Inte terve rvention ntion - - PowerPoint PPT Presentation

Pa Part t C HIV IV Ea Early ly In Inte terve rvention ntion Se Services vices Existing isting Geo eogr grap aphic hic Ser ervice vice Area eas s (EISEGA), ISEGA),

Ne New w and Co Competing eting Co Continuation inuation HRSA HRSA-14 14-059 59 Technical nical As Assist istance ance Co Confere erence nce Ca Call ll No Novemb mber er 13, 2013

DHHS HS/ / HRSA HIV/ V/AI AIDS DS Bu Burea eau Divis ision

• n of C

Comm mmunit unity y HIV/AIDS S Program

• grams

s Dire rector: ctor: Polly y Ross ss, , M.D.

Ag Agenda enda

• HRSA-14-059 FOA, SF424 Application Guide
• Acronyms
• Part C EIS Overview
• Changes in FOA versions
• National Initiatives – HIV Care Continuum, ACA
• Program Narrative
• Work Plan and Progress Report Summaries
• Budget
• Application Review by HRSA
• Grant Writing and Submission Tips
• Q & A

2

Fundin ing g Op Opport rtunit nity y Announce nceme ment nt (F (FOA OA) ) HRSA RSA-14 14-05 059

• This FOA solicits applications from existing

grantees and new applicants for funding under the Ryan White HIV/AIDS Program (RWHAP) Part C Early Intervention Services (EIS)

• Applicants must propose services for the

Service Areas published in Appendix B of the FOA, pp. 48-53.

• Funding requests must not exceed the amount

listed for each Service Area in Appendix B.

1) Program Specific Instructions

• Part C FOA HRSA-14-059 (“FOA”)

2) HRSA’s general guidance

• SF 424 Application Guide (“Application Guide”)
• link found in the FOA (pg. 16), recommended to

use the September 9, 2013 version

• An explanatory video of the Application Guide can be

found at http://ww.hrsa.gov/grants/apply/applicationguide/

4

Two Components of the HRSA14-059 Application

Ac Acrony

• nyms

ms

• Application Guide

SF 424 Application Guide

• CQM

Clinical Quality Management

• DCHAP

Division of Community HIV/AIDS Programs

• DGMO

Division of Grants Management Operations

• DUNS

Data Universal Number System

• EHB

Electronic Handbooks

• EIS

Early Intervention Services

• FOA

Funding Opportunity Announcement

• GMS

Grants Management Specialist

• HAB

HIV/AIDS Bureau

• MAI

Minority AIDS Initiative

• PO

Project Officer

• RWHAP

Ryan White HIV/AIDS Program

• SAM

System for Award Management

5

Part t C EIS IS Ov Overview rview

• The purpose is to provide a comprehensive

continuum of outpat atient nt HIV primary care services.

• Required

ed Servi vices ces include:

• HIV Counseling, testing, and referral;
• Medical evaluation and clinical care;
• Other primary care services; and
• Referrals to other health services.
• Medica

cal Model of Care

• Assess
• Treat
• Refer
• Provision of coordinated, comprehensive, culturally

and linguistically competent services.

6

Changes anges in th the FO FOA

11/6/13 - Summary of Changes:

• For new applicants, Project Abstract should clearly state the

grantee they intend to replace and the service area they are proposing to cover (pg. 16).

• In the Methodology Section of the Program Narrative, under

Referral System, applicants should describe plans for outreach and enrollment of RWHAP clients into new health coverage

• ptions. Review Criterion 2 is updated to evaluate the quality of

the response (pp. 21, 38).

• A program specific line item budget is only requested for Year

One of the proposed project period (pg. 30).

• Attachment 7 (Proof of Non-Profit Status) is required for all

applicants.

• Section V.2.- additional clarification is provided for applicants

requesting a Funding Preference (pp.41-42).

El Eligibility igibility

• Existing Part C grantees with project periods

ending April 30, 2014 and

• New organizations proposing to replace a

current grantee. (Appendix B)

• Public or private nonprofit entities, including

but not limited to: : Federally Qualified Health

Centers, rural health centers, health centers under the Indian Health Service, university medical centers and affiliated clinics, and faith- based or community-based organizations

9

Continuum of HIV Care

Engagement in HIV/AIDS Care

Unaware of HIV Status (not tested or never received results) Know HIV Status (not referred to care; did not keep referral) May Be Receiving Other Medical Care But Not HIV Care Entered HIV Primary Medical Care But Dropped Out (lost to follow-up) In and Out of HIV Care

• r

Infrequent User Fully Engaged in HIV Primary Medical Care

Not in Care Fully Engaged

HHS Com

• mmo

mon n HIV IV In Indi dica cators tors

• Seven common core HIV indicators were approved by

Secretary Sebelius on June 28, 2013.

• HRSA/HAB has incorporated the following six

indicators in the 2014 RSR, which will be a reporting requirement for all RWHAP grantees beginning January 1, 2014:

• HIV Positivity
• Linkage to HIV Medical Care
• Retention in HIV Medical Care
• Antiretroviral Therapy (ART) in Persons in HIV Medical Care
• Viral Load Suppression Among Persons in HIV Medical Care
• Housing Status
• More information is available at:

http://www.aids.gov/pdf/hhs-common-hiv-indicators.pdf

Af Affordable fordable Care re Ac Act

• The RWHAP is the payer of last resort. Grantees must

assure that providers make reasonable efforts to secure non-RWHAP funds whenever possible for services to clients.

• Grantees are expected to vigorously pursue enrollment into

health care coverage for which their clients may be eligible under the Affordable Care Act (e.g., Medicaid, CHIP, Medicare, state-funded HIV/AIDS programs, employer- sponsored health insurance coverage, and/or other private health insurance options in the Marketplace).

• ACA resources:
• http://www.healthcare.gov
• http://hab.hrsa.gov/affordablecareact/
• http://http://www.hab.hrsa.gov/affordablecareact/outreachenrollment.html

Pr Project

• ject Narrative

rrative

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

Wo Work k Pl Plan an Su Summary mmary

• HRSA/HAB strongly recommends a table

format for the summary of the proposed Work

• Plan. (FOA, pp. 24-26)
• List measureable objectives for Year One
• Include objectives for each sub-contractor

when applicable

• Action steps, evaluation methods, and

person(s) responsible are not necessary.

• Submit the Work Plan Summary as

At Attac achm hmen ent t 12 12

Sample mple Wo Work k Plan an (1)

Acces ess to Care (Entire e HIV progr gram am) FY 2014 4 Objecti tive e (#

• nly)
• 1. Total number of patients
• 2. # New patients enrolled in care

Couns nsel eling ng and Testing ng Funded ded by Part C FY 2014 4 Objecti tive (# only)

• 1. # Counseled and Tested
• 2. # Persons w/ positive HIV test results
• 3. # linked to HIV medical care w/in 3 months of

diagnosis (from #2)

• 4. # of AIDS diagnoses w/in 3 months of diagnosis

(from #2)

Sa Sample mple Wo Work k Pl Plan an (2)

Compreh prehen ensiv ive, e, Coordin

• rdinat

ated ed Prim imary ary HIV Medic dical l Care re Funde nded d by Part rt C FY 2014 14 Objec jectiv ive (# (# only ly) Total/ Subcontract A/B

• 1. # of patients receiving Medical Services
• 2. # of patients receiving Mental health screening
• 3. # of patients receiving Mental health treatment
• 4. # of patients receiving Substance abuse screening
• 5. # of patients receiving Substance abuse treatment
• 6. # of patients screened for Hepatitis B
• 7. # of patients screened for Hepatitis C
• 8. # of patients receiving treatment for Hepatitis C
• 9. # of patients receiving Oral health care
• 10. # of patients receiving Medical nutrition and therapy provided

by qualified clinician (dietician, medical provider RX)

• 11. # of clients receiving Treatment adherence services provided

by licensed clinician

• 12. # of patients receiving Medical case management, including

written plan of care

• 13. # of patients receiving Specialty referrals
• 14. If your approved budget lists support services to help

individuals achieve medical outcomes, list # for each service. Insert additional lines as needed.

Cli linica nical l Qua uali lity ty Ma Mana nage geme ment nt

Clinical al Quality ty Managem agement ent Progr gram am ( E Entire e HIV Progr gram am) FY 2014 4 Objecti tive e (#, %) %) Provide measures your organization has selected for CQI, which should include more than 1 Core HIV Indicator. Insert additional lines as needed. For DHHS Core HIV Indicators: http://www.aids.gov/pdf/hhs-common-hiv-indicators.pdf; for the HAB performance measures: http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html Number of persons with an HIV Diagnosis with a viral load <200 copies/mL at the last measurement Number of persons with HIV who had at least one HIV medical care visit in each 6 month period with at least 60 days between the visits. Number of persons with HIV who were prescribed ART

Su Summa mary ry Pr Progress

• gress Report

port

• Existing grantees must provide data on

Work Plan objectives and actual results for each year since the last competing application (2009 or later through September

30, 2013).

• A table format is strongly recommended

(FOA, pg. 27).

• The Progress Report should provide

individual sub-contractor performance data for each budget period as applicable.

New w Appli plicants cants

• Identify the Service Area in which your
• rganization proposes Part C funded

services in the abstract and project narrative

(FOA, pg. 17)

• Describe your organization’s recent

experience in providing HIV counseling and testing (FOA, pg. 20), HIV primary medical care (FOA, pg. 26)

• Provide a transition plan for patients being

served by the current grantee (FOA, pg. 26)

Bu Budget dget

• See HRSA SF- 424 Application Guide section 4.1.iv

and v (pp. 24-30) and FOA section IV.2.iii (pp. 30- 34) for instructions on preparing the budget and budget justification narrative.

• Upload a Part C program specific line item budget

for Year One only in a PDF format as Attachment 2. This should include the 5 Part C EIS cost categories:

• -EIS, Core Medical Services, Clinical Quality

Management, Support Services, Administration

Pa Part t C Bu Budg dget et Req equi uirem emen ents ts

• At least 50% of Part C budget must be allocated for

EIS/Primary care services

• At least 75% of the Part C budget, after CQM and

Administrative costs are subtracted, must be allocated for Core Medical Services

• Support Services are services used to achieve HIV

medical outcomes

• Reasonable % for Clinical Quality Management (CQM)
• Administrative costs, including indirect, are capped

at 10.0% of the total EIS award amount

Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111- 87,October 30,2009), §2651(b)(2)-(c)(1)

Sam ampl ple e Par art t C Li Line ne It Item em Bu Budg dget et

Sa Salary lary Limitation mitation Cap

• Salary Limitation - see 4.1. iv Budget-Salary

Limitation for additional information in the SF- 424 Application Guide (pp. 25, 29)

• The Consolidated Appropriations Act, 2012 (P.L.

112-74) enacted December 23, 2011, limits the salary amount that may be awarded and charged to HRSA grants and cooperative agreements.

• Award funds may not be used to pay more than

$179,700 annually for an individual’s salary (exclusive of fringe).

• The salary limitation applies to sub-awards/

subcontracts.

Su Subcontractors bcontractors

• Contractors and sub-recipients providing services under

the Part C grant must adhere to the same legislative and programmatic requirements as the grantee.

• The grantee is accountable for the sub-recipient’s
• performance
• the appropriate expenditure of funds under the award
• and the other obligations of the Part C award.
• Grantees are required to annually monitor all

subcontractors.

• Subcontractors must register in SAM, report program

income, and report and validate program expenditures.

At Attachments tachments

• A list of Attachments is found on pages

34 - 36 in the FOA.

• Upload attachments in the order listed
• Attachments are not to be used as a

continuation of the project narrative.

• Unless otherwise noted, attachments

count toward the 80-page application limit.

• Label each attachment clearly.

Sta taffing ffing Plan an

• Attachment 4
• See FOA pg. 25 and Application Guide section 4.1.vi

(pg. 30)

• Table format is strongly recommended.
• List key personnel: Program Coordinator, Medical

Director, Quality Management lead, all HIV medical providers, and all Part C funded staff

• Include roles, responsibilities, qualifications,

education, training, HIV experience and expertise

• Provide all sources of funding with corresponding

time effort for each staff person

Sample Staffing Plan

Name Educa ucation ion Title le FTE FTE Fundin nding g Sourc urce Exper perien ience Nurse Jones FNP Nurse Practitioner 1.0 1.0 Part C

2 years FNP, 8 years RN in hospital setting, less than 2 months HIV experience

Nurse Thomas RN Clinic Nurse Mgr 1.0 0.2 Part A 0.8 Part C

2 years RN with less than 1 month HIV experience

• Ms. Kona

Assoc Degree Admin. Assistant 1.0 1.0 Part A

4 years working in HIV clinic scheduling appts, making referrals, medical data entry

• Mr. Lewis

MSW Medical Case Mgr 1.0 1.0 Part B

3 years providing HIV medical case management

• Ms. Johnson

RD Contracted Registered Dietician 0.2 0.3 Part C 0.3 Part D 0.2 hospital 0.2 WIC program

2 years HIV nutritional Counseling and 20 years nutritional counseling experience

26

Fu Funding nding Restriction strictions

• Inpatient Services
• Syringe Services
• Residential treatment
• Clinical research
• Nursing home care
• Cash payments to clients
• Purchase or improvement of real property
• Lobbying or Grant Writing

Services must be consistent with HAB Policy Notice # 10-02

http://hab.hrsa.gov/manageyourgrant/pinspals/eligible1002.html

Funds from Part C Grants May Not Support:

Appli plicat cation ion Review view

Each application must meet eligibility and completeness requirements to be reviewed by HRSA.

Eligibility

• -submission in Grants.gov by the

published deadline with confirmed validation and receipt by HRSA

• -application is within 80-page limit

Ineligible applications will not be reviewed.

App ppli lica cation tion Rev eview iew ( (2) 2) Applications will be considered incomplete if:

• A Project Narrative is not included;
• Budget documents are not

complete– Part C Line item budget, Budget Justification Narrative, and SF-424A; or

• A proposed Work Plan Summary

is not included.

INCOMPLETE applications will not be reviewed for funding!

Applications will be reviewed based on the criteria listed in the FOA (pp. 37-41)

• Pay careful attention to each of the 6

Review Criteria

• Don’t make assumptions – explain

everything

• Provide the most accurate data and

information about your program possible

App ppli lica cation tion Rev eview iew (3) 3)

Ap Appl plic ication: ation: Wh Wher ere e is is it it? ?

• Final Guidance located at www.

ww.gran rants. ts.go gov

• Also found at
• ww

www. w.hrsa.gov/gr rsa.gov/grants ants

• Announcement HRSA-14-059, CFDA 93.918

Application Instructions (FOA & Application Guide)

• Application Guide Package

www.hrsa.gov/grants/guideforreview/applicationgui deforreview.doc

• Adobe Reader 8.1.1 version or later

31

Gran ant t Su Subm bmission ission Ti Tips ps

• Read the FOA and the Application Guide

carefully and follow instructions.

• Include your agency name and the name of this

application on all pages (Part C EIS)

• Refer to the Application Guide, pg. 37, section

4.7. for additional Tips for Writing a Strong Application

• Apply early; don’t wait until the last minute in

case you run into challenges!

• Make sure the person who can submit for your
• rganization will be available
• Hav

ave e all l your ur pin numbe mbers s and passwo sswords ds hand ndy! y!

32

System tem of Aw f Award ard Management nagement (SAM) M)

• Central Contractor Registration (CCR) transitioned to the System for

Award Management (SAM) at the end of July 2012.

• SAM will reduce the burden on those seeking to do business with

the government. Vendors will be able to log into one system to manage their entity information in one record, with one expiration date, through one streamlined business process.

• SAM inform
• rmat

ation n must t be update ted d at least t every y 12 months ths to remain in active ive (for

• r both grante

ntees es and sub- recipie pient nts). s). Refer to Application Guide, pp. 16-18 for

instructions on how to Register with the System for Award Management (SAM)

• https

tps://ww ://www.sa w.sam.go m.gov

64

Trac acking king Gran ants. ts.Gov Gov Su Subm bmis issi sion

• ns
• Submission Receipt E-mail
• Submission Receipt (receive within 2 business days)
• “Track My Application” link
• Submission Validation E-mail
• 2nd e-mail from Grant.Gov validating your application

OR

• Rejection

jection with th errors rors

• Grantor Agency Retrieval Email
• Third e-mail from Grants.Gov
• HRSA has confirmed receipt of application package

Grants.Go ts.Gov v website te http http:// ://ww www.g w.gra rants.go nts.gov/ap v/appl plica icants/a nts/app pply_fo ly_for_g r_gra rants.jsp ts.jsp

34

3.6. Reques estin ting g a Waiver er from the El Electro tronic ic Su Submiss ssion ion Re Requir irem ement ent

• Refer to Application Guide,

, pp. 22 22

• All applicants must submit through Grants.gov unless they
• btain a written exemption.
• Applicants must request an exemption in writing from

DGPWaivers@hrsa.gov, and provide details as to why they are technologically unable to submit electronically through the Grants.gov portal.

• Deadline extensions will not be granted for Grants.gov

verification errors, last-minute registration, or submission errors on the part of the applicant.

35

REM EMIND INDER ER

• The application should be electronically

submitted in Grants.gov by Dec ecember ember 30 30, 201 , 2013 3 , 11:59 pm ET

• We recommend submission of the

application at least fo four ur business days before due date.

• Grants.gov Contact Center: 1-800-518-4726
• r support@grants.gov or

http://grants.gov/iportal (24/7 except Federal

holidays)

TH THANK ANK YOU OU

for the care and the commitment you give to people living with HIV/AIDS!!

QU QUESTIONS? STIONS?

• Please use the Chat pod for any

questions you may have.

• If you prefer, we will have an audio

line for questions.

• Please listen to the operator for

instructions.

• We will answer questions in the
• rder we receive them.

CON ONTACTS TACTS

Pr Program ram Lead Stephanie Yun Senior Program Advisor HRSA/ HAB/ DCHAP Phone: 301.443.0349 E-mail: syun@hrsa.gov DG DGMO MO Lead Olusola Dada

Grants Management Specialist

HRSA/OFAM/DGMO Phone: 301.443.0195 E-mail: odada@hrsa.gov

HAB TARGET CENTER https://careacttarget.org/