Part D Grants for Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth (Part D WICY) Existing Geographic Service Areas FY 2015 Technical Assistance Conference Call January 8, 2015 Presented by: DHHS/ HRSA HIV/AIDS Bureau Division of Community HIV/AIDS Programs Director: Polly E. Ross, M.D. Deputy Director: Lynn Wegman, M.P.A.
Funding Opportunity Announcement (FOA) HRSA-15-022 This FOA solicits applications for Ryan White HIV/AIDS funding under the Part D Program who propose to implement Ryan White Part D funded Proposed projects will be implemented in specific service areas as listed in Appendix B of the FOA 3
Application Guidance Two Components: Download Both Documents Program specific instructions --Part D FOA HRSA-15-022 --( FOA ) SF 424 Application Guide, updated December 2014 -- ( Application Guide ) --link found on FOA, pg. ii and 9 4
Agenda Overview of Part D WICY Program Budget Staffing Plan Personnel Requirements Project Abstract Program Narrative Work Plan Evaluation & Technical Support Capacity Organizational Information Review Criteria Attachments: Supplemental Funding Overview of application process Q &A 5
Acronyms Application Guide SF 424 Application Guide CCR Central Contractor Registry 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 EMA/TGA Eligible Metropolitan or Transitional Grant Area(s) (Part A) FOA Funding Opportunity Announcement GMS Grants Management Specialist HAB HIV/AIDS Bureau MAI Minority AIDS Initiative PO Project Officer SAM System for Award Management WICY Women, Infants, Children, and Youth
Part D WICY Overview What Is New: HHS Core HIV Indicators and the HIV Care Continuum Funding Amount Must not exceed the published amount for the competing service area as listed in FOA, Appendix B: applications will be deemed ineligible and not reviewed. Part D Supplemental Requests are Part of this FOA not a Separate Request 90 page limit 7
Part D WICY Overview The purpose of Ryan White HIV/AIDS Program Part D funding is to provide family-centered primary medical care involving outpatient or ambulatory care to women, infants, children, and youth (WICY) living with HIV/AIDS when payments for such services are unavailable from other sources. Part D funding is intended to improve access to primary HIV medical care for low income, vulnerable, medically underserved HIV-infected WICY through the provision of coordinated, comprehensive, culturally and linguistically competent healthcare services directly, by contract, or by memoranda of understanding (MOU). 8
Re-Focusing of the Part D Program in FY 2012 The entire Ryan White HIV/AIDS Program Part D was re-competed in 2012 in order to respond to the changing HIV epidemiology and the National HIV/AIDS Strategy with the goal of providing comprehensive health care services for the WICY populations in areas of greatest need for services. 9
Minority AIDS Initiative (MAI) RWHAP Part D WICY awardees will be assigned funds under the MAI by the HRSA/HAB Division of Community HIV/AIDS Programs (DCHAP), which administers the RWHAP Part D program. This assignment is based on the percentage of the RWHAP Part D populations served from racial/ethnic minority communities as reported in the most recent Ryan White Services Report (RSR).. The amount of MAI funds awarded will be noted under the grant specific terms section (if applicable) of the Notice of Award (NoA) which establishes the final funding for the budget period. Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87,October 30,2009), 2693 10
Part D Requirements Provision of HIV outpatient or ambulatory medical care, including behavioral health, nutrition, and oral health services Specialty care, including HIV specialty care, obstetrics/gynecology, neurology, hepatology Support Services which help WICY clients access primary HIV medical care and are linked to measurable health outcomes. 11
Part D Requirements and Expectations Applicants should address each of the Part D requirements and expectations found on pages 3-4 of the FOA in their proposal narrative.
Award Information 2 year project period (August 1, 2015 through July 31, 2017. Approximately $64.5 million is available for awards. Funding requests: Must not exceed the published amount for the competing service area as listed in FOA, Appendix B Must correlate with the number of WICY patients to receive medical and social services directly from the applicant and the costs of providing such care If funding amount requested exceeds amount listed in Appendix B, the application will be deemed ineligible and not reviewed. 13
Eligible Applicants Agencies throughout the U.S. and U.S. territories. Organizations must propose to provide primary medical care (directly or through contracts or memoranda of understanding) for women, infants, children, and youth living with HIV/AIDS. 14
Eligible Organizations Public or private nonprofit entities, including but not limited to: State and local governments, affiliated agencies Federally qualified health centers, Rural Health Centers Health Centers under the Indian Health Service University Medical Centers and affiliated clinics Faith-based or community-based organizations 15
HHS Core HIV Indicators and the HIV Care Continuum Retention in medical care Housing status HIV Positivity Late HIV Diagnosis Linkage to Medical Care ART Viral Load Suppression Mugavero M et al. Clin Infect Dis 2011; 52(Suppl 2): S238-S246.
Affordable Care 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, employersponsored 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 17
HHS Common HIV Indicators Seven common core HIV indicators were approved by the HHS Secretary on June 28, 2013. HRSA/HAB has incorporated the following six indicators in the 2014 RSR, which became a reporting requirement for all RWHAP grantees 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 18
Payer of Last Resort Applicant or contracted providers must participate and be able to bill for all Medicaid covered services 2652(b) Grant funds should not be used for any service for which payment has been or can reasonably expected to be made under any state compensation program, under an insurance policy, under any Federal or state health benefits program, except Indian Health Service, or on a pre-paid basis 2664(f) 19
Part D Budget Categories 1. Medical Service Costs 2. Clinical Quality Management (CQM) Costs 3. Support Service Costs 4. Administrative Costs (10%, which includes any Indirect Costs) Refer to pages 25-27 of the FOA and pages 29-31 of Application Guide. 20
Examples of Medical Services Licensed medical providers who can assess, treat and refer Proportional medical support- nurses, med assistants HIV-related laboratory and diagnostic tests, immunizations Adherence monitoring/education by licensed clinician Oral health care Mental health Medical Nutrition therapy Substance abuse Medical Case Management Specialty Care Services Travel to provide clinical care HIV-related pharmaceutical assistance 21
Clinical Quality Management Continuous Quality Improvement (CQI) activities Clinical quality management coordination Data collection for clinical quality management purposes (collect, aggregate, analyze, and report on measurement data) Consumer Involvement to improve services Electronic Medical Records: Data analysis for CQM, software and hardware upgrades (such as bridges, links, imports) necessary to facilitate CQM activities Staff training/technical assistance (including travel and registration) to improve services this includes the Annual Clinical Update, the every other year All Grantee Meeting, and the annual RSR training update Participation in the RWHAP Part B Statewide Coordinated Statement of Need (SCSN) process and local planning bodies and other local meetings
Support Services Non-medical & familycentered Transportation for medical appointments Outreach to identify WICY living with HIV to link, engage, and retain them in medical care Childcare during medical appointments Patient education materials Respite Care for caregivers Translation or interpretation services Eligibility Specialists
Administrative Audits Clerical Support/Receptionist Computer hardware and software, EMR/EHR Indirect costs (Only if Federally negotiated indirect cost rate exists)* Liability insurance Program Coordination Program evaluation, required data reporting Postage Payroll/accounting services Rent, utilities, and other facility support costs Telephone, cell phone, pagers Office supplies *Included in the 10% Admin cap
Salary Limitation Cap The Consolidated Appropriations Act, 2014, Division H, 203, Pub. L. 113-76 signed into law on January 17, 2014, increases the Executive Level II salary amount that may be awarded and charged to HRSA grants and cooperative agreements. Award funds may not be used to pay more than $181,500 annually for an individual s salary (exclusive of fringe). The salary limitation applies to sub-awards/ subcontracts. 25
Example of Salary Limitation Individual s actual base full time salary: $350,000 50% of time will be devoted to project Direct salary $175,000 Fringe (25% of salary) $43,750 Total $218,750 Amount that may be claimed on the application budget due to the legislative salary limitation: Individual s base full time salary adjusted to Executive Level II: $181,500 50% of time will be devoted to the project Direct salary $90,750 Fringe (25% of salary) $22,687.50 Total amount $113,437.50 26
Part D Funds cannot be used for: Inpatient services Nursing home care Syringe services programs Supplementation of payments by Medicaid, Medicare or other insurance programs Clinical research Cash payments to clients Purchase or improvement of real estate/property Entertainment costs Activities related to influencing Federal/ state/ local legislation, appropriations, regulation, and administrative action. (Services must be consistent with HAB Policy Notice 10-02. http://hab.hrsa.gov/manageyourgrant/pinspals/eligible1002.html ) 27
Budget: Parts Budget Information consists of three major parts: 1. Budget Information for Non-Construction Programs (SF 424A, federal line item budget) 2. Part D program-specific line item budget (in table format and PDF) 3. Budget justification narrative 28
Budget: Requirements Show only Federal Part D WICY funds The budget should demonstrate how the Part D funds will support a comprehensive system of HIV medical services for all WICY populations. CQM costs must be at a reasonable level Administrative costs are capped at 10.0% of the total Part D award amount (including indirect costs) Include calculations for all items in the budget justification 29
Sample Line Item Budget Line Item Annual Salary Program FTEs Program Salary Subtotal Medical Services CQM Support Services Administrative Program TOTAL Personnel, Name & Position Salary FTE Subtotal Fringe benefit rate Total Personnel Travel Total Travel Supplies Total Supplies Contractual Total Contractual Other Total Other Total Direct Costs Indirect Costs GRAND TOTAL % budgeted by cost category % 10.0% cap 30
Budget: Program- Specific Line Item Refer to the FOA to correctly categorize proposed budget allocations in the programspecific line item budget. Applicants must submit line item budgets for the entire project period (2 years) in the SF424A. Submit the Part D program-specific line item budget for Years One and Two in a PDF format, NOT an Excel spreadsheet, as Attachment 2. 31
Budget: Program- Specific Line Item Travel may be allocated to Medical Services for medical providers traveling to clinic sites, CQM for quality management activities, Support Services for patients traveling to medical appointments. If indirect costs are claimed, a current federally approved indirect cost rate agreement must be submitted as Attachment 3. Remember that indirect costs will be counted toward the administrative limit of 10% of the total funding amount. 32
Budget: Line Item and Justification Narrative Tips List ALL staff names and position titles to be funded Be consistent with names and position titles Clearly describe each line-item in the budget justification narrative, specific to the cost category Include details of contracts, by cost category in both the line-item budget and budget justification narrative Include calculations for all items in the budget justification narrative (unit cost, total number of units, and number of persons to be served) Provide a Budget Justification for Year One, then summarize any changes in Year Two. Remember Be Clear and Concise! 33
BUDGET: Justification Narrative Sample Patient Transportation for Medical Visits Metro cards: $4 per trip X 100 cards = $400 --for 25 persons to use for medical visits (NOTE: This assumes a calculation of 4 tickets per person or 2 round trips to medical visits.) 34
Budget: Reminders Section B of SF-424A: Must include line item budget summary for the entire Project Period (Years 1 and 2) Applicants will submit a Part D Program-Specific line item budget (Attachment 2) and budget justification for Years One and Two. If applicable, include current Negotiated Indirect Cost Rate Agreement (Attachment 3) Business Official listed will be the DGMO point of contact if an award is made. Ensure this is the appropriate contact in your agency or organization. Verify contact information for the Business Official. 35
Staffing Plan Include the following information for all staff for your HIV program including key staff not funded by the grant. Education, training, HIV experience and expertise Language fluency and cultural competence Provide FTE and all funding sources for each staff member Specifically identify Program Coordinator Staff managing and overseeing grant activities Staff monitoring activities of contractors Medical Director and all medical providers Lead for quality management activities Table format is recommended Attachment 4: Staffing Plan Attachment 5: Position Descriptions for Key Personnel 36
Sample Staffing Plan Name Education Title FTE Funding Source Experience Nurse Jones FNP Nurse Practitioner 1.0 1.0 Part D Nurse Thomas RN Clinic Nurse Mgr 1.0 0.2 Part A 0.8 Part D Ms. Kona Assoc Degree Admin. Assistant 1.0 1.0 Part A Mr. Lewis MSW Medical Case Mgr 1.0 1.0 Part B Ms. Johnson RD Contracted Registered Dietician 0.2 0.3 Part D 0.3 Part C 0.2 hospital 0.2 WIC program 2 years FNP, 8 years RN in hospital setting, less than 2 months HIV experience 2 years RN with less than 1 month HIV experience 4 years working in HIV clinic scheduling appts, making referrals, medical data entry 3 years providing HIV medical case management 2 years HIV nutritional Counseling and 20 years nutritional counseling experience 37
Certifications and Assurances Applicants must have the Authorizing Organization Representative (AOR) sign the Part D Agreement and Assurances found in Appendix A. Scan the signed copy into the application as Attachment 6. Provide documentation of your non-profit status as Attachment 7. Submit a list of Medicaid numbers for all medical providers and clinic licensure as applicable as Attachment 1. 38
Project Abstract: A snapshot of your program Project title, applicant contact information Summary of Request: A brief description of the applicant organization (including model of care, services, service sites, and geographic area). Target populations: Estimated number of women, youth, infants, and children infected with HIV/AIDS you plan to serve in the first year. Demographic profile. Number and overall percentage of clients from racial or ethnic minority communities. Demographics and qualifications of staff. 39
Project Abstract (Cont.) Problem/ Challenges: Present the needs to be met through this project related to unmet need, gaps in service, and barriers to care for women, youth, and children living with HIV in your service area. Objectives of the program: Summarize the proposed services to be funded as reflected in the major goals and objectives of your Work Plan. REMINDER: Abstract is only 1 page in length See Application Guide, pg. 37 40
Project Narrative Introduction Needs Assessment Methodology Work Plan Resolution of Challenges Evaluation and Technical Support Organizational Information 41
Project Narrative Introduction Describe the purpose of the proposed project Describe the proposed service area Discuss why your service area is in need of Part D funding Describe why your agency is the appropriate entity to receive funds 42
Project Narrative Needs Assessment: Four Major Sections 1. HIV Seroprevalence & Surrogate Markers 2. The Social Context of HIV/AIDS 3. Target Populations 4. Local HIV Service Delivery System and recent changes 43
Project Narrative Needs Assessment: HIV Epidemiology Table (2012, 2013, 2014) HIV incidence and prevalence AIDS incidence and prevalence Number testing positive and overall seropositivity rate for HIV testing Other disease rates that indicate high-risk behaviors Narrative Discuss HIV epidemiology for your service area (as above) in comparison to state or EMA data Discuss unmet need from Parts A or B grantee of record 44
Project Narrative Needs Assessment: Social Context of HIV/AIDS Social and economic characteristics of the community and their impact on the provision of HIV services in your area Describe the social context of HIV in your community, may include percentages of: Minority populations Adolescent (13-24) Homelessness Uninsured Drug/alcohol users Unemployment Population below 100% of FPL Other factors influencing access to care Table format is recommended 45
Project Narrative Needs Assessment: Target Populations TABLE ELEMENTS Provide data on target populations (women, infants, children, and youth) who have received medical care through your organization between 2012 and 2014 Distinguish between those who received general medical care and HIV services Race/ethnicity, age, and gender Mode of HIV transmission; HIV infected youth Pregnancy rates total and adolescent Insurance status Indicate date and source of cited data 46
Sample Target Population Table Number of: 2012 2013 2014 Total Patients Total New Patients Clients with AIDS Clients HIV, non-aids Race/Ethnicity: Age ranges: (0-12, 13-24, 25-64, over 65 years) Gender (male, female, transgender) Exposure category (HIV-positive clients) HIV positive youth (13-24) behaviorally/perinatally infected Total Pregnant women Adolescents (24 and younger) pregnant females Insurance status 47
Project Narrative NARRATIVE Needs Assessment: Target Populations Compare target HIV WICY populations to be served to the general population in your service area. Identify recent 3-year trends in target groups within your organization. If your project does not propose services for each of the WICY populations, discuss why this is appropriate. Describe organizations in your service area with whom you will coordinate services to provide a comprehensive continuum of HIV services 48
Project Narrative Local Service Delivery System Describe thoroughly: Public and Private HIV service providers (including your agency) in the area in table format: Describe specific services provided and Number of unduplicated clients served annually Ryan White funding received Details of proposed service area (Map--Attachment 8) Unmet health needs Number of persons who know they are infected but not in care. Gaps in HIV services and barriers to care Changes in the health care delivery system that affects your delivery of HIV services 49
Sample Service Delivery Chart Organization Funding Sources & Amounts Services Provided Total Clients/ WICY (Unduplicated) Good Life ASO Part A = $80,000 Part B= $60,000 County = $20,000 HIV Testing and Counseling, Substance Abuse Counseling 300/ 150 women, 25 youth, 5 children Dr. Doolittle Private, for profit Primary care for HIV+ 60/ 15 women General Hospital Part A = $99,000 Primary medical care, Dental, adherence counseling, mental health, 1,200/ 350 women, 50 youth, 20 children, 20 exposed infants 50
Methodology Scope of Work 1) Linkage to Care 2) Comprehensive, Coordinated Systems of Care -- Medical Evaluation and Clinical Care -- Women s Health -- Adolescent Health -- Other Medical Services -- Support Services 3) Consumer Involvement 4) Coordination 51
Methodology Linkage to Care Describe Counseling and Testing availability and proposed targeted/unique efforts for: Women Youth/Adolescents Pregnant women How efforts will not be duplicative of other funding How you will link to or provide primary medical care services for all those who test HIV positive Describe collaboration with Parts A and/or B programs to enroll clients identified and retain them in medical care 52
Methodology Comprehensive, Coordinated Systems of Care Medical Evaluation and Clinical Care Describe HIV diagnostic and therapeutic services Describe protocols to provide care to new patients Describe HIV clinical trials education and enrollment Describe availability of laboratory services Discuss ADAP or other pharmacy assistance programs Describe staff training related to HIV primary medical care Describe AETC training and how it will increase your capacity Describe after hours and weekend coverage Describe referrals and tracking of specialty and subspecialty care 53
Methodology Women s Health Describe the following for your female clients Prenatal care for HIV infected women Availability of drugs to reduce HIV transmission Treatment Adherence Family planning, chronic disease self management, domestic violence awareness Health needs of HIV positive peri-menopausal and menopausal women Coordination of medical care for HIV infected pregnant women Continue primary medical care after delivery Provide or link pediatric care to exposed, infected and affected children Describe other services to retain women in HIV primary medical care 54
Methodology Describe the following: Adolescent Health HIV infected youth by mode of transmission (perinatal or behavioral), age, race, and gender Specific health concerns of adolescents to be served Discuss the following: Retention of youth in care Youth health education on topics such as HIV infection/disease, treatment adherence, prevention methods, family planning, and chronic disease management Describe transitioning youth into adult medical care Identify the number of youth anticipated to transition annually 55
Methodology Other Medical Services Describe the following services if listed in the proposed Part D budget: Oral health care Adherence education/counseling from licensed clinicians Outpatient mental health screening, assessment, and treatment Substance abuse screening, assessment, and treatment Nutritional services HIV prevention incorporated into medical care for PLWHA Screening patients for behavioral risk Behavioral interventions Providing partner and counseling referral services 56
Methodology Describe Support Services How clients will have access to support services to achieve their HIV medical outcomes Case management, translation services, medical transportation How will each support service will be provided and how it will link to improved health outcomes Describe How your program will assist clients in receiving financial support and services Assistance or access to other health services, mental health services, social or other appropriate services 57
Methodology Consumer Involvement Describe how consumers are or will be involved in decisions regarding their personal health care regimens Describe how consumers will be: Involved in the planning, implementation and evaluation of the Part D program Methods to keep them informed and provide feedback 58
Methodology Coordination Discuss how you will address the unmet needs, gaps in services, and barriers to care for the WICY identified in your service area Describe how you will collaborate and coordinate services with other HIV service providers and ensure against duplication of services. Describe how Part D funds will improve patient outcomes in relation to those needs identified through local and state processes (needs assessments) Describe how the proposed services are not duplicative of Parts A and B by providing funding levels from each Part and the covered services. 59
Methodology Coordination (cont.) Submit letters from Part B and Part A as applicable which Document your organization s participation in Parts A/B activities and Describe the need for Part D funds as Attachment 9 List your collaborating organizations and briefly describe the agreed-upon services in Attachment 10.
Work Plan Four Major Areas: Access to Care Comprehensive, Coordinated HIV Primary Medical Care Other Medical and Support Services Clinical Quality Management Program Include as Attachment 11 Include only the clients and services to be funded by Part D. 61
Work Plan Sample Access to Care Objective FY 2015 Objective (# only) FY 2016 Objective (# only) 1. # Women/ Youth/ Children Counseled & Tested as funded by Part D 2. # of Positive HIV tests for Women/ Youth/ Children 3. # New HIV+ Women/ Youth/ Children enrolled in medical care Total/Subcontractor A/ B Total/Subcontractor A/ B Comprehensive, Coordinated Primary HIV Medical Care funded by Part D 1. Total # of WICY receiving Primary HIV care 2. #HIV+ Women (>24 yrs) in Medical care 3. # of HIV+ Youth (13-24 yrs) in medical care 4. # of HIV+ Infants/Children in medical care 5. # of HIV-exposed Infants 6. # of Pregnant HIV+ women 7. # of youth transitioned into adult HIV medical care 8. # Treatment adherence services provided by qualified clinician 9. # of specialty referrals FY 2015 Objective (# only) FY 2016 Objective (# only) Total/Subcontractor A/ B Total/Subcontractor A/ B
Work Plan Sample (cont.) Other Medical Services as applicable (funded by Part D) FY 2015 Objective (# only) FY 2016 Objective (# only) 10. # persons receiving Mental Health screening, assessment, and treatment 11. # persons receiving substance abuse screening, assessment, and treatment 12. # persons receiving Oral health care 13. # persons receiving Medical nutrition screening 14. # persons receiving Medical nutrition therapy provided by qualified clinician (dietician, medical provider RX) Total/Subcontractor A/ B Total/Subcontractor A/ B 15. # persons receiving Medical case management, including written plan ofcare Support Services as applicable (e.g. medical transportation, child care, translation services, non-medical case management) # assisted with medical transportation # receiving translation services FY 2015 Objective (# only) FY 2016 Objective (# only)
Work Plan Sample (cont.) Clinical Quality Management Program List the performance measures your organization selected in FY12 for improvement (see below for examples). Insert additional lines as needed. For the HAB performance measures, see http://hab.hrsa.gov/deliverhivaidscare/habperformmeasure s.html Viral Load Suppression (Retention in Care measure) FY 2015 Objective (# or %) FY 2016 Objective (# or %) Total/Subcontractor A/ B Total/Subcontractor A/ B ARV Therapy For Pregnant Women Pap Smear adolescents transitioned into and retained in adult medical care
Resolution of Challenges Describe major challenges anticipated in designing and implementing Part D funded services as listed in the Work Plan. Discuss how you will resolve these challenges. Discuss challenges that may occur in providing HIV services for the targeted WICY populations and how they will be addressed. 65
Evaluation and Technical Support Your application should fully address your evaluation activities including quality management (QM) and information systems. QM should include: Infrastructure Performance Measurement Quality Improvement Please refer to FOA, pages 22-23 for additional information. 66
Management Information Systems Describe your current information system and your ability to collect and report Part D required data to include the following: The number of existing and new HIV infected individuals Demographic profile of patients Epidemiological data Ryan White-funded services provided to each client living with HIV Track and report the extent to which the costs of HIV-related health care are paid by third party payers for health care services to be provided in the proposed Part D program Training on required reports will be provided to successful applicants. 67
Electronic Health Records Describe if you currently use or propose to implement an Electronic Health Record (EHR). Applicants are expected to use ONC-certified systems which can be configured to meet HAB data reporting requirements. References: Office of National Coordinator for Health Information Technology (ONC) www.hrsa.gov/healthit/ehrguidelines.html Department of Health and Human Services Meaningful Use www.cms.gov/ehrincentiveprograms 68
Organizational Information Describe your organization s capacity and expertise to provide comprehensive medical services for WICY populations by describing your administrative, fiscal, and clinical operations. How does a Part D WICY project fit within the scope of the organization s mission? Describe your organization s ability to recruit and retain health care providers and staff with experience and cultural competency to serve the target populations. The structure of your organization. Attachment 13: Project Organizational Chart 69
Understand the Review Criteria Pay careful attention to each of the 6 Review Criteria Use the Review Criteria as a score sheet when you review your application Reviewers will use these criteria to review your application 70
Proposed Service Area Specify your proposed service area in detail in the application. Your proposed Part D funded activities must ensure a comprehensive system of HIV health services is available to all Ryan White eligible WICY clients in the service area without duplication of effort or funding. 71
Attachments List of Attachments can be found in the FOA: Section v. Attachments Pgs. 29-35 Provide attachments in the order specified Unless otherwise noted, attachments count toward the application page limit. 72
Attachment 15: Supplemental Funding Part D Supplemental Requests are Part of this FOA not a Separate Request: Applicants can choose only one (1) supplemental activity either : 1) a HIV Care Continuum activity or 2) an Infrastructure Development The supplemental request will be evaluated separately with a separate review criterion Funding up to $100,000 max Attachment 15:Part D Supplemental Narrative and Budget Documents pages 33-36 of the FOA 73
Attachment 15: Supplemental Funding KEY POINTS Applicants must clearly identify the one activity proposed and one the Stage of the HIV Care Continuum that will be addressed One (1) HIV Care Continuum activity per applicant organization will be funded by the Division of Community HIV/AIDS programs in FY 15. This includes future Part C supplemental opportunities related to HIV Care Continuum.
Attachment 15: Supplemental Funding HIV Care Continuum Activities as described in FOA pgs. 33-34 can be either: Disease Case Finding Motivational Interviewing Patient-Based Treatment Adherence Patient Self-Managed Chronic Disease Management Current participants PEACOC
Attachment 15: Supplemental Funding HIV Care Continuum Activities Required Items: Activity Summary: to include brief summary of interventions to address the HIV Care Continuum Baseline HIV Care Continuum Data: Table Format Evaluation Plan: to measure the outcome of the activities.
Attachment 15: Supplemental Funding Infrastructure Development Activities as describe FOA pgs.34-35 can be either: Electronic Health Records Attachment 15: Supplemental Funding Financial Management Systems Management Information System- Identifying, establishing and strengthening administrative, managerial, and management information system (MIS)
Attachment 15: Supplemental Funding Infrastructure Development Activities Required Items: Activity Summary: to include brief summary of the proposed infrastructure activity Evaluation Plan: to measure the outcome of the infrastructure activity
Attachment 15: Supplemental Funding Supplemental Funding Budget Documents: HRSA SF424A form Line item budget Budget justification narrative specific to the proposed Part D supplemental activity 10% Admin Cap Notes: Administrative Costs are those costs to be used by grantees for grant management and monitoring activities, including costs related to any staff or activity unrelated to services or indirect costs.
Application: Where is it? Final Guidance located at Also found at www.grants.gov www.hrsa.gov/grants Announcement HRSA-15-022, CFDA 93.153 Application Instructions (FOA & Application Guide) Application Guide Package www.hrsa.gov/grants/guideforreview/applicationg uideforreview.doc Adobe Reader 8.1.1 version or later 80
Grant Writing Essentials Read the FOA and the Application Guide carefully and follow instructions. Develop a grant writing work plan with time framed assignments. Don t make assumptions explain everything. Tell the truth. Understand the review criteria. Refer to Application Guide, pg. 43, section 4.7. for additional Tips for Writing a Strong Application 81
Content and Form Attachments count in page limit; NOT Standard Forms Only number attachment pages created by applicant NOTE: Do not number OMB forms An electronic table of contents will be constructed by HRSA Include your agency name and the name of this application on all pages (Part D WICY) Face Page (SF-424) DUNS Project period Federal amount requested 82
Page Limit APPLICATION CANNOT EXCEED 90 PAGES Project Summary/Abstract Project Narrative Line-item Budget Budget Justification Narrative All Attachments Applications over the limit will not be reviewed. 83
Application Submission Process BEFORE registering at www.grants.gov Obtain a Data Universal Number System (DUNS) number Register in the System for Award Management (SAM) Agency or Organization MUST register online at www.grants.gov Refer to Application Guide, pp. 20-21 for instructions on how to Register with the System for Award Management (SAM) 84
System of Award Management (SAM) 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 information must be updated at least every 12 months to remain active (for both grantees and subrecipients). https://www.sam.gov
Application Submission Process First: Second: Third: Register your organization at www.grants.gov Click on Get Registered Register yourself or designee as Authorized Organization Representative Get authorized by your agency to submit Registration can take 1-3 months. Start Now! 86
PEARLS for Success! Read/review the FOA and SF 424 Application Guide carefully Include all requested information/documents Apply early! Make sure the person who can submit for your organization will be available Plan ahead for scanning documents Use the latest versions Application package Adobe Reader software 8.1.1 or later Have all your pin numbers and passwords handy! 87
PEARLS for Success! Review Application Guide page 43, section 4.6. Correcting Mistakes: If an application is submitted more than once prior to the application due date, HRSA will only accept the applicant s last validated electronic submission, under the correct opportunity, prior to the Grants.gov application due date as the final and only acceptable application. In Box 1 of the SF-424, check Changed/Corrected Application. It is incumbent on applicants to ensure that the AOR is available to submit the application to HRSA by the published due date. HRSA will not accept submission or re-submission of incomplete, rejected, or otherwise delayed applications after the deadline. Therefore, an organization is urged to submit an application in advance of the deadline. If an application is rejected by Grants.gov due to errors, it must be corrected and resubmitted to Grants.gov before the deadline date and time. Deadline extensions will not be provided to applicants who do not correct errors and resubmit before the posted deadline. 88
Grants.gov Contact Information When to contact Grants.gov Helpdesk Error messages Other technical issues Application DID NOT transmit to HRSA Contact Grants.gov HELP DESK Contact Center Phone: 1-800-518-4726 Hours of Operation: 24 hours a day 7 days a week, excluding Federal Holidays Support@grants.gov, http://grants.gov/iportal 89
Tracking Grants.Gov Submissions Submission Receipt E-mail Submission Receipt (receive within 2 business days) Track My Application link Submission Validation E-mail 2 nd e-mail from Grant.Gov validating your application OR Rejection with errors Grantor Agency Retrieval Email Third e-mail from Grants.Gov HRSA has confirmed receipt of application package Grants.Gov website http://www.grants.gov/applicants/apply_for_grants.jsp 90
Do Not Go Over the 90 Page Limit! Convert the two separate line item budgets into a PDF file before uploading into Grants.Gov. Print your entire application before uploading into Grants.Gov, so you can make sure you are not over the 90 page limit. Any applications over the page limit will not be reviewed! Your application will automatically be rejected by Grants.Gov. 91
3.6. Requesting a Waiver from the Electronic Submission Requirement Refer to Application Guide, pp. 26-27 All applicants must submit through Grants.gov unless they obtain 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. 92
Deadline Date! Applications must be submitted electronically via www.grants.gov on February 18, 2015 and e-marked no later than at 11:59 PM ET. 93
Application: Submission Process REQUIREMENTS: Data Universal Number System (DUNS) number An active System for Award Management (SAM) registration SAM information must be updated at least every 12 months to remain active (for both grantees and sub-recipients). Refer to Application Guide, pp.19-23 for instructions on how to Register with the System for Award Management (SAM) (https://www.sam.gov ). Agency or Organization registration online at www.grants.gov An Authorized Organization Representative (AOR) who can submit an application. Registration can take at least one month Start Now! 94
Tracking Grants.Gov Submissions - 4 Emails 1)Submission Receipt E-mail Submission Receipt (receive within 2 business days) Track My Application link 2) Submission Validation E-mail 2 nd e-mail from Grant.Gov validating your application OR Rejection with errors 3) Grantor Agency Retrieval Email Third e-mail from Grants.Gov HRSA has confirmed receipt of application package 95
Tracking Grants.Gov Submissions - 4 Emails (2) 4) Agency Tracking Number Assignment E-mail Grants.Gov website http://www.grants.gov/applicants/apply_for_grants.jsp An applicant MUST RECEIVE the FIRST THREE (3) EMAILS TO SUCCESSFULLY HAVE SUBMITTED AN APPLICATION! --Receipt of all four separate emails may occur over a week s time. --DO NOT WAIT UNTIL THE LAST MINUTE to submit an application! 96
Grants.gov Message upon Application Upload Home> Apply for Grants > Confirmation Confirmation Thank you for submitting your grant application package via Grants.gov. Your application is currently being processed by the Grants.gov system. Once your submission has been processed, Grants.gov will send email messages to advise you of the progress of your application through the system. Over the next 24 to 48 hours, you should receive two emails. The first will confirm receipt of your application by the Grants.gov system, and the second will indicate that the application has either been successfully validated by the system prior to transmission to the grantor agency or has been rejected due to errors. IMPORTANT NOTICE: If you do not receive a receipt confirmation and either a validation confirmation or a rejection email message within 48 hours, please contact us. The Grants.gov Contact Center can be reached by email at support@grants.gov, or by telephone at 1-800- 518-4726. Always include your Grants.gov tracking number in all correspondence. The tracking numbers issued by Grants.gov look like GRANTXXXXXXXXX. 97
4 EMAILs in GRANTS.Gov Submission Type E-mail Subject Time Frame Sent By Recipient Competing Application 1 st e-mail Submission Receipt Within 48 hours Grants.gov AOR 2 nd e-mail Most Crucial Submission Validation Receipt OR Rejected with Errors Within 48 hours Grants.gov AOR 3 rd e-mail Grantor Agency Retrieval Receipt 4 th e-mail Agency Tracking number assignment Within Hours of second e-mail Within 3 business days Grants.gov Grants.gov AOR AOR SF424 Application Guide, 8.2.5, pp. 54-55 98
Unsuccessful Submission Requesting a Waiver from the Electronic Submission Requirement Refer to Application Guide, pp. 26, 53 55. All applicants must submit through Grants.gov unless they obtain a written exemption. Applicants must request an exemption in writing within 5 days of the application deadline 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.
REMINDER The application should be electronically submitted in Grants.gov by Wednesday, February 18, 2015, 11:59 pm ET We recommend submission of the application at least FIVE business days before due date. Grants.gov Contact Center: 1-800-518-4726 or support@grants.gov or https://grantsportal.psc.gov/welcome.aspx?pt=grants (24/7 except Federal holidays)
ALERT ALERT ALERT ALERT Grants.gov will not be available: Grants.gov Scheduled Maintenance Outage: February 14-17, 2015. Monday February 16 President's Holiday
REMINDER Funding Amount must not exceed the published amount for the competing service area as listed in FOA, Appendix B: applications will be deemed ineligible and not reviewed. Applicants should address each of the Part D requirements and expectations
Good luck! and From all of us at the HIV/AIDS Bureau Thank you for the care and the commitment you give to people living with HIV/AIDS. 103
CONTACTS Adejumoke Oladele Part D Lead Division of Grants Management Operations HRSA 301-443-2441 aoladele@hrsa.gov Monique G. Hitch, MSHA Branch Chief Part D Lead Division of Community HIV/AIDS Programs HRSA/HAB 301-443-3944 mhitch@hrsa.gov