Ryan White HIV/AIDS Part C Capacity Development Program Pre-Application Technical Assistance Conference Call HRSA-15-024 March 12, 2015 Department of Health and Human Services Health Resources and Services Administration HIV/AIDS Bureau, Division of Community HIV/AIDS Programs Director: Polly E. Ross, M.D. Agenda • HRSA-15-024 FOA, SF424 Application Guide • Acronyms • Overview of Ryan White HIV/AIDS Part C Capacity Development Program • National Initiatives – HIV Care Continuum, ACA • Allowable activities • Program Narrative • Work Plan and Progress Report Summaries • Budget • Application Review by HRSA • Grant Writing and Submission Tips • Q&A 2 Funding Opportunity Announcement (FOA) HRSA-15-024 • This FOA solicits applications from existing Part C grantees under the Ryan White HIV/AIDS Program (RWHAP) for the Part C Capacity Development Program. • Awards will support activities that address and impact gaps in the HIV Care Continuum which have been identified in the grantee’s service area. 3 Two Components of the HRSA15-024 Application 1) Program Specific Instructions • Capacity Development FOA HRSA-15-024 (“FOA”) 2) HRSA’s general guidance • SF 424 Application Guide (“Application Guide”) • Links are found throughout the FOA (beginning pp. i and 5); the January 2015 version is most current 4 Acronyms • Application Guide • CQM SF 424 Application Guide Clinical Quality Management • DGMO Division of Community HIV/AIDS Programs Division of Grants Management Operations • DCHAP • • • • • • • • • • DUNS EHB EIS FOA GMS HAB HIV CoC PO RWHAP SAM Data Universal Number System Electronic HandbooksEarly Intervention Services Funding Opportunity Announcement Grants Management Specialist HIV/AIDS Bureau HIV Care Continuum Project Officer Ryan White HIV/AIDS Program System for Award Management 5 Part C Capacity Development PURPOSE Capacity Development funds are to be used to assist current Part C grantees in their efforts to strengthen their organizational infrastructure and to increase their capacity to develop, enhance, or expand access to high quality HIV primary health care services for people living with HIV (PLWH). Please refer to page 1 of the FOA. 6 FY2014 Capacity Development Awards • Applicants may propose one (1) activity to address the gaps and need for a comprehensive continuum of outpatient HIV primary care services for a one (1) year Project Period. • Applicants may request funding amounts of up to $100,000 for the Project Period. • Only specific short term activities will be funded under this grant. Please refer to pages 3 and 4 of the FOA. 7 HIV Care Continuum www.AIDS.gov 8 Only one activity will be funded under FY 2015 Capacity Development 1. HIV Care Innovation activity options: • • • • Disease Case Finding; Motivational Interviewing; Patient-Based Treatment Adherence; or Patient Self-Managed Chronic Disease Management. or 2. Infrastructure Development activity options: • Electronic Health Records (EHR) • Financial Management Systems; or • Management Information System. 9 FY2015 Capacity Development: Addressing the HIV Care Continuum • Applicants must provide baseline data (calendar years 2013 and 2014) for each stage of the HIV CoC. • Proposed activities must be linked directly to a specific stage with a target level of improvement. (Example: increasing viral load suppression from baseline 50% to 60%) • The use of HHS core/HAB HIV indicators is strongly encouraged. 10 HIV Care Innovation- Option A Disease Case Finding • Train designated staff in disease case finding techniques through local health departments and/or CDC funded training centers and apply these skills in the clinical setting to link persons into care after HIV testing • Stages of the HIV Care Continuum: (pick one) (1) Linkage to HIV medical care, or (2) Retention in HIV medical care 11 HIV Care Innovation- Option B Motivational Interviewing • Train staff in Motivational Interviewing through the local AIDS Education and Training Center (AETCs) or other resources to engage patients in HIV care and work with both staff and patients on retention and apply the training in the clinical setting • Stages of the HIV Care Continuum: (pick one) (1) Linkage to HIV medical care ,or (2) Retention in HIV medical care, or (3) Appropriate prescription of Antiretroviral Therapy [ART] 12 HIV Care Innovation- Option C Patient-Based Treatment Adherence • Implement an innovative, patient-based treatment adherence program to provide long term adherence support for chronically non-adherent patients and apply the program • Stages of the HIV Care Continuum: (pick one) (1) Appropriate prescription of ART, or (2) HIV viral load suppression 13 HIV Care Innovation- Option D Patient Self-Managed Chronic Disease Management • Institute a clinic-wide Chronic Disease Management Program for HIV/AIDS based on the Stanford program or other resources for patient selfmanagement to engage patients in long term disease control and apply the program • Stages of the HIV Care Continuum: (pick one) (1) Retention in HIV medical care, or (2) HIV viral load suppression 14 Infrastructure Development Option A Electronic Health Records • Purchasing and implementing EHRs to improve the quality, safety, and efficiency of patient health care. • Stages of the HIV Care Continuum: (pick one) (1) Linkage to HIV medical care ,or (2) Retention in HIV medical care, or (3) Achieving a high HIV viral load suppression rate 15 Infrastructure Development Option B Financial Management System • Purchasing and implementing a financial accounting system or software capable of managing multiple sources of funding for HIV primary care services. • Stages of the HIV Care Continuum: (pick one) (1) Linkage to HIV medical care ,or (2) Retention in HIV medical care, or (3) Achieving a high HIV viral load suppression rate 16 Infrastructure Development Option C Management Information System • Identifying, establishing and strengthening administrative, managerial, and management information system (MIS) structures to offer, enhance, or expand comprehensive HIV primary healthcare. • Stages of the HIV Care Continuum: (pick one) (1) Linkage to HIV medical care, or (2) Retention in HIV medical care, or (3) Achieving a high HIV viral load suppression rate 17 Application Structure You must address the following sections listed in the FOA • Project Abstract • Project Narrative • Introduction • Needs Assessment • Methodology • Work Plan • Resolution of Challenges • Evaluation and Technical Support Capacity • Organizational Information • Budget • Budget Justification Narrative • Attachments 18 Abstract Include Description of: 1. Organizational Mission 2. Summary of HIV primary care services 3. Summary of proposed capacity activity with the specific stage in the HIV Care Continuum to be addressed by the activity 4. Amount requested (up to $100,000) for the entire project period 5. State if statutory preference is requested. See pages 6 in the FOA and 37-38 of the Application Guide. 19 Project Narrative Major Sections: --Needs Assessment --Methodology -- Work Plan --Evaluation and Technical Support Capacity --Organizational Information Funding preference if applicable See pages 6-13 in the FOA 20 Needs Assessment 2 required components: (1) Baseline HIV Care Continuum Data --applicant’s own program data for each stage of the Care Continuum --calendar years 2013 and 2014 --provide definitions for denominators, numerators (2) HIV Service Delivery System 21 Sample Table for Baseline Data HIV Care Continuum Stage 2013 2014 Numerator/Denominator and (%) Numerator/Denominator and (%) Linkage to Care Retention in Care Number of PLWH prescribed ART Viral Load less than 200 cop/mL 22 Sample Table Including Specific Target Populations HIV Care Continuum Stage 2013 2014 Numerator/Denominator and (%) Numerator/Denominator and (%) Linkage to Care (Total) Linkage to Care (MSM) Retention in Care (Total) Retention in Care (MSM) Number on ARVs (Total) Number on ARVs (MSM) Viral Load less than 200 cop/mL (Total) Viral Load less than 200 cop/mL (MSM) 23 Sample HIV Service Delivery Table Organizations (1000 PLWH in service area) HIV CoC Stages # or % w/ Viral Load Suppression # of HIV tests (# positive tests) # of PLWH enrolled in HIV care # or % prescribed Antiretroviral Therapy Good Life ASO (MSMs, youth) (RW Parts A, B, D) 250 (5) 100 60 (60%) 50 (50%) FQHC Central (RW Parts A, C) 2,000 (5) 200 120 (60%) 90 (45%) Dr. Doolittle (women) (RW Part D) 100 (1) 100 80 (80%) 60 (60%) General Hospital (RW Parts A, B, C) 500 (4) 500 350 (70%) 300 (60%) 24 Methodology Propose methods that will be used to address the selected activity, collaboration and coordination efforts and strategies, and how the organization proposes to continue the activity at the end of the project period. The selected activity must be under one of the two categories for funding under this FOA: 1. HIV Care Innovation, or 2. Infrastructure Development 25 Methodology Collaboration and Coordination Outline the needed partners for the proposed project ( if applicable) • the tasks that each partner proposes to perform, • the responsible party of the partner, • the amount of funds, if any, allocated to the partner, • letters of Support and/or Letters of Commitment from each partner and/or collaborating entity should be included in Attachment 3 26 Methodology Sustainability How will the organization maintain or continue the efforts set forth in this project beyond the project period? • Supporting maintenance of systems and newly trained staff; • Supporting the activity that addresses the identified gap in the HIV Care Continuum; • Applicants should include a description of the plan for the dissemination of information/products developed. 27 Work Plan- Part 1 Narrative Separate from the table, the application should include a narrative regarding the approach to addressing the targeted activity. Applicants should list all action steps that will be necessary to implement the capacity development proposal and accomplish the proposed objectives. 28 Work Plan- Part 2 Table The work plan table (attachment 1) should contain • A Problem Statement(s) (1-2 sentences); • A description of each Goal that corresponds to a problem statement (1-2 sentences) • A description of each Objective that corresponds to a goal (1 sentence); • A listing of Key Action Steps for each objective (1-2 sentences); and • A targeted Completion Date (Month/Year) for each objective and each action step. 29 Sample Work Plan- Table Problem Statement: Only 60% of PLWH who were on antiretroviral therapy in CY2013 were virally suppressed . Goal: Improve viral load suppression rate of PLWH who are on ART from 60% (CY2013) to 65% for CY 2014 and 75% for CY2015. Objective Designated clinic staff will complete treatment adherence training Key Steps RN, Pharmacists, MCMs will undergo adherence training. Completion Date Month 6 PLWH who are on ART will receive treatment adherence Revise the clinic schedule and room assignments Month 3 Evaluation Method Performance Level Track # of persons who complete the adherence training quarterly 95% of designated staff will be trained by month 6 Track # of appointment slots for treatment adherence Increase # of treatment adherence slots by 50% Track # of PLWH attending treatment adherence appointments. % on ART indicator / HAB Viral Load suppression indicator Increase # of kept adherence appointments by 25% Increase VL suppression to 65% in CY2014 Increase VL suppression to 75% in CY2015 30 Evaluation and Technical Support Capacity The 2 required components are: • Data Infrastructure • Describe data collection system and infrastructure for monitoring the HIV CoC stages • Project Evaluation • Describe the CQM program and evaluation activities for the project • Discuss the performance measures selected (HHS core/ HAB HIV indicators are recommended.) 31 Organizational Information • Organizational capabilities and expertise that demonstrate the ability to implement a system of change • Staffing Plan (Attachment 2) • Describe how this proposal will enable the applicant to the address the local community’s HIV CoC • Involvement of PLWHA in the development and assessment of the applicant’s HIV program – not specific to capacity activities Include an organizational chart as attachment 7. 32 Staffing Plan • Table format is recommended • Include all key staff for the HIV program and those to be involved in Capacity Development activities • Names and Positions • Education & Experience/Qualifications Upload as Attachment 2. DO NOT INCLUDE RESUMES !!! 33 Sample Staffing Plan Name Ms. Doe Education MPH Title Program Coordinator Medical Director Dr. A. Jones Ms. Kona Mr. Lewis Ms. Johnson MD Assoc Degree CQM Coordinator, Retention Specialist Capacity Dev. Role Oversight of grant award and project implementation Oversight of clinic staff , SOPs, & CQI projects DIS training, oversight of CQM activities MSW Medical Case Mgr treatment adherence training RN Contracted Registered Dietician DIS & treatment adherence training Experience 5 years as program coordinator, previously was Data/CQM Manager for same entity. 15 years providing HIV primary care 4 years working in HIV clinic scheduling appts, making referrals, medical data entry 3 years providing HIV medical case management 20 years working as a HIV nurse and patient educator 34 Budget Your budget has three parts: 1. SF 424A – From the Application Package 2. Capacity Development specific Line Item Budget (Attachment 4) 3. Budget Justification Narrative 35 Budget • See HRSA SF- 424 Application Guide section 4.1.iv and v (pp. 30-37) and FOA section IV.2.iii (pp. 13-14) for instructions on preparing the budget and budget justification narrative. • Upload a Capacity Development specific line item budget in a PDF format as Attachment 4. 36 Budget Justification Narrative • Applicants should provide specific, detailed justifications for all allocated items in the program specific line item budget. • Allocations must relate to the proposed HIV CoC activities described in the Project Narrative. • For example, travel or training costs must specify the unit cost per person and the number of persons to be involved per activity. • If indirect costs are requested, a current negotiated cost rate agreement must be submitted as Attachment 5. 37 Salary Limitation Cap • The Consolidated and Further Continuing Appropriations Act, 2015, Division G, § 203, (P.L. 113-235) signed into law on December 16, 2014, continues 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 $183,300 annually for an individual’s salary (exclusive of fringe). • The salary limitation applies to sub-awards/ subcontracts. 38 Example: Salary limitation •Individual’s full time salary: $255,000 50% of time will be devoted to project Direct salary: • A $127,500 Fringe (25% of salary): $31,875 Total: $159,375 Amount that may be claimed on the Federal grant •Individual’s base full time salary adjusted to Executive Level II: $183,300 50% of time will be devoted to project Direct salary: $91,650 Fringe (25% of salary): $22,912.50 Total: $114,562.50 39 Cost Allowability Allowable Cost Meets the criteria for authorized expenditures specified in the cost principles, program legislation, and program policy. The costs must also be: • Allocable • Reasonable • Necessary 40 Funding Restrictions Capacity Development Funds May Not Support: • ongoing service delivery, primary medical care, research or prevention • the purchase of land, or construction/ renovation of any building or other facility • to reimburse for pre-award costs • to support long term activities 41 Funding Preference • Applicants may request a funding preference if the capacity development activities will be implemented in one or both of the following areas: • Rural communities • Underserved communities with respect to HIV related health services • Upload the request as Attachment 6 • More information may be found in the FOA page 18-19 42 Attachments • A list of Attachments is found on pages 1415 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 30-page application limit. • Label each attachment clearly. 43 What is counted towards the page limit? APPLICATIONS CANNOT EXCEED 30 PAGES! • • • • • • Work Plan Staffing Plan and Job Description for Key Personnel Letters of Support and/or Commitment Line-item Budget Budget Justification Narrative All Attachments (except where noted on pp. 14-15 of FOA) Applications over the page limit will not be eligible for review. 44 Application Review In order to be reviewed: -applications must be submitted on time -submission in Grants.gov by the published deadline with confirmed validation and receipt by HRSA -applications must be within 30-page limit; -applications will be reviewed for completeness and eligibility Ineligible applications will not be reviewed. 45 Application Review (2) Applications will be reviewed based on the criteria listed in the FOA (pp. 16-18). • 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 46 Review Criteria Points (1) (2) (3) (4) (5) (6) Need = 20 points Response = 25 points Evaluative Measures = 10 points Impact = 15 points Resources/Capabilities = 10 points Support Requested = 20 points See pages 16-18 in the FOA 47 Application: Where is it? • located at www.grants.gov • Also found at • www.hrsa.gov/grants • Announcement HRSA-15-024, CFDA 93.918 Application Instructions (FOA & Application Guide) • Application Guide Package www.hrsa.gov/grants/apply/applicationguide/ • Adobe Reader 8.1.1 version or later is required. 48 Grant Submission Tips Read the FOA and the Application Guide carefully and follow instructions. Include your agency name and the name of this application on all pages (Ryan White HIV/AIDS Part C Capacity Development Program) Refer to the Application Guide, pg. 44, 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 organization will be available • Have all your pin numbers and passwords handy! 49 424 Application Guide Tips What is funding amount to be entered for SF-424 #18a (cover page)? Provide the year one budget period funding total of the proposed project period. Do NOT go over the ceiling funding amount of $100,000. SF-424 cover sheet is a standard form. For additional information please go to: http://www.grants.gov/web/grants/form-instructions/sf-424-instructions.html Where do I upload the project abstract? Upload on page 2 of the SF-424 Box #15 Select “Add Attachments” to upload the project abstract See page 41 in the SF-424 Application Guide 50 Grants.gov Contact Information • 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! Electronic Submission User Guide: http://www.hrsa.gov/grants/apply/userguide.pdf • Grants.gov Contact Center: 1-800-518-4726 or [email protected] or https://grantsportal.psc.gov/Welcome.aspx?pt=Grants (24/7 except Federal holidays) 51 Tracking Grants.Gov Submissions • 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 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 52 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 four (4) emails to have successfully submitted an application through Grants.Gov • Receipt of all four separate emails may occur over a week’s time. • Do not wait until the last minute to submit an application! 53 4 EMAILs in GRANTS.Gov SF424 Application Guide, 8.2.5, pp. 55-56 54 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 [email protected], 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.” 55 REMINDER • The application should be electronically submitted in Grants.gov by April 27 , 2015, 11:59 pm ET • We recommend submission of the application at least four business days before due date. • Grants.gov Contact Center: • 1-800-518-4726 or [email protected] • (24/7 except Federal holidays) 56 Your questions are welcome! Applicants in need of technical assistance as they prepare their applications may call or email Program Contact Marinna Banks-Shields [email protected] 301-945-0938 Grants Contact Potie Pettway [email protected] 301-443-1014 HAB TARGET Website http://careacttarget.org/webcasts.asp 57
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