U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
HIV/AIDS Bureau
Special Projects of National Significance Program
Systems Linkages and Access to Care for Populations at High
Risk of HIV Infection Initiative – Demonstration States
Announcement Type: New Limited Competition - modified 3-18-11
Announcement Number: HRSA-11-098
Catalog of Federal Domestic Assistance (CFDA) No. 93.928
FUNDING OPPORTUNITY ANNOUNCEMENT
Fiscal Year 2011
Letter of Intent Due Date: March 2, 2011
Application Due Date: April 4, 2011
Ensure your Grants.gov registration and passwords are current immediately!!
Deadline extensions are not granted for lack of registration.
Registration can take up to one month to complete.
Release Date: February 2, 2011
Date of Issuance: February 2, 2011
This announcement has been modified as follows:
The anticipated number of grantees to be funded has been increased from six to eight
Adan Cajina
Branch Chief, Demonstration and Evaluation Branch
Email: ACajina@hrsa.gov
Telephone (301) 443-3180
Fax: (301) 594-2511
Legislative Authority: Public Health Service Act, Section 2691 (42 USC 300ff-101), as amended
by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (P.L. 111-87)
Table of Contents
I. FUNDING OPPORTUNITY DESCRIPTION .................................................................1
1. PURPOSE ............................................................................................................................................. 1
2. BACKGROUND ..................................................................................................................................... 1
3. PROGRAM REQUIREMENTS AND EXPECTATIONS .............................................................................. 5
II. AWARD INFORMATION .............................................................................................12
1. TYPE OF AWARD ............................................................................................................................... 12
2. SUMMARY OF FUNDING .................................................................................................................... 12
III. ELIGIBILITY INFORMATION..................................................................................12
1. ELIGIBLE APPLICANTS ..................................................................................................................... 12
2. COST SHARING/MATCHING .............................................................................................................. 12
3. OTHER ............................................................................................................................................... 13
IV. APPLICATION AND SUBMISSION INFORMATION.............................................13
1. ADDRESS TO REQUEST APPLICATION PACKAGE............................................................................. 13
2. CONTENT AND FORM OF APPLICATION SUBMISSION ...................................................................... 14
i. Application Face Page ............................................................................................................ 17
ii. Table of Contents .................................................................................................................... 17
iii. Application Checklist .............................................................................................................. 17
iv. Budget ...................................................................................................................................... 17
v. Budget Justification ................................................................................................................ 18
vi. Staffing Plan and Personnel Requirements ........................................................................... 19
vii. Assurances ............................................................................................................................... 20
viii.Certifications .............................................................................................................................. 20
ix. Project Abstract ....................................................................................................................... 20
x. Program Narrative .................................................................................................................. 20
xi. Attachments ............................................................................................................................. 25
3. SUBMISSION DATES AND TIMES........................................................................................................ 27
4. INTERGOVERNMENTAL REVIEW ...................................................................................................... 28
5. FUNDING RESTRICTIONS .................................................................................................................. 28
6. OTHER SUBMISSION REQUIREMENTS .............................................................................................. 29
V. APPLICATION REVIEW INFORMATION - REQUIRED ......................................30
1. REVIEW CRITERIA ............................................................................................................................ 30
2. REVIEW AND SELECTION PROCESS ................................................................................................... 36
3. ANTICIPATED ANNOUNCEMENT AND AWARD DATES ...................................................................... 36
VI. AWARD ADMINISTRATION INFORMATION ......................................................36
1. AWARD NOTICES............................................................................................................................... 36
2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS ........................................................... 37
3. REPORTING ....................................................................................................................................... 38
VII. AGENCY CONTACTS ................................................................................................39
VIII. TIPS FOR WRITING A STRONG APPLICATION ..............................................39
HRSA-XX-XXX
I. Funding Opportunity Description
1. Purpose
The Special Projects of National Significance (SPNS) Program is authorized by Section 2691 of
the Public Health Service Act, as amended by the Ryan White HIV/AIDS Treatment Extension
Act of 2009 (P.L. 111-87) referred hereafter as the Ryan White HIV/AIDS Program. The SPNS
Program supports the development of innovative models of HIV care to quickly respond to the
emerging needs of clients served by the Ryan White HIV/AIDS Programs. SPNS evaluates the
effectiveness of these models’ design, implementation, utilization, cost, and health related
outcomes, while promoting the dissemination and replication of successful models.
This SPNS Program Competitive Application funding opportunity announcement is provided to
assist applicants in preparing a request for funding under the fiscal year (FY) 2011 Systems
Linkages and Access to Care for Populations at High Risk of HIV Infection Initiative –
Demonstration States. This funding opportunity will support grantees of record funded under
Ryan White HIV/AIDS Program Part B Grants to States and Territories to develop innovative
systemic models of linkage to improve access to and retention in quality HIV care. Populations
of interest are limited to those persons who are at high risk for and/or infected with HIV but are
unaware of their HIV status; are aware of their HIV infection but have never been referred to
care; are aware but have refused referral to care; or have dropped out of care. Six awards are
anticipated, with funds for up to 4 years at a maximum grant award of $1,000,000 per year.
Funding for an evaluation and technical assistance center to coordinate the initiative will be
made available under a separate announcement (HRSA-11-129). Applicants should carefully
read the requirements for the Evaluation and Technical Assistance Center to better understand
the importance of the national, multi-state evaluation requirements.
Applicant organizations must demonstrate a high incidence of HIV cases based upon the most
recent available data within their States or Territories, and their ability to access these target
population(s) who are out of care. Applicants also must demonstrate how they will leverage this
funding along with existing resources to work with key partners and stakeholders across their
State’s public health system and communities to identify and conduct counseling and testing of
high risk and HIV-infected, out of care populations and link those who are positive into care.
The initiative will promote the development of innovative strategies that successfully integrate
different components of the public health system such as surveillance and counseling and testing,
in the implementation of innovative and effective methods for linkage and retention into quality
HIV care for hard-to-reach populations who have never been in or who have dropped out of care.
Awardees will be required to participate in a four-year comprehensive multi-state evaluation led
by an evaluation center to identify and document successful models for purposes of
dissemination and replication at the national level.
2. Background
According to the Centers for Disease Control and Prevention (CDC), an estimated 21 percent of
the 1,106,400 adults and adolescents living with HIV in the United States at the end of 2006
HRSA-11-098 1
were unaware of their infection.1 Another CDC study found that those unaware account for over
half of new sexually transmitted HIV infections, with transmission rates 3.5 times higher than
those who are aware.2 Additionally, as many as one third of those diagnosed and aware of their
HIV infection remain out of care,3often for years.4 Timely entry into HIV care post-diagnosis
has been found to have a number of benefits, including decreased morbidity, mortality and
infectiousness,5 as well as exposure to secondary prevention through clinical interventions.6
There are many reasons why HIV-positive persons may delay entering care upon diagnosis,
including structural, financial and personal/cultural barriers arising from racial, ethnic and
gender disparities.7 Continuous retention in care has benefits similar to those of timely entry,
and a number of strategies have been developed to promote retention such as intensive case
management, patient navigation, peer support groups, and mobile van outreach to find clients who
7,8
were lost to follow-up.
The new National HIV/AIDS Strategy (NHAS9) developed by the White House Office of
National AIDS Policy (ONAP10) and released in July 2010 has three primary goals: 1) reducing
the number of people who become infected with HIV, 2) increasing access to care and
optimizing health outcomes for people living with HIV, and 3) reducing HIV-related health
disparities. The NHAS states that more must be done to ensure that new prevention methods are
identified and that prevention resources are more strategically deployed. Further, the NHAS
recognizes the importance of getting people with HIV into care early after infection to protect
their health and reduce their potential of transmitting the virus to others. HIV disproportionately
affects people who have less access to prevention and treatment services and, as a result, often
have poorer health outcomes. Therefore, the NHAS advocates adopting community-level
approaches to reduce HIV infection in high-risk communities and reduce stigma and
discrimination against people living with HIV. To ensure success, the NHAS requires the
Federal government and State, tribal and local governments to increase collaboration, efficiency,
1
Campsmith ML, Rhodes PH, Hall HI, Green TA. (2010) Undiagnosed HIV Prevalence Among Adults and
Adolescents in the United States at the End of 2006. Journal of Acquired Immune Deficiency Syndromes, 53 (5):
619-624.
2
Marks G, Crepaz N, Janssen RS. (2006) Estimating sexual transmission of HIV from persons aware and unaware
that they are infected with the virus in the USA. AIDS, 20:1447-50140.
3
Fleming PL, Byers RH, Sweeney PA, Daniels D, Karon JM, Janssen RS. (2002) HIV prevalence in the United
States, 2000. Presented at the 9th Conference on Retroviruses and Opportunistic Infections, February 24-28, 2002,
Seattle, WA. Accessed 10/27/10 from http://www.retroconference.org/2002/abstract/13996.htm
4
Samet JH, Freedberg KA, Savetskya JB, Sullivan LM, Stein MD. (2001) Understanding delay to medical care for
HIV infection: the long-term non-presenter. AIDS, 15 (1): 77-85.
5
Department of Health and Human Services, Panel on Antiretroviral Guidelines for Adults and Adolescents (2009)
Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents, December 1, 2009.
Accessed 10/27/10 from http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf
6
Myers JJ, Shade SB, Rose CD, Koester K, Maiorana A, Malitz FE, Bie J, Kang-Dufour MS, Morin SF (2010).
Interventions Delivered in Clinical Settings are Effective in Reducing Risk of HIV Transmission Among People
Living with HIV: Results from the Health Resources and Services Administration (HRSA)'s Special Projects of
National Significance Initiative. AIDS and Behavior, 14 (3): 483-492.
7
Tobias C, Cunningham WE, Cunningham CO, Pounds MB (2007) Making the Connection: The Importance of
Engagement and Retention in HIV Medical Care. AIDS Patient Care & STDs, 21 (Supplement 1): S3-S8.
8
Gardner L, Marks G, Metsch L, Loughlin A, O’Daniels C, Del Rio C, Anderson-Mahoney P, & Wilkinson JD for
the ARTAS Study Group (2007) Psychological and Behavioral Correlates of Entering Care for HIV Infection: The
Antiretroviral Treatment Access Study (ARTAS) AIDS Patient Care and STDs, 21 (6): 418-425.
9
Office of National AIDS Policy (2010) National HIV/AIDS Strategy for the United States. ONAP, The White
House. See http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf
10
http://www.whitehouse.gov/administration/eop/onap/
HRSA-11-098 2
and innovation. Therefore, to the extent possible, Ryan White program activities should strive to
support the three primary goals of the National HIV/AIDS Strategy.
The three primary goals of the NHAS are broken down into action steps, each with
recommended actions. Each goal has anticipated benchmark results to be achieved by 2015.
The first two primary goals identify means of addressing the unaware and aware but out of care
populations. The first primary goal of reducing new HIV infections includes an actionable step
of expanding targeted efforts to prevent HIV infection using a combination of effective, evidence-
based approaches. One of the recommended actions (2.2) to achieve this step is to support and
strengthen HIV screening and surveillance activities. There is a need to support existing
surveillance methods to identify populations at greatest risk that need to be targeted for HIV
prevention services.11 Another recommended action (2.4) is the expansion of prevention with
HIV-positive individuals. Although most people diagnosed with HIV do not transmit the virus to
others, there are effective approaches that support people living with HIV in avoiding
transmitting HIV to others.10 In addition to lowering the annual number of new infections by 25
percent and reducing the HIV transmission rate, the anticipated results of achieving this first
primary goal include increasing the percentage of people living with HIV who know their
serostatus from 79 percent to 90 percent.12
The second primary goal of the NHAS is to increase access to care and optimize health outcomes
for people living with HIV, and includes the actionable step of establishing a seamless system to
immediately link people to continuous and coordinated quality care when they are diagnosed
with HIV.13 The following actions are recommended to realize this step:
1.1 Facilitate linkages to care: HIV resources should be targeted to include support for
linkage coordinators in a range of settings where at risk populations receive health and
social services.
1.2 Promote collaboration among providers: All levels of government should increase col-
laboration between HIV medical care providers and agencies providing HIV counseling
and testing services, mental health treatment, substance abuse treatment, housing and
supportive services to link people with HIV to care.
1.3 Maintain people living with HIV in care: Clinical care providers should ensure that all
eligible HIV-positive persons have access to antiretroviral therapy. Those who start
therapy need to be maintained on a medication regimen, as recommended by the HHS
treatment guidelines.14
Anticipated results of achieving this goal by 2015 include increasing the proportion of newly
diagnosed patients linked to clinical care within three months of their HIV diagnosis from 65
percent to 85 percent; and increasing the proportion of Ryan White HIV/AIDS Program clients
who are in continuous care (at least 2 visits for routine HIV medical care at least 3 months apart
within a 12 month period) from 73 percent to 80 percent.13
The National HIV/AIDS Implementation Plan15 outlines the specific steps to be taken by various
Federal agencies to support the high-level priorities outlined in the NHAS. Along with other
11
NHAS, page 19.
12
NHAS, page 8
13
NHAS, page 23.
14
NHAS, page 25
HRSA-11-098 3
federal agencies, the NHAS Implementation Plan tasked the HIV/AIDS Bureau (HAB) of HRSA
with the following actions to be performed:
Collaborate with States and localities on pilot initiatives for expanding the most
promising models for integrating HIV testing, outreach, linkage and retention in high risk
communities.16
Develop plans that support health care providers and other staff who deliver HIV test
results to conduct linkage facilitation to ensure clients access appropriate care following
a positive diagnosis.17
Work with States, tribal governments, localities, and community-based organizations
(CBOs) to promote co-location of providers of HIV screening and care services as a
means of facilitating linkages to care and treatment, and to enhance current referral
systems within CBOs.16
The 2009 Re-authorization of the Ryan White HIV/AIDS Program emphasized the need to
examine the size and demographics of the estimated population of individuals with HIV/AIDS
who are unaware of their HIV status, as well as the needs of individuals with HIV/AIDS who
know their HIV status and are not receiving HIV-related services; and linking them to care.18
Consequently, the 2011 Part B Guidance (HRSA-11-061)19 requires that Part B grantees describe
their plans for addressing the unmet needs for HIV-related services by those who are aware of
their HIV status, focusing on those who are not in care. Under its Early Identification of
Individuals with HIV/AIDS (EIIHA) requirement, the Part B guidance also requests descriptions
of grantees’ strategies, plans and data associated with ensuring that individuals who are unaware
of their HIV positive status are identified, informed of their status, referred into care, and linked
to care. The guidance defines EIIHA as the identifying, counseling, testing, informing, and
referring of diagnosed and undiagnosed individuals to appropriate services, as well as linking
newly diagnosed HIV positive individuals to care. The objective of EIIHA is to increase the
number of individuals who are aware of their HIV status, as well as increase the number of HIV
positive individuals who are in care. HAB’s efforts to identify those unaware of their HIV
infection are being augmented by HRSA’s Bureau of Primary Health Care (BPHC).20 Through
its 1,100 community health center (CHC) grantees, BPHC provides care to nearly 19 million
patients in the nation’s most needy communities,21 and in the implementation of the NHAS and
the Affordable Care Act, the CHCs are expected to expand and assume greater roles in providing
care to HIV-infected people in the future.22
15
Office of National AIDS Policy (2010) National HIV/AIDS Strategy Federal Implementation Plan, July 2010.
ONAP, The White House. Accessed from http://www.whitehouse.gov/files/documents/nhas-implementation.pdf
16
NHAS Implementation Plan, page 14.
17
NHAS Implementation Plan, page 18.
18
The Ryan White HIV/AIDS Treatment Extension Act of 2009 (P.L. 111-87) Accessed from
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_public_laws&docid=f:publ087.111.pdf
19
See HIV Care Grant Program Part B States/Territories Formula and AIDS Drug Assistance Program Formula and
ADAP Supplemental Awards Funding Opportunity Announcement # HRSA-11-061, Fiscal Year 2011. Division of
Service Systems, HIV/AIDS Bureau, Health Resources and Services Administration. Accessed from
https://grants.hrsa.gov/webExternal/FundingOppDetails.asp?FundingCycleId=4012E24E-92BC-400C-94CF-
0D63436711D8&ViewMode=EU&GoBack=&PrintMode=&OnlineAvailabilityFlag=&pageNumber=&version=&N
C=&Popup=
20
See BPHC Program Assistance Letter (PAL # 2010-13) HIV Testing in Health-Care Settings at:
http://bphc.hrsa.gov/policy/pal1013/pal1013.pdf
21
See BPHC Fact Sheet at http://www.hrsa.gov/about/organization/bureaus/bphc/bphc.pdf
22
See NHAS, page 27; the NHAS Implementation Plan, pages 18 and 20; and
http://www.healthcare.gov/law/introduction/index.html for information on the Affordable Care Act
HRSA-11-098 4
In FY2011, HRSA, the CDC,23 the HIV Prevention Trials Network of NIAID,24 the National
Institute on Drug Abuse and National Institute of Mental Health,25 and other federal agencies
have ongoing or have begun new testing, prevention, and HIV-research initiatives that may
identify significant new numbers of HIV infected people who will be seeking services. Ongoing
CDC initiatives26 and HAB’s efforts through Ryan White grantees to estimate and address the
unmet needs of those aware of their HIV status but out of care, along with the new requirement
for Ryan White Parts A and B grantees to identify and bring into care those persons that are
unaware of their positive HIV status within their jurisdictions, may result in many more People
Living With HIV (PLWH) entering treatment.
However, to accomplish these inter-related goals, the need to coordinate systemic linkages to
counseling and testing, surveillance, referrals, and care provision among a diverse group of
traditional HIV-focused and newer non-traditional partners remains key. In a 2009 White
Paper,27 the CDC outlined its strategic vision for program collaboration and service integration
(PCSI) in its HIV, Hepatitis, Sexually Transmitted Diseases and Tuberculosis prevention efforts.
This White Paper defined a framework for PCSI; presented principles for effective PCSI;
identified means of working with internal and external stakeholders to accomplish common
goals; addressed methods to monitor and evaluate progress towards PCSI; and described how
CDC will work with partners at national, state, and local levels to advance PCSI in its prevention
efforts.
3. Program Requirements and Expectations
The SPNS Systems Linkages and Access to Care for Populations at High Risk of HIV Infection
Initiative will award funds for up to 4 years to support Ryan White Part B grantees that fund and
coordinate HIV/AIDS medical care and services in States and Territories with demonstrable high
incidence of HIV infection. Demonstration States are expected to design and implement
strategic plans focused on the development of innovative mechanisms which establish effective
and sustainable linkages among organizations within their States or Territories that currently
provide or may provide HIV-related services in the near future. The principal goal of these new
systemic linkages in this SPNS initiative is to demonstrate improvement in access to and
retention in high quality, competent HIV care and services for hard-to-reach populations of HIV-
infected persons, who are unaware of their status; who have never been in care; or who have
dropped out of care. Successful applicants will be expected to evaluate their systems linkage
23
See CDC-RFA-PS10-10181 Enhanced Comprehensive HIV Prevention Planning & Implementation for MSAs
Most Affected by HIV/AIDS at
http://www.grants.gov/search/announce.do;jsessionid=KXmpMJnRmtp611nffV52K2nlj05LNqLsJc7f9n8SR1yPqy
G26kK2!880821633
24
HPTN 065 TLC-Plus: A Study to Evaluate the Feasibility of an Enhanced Test, Link to Care, Plus Treat Approach
for HIV Prevention in the United States. HIV Prevention Trials Network, Division of AIDS, National Institute for
Allergy and Infectious Diseases. Accessed from http://www.hptn.org/research_studies/hptn065.asp
25
See NIDA/NIMH RFA-DA-11-001 Seek, Test, Treat, and Retain: Addressing HIV among Vulnerable
Populations (R01) at http://grants.nih.gov/grants/guide/rfa-files/RFA-DA-11-001.html
26
A current list of CDC initiatives may be found at http://www.cdc.gov/hiv/topics/prev_prog/index.htm
27
CDC (2009). Program Collaboration and Service Integration: Enhancing the Prevention and Control of
HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis in the United States. Available at:
http://www.cdc.gov/nchhstp/programintegration/docs/207181-C_NCHHSTP_PCSI%20WhitePaper-508c.pdf
HRSA-11-098 5
plans and disseminate their findings with a goal of potential replication by other Ryan White
HIV/AIDS Program grantees.
For the purposes of this initiative, systems linkage is defined as the enhancement of existing – or
the implementation of new, innovative – sustainable collaborative relationships or partnerships
among Ryan White and other, non-traditional HIV service organizations. Effective systems
linkage should result in optimal HIV program coordination as demonstrated by improvements in
the provision of care of people living with HIV. These collaborative relationships are based
upon formal agreements with specified roles and responsibilities for provider entities or other
organizations within a State or Territory. These formal agreements may already exist, or they
may be created through the implementation of a linkages plan by a Demonstration State. The
formalization may occur through the implementation of interagency agreements, contracts or
sub-grants awarded and administered by the applicant organization. Successful applicants will
possess the capacity to work with HIV specific and non-HIV service providers who are offering
different services to the HIV infected or affected populations. This can be demonstrated through
the execution of contracts, signed memoranda of understanding, or other agreements which
demonstrate that partnerships have been established with collaborating organizations.
Successful applicants will establish effective and sustainable systemic linkages that optimize
the coordination of existing HIV counseling and testing, surveillance, prevention and treatment
resources within their States or Territories. At a minimum, these linkages will be established
with all other Ryan White grantee organizations (Parts A, B, C, D and F) co-located in their
States and Territories. Additionally, successful applicants will establish linkages with
traditional and non-traditional HIV service partners such as hospital emergency rooms;
community health centers; outpatient, urgent care, sexually transmitted disease, mental health
and/or substance abuse treatment clinics; correctional health-care facilities; and other primary
care settings.
The Department of Health and Human Services was directed by Congress to establish a national
HIV/AIDS testing goal of 5,000,000 tests for HIV/AIDS annually through federally-supported
HIV/AIDS prevention, treatment, and care programs, including the Ryan White HIV/AIDS
Program.28 In September 2006, CDC released its Revised Recommendations for HIV Testing of
Adults, Adolescents, and Pregnant Women in Health-Care Settings29 which seeks to increase HIV
screening of patients, improve earlier detection of HIV infection and to connect those previously unaware
of their infection into treatment and prevention services. To accomplish these objectives, the
recommendations called for the expansion of HIV testing beyond traditional HIV providers to
include hospital emergency rooms, urgent care clinics, inpatient services, substance abuse
treatment clinics, public health clinics, community clinics, correctional health-care facilities, and
other primary care settings. Because the primary focus of this SPNS initiative is the
establishment or enhancement of systemic linkages among HIV service organizations, funding
for HIV testing will be limited to a maximum of 10 percent of total annual awards. Awardees
will be expected to facilitate timely access to core medical and other appropriate services as
28
The Ryan White HIV/AIDS Treatment Extension Act of 2009 (P.L. 111-87), Section 2688, page 12. Accessed
from http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_public_laws&docid=f:publ087.111.pdf
29
See CDC (2006) Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in
Health-Care Settings. Morbidity and Mortality Weekly Report, 55 (RR14): 1-17. Accessed from
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm?s_cid= Please note that at the time of this writing,
the CDC is also in the process of updating these recommendations for HIV testing in non-health care settings, with
publication expected in late 2010 or early 2011.
HRSA-11-098 6
required by the Ryan White HIV/AIDS Program for all persons identified as HIV-infected
through this initiative.
Successful applications will demonstrate an in-depth understanding of the issues that interfere
with identifying those who are unaware of their HIV status, as well as linking and retaining those
newly diagnosed in quality HIV care. Defining exactly what is meant by being linked to and
retained in HIV treatment services can become complex. The HIV/AIDS Bureau conducted an
expert consultation meeting in 2005 focusing on outreach efforts to engage HIV-infected persons
in care, and later published a report30 containing an engagement in care continuum model
intended to assist service providers and policymakers design programs to meet variable client
needs (see Figure 1). At one end of the continuum are those who are completely unaware of
their HIV status and thus not in care, while those fully engaged in continuous HIV care are at the
other end. In between are various degrees of engagement. Ideally, HIV-infected persons would
progress from learning they are HIV positive to immediate linkage to HIV care to maintaining
full engagement in quality HIV care. However, the reality is quite different. Research has
shown that clients may move through different stages along the continuum at various times in
their lives.30
Figure 1: Engagement in Care Continuum
Not in Care In Care
Unaware of HIV Know HIV May Be Entered HIV
Fully Engaged in
Status Status Receiving Other Primary Medical In and Out of
HIV Primary
(never tested or (not referred to Medical Care Care but Dropped HIV Care or
Medical Care
never received care or didn’t But Not HIV Out Infrequent User
(linked to care)
results) keep referral) Care (lost to follow-up)
For the purposes of this initiative, an HIV-infected person will be considered as fully engaged in
HIV primary medical care if he or she has had a medical visit with a provider with prescribing
privileges (i.e., an MD, PA, or NP) in an HIV care setting two or more times at least 3 months
apart during the measurement year. Please note that this definition is used by the Medical Visits
HAB Performance Measure and also will be considered as successful linkage to HIV primary
care in this initiative.
The primary target population for this initiative is individuals who are unaware of their HIV
status. The initiative will use the same definition of those who are unaware of their HIV status
as the EIIHA definition contained in the FY2011 Part B guidance: any individual who has not
been tested for HIV in the past 12 months, or any individual who has not been informed of their
HIV test result (HIV positive or HIV negative), or any HIV positive individual who has not been
informed of their confirmatory HIV test result.31 Secondary target populations include, but are
not limited to:
30
Health Resources and Services Administration, HIV/AIDS Bureau. August 2006. Outreach: Engaging People in
HIV Care Summary of a HRSA/HAB 2005 Consultation on Linking PLWH Into Care. Accessed from
ftp://ftp.hrsa.gov/hab/HIVoutreach.pdf
31
See page 16 of the Part B Guidance at
https://grants.hrsa.gov/webExternal/FundingOppDetails.asp?FundingCycleId=4012E24E-92BC-400C-94CF-
HRSA-11-098 7
Those who are aware of their HIV-positive status but have yet to be successfully linked to
HIV care
Those who may be receiving other medical care but not HIV care
Those who entered HIV care but later dropped out of care (lost to follow-ups)
Those who are in and out of HIV care (sporadic or infrequent users of HIV care)
The primary outcomes of this initiative are the improvement of access to and retention in quality
HIV care for the above populations. Secondary outcomes include facilitating their timely entry
into HIV care and preventing vulnerable clients from dropping out of care. Once fully
implemented, a new or enhanced systemic linkage plan will demonstrate the following:
1) an increase in number of people living with HIV who know their serostatus;
2) an increase in number of newly diagnosed linked to care within three months of diagnosis;
3) an increase in number of individuals living with HIV who are virally suppressed; and
4) an increase in number of people living with HIV retained continuously in quality
HIV/AIDS care
The research literature has identified various barriers encountered by these populations that
prevent them from either being tested or entering care after receiving an HIV-positive diagnosis.
The Institute of Medicine (IOM) has classified barriers to accessing care into three categories:
structural, financial and personal/cultural barriers.32 Although SPNS and other research and
evaluation programs have previously identified various strategies to successfully link and retain
hard-to-reach populations in HIV care,33 this systemic linkages initiative will focus on
facilitating the coordination and cooperation among organizations implementing these
population-specific interventions. In addition, more must be done to support HIV-infected
persons in addressing the access delays that occur between testing and treatment, in order to
assure timely access to not only HIV primary care but also mental health and substance abuse
treatment and other supportive services that promote access and retention in HIV care.
Applicants therefore should focus on the structural barriers faced by those who are unaware of
their HIV infection and those aware but out of care. IOM defined structural barriers as
“impediments to medical care directly related to the number, type, concentration, location or
organizational configuration of health care providers.”34 Applicants must describe innovative
strategies using novel mechanisms to overcome these structural barrier impediments. Recipients
of this grant award will be expected to implement pioneering systemic linkage strategies that
may include components of effective and evidence-based service delivery models. These
innovative mechanisms may evolve from proven or novel care coordination models employing
cooperative, coordinated efforts among organizations at a systems level, but all such
mechanisms, strategies and models first must be pilot-tested prior to their wider-scale
implementation at regional or state levels.
This SPNS initiative will require the adoption of the Collaborative Model developed by the
Institute for Healthcare Improvement (IHI) as its framework to achieve its aims. IHI developed
0D63436711D8&ViewMode=EU&GoBack=&PrintMode=&OnlineAvailabilityFlag=&pageNumber=&version=&N
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32
Institute of Medicine (1993) Access to Health Care in America. National Academy Press, Washington, DC.
33
See http://hab.hrsa.gov/treatmentmodernization/spns.htm
34
Institute of Medicine (1993) Access to Health Care in America, page 39.
HRSA-11-098 8
this model to assist healthcare organizations in making improvements in the quality of their
service delivery while reducing costs. In 2003 IHI published its most recent white paper in its
Breakthrough Series using its Collaborative Model.35 The model employs a team-based
approach utilizing experts in topical areas as faculty to assist organizations in piloting small-
scale changes through Plan-Do-Study-Act (PDSA) cycles. If proven successful, these changes
will be incorporated at an organizational or systems level and shared with other organizations.
Since the model seeks to close the gaps between what organizations know and what they do,
improved data collection is a key to success. Additional information on the quality improvement
(QI) and Plan-Do-Study-Act (PDSA) techniques of the IHI Collaborative Model are available
through the National Quality Center’s Quality Academy.36
The Collaborative Model has been used in other HRSA collaborative initiatives beginning in
1999 for a range of health programs including organ procurement and transplantation,37 patient
safety and clinical pharmacy services,38 and health disparities across several health concerns.39
HAB has previously used the model in Title I and Title III Collaboratives and most recently, in
the Cross-Part Quality Management Collaborative. The Cross Part Collaborative was an 18
month initiative conducted from 2008 to 2010 and sponsored by HAB with support from the
National Quality Center. 40 This initiative sought to strengthen statewide collaboration across all
Ryan White HIV/AIDS Program Parts (Parts A, B, C, D, and F) co-located within five States. Its
goal was to improve alignment of quality management goals to jointly meet the Ryan White
HIV/AIDS Program legislative mandates, and for joint quality improvement activities to better
coordinate HIV services seamlessly across Parts. The ultimate purpose of the Collaborative
(was) to advance the quality of care for people living within a state.41 The establishment of
effective and sustainable linkages among organizations will necessarily involve the coordination
of data collection methodologies that include quality improvement efforts to enhance
surveillance methods and HIV care. Applicants should refer to HAB’s Performance Measures42
for potential outcome measures in considering the statewide evaluation of their systemic linkage
plans.
Applicants’ systems linkage plans will include pilot testing of their innovative mechanisms
through PDSA cycles, with the participation of collaborating organizations within their States or
Territories. Expert technical assistance and consultation will be provided by content consultants
assigned by the Evaluation and Technical Assistance Center (ETAC). In collaboration with the
ETAC, successful applicants will be required to conduct statewide collaboration meetings with
participating organizations within their States or Territories. In Year 1, the first statewide
collaboration meeting will be devoted to training staff of participating organizations in PDSA
techniques by ETAC consultants, and introduction and refinement of the linkage mechanisms to
be pilot tested. In Year 2, successful applicants will be required to host two Learning Sessions
with participating organizations, assisted by ETAC content consultants. Participants will learn
35
IHI (2003) The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI
Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003. Accessed from
http://www.ihi.org/IHI/Results/WhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchieving+Breakthr
oughImprovement.htm
36
See http://www.nationalqualitycenter.org/index.cfm/17263
37
See http://optn.transplant.hrsa.gov/news/newsDetail.asp?id=307
38
See http://www.hrsa.gov/publichealth/clinical/patientsafety/
39
See http://www.hrsa.gov/publichealth/business/healthit/collaboratives.html
40
See http://www.nationalqualitycenter.org/index.cfm/17112/19344
41
HAB/NQC Cross-Part Quality Management Collaborative Charter, page 2
42
See a description of HAB’s Performance Measures at http://hab.hrsa.gov/special/habmeasures.htm
HRSA-11-098 9
from each other, discussing the pilot testing of the linkage mechanisms and sharing the results.
Systems linkage mechanisms proven successful through PDSA pilot tests will then be
implemented on a wider scale and evaluated in larger settings at the state level in Years 3 and 4.
With the assistance of the ETAC, Demonstration States will be expected to host, at a minimum,
one statewide meeting in Year 3 to coordinate the wider scale implementation and to promote the
adoption of proven linkage mechanisms with other traditional and non-traditional HIV service
partners within the State or Territory who did not participate in Years 1 and 2.
Successful applicants will be expected to work collaboratively with the SPNS-funded Evaluation
and Technical Assistance Center (ETAC) and SPNS staff to design and implement a national,
multi-state evaluation. The ETAC will provide technical assistance at statewide meetings, SPNS
grantee meetings, during teleconferences, and at site visits (when necessary) over the course of
the entire project. The ETAC also will serve as the principal resource for Demonstration States
in all aspects of evaluation design and delivery. In addition to the multi-state evaluation, the
ETAC will provide technical assistance to the Demonstration States in the refinement of their
linkage mechanisms to be pilot tested in Year 2, and in the design of their statewide evaluation
plans to be implemented in Year 3.
Demonstration States must agree to fully participate in the multi-state evaluation of this SPNS
initiative led by the ETAC. The multi-state evaluation may include quantitative and/or
qualitative measures of the societal, organizational, community and interpersonal mechanisms
involved in establishing systemic linkages that promote engagement and retention in care.
Demonstration States will be required to collect and report relevant data to the ETAC, including
but not limited to the pilot testing of their systems linkage mechanisms; the wider-scale
implementation of proven linkage mechanisms; HIV incidence surveillance; counseling and
testing; quality improvement; and access to and retention in care of newly diagnosed clients.
Applicants should carefully read the requirements for the Evaluation and Technical Assistance
Center under Announcement Number HRSA-11-129 to better understand the importance of the
national, multi-state evaluation requirements.
During Years 3 and 4, Demonstration States, with the assistance of the ETAC, will implement a
statewide evaluation plan to assess whether the system linkage mechanisms proven effective in
their pilot testing are effective in their wider application in improving access to and retention in
high quality, competent HIV care and services for those unaware of their HIV-infection and
those aware who are out of care. Demonstration States will be expected to closely collaborate
with their state and local surveillance offices and leverage the health information technologies
(HIT) of health service organizations at the local, state and national levels to improve the
collection and reporting of data that describes their targeted populations. They also will be
expected to collect and report programmatic data related to relevant outcome, process and cost
measures; conduct self-assessments and quality improvement activities; and qualitative
evaluations that directly relate to improving timely entry, access to and retention of those
unaware of their HIV status and those aware but not yet engaged in care. The applicant’s
proposed staffing plan must include, at a minimum, a half-time (50 percent full-time equivalent)
statewide evaluator to design and oversee the implementation of the statewide evaluation and
coordinate the multi-state evaluation activities led by the ETAC. Evaluation staff should have
demonstrated knowledge and expertise in conducting real world healthcare evaluations.
Data collected in this SPNS initiative is classified as either public health evaluation data or
client-level data. Public health evaluation data, such as HIV incidence data and Ryan White
HRSA-11-098 10
Services (RSR) data, are reported without disclosure of private health information. The Privacy
Rule of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 grants
exemptions to covered entities who collect and report protected health information (PHI) for the
purposes of communicable disease surveillance in public health activities and quality
improvement in health care operations.43 However, due to the need to establish the effectiveness
of linkage mechanisms in identifying the unaware and out of care populations, especially during
the Years 1 and 2 of the initiative, further client-level data collection with the potential for PHI
disclosure may be required. Collection of client-level data beyond data that is routinely reported
to HRSA, CDC and state and local entities for public health activities or health care operations
will be subject to the Privacy Rule of HIPAA44 and to human subjects research protections45
which require state and local institutional review board approval and annual renewal.
Demonstration States also must cooperate with ETAC and SPNS regarding the privacy and
confidentiality of patients’ medical records and their health-seeking efforts. Demonstration
States must have a plan in place to safeguard patients’ privacy and confidentiality, in accordance
with HIPAA regulations and human subjects research protections. The project director and all
key personnel should take the National Institutes of Health (NIH) IRB online training46 and other
training as appropriate. Applicants must demonstrate they have documented procedures for
electronically and physically protecting the privacy of patient information and data. All client-
level data to be collected by Demonstration States in the multi-state evaluation must be
electronically maintained and electronically transferable to the ETAC’s web-based data
collection system. Finally, successful applicants will be required to submit to SPNS and to the
ETAC on an annual basis proof of IRB approvals and renewals for all client-level data collection
instruments, informed consents and evaluation materials.
Demonstration States are expected to lead efforts to disseminate project findings and lessons
learned within their State or Territory, and to participate in dissemination efforts at the national
level. Project findings to be disseminated include, but are not limited to, innovative strategies,
novel approaches and linkage mechanisms to help other Ryan White grantees and HIV service
providers improve their care coordination. Demonstration States will be expected to host at a
minimum, one statewide meeting in Year 3 to coordinate the wider scale implementation, which
will afford an opportunity to promote the adoption of proven linkage mechanisms with other
traditional and non-traditional HIV service partners within the State or Territory who did not
participate in Years 1 and 2.
Successful applicants will have personnel with the necessary skills to communicate project
findings to local communities, state and national conferences, and policymakers, and to
collaborate in writing and publishing findings in peer reviewed journals. Successful applicants
will be expected to provide requested materials for inclusion on the Initiative’s website, which
will be maintained by the ETAC. Evaluation staff of Demonstration States, with input from
other staff, will be required to develop a system linkage strategy manual to support replication of
successful systems linkage mechanisms by other organizations within their State and by other
Ryan White grantees. Successful applicants will be expected to address how collaborative
43
See Summary of the HIPAA Privacy Rule at:
http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html
44
See HIPAA and the Privacy Rule at: http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html
45
See Code of Federal Regulations Title 45 Part 56 Protection of Human Subjects at:
http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm
46
See http://phrp.nihtraining.com/users/login.php
HRSA-11-098 11
linkage systems proven successful will be sustained within the funded States and Territories
beyond the term of the SPNS initiative.
Successful applicants will be expected to attend a single grantees meeting with other SPNS
Systems Linkages Initiative Demonstration States during Years 1 and 2, and two meetings in
each of Years 3 and 4. Training in the use of IHI Collaboration Model techniques will be
provided by the ETAC during the first such meeting. All SPNS grantee meetings will take place
in the Washington, DC metropolitan area, and the grantee should allocate funds for the Project
Director, evaluator, and one other key staff person to attend these 2 day meetings.
SPNS funding may not be used to supplant or supplement concurrent Ryan White activities or
services already funded under Part B or any other Part grants. With the exception of funding
additional HIV testing not to exceed 10 percent of the award, this SPNS-supported initiative
should not be a continuation of existing services within or affiliated with the Demonstration
State. Funds awarded under this grant may not be used for direct services, including HIV care
and testing, that are billable to third party payers.
II. Award Information
1. Type of Award
Funding will be provided in the form of a grant.
2. Summary of Funding
The SPNS program will provide funding for Federal fiscal years 2011-2014 with an anticipated
start date of September 1, 2011. Approximately $8,000,000 is expected to be available annually
to fund 8 grantees. Applicants may apply for a ceiling amount of up to $1,000,000 per year. The
period of support is up to four (4) years. Funding beyond the first year is dependent on the
availability of appropriated funds for the SPNS Program in subsequent fiscal years, grantee
satisfactory performance, and a decision that continued funding is in the best interest of the
Federal government.
III. Eligibility Information
1. Eligible Applicants
Eligible applicants are limited to Ryan White Part B funded grantees of record, to include the
lead administrative agencies for all 50 States. Additionally, the District of Columbia, the
Commonwealth of Puerto Rico, the Territories of the Virgin Islands, Guam, American Samoa,
the Commonwealth of the Northern Mariana Islands, the Republic of Palau, the Federated States
of Micronesia, and the Republic of the Marshall Islands are also eligible to apply for these funds.
2. Cost Sharing/Matching
There is no cost sharing or matching requirement
HRSA-11-098 12
3. Other
Applications that exceed the ceiling amount of $1,000,000 will be considered non-responsive
and will not be considered for funding under this announcement.
SPNS funding may not be used to supplant or supplement Ryan White activities or services
already funded under concurrent Parts A, B, C, D, or F grants.
Federal funds provided through this grant may not be used for the following purposes:
1) To directly provide health care or testing services that are billable to third party payers
(e.g., private health insurance, prepaid health plans, Medicaid, Medicare, other Ryan
White Program funding including ADAP);
2) With the exception of testing services allowable under criteria established in this
guidance, to directly provide health care services or duplicate existing services;
3) Purchase, construction of new facilities or capital improvements to existing facilities;
4) Purchase or improvement to land;
5) Purchase vehicles;
6) Fundraising expenses;
7) Lobbying activities and expenses;
8) Reimbursement of pre-award costs;
9) International travel; and/or
10) Cash payments to intended service recipients, as opposed to various non-cash incentives
to encourage participation in evaluation activities.
Any application that fails to satisfy the deadline requirements referenced in Section IV.3 will be
considered non-responsive and will not be considered for funding under this announcement.
IV. Application and Submission Information
1. Address to Request Application Package
Application Materials and Required Electronic Submission Information
HRSA requires applicants for this funding opportunity announcement to apply electronically
through Grants.gov. All applicants must submit in this manner unless they obtain a written
exemption from this requirement in advance by the Director of HRSA’s Division of Grants
Policy. 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. Your email must include the HRSA announcement number for which you are
seeking relief, the name, address, and telephone number of the organization and the name and
telephone number of the Project Director as well as the Grants.gov Tracking Number
(GRANTXXXX) assigned to your submission along with a copy of the “Rejected with Errors”
notification you received from Grants.gov. HRSA and its Grants Application Center (GAC)
will only accept paper applications from applicants that received prior written approval.
However, the application must still be submitted under the deadline.
Refer to HRSA’s Electronic Submission User Guide, available online at
http://www.hrsa.gov/grants/userguide.htm, for detailed application and submission instructions.
HRSA-11-098 13
Pay particular attention to Sections 2 and 5 that provide detailed information on the competitive
application and submission process.
Applicants must submit proposals according to the instructions in the Guide and in this funding
opportunity announcement in conjunction with Application Form SF-424. The forms contain
additional general information and instructions for applications, proposal narratives, and budgets.
The forms and instructions may be obtained from the following site by:
(1) Downloading from www.grants.gov, or
(2) Contacting the HRSA Grants Application Center at:
910 Clopper Road
Suite 155 South
Gaithersburg, MD 20878
Telephone: 877-477-2123
HRSAGAC@hrsa.gov
Specific instructions for preparing portions of the application that must accompany Application
Form SF-424 appear in the “Application Format” section below.
2. Content and Form of Application Submission
Application Format Requirements
The total size of all uploaded files may not exceed the equivalent of 80 pages when printed by
HRSA, or a total file size of 10 MB. This 80-page limit includes the abstract, project and budget
narratives, attachments, and letters of commitment and support. Standard forms are NOT
included in the page limit.
Applications that exceed the specified limits (approximately 10 MB, or 80 pages when
printed by HRSA) will be deemed non-responsive. Non-responsive applications will not be
considered under this funding announcement.
Application Format
Applications for funding must consist of the following documents in the following order:
HRSA-11-098 14
SF-424 Non Construction – Table of Contents
It is mandatory to follow the instructions provided in this section to ensure that your application can be printed efficiently and consistently for review.
Failure to follow the instructions may make your application non-responsive. Non-responsive applications will not be considered under this funding
opportunity announcement.
For electronic submissions, applicants only have to number the electronic attachment pages sequentially, resetting the numbering for each
attachment, i.e., start at page 1 for each attachment. Do not attempt to number standard OMB approved form pages.
For electronic submissions, no Table of Contents is required for the entire application. HRSA will construct an electronic table of contents in the
order specified.
W hen providing any electronic attachment with several pages, add a Table of Contents page specific to the attachment. Such pages will not be
counted towards the page limit.
Application Section Form Type Instruction HRSA/Program Guidelines
Application for Federal Assistance Form Pages 1, 2 & 3 of the SF-424 face page. Not counted in the page limit
(SF-424)
Project Summary/Abstract Attachment Can be uploaded on page 2 of SF-424 - Box Required attachment. Counted in the page limit.
15 Refer to the funding opportunity announcement
for detailed instructions.
Additional Congressional District Attachment Can be uploaded on page 3 of SF-424 - Box As applicable to HRSA; not counted in the page
16 limit.
Application Checklist Form HHS- Form Pages 1 & 2 of the HHS checklist. Not counted in the page limit.
5161-1
Project Narrative Attachment Form Form Supports the upload of Project Narrative Not counted in the page limit.
document
Project Narrative Attachment Can be uploaded in Project Narrative Required attachment. Counted in the page limit.
Attachment form. Refer to the funding opportunity announcement
for detailed instructions. Provide table of
contents specific to this document only as the
first page.
SF-424A Budget Information - Form Page 1 & 2 to supports structured budget for Not counted in the page limit.
Non-Construction Programs the request of Non-construction related funds.
Budget Narrative Attachment Form Form Supports the upload of Project Narrative Not counted in the page limit.
document.
Budget Narrative Attachment Can be uploaded in Budget Narrative Required attachment. Counted in the page limit.
Attachment form. Refer to the funding opportunity announcement
for detailed instructions.
SF-424B Assurances - Non- Form Supports assurances for non-construction Not counted in the page limit.
HRSA-11-098 15
Application Section Form Type Instruction HRSA/Program Guidelines
Construction Programs programs.
Project/Performance Site Form Supports primary and 29 additional sites in Not counted in the page limit.
Location(s) structured form.
Additional Performance Site Attachment Can be uploaded in the SF-424 Performance Not counted in the page limit.
Location(s) Site Location(s) form. Single document with
all additional site location(s)
Disclosure of Lobbying Activities Form Supports structured data for lobbying Not counted in the page limit.
(SF-LLL) activities.
Other Attachments Form Form Supports up to 15 numbered attachments. Not counted in the page limit.
This form only contains the attachment list.
Attachment 1-15 Attachment Can be uploaded in Other Attachments form Refer to the attachment table provided below for
1-15. specific sequence. Counted in the page limit.
To ensure that attachments are organized and printed in a consistent manner, follow the order provided below. Note that these instructions may
vary across programs.
Evidence of Non-Profit status and invention related documents, if applicable, must be provided in the other attachment form.
Additional supporting documents, if applicable, can be provided using the available rows. Do not use the rows assigned to a specific purpose in the
program funding opportunity announcement.
Merge similar documents into a single document. W here several pages are expected in the attachment, ensure that you place a table of contents
cover page specific to the attachment. The Table of Contents page will not be counted in the page limit.
Attachment Number Attachment Description (Program Guidelines)
Attachment 1 Line Item Budgets
Attachment 2 Narrative Staffing Plan
Attachment 3 Position Descriptions
Attachment 4 Biographical Sketches of Key Personnel
Attachment 5 Table of Part B Program Current Statewide Collaborative and Service Agreements for all services
Attachment 6 Evidence of Consistency with Statewide Coordinated Statement of Need
Attachment 7 Table of Part B Program Proposed System of Statewide Linkages among HIV Service Organizations
Attachment 8 Current and Proposed Letters of Agreement, and/or Memoranda of Agreement or Understanding
Attachment 9 Work Plan
Attachment 10 Cultural and Linguistic Factors Statement
Attachment 11 Healthy People 2020 Summary
Attachment 12 Other Relevant Documents
HRSA-11-098 16
Application Format
i. Application Face Page
Complete Application Form SF-424 provided with the application package. Prepare
according to instructions provided in the form itself. For information pertaining to the
Catalog of Federal Domestic Assistance, the CFDA Number is 93.928.
DUNS Number
All applicant organizations (and subrecipients of HRSA award funds) are required to have a
Data Universal Numbering System (DUNS) number in order to apply for a grant or
cooperative agreement from the Federal Government. The DUNS number is a unique nine-
character identification number provided by the commercial company, Dun and Bradstreet.
There is no charge to obtain a DUNS number. Information about obtaining a DUNS number
can be found at http://fedgov.dnb.com/webform or call 1-866-705-5711. Please include the
DUNS number in item 8c on the application face page. Applications will not be reviewed
without a DUNS number. Note: A missing or incorrect DUNS number is the number one
reason for applications being “Rejected for Errors” by Grants.gov. HRSA will not extend the
deadline for a missing or incorrect DUNS.
Additionally, the applicant organization (and any subrecipient of HRSA award funds) is
required to register annually with the Federal Government’s Central Contractor Registry
(CCR) in order to do electronic business with the Federal Government. It is extremely
important to verify that your CCR registration is active. Information about registering with
the CCR can be found at http://www.ccr.gov.
ii. Table of Contents
The application should be presented in the order of the Table of Contents provided earlier.
Again, for electronic applications no table of contents is necessary as it will be generated by
the system. (Note: the Table of Contents will not be counted in the page limit.)
iii. Application Checklist
Complete the HHS Application Checklist Form HHS 5161-1 provided with the application
package.
iv. Budget
Complete Application Form SF-424A – Budget Information for Non-Construction Programs
provided with the application package. Complete Sections A, B, E, and F.
Applicants also must submit separate line item budget spreadsheet tables for each year of the
proposed project period, using the budget categories in the SF 424A and breaking down
sub-categorical costs. Under Personnel, please list each position by title and name, with
annual salary, FTE, and salary charged to the grant. Equipment, supplies and contractual
should each have individual items listed separately. The amounts requested on the SF424A
and listed on the line-item budget must match. The budget must relate to the activities
proposed in the Project Narrative and the Work Plan. These line item budgets should be
included as Attachment 1.
HRSA-11-098 17
Budget for Multi-Year Award
This announcement is inviting applications for project periods up to four (4) years. Although
the project period may be for up to four (4) years, awards will be made on a non-competitive
basis for a one year budget period. Timely submission and HRSA approval of your Progress
Report(s) and any other required submissions for the prior budget period initiates a new
budget period and the release of the next year’s funds. Funding beyond the one-year budget
period and within the four (4) year project period is subject to availability of funds,
satisfactory progress of the grantee and a determination that continued funding is in the best
interest of the Federal government.
v. Budget Justification
Provide a narrative that explains the amounts requested for each line in the budget. The
budget justification should specifically describe how each item will support the achievement
of proposed objectives. The budget period is for ONE year. However, the applicant must
submit one-year budgets for each of the subsequent budget periods within the requested
project period (usually one to four years) at the time of application. Line item information
must be provided to explain the costs entered in the SF-424A. The budget justification
must clearly describe each cost element and explain how each cost contributes to
meeting the project’s objectives/goals. Be very careful about showing how each item in the
“other” category is justified. For subsequent budget years, the justification narrative should
highlight the changes from year one or clearly indicate that there are no substantive budget
changes during the project period. The budget justification MUST be concise. Do NOT use
the justification to expand the project narrative. Please note that the primary focus of this
SPNS initiative is the establishment or enhancement of systemic linkages among HIV service
organizations, and funding for HIV testing supplies or related testing programmatic costs will
be limited to 10 percent of total award.
Include the following in the Budget Justification narrative:
Personnel Costs: Personnel costs should be explained by listing each staff member who
will be supported from funds, name (if possible), position title, percentage of full-time
equivalency, and annual salary. In-kind personnel contributions, including percentage of
full-time equivalency, should also be listed.
Fringe Benefits: List the components that comprise the fringe benefit rate, for example
health insurance, taxes, unemployment insurance, life insurance, retirement plan, tuition
reimbursement. The fringe benefits should be directly proportional to that portion of
personnel costs that are allocated for the project.
Travel: List travel costs according to local and long distance travel. Long distance travel
for three staff members to attend the SPNS grantee meetings in Washington, DC should
be broken down by airfare/train fare, ground transportation, lodging and meals and
incidental expenses (use federal per diem rates). For local travel, the mileage rate,
number of miles, reason for travel and staff members completing the travel should be
outlined. The budget should also allocate sufficient support to meet the travel expenses
associated with assisting staff from participating organizations to attend the statewide
collaboration meetings, and other proposed trainings or workshops.
HRSA-11-098 18
Equipment: List equipment costs and provide justification for the need of the equipment
to carry out the program’s goals. Extensive justification and a detailed status of current
equipment must be provided when requesting funds for the purchase of computers and
furniture items that meet the definition of equipment (a unit cost of $5,000 or more and a
useful life of one or more years). Please note that most computer devices and digital
accessories generally do not meet the Federal equipment definition ($5,000 or more per
unit), and therefore those costs should be listed in the Supplies category.
Supplies: List the items that the project will use. In this category, separate office
supplies from medical and educational purchases. Office supplies could include
computers and peripherals that do not meet the definition of equipment, paper, pencils,
and the like. Medical supplies are syringes, blood tubes, plastic gloves, etc., and
educational supplies may be pamphlets and educational videotapes. Remember, they
must be listed separately.
Contractual: Applicants are responsible for ensuring that their organization has in place
an established and adequate procurement system with fully developed written procedures
for awarding and monitoring all contracts. Applicants must provide a clear explanation
as to the purpose of each contract, how the costs were estimated, and the specific contract
deliverables. Reminder: recipients must notify potential subrecipients that entities
receiving subawards must be registered in the Central Contractor Registry (CCR) and
provide the recipient with their DUNS number.
Other: Put all costs that do not fit into any other category into this category and provide
an explanation of each cost in this category. In some cases, rent, utilities and insurance
fall under this category if they are not included in an approved indirect cost rate.
Indirect Costs: Indirect costs are those costs incurred for common or joint objectives
which cannot be readily identified but are necessary to the operations of the organization,
e.g., the cost of operating and maintaining facilities, depreciation, and administrative
salaries. For institutions subject to OMB Circular A-21, the term “facilities and
administration” is used to denote indirect costs. If an organization applying for an
assistance award does not have an indirect cost rate, the applicant may wish to obtain one
through HHS’s Division of Cost Allocation (DCA). Visit DCA’s website at:
http://rates.psc.gov/ to learn more about rate agreements, the process for applying for
them, and the regional offices which negotiate them.
vi. Staffing Plan and Personnel Requirements
Applicants must present a staffing plan as Attachment 2, and provide a justification for the
plan that includes education and experience qualifications and rationale for the amount of time
being requested for each staff position. The applicant’s proposed staffing plan must include,
at a minimum, a half-time (50 percent full-time equivalent) statewide evaluator to design and
oversee the implementation of the statewide evaluation and coordinate the multi-state
evaluation activities led by the ETAC. The applicant’s proposed staffing plan must include
personnel with the necessary skills to communicate project findings to local communities,
state and national conferences, and policymakers, and to collaborate in writing and publishing
findings in peer reviewed journals.
Position descriptions that include the roles, responsibilities, and qualifications of proposed
HRSA-11-098 19
project staff must be included in Attachment 3. Biographical sketches for any key employed
personnel that will be assigned to work on the proposed project must be included in
Attachment 4.
vii. Assurances
Complete Application Form SF-424B Assurances – Non-Construction provided with the
application package.
viii. Certifications
Use the Certifications and Disclosure of Lobbying Activities Application Form provided with
the application package.
ix. Project Abstract
Provide a summary of the application. Because the abstract is often distributed to provide
information to the public and Congress, please prepare this so that it is clear, accurate,
concise, and without reference to other parts of the application. It must include a brief
description of the proposed project including its goals; the needs to be addressed; a summary
of proposed plan of project operation; the target populations to be served; and a summary of
the systemic linkage plan. The project abstract must be single-spaced and limited to one page
in length. Please place the following at the top of the abstract:
Project Title
Applicant Name
Address
Contact Name and Phone Numbers (Voice, Fax)
E-Mail Address
Web Site Address, if applicable
x. Program Narrative
This section provides a comprehensive framework and description of all aspects of the
proposed program. It should be succinct, self-explanatory and well organized so that
reviewers can understand the proposed project.
Use the following section headers for the Narrative:
INTRODUCTION
Provide a clear and succinct description of the proposed project to include the strategies,
partnerships, and innovative methods for systemic linkages to be implemented that will
improve access to and retention in quality HIV care for those unaware of their status and
those aware but out of care. Clearly describe how the proposed project addresses key
factors involved in identifying people living with HIV and facilitating their timely entry
and retention in HIV care. Briefly describe the proposed innovative strategies for
identifying populations unaware of their HIV status within the State or Territory.
NEEDS ASSESSMENT
This section outlines the specific needs of your State or Territory, and should help
reviewers understand the communities and/or population(s) that will be served by the
proposed project. Describe the most recent available HIV incidence data within the State
or Territory, and the specific State and local methods used to calculate it. Describe the
HRSA-11-098 20
specific target populations who are unaware of their HIV status and those aware but out of
care using demographics from the most recent surveillance data available from all possible
sources, including but not limited to CDC HIV infection surveillance reports; State and
Territorial health department HIV epidemiology profiles; and epidemiology reports
produced by City health departments. Identify the specific population(s) to be targeted by
the project, and the organization’s ability and plans to access them. Describe the specific
and unique issues in your State or Territory that interfere with identifying those who are
unaware of their HIV status, and describe the proposed means of early identification of
those who are HIV-infected. Discuss the unmet health needs of people living with
HIV/AIDS who are out of care in your State or Territory. The Unmet Needs and Early
Identification of Individuals with HIV/AIDS (EIIHA) sections of the applicant’s FY2011
Part B application may be used in whole or in part.
Describe current HIV testing capacity within your State or Territory, including all HIV
testing initiatives implemented or to be implemented in the near future. These testing
activities include but are not limited to those directly funded and implemented by the
applicant organization, and those being funded or directly implemented by the CDC and
other federal agencies. Discuss barriers that are likely to be encountered in counseling and
testing and access to and retention in care for those newly diagnosed by the project, and
what strategies should be used to overcome them.
Describe all current collaborative efforts and service agreements within the Part B
program’s jurisdiction, to include other Ryan White, HRSA, CDC, State Medicaid, and
other HIV service providers of counseling and testing, prevention, surveillance and
treatment activities, and include a table as Attachment 5. Include an assessment of the
current level of cooperation and collaboration among HIV service organizations within the
State or Territory and identify areas of opportunities.
Authorizing legislation indicates that the Secretary may not make a grant unless the
applicant submits evidence that the proposed program is consistent with the Statewide
Coordinated Statement of Need (SCSN), and that the applicant agrees to participate in the
ongoing revision process of the SCSN. Provide a statement indicating how the proposed
project is consistent with your state’s SCSN, and include as Attachment 6.
METHODOLOGY
This section provides a description of the proposed methodologies to be used in meeting
the program requirements and expectations described earlier in this funding opportunity
announcement.
Describe the innovative mechanisms to be pilot tested in Years 1 and 2 of the project that
will establish effective and sustainable linkages that optimize the coordination of existing
HIV counseling and testing, surveillance, prevention, and treatment resources among
participating organizations. Discuss how these novel mechanisms will overcome the
structural barriers faced by those who are unaware of their HIV infection and those aware
but out of care. Describe how these mechanisms, if fully implemented in Years 3 and 4 of
the initiative, will improve HIV care coordination and service delivery among all other
Ryan White grantee organizations co-located within the State or Territory. Describe how
these mechanisms, if fully implemented in Years 3 and 4 of the initiative, will improve
HIV care coordination and service delivery with other traditional (such Part B provider
HRSA-11-098 21
agencies) and non-traditional HIV service partners, including but not limited to, hospital
emergency rooms; community health centers; outpatient, urgent care, sexually transmitted
disease, mental health and/or substance abuse treatment clinics; correctional health-care
facilities; and other primary care settings. Describe how this funding is to be leveraged
along with existing resources to work with key partners and stakeholders across the public
health system and communities to identify and conduct counseling and testing of high risk
and HIV-infected, out of care populations and link them into care.
Identify the organizations and agencies with which the applicant will collaborate in the
project, and include a table as Attachment 7. Applicants will be expected to work with
both current and newly established collaboration organizations in this SPNS initiative.
During Years 1 and 2, successful applicants will be expected to assist participating
organizations in planning and implementing the PDSA cycles for the pilot studies, and also
host three statewide collaboration meetings with assistance from the Evaluation and
Technical Assistance Center. During Years 3 and 4, the applicant should approach
additional organizations to implement the linkage mechanisms proven successful in Year
2. Include current and proposed Letters of Support, and/or Memoranda of Agreement or
Understanding, for contractual agreements contained within the proposal, with each not to
exceed one page in length, as Attachment 8. Please note that each collaborating
organization must explicitly state its consent to participate in both statewide and multi-
state evaluations, which may require IRB approvals if client-level data is to be collected.
Describe how the strategic linkage plan will address specific goals, steps, recommended
actions and benchmark results anticipated by 2015 of the National HIV/AIDS Strategy.
Describe how current and anticipated HIV counseling and testing and prevention
initiatives, including HIV-related research projects that include testing activities, may
impact the goals and objectives of the systemic linkage plan, including any possible
synergies, such as increased testing capacity and enhanced surveillance. Describe plans to
extend current HIV testing capabilities to health care organizations within your borders
that currently do not offer testing or who have just begun to offer testing but lack adequate
capacity. Describe any proposed data collection methodologies that include quality
improvement efforts to enhance surveillance methods or to improve HIV care.
Present a draft of a statewide evaluation plan to be implemented in Year 3 of the initiative;
with the understanding it will be refined in collaboration with the Evaluation and Technical
Assistance Center (ETAC). The statewide evaluation plan will document and evaluate the
effectiveness of the innovative linkage mechanisms found to be successful through pilot
testing in Years 1 and 2 of the initiative. The draft statewide evaluation plan should
include a synopsis of the evaluation questions to be explored, and propose analyses to
measure and assess the effects of implementing successful systems linkage mechanisms.
Possible outcome measures to be considered include those at the client, provider and
system/structural-levels; client characteristics of those tested and linked into care; and their
relationship to the effectiveness of the linkage mechanisms; and measures of improvement
in the delivery and quality of HIV primary care. The draft statewide evaluation plan should
also include methods to assess potential barriers to the effective implementation of the
innovative linkage mechanisms. Applicants should describe how any potential cross-
contaminating effects by other ongoing and anticipated counseling and testing and HIV
prevention initiatives and activities will be addressed in their statewide evaluation.
Evaluation staff, with input from other staff, will be required to develop a system linkage
HRSA-11-098 22
strategy manual that describes the successful innovative mechanisms and addresses their
replicability by other organizations. Finally, applicants must address how these
collaborative linkage systems will be sustained within their States and Territories beyond
the four year project period of the SPNS initiative.
In addition to conducting a statewide evaluation in Years 3 and 4, Demonstration States
must agree to fully participate in the national, multi-state evaluation led by the ETAC.
Applicants must identify appropriate and effective methods for ensuring the quality and
security of all data they collect and report during the initiative. Demonstration State staff
must participate in dissemination of project findings and lessons learned. During Years 1
and 2, successful applicants will be required to share the results of their pilot studies
obtained through PDSA cycles with other participating organizations at the statewide
collaboration meetings. During Years 3 and 4, successful applicants will be expected to
collaborate with the ETAC in the dissemination of their successful innovative strategies,
novel approaches and linkage mechanisms to help other Ryan White grantees and HIV
service delivery organizations, both within and outside their States and Territories, to
improve their care coordination to reach the unaware and out of care populations.
Applicants should describe their plans for disseminating these findings and lessons learned
to local, state, and national audiences and policy makers.
WORK PLAN
Provide a work plan that delineates steps for implementing and assessing project activities.
The work plan is to be used as a tool to actively manage the project by measuring progress,
identifying necessary changes, and quantifying accomplishments. The work plan should
directly relate to the methods described in the Methodology section and the Program
Requirements and Expectations of this guidance. Use a time line that includes each
activity and identifies the staff responsible. All aspects of design, development, pilot
testing, implementation, and evaluation, along with the role of everyone involved in each
activity, must be included in this section.
The work plan should include (1) goals; (2) objectives; and (3) action steps that are
specific, time-framed, and measurable. Include staff responsible for each action step and
by what date. Clearly indicate the anticipated start date of the project, and clearly outline
the action steps taken to fully implement the project activities. Goals are to be written for
the entire proposed 4-year project period, but work plan objectives should be clearly
written under the goals set for Year 1. Include the project’s Work plan in Attachment 9.
RESOLUTION OF CHALLENGES
Discuss challenges that are likely to be encountered in planning and implementing the
activities described in the work plan. Describe approaches to be used to resolve challenges
and how these will be documented as part of the evaluation process.
EVALUATION CAPACITY
Describe the applicant’s capacity to conduct a comprehensive statewide evaluation of the
proposed project. Describe how the proposed key project personnel (including any
consultants and subcontractors) have the necessary knowledge, experience, and skills in
designing and implementing public health program evaluations, specifically evaluations of
innovative HIV access and retention projects. Describe the applicant’s knowledge,
experience, and skills in utilizing quality management methodology/tools/resources to
HRSA-11-098 23
improve health care and social service delivery programs. If applicable, describe the
experience, skills and training of the proposed key project personnel in evaluating
programs reaching those who are unaware of their HIV status or those aware but out of
care, including any published materials and previous work of a similar nature.
The applicant must state its willingness to work in close collaboration with the Evaluation
and Technical Assistance Center throughout the initiative. This collaboration includes but
is not limited to training in and use of the IHI Collaborative Model; refinement of systems
linkage mechanisms; facilitation of statewide collaboration meetings and learning sessions;
pilot testing of linkage mechanisms; refinement and analysis of statewide evaluation plans;
attendance at SPNS grantee meetings (one in Years 1 and 2, and 2 in Years 3 and 4);
collection and reporting of outcome, process and cost data for the multi-state evaluation
and additional focused evaluation studies; and dissemination efforts at the national, State
and local levels. Describe the experience, skills, and knowledge of any key project
personnel (including any consultants and subcontractors) in participating in a multi-state
evaluation of national scope. Describe the proposed key personnel’s experience in writing
and publishing study findings in peer reviewed journals and in disseminating findings to
local communities, national conferences and to policy makers.
ORGANIZATIONAL INFORMATION
Provide information on the applicant organization’s current structure and scope of current
activities. Describe how these all contribute to the ability of the organization to conduct
the program requirements and meet program expectations. Describe areas in which you
anticipate needing technical assistance designing, implementing and evaluating your
program. Also, describe anticipated staff training needs related to the proposed project and
how these needs will be met. If awarded, this information will assist HRSA and the ETAC
to better address your needs and help you to identify technical assistance and training
providers.
Applicants should describe their cultural competency capabilities. Cultural competence
means having a set of congruent behaviors, attitudes, and policies that come together in a
system or organization or among professionals that enables effective work in cross-cultural
situations.47 It includes an understanding of integrated patterns of human behavior,
including language, beliefs, norms, and values, as well as socioeconomic and political
factors that may have significant impact on psychological well-being and incorporating
those variables into assessment and treatment. Include the project’s cultural and linguistic
competence factors in Attachment 10.
ADDITIONAL NARRATIVE GUIDANCE
Instructions: In order to ensure that the Generic Review Criteria in the Funding
Opportunity Announcement Template are fully addressed, this table provides a bridge
between the sample narrative language and where each section falls within the review
criteria.
47
See National Standards for Culturally and Linguistically Appropriate Services at:
http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15
HRSA-11-098 24
Narrative Section Generic Review Criteria
Introduction (1) Need
Needs Assessment (1) Need
Methodology (2) Response, (3) Evaluative Measures &
(4) Impact
Work Plan (2) Response & (4) Impact
Resolution of Challenges (2) Response
Evaluation Capacity (5) Resources/Capabilities
Organizational Information (5) Resources/Capabilities
Budget and Budget Justification (6) Support Requested – the budget section
should include sufficient justification to
allow reviewers to determine the
reasonableness of the support requested.
xi. Attachments
Please provide the following items to complete the content of the application. Please note that
these are supplementary in nature, and are not intended to be a continuation of the project
narrative. Unless otherwise noted, all attachments count against the 80 page limit. Each
attachment must be clearly labeled.
Attachment 1: Line Item Budgets Spreadsheet
Attachment 2: Staffing Plan
Attachment 3: Position Descriptions
Keep each to one page in length as much as is possible. Include the role, responsibilities, and
qualifications of proposed project staff. It is permissible to have more than one new job
description per page.
Attachment 4: Biographical Sketches of Key Personnel
Include biographical sketches for persons occupying the key positions not to exceed two
pages in length. In the event that a biographical sketch is included for an identified individual
who is not yet hired, please include a letter of commitment from that person with the
biographical sketch.
Attachment 5: Table of Part B Program Current Statewide Collaborative and Service
Agreements for all services. List all current collaborative efforts and service agreements
within the Part B program’s jurisdiction, to include other Ryan White, HRSA, CDC and other
funded HIV service providers of counseling and testing, prevention, surveillance and
treatment activities.
HRSA-11-098 25
Attachment 6: Evidence of Consistency with Statewide Coordinated Statement of Need
Authorizing legislation indicates that the Secretary may not make a grant unless the applicant
submits evidence that the proposed program is consistent with the statewide coordinated
statement of need (SCSN), and agrees to participate in the ongoing revision process of such
statement of need. Please describe how the program is consistent with your State’s or
Territory’s SCSN.
Attachment 7: Table of Part B Program Proposed System of Statewide Linkages among HIV
Service Organizations. Identify the organizations and agencies with which you will work to
enhance existing collaborative linkages or to establish new ones in your project. This table
may be subdivided into organizations which will participate in the pilot-testing in Years 1 and
2 and additional organizations which will participate in the full scale implementation of
successful linkage mechanisms in Years 3 and 4.
Attachment 8: Current and Proposed Letters of Support, and/or Memoranda of Agreement
or Understanding, for contractual agreements contained within the proposal. Provide any
documents that describe working relationships between the applicant agency and other
agencies and programs cited in the application, with each not to exceed one page in length.
Documents that confirm actual or pending contractual agreements should clearly describe the
roles of the subcontractors and any deliverable. Please note that each collaborating
organization must explicitly state its consent to participate in both statewide and multi-state
evaluations, which may require IRB approvals if client-level data is to be collected. Letters of
Support and Memoranda of Agreement or Understanding must be dated and signed by an
authorized official. Please note that each collaborating organization must explicitly state its
consent to participate in both a statewide and multi-state evaluation.
Attachment 9: Work Plan
The work plan should include (1) goals; (2) objectives that are specific, time-framed, and
measurable; (3) action steps; and (4) staff responsible for each action step and by what date.
Clearly indicate the anticipated start date of the project, and outline the action steps taken to
fully implement the project activities. Goals are to be written for the entire proposed 4-year
project period, but work plan objectives should be clearly written under the goals set for Year
1. Objectives and key action steps should be written in time-framed and measurable terms.
Attachment 10: Cultural and Linguistic Factors
The Health Resources and Services Administration (HRSA) envisions optimal health for all,
supported by a health care system that assures access to comprehensive, culturally competent,
quality care.
HRSA defines cultural and linguistic competence as a set of congruent behaviors, attitudes,
and policies that come together in a system, organization, or among professionals and enable
that system, organization, or those professionals to work effectively in cross-cultural and
linguistically diverse situations. Healthcare providers funded through HRSA grants need to
be alert to the importance of cross-cultural and language-appropriate communications, as well
as general health literacy issues. HRSA supports and promotes a unified health
communication perspective that addresses cultural competency, limited English proficiency,
and health literacy in an integrated approach in order to develop the skills and abilities needed
by HRSA-funded providers and staff to deliver the best quality health care effectively to the
diverse populations they serve.
HRSA-11-098 26
HRSA is committed to ensuring access to quality health care for all. Quality care means
access to services, information, and materials delivered by competent providers in a manner
that factor in the language needs, cultural richness, and diversity of populations served.
Quality also means that, where appropriate, data collection instruments used should adhere to
culturally competent and linguistically appropriate norms. For additional information and
guidance, refer to the National Standards for Culturally and Linguistically Appropriate
Services in Health Care published by the U.S. Department of Health and Human Services.48
Wherever appropriate, describe the program’s or institution’s strategic plan, policies, and
initiatives that demonstrate a commitment to providing culturally and linguistically competent
health care and developing culturally and linguistically competent health care providers,
faculty, staff, and program participants. This includes participation in, and support of
programs that focus on cross-cultural health communication approaches as strategies to
educate health care providers serving diverse patients, families, and communities.
Wherever appropriate identify programs that work to (1) improve medication compliance of
patients, and (2) improve patient understanding regarding health conditions and (3) improve
the ability of the patient to manage their condition. Wherever appropriate, describe a plan to
recruit and retain key staff with demonstrated experience serving the specific target
population and familiarity with the culture and language of the particular communities served.
Wherever appropriate, describe the program or institution’s strategic plan, policies, and
initiatives that demonstrate a commitment to serving the specific target population and
familiarity with the culture and literacy level of the particular target group. Wherever
appropriate, present a summary of specific training, and /or learning experiences to develop
knowledge and appreciation of how culture and language influences health literacy
improvement and the delivery of high quality, effective and predictably safe healthcare
services.
Attachment 11: Healthy People 2020 Summary
Applicants must summarize the relationship of their projects and identify which of their
programs objectives and/or sub-objectives relate to the goals of the Healthy People 2020
initiative. Refer to page 38 for further information.
Attachment 12: Other Relevant Documents
Include here any other documents that are relevant to the application and or referenced in the
application.
3. Submission Dates and Times
Notification of Intent to Apply
Letters of intent are strongly recommended. However, an applicant is eligible to apply even if no
letter of intent is submitted. The letter should identify the applicant organization and its intent to
apply, and briefly describe the proposal to be submitted. Receipt of Letters of Intent will not be
acknowledged. This letter should be sent by March 2, 2011 by mail or fax to:
48
See National Standards for Culturally and Linguistically Appropriate Services at:
http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15
HRSA-11-098 27
Director, Division of Independent Review
HRSA Grants Application Center (GAC)
HRSA-11-098
910 Clopper Road, Suite 155 South
Gaithersburg, MD 20878
Fax: (877) 477-2345
Application Due Date
The due date for applications under this funding opportunity announcement is April 4, 2011 at
8:00 P.M. ET. Applications completed online are considered formally submitted when the
application has been successfully transmitted electronically by your organization’s Authorized
Organization Representative (AOR) through Grants.gov and has been validated by Grants.gov on
or before the deadline date and time.
The Chief Grants Management Officer (CGMO) or designee may authorize an extension of
published deadlines when justified by circumstances such as natural disasters (e.g., floods or
hurricanes) or other disruptions of services, such as a prolonged blackout. The CGMO or
designee will determine the affected geographical area(s).
Late applications:
Applications which do not meet the criteria above are considered late applications and will not be
considered in the current competition.
4. Intergovernmental Review
The Special Projects of National Significance Program is a program subject to the provisions of
Executive Order 12372, as implemented by 45 CFR 100. Executive Order 12372 allows States
the option of setting up a system for reviewing applications from within their States for
assistance under certain Federal programs. Application packages made available under this
funding opportunity will contain a listing of States which have chosen to set up such a review
system, and will provide a State Single Point of Contact (SPOC) for the review. Information on
States affected by this program and State Points of Contact may also be obtained from the Grants
Management Officer listed in the Agency Contact(s) section, as well as from the following Web
site: http://www.whitehouse.gov/omb/grants_spoc.
All applicants other than federally recognized Native American Tribal Groups should contact
their SPOC as early as possible to alert them to the prospective applications and receive any
necessary instructions on the State process used under this Executive Order.
Letters from the State Single Point of Contact (SPOC) in response to Executive Order 12372 are
due sixty days after the application due date.
5. Funding Restrictions
Applicants responding to this announcement may request funding for a project period of up to
four (4) years, at no more than $1,000,000 per year. Awards to support projects beyond the first
budget year will be contingent upon Congressional appropriation, satisfactory progress in
HRSA-11-098 28
meeting the project’s objectives, and a determination that continued funding would be in the best
interest of the Federal government.
Funds under this announcement may not be used for the following purposes:
1) To directly provide health care or testing services that are billable to third party payers
(e.g., private health insurance, prepaid health plans, Medicaid, Medicare, other Ryan
White Program funding including ADAP);
2) With the exception of testing services allowable under criteria established in this funding
opportunity announcement, to directly provide health care services or duplicate existing
services;
3) Purchase, construction of new facilities or capital improvements to existing facilities;
4) Purchase or improvement to land;
5) Purchase vehicles;
6) Fundraising expenses;
7) Lobbying activities and expenses;
8) Reimbursement of pre-award costs;
9) International travel; and/or
10) Cash payments to intended service recipients, as opposed to various non-cash incentives
to encourage participation in evaluation activities.
Because the primary focus of this SPNS initiative is the establishment or enhancement of
systemic linkages among HIV service organizations, funding for HIV testing will be limited to a
maximum of 10 percent of total annual awards.
SPNS funding may not be used to supplant or supplement concurrent Ryan White activities or
services already funded under Part B or any other Part grants.
6. Other Submission Requirements
As stated in Section IV.1, except in rare cases HRSA will no longer accept applications in paper
form. Applicants submitting for this funding opportunity are required to submit electronically
through Grants.gov. To submit an application electronically, please use the
http://www.Grants.gov application site. When using Grants.gov you will be able to download a
copy of the application package, complete it off-line, and then upload and submit the application
via the Grants.gov site.
It is essential that your organization immediately register in Grants.gov and become familiar
with the Grants.gov site application process. If you do not complete the registration process you
will be unable to submit an application. The registration process can take up to one month.
To be able to successfully register in Grants.gov, it is necessary that you complete all of the
following required actions:
• Obtain an organizational Data Universal Number System (DUNS) number
• Register the organization with Central Contractor Registry (CCR)
• Identify the organization’s E-Business Point of Contact (E-Biz POC)
• Confirm the organization’s CCR “Marketing Partner ID Number (M-PIN)” password
• Register an Authorized Organization Representative (AOR)
HRSA-11-098 29
• Obtain a username and password from the Grants.gov Credential Provider
Instructions on how to register, tutorials and FAQs are available on the Grants.gov web site at
www.grants.gov. Assistance is also available 24 hours a day, 7 days a week (excluding Federal
holidays) from the Grants.gov help desk at support@grants.gov or by phone at 1-800-518-4726.
Applicants should ensure that all passwords and registration are current well in advance of the
deadline.
Formal submission of the electronic application: Applications completed online are
considered formally submitted when the application has been successfully transmitted
electronically by your organization’s AOR through Grants.gov and has been validated by
Grants.gov on or before the deadline date and time. Applications that do not meet these criteria
will be considered unresponsive and will not be considered in the competition.
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, you
are urged to submit your application in advance of the deadline. If your application is rejected
by Grants.gov due to errors, you must correct the application and resubmit it 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.
If, for any reason, an application is submitted more than once prior to the application due
date, HRSA will only accept the applicant’s last validated electronic submission prior to the
application due date as the final and only acceptable submission of any competing
application submitted to Grants.gov.
Tracking your application: It is incumbent on the applicant to track application status by
using the Grants.gov tracking number (GRANTXXXXXXXX) provided in the confirmation
email from Grants.gov. More information about tracking your application can be found at
http://www07.grants.gov/applicants/resources.jsp. Be sure your application is validated by
Grants.gov prior to the application deadline.
V. Application Review Information - Required
1. Review Criteria
Procedures for assessing the technical merit of applications have been instituted to provide for an
objective review of applications and to assist the applicant in understanding the standards against
which each application will be judged. Critical indicators have been developed for each review
criterion to assist the applicant in presenting pertinent information related to that criterion and to
provide the reviewer with a standard for evaluation. Review criteria are outlined below with
specific detail and scoring points.
Review Criteria are used to review and rank applications. The SPNS Program has six (6) review
criteria:
Criterion 1: Need (10 Points)
HRSA-11-098 30
The extent to which the application addresses the need for developing and evaluating systems
linkage projects aimed at improving timely access to and retention in quality HIV care for those
who are unaware of their HIV status and those who are aware but out of care.
This corresponds to the Introduction and Needs Assessment sections of the Narrative.
i. Introduction (5 Points)
The extent to which the applicant succinctly describes the purpose of the proposed
project, including the proposed strategies, partnerships, and innovative methods for
systemic linkages to be implemented that will improve access to and retention in
quality HIV care for those unaware of their status and those aware but out of care.
Strength and clarity of the description of the key factors involved in identifying
people living with HIV and facilitating their timely entry, and retention in HIV care.
Strength and clarity of the brief description of the proposed innovative strategies for
identifying populations unaware of their HIV status within the State or Territory.
ii. Needs Assessment (5 Points)
Strength and clarity of the description of the most recent available HIV incidence data
within the State or Territory, and the specific state and local methods used to
calculate it.
Extent to which the demographic data provided describe the specific target
populations who are unaware of their HIV status and those aware but out of care.
Evidence of use of the most recent surveillance data available from sources including
but not limited to local, State and Federal surveillance and prevention entities to
describe specific target populations who are unaware of their HIV status and those
aware but out of care.
Extent to which the application clearly identifies the specific population(s) to be
targeted by the project, and the organization’s ability and plans to access them.
Extent to which the application clearly describes the specific and unique issues in its
State or Territory that interfere with identifying those who are unaware of their HIV
status.
Strength and feasibility of the proposed means of early identification of those who are
HIV-infected.
Strength and clarity of the discussion of the unmet health needs of people living with
HIV/AIDS in its State or Territory.
Strength and clarity of the description of current HIV testing capacity within the State
or Territory, including all HIV testing initiatives implemented or to be implemented
in the near future, and those directly funded and implemented by the applicant
organization, and those being funded or directly implemented by the CDC and other
federal agencies.
Strength and clarity of the discussion of likely barriers to be encountered in
counseling and testing and access to and retention in care for those newly diagnosed
by the project, and strategies to overcome them.
Strength and clarity of the description of current collaborative efforts and service
agreements within the Part B program’s jurisdiction, including other Ryan White,
HRSA, CDC, State Medicaid, and other HIV service providers of counseling and
testing, prevention, surveillance and treatment activities (in Attachment 5).
HRSA-11-098 31
Clarity and completeness of the assessment of the current level of coordination and
collaboration among HIV service organizations within the State or Territory.
Evidence that the proposed systems linkages project is consistent with the statewide
coordinated statement of need (in Attachment 6).
Criterion 2: Response (35 Points)
The extent to which the proposed project responds to the Purpose included in the program
description. The extent to which the proposed methodologies to be used in meeting the program
requirements are logical and appropriate. The clarity of the proposed goals and objectives, and
their relationship to the project. The extent to which the activities described in the application
are capable of addressing the problem and attaining the project’s objectives.
This corresponds to the Methodology, Work Plan and Resolution of Challenges sections of the
Narrative.
i. Methodology (20 Points)
Strength and feasibility of innovative mechanisms to be pilot tested in Years 1 and 2 of
the project that will establish effective and sustainable linkages that optimize the
coordination of existing HIV counseling and testing, surveillance, prevention and
treatment resources among participating organizations.
Strength and feasibility of the novel mechanisms in overcoming the structural barriers
faced by those who are unaware of their HIV infection and those aware but out of care.
Strength and feasibility of these mechanisms, if fully implemented in Years 3 and 4 of the
initiative, in improving HIV care coordination and service delivery with all other Ryan
White grantee organizations co-located within the State or Territory.
Strength and feasibility of these mechanisms, if fully implemented in Years 3 and 4 of the
initiative, in improving HIV care coordination and service delivery with other traditional
(such as Part B providers) and non-traditional HIV service partners, including but not
limited to, hospital emergency rooms; community health centers; outpatient, urgent care,
sexually transmitted disease, mental health and/or substance abuse treatment clinics;
correctional health-care facilities; and other primary care settings.
Strength of the proposed means of leveraging the funding in this initiative along with
existing resources to work with key partners and stakeholders across the public health
system and communities to identify and conduct counseling and testing of high risk and
HIV-infected, out of care populations and link them into care.
Appropriateness of the organizations and agencies described in the application with
which the applicant will collaborate in the project (in Attachment 7).
Extent to which the applicant proposes to work both with organizations with which it has
current collaborative efforts and service agreements (listed in Attachment 5) and with
new collaborating organizations (listed in Attachment 7).
Evidence of appropriate Letters of Support, and/or Memoranda of Agreement or
Understanding, for contractual agreements from the proposed collaborating organizations
that explicitly consent to participation in both a statewide and multi-state evaluation (in
Attachment 8).
Strength of the proposed project in addressing specific goals, steps, recommended actions
and benchmark results anticipated by 2015 of the National HIV/AIDS Strategy.
Extent to which the application describes the impact of current and anticipated HIV
counseling and testing and prevention initiatives, including HIV-related research projects
HRSA-11-098 32
that include testing activities, on the goals and objectives of the systemic linkage plan,
including any possible synergies, such as increased testing capacity and enhanced
surveillance.
Extent to which the applicant plans to extend current HIV testing capabilities to health
care organizations within its borders that currently do not offer testing or who have just
begun to offer testing but lack adequate capacity.
Strength and appropriateness of any proposed data collection methodologies that include
quality improvement efforts to enhance HIV surveillance methods or to improve HIV
care.
Evidence the applicant addresses sustaining the collaborative linkage systems within their
States and Territories beyond the four year project period of the SPNS initiative.
ii. Work Plan (10 Points)
Strength and feasibility of the applicant’s Work Plan and its goals for the 4-year project
period (in Attachment 9).
Extent to which the goals and objectives of the applicant’s Work Plan address the
program expectations and requirements the applicant described in the Methodology
section of the Narrative.
Evidence the applicant’s timeline includes each activity and identifies the staff
responsible to accomplish the goals and objectives of the project.
Evidence the applicant’s objectives for Year 1 are specific to each goal, time-framed, and
measurable.
Strength and feasibility of the applicant’s work plan with regard to the anticipated start
date of the project and the action steps necessary to fully implement project activities.
iii. Resolution of Challenges (5 Points)
Extent to which the applicant identifies possible challenges that are likely to be
encountered during the planning and implementation of the project.
Extent to which the applicant identifies appropriate responses to be used to resolve those
challenges.
Evidence the applicant plans to document the resolution of challenges encountered as part
of the evaluation process.
Criterion 3: Evaluative Measures (20 points)
The effectiveness of the method proposed to monitor and evaluate the project results.
Evaluative measures must be able to assess to what extent the program objectives have been
met and to what extent these can be attributed to the project.
This corresponds to the evaluation methodology described in the Methodology section of the
Narrative.
Strength of the draft statewide evaluation plan to be implemented in Year 3 of the
initiative, with the acknowledgment that it will be refined in collaboration with the
Evaluation and Technical Assistance Center.
Strength and appropriateness of the draft statewide evaluation plan’s proposed evaluation
questions, analyses and outcome measures to assess the effects of implementing
successful systems linkage mechanisms.
HRSA-11-098 33
Strength and feasibility of the draft statewide evaluation plan’s proposed methods to
assess potential barriers to the effective implementation of the innovative linkage
mechanisms.
Strength and feasibility of the draft statewide evaluation’s means of addressing any
potential cross-contaminating effects by other ongoing and anticipated counseling and
testing and HIV prevention initiatives and activities in their systemic linkage plans.
Evidence of the applicant’s commitment to work in close collaboration with the
Evaluation and Technical Assistance Center and fully participate in the multi-state
evaluation activities.
Strength and appropriateness of the applicant’s means for ensuring the quality and
security of all data they will collect and report during the initiative.
Criterion 4: Impact (10 Points)
The extent and effectiveness of plans for dissemination of project results and whether the project
results may be national in scope, The extent to which the project activities are replicable, and
the sustainability of the program beyond the Federal Funding.
This corresponds to the Methodology and Work Plan sections of the Narrative.
Evidence the applicant clearly expresses its commitment to collaborate with the
Evaluation and Technical Assistance Center in the dissemination of program findings and
lessons learned from their innovative strategies, novel approaches and linkage
mechanisms to help other Ryan White grantees and other HIV service delivery
organizations to improve their care coordination, both within and outside their State or
Territory.
Strength and appropriateness of the applicant’s plans for disseminating findings and
lessons learned to local, state, and national audiences and policy makers.
Evidence of the applicant’s intent to develop a system linkage strategy manual that
describes the successful innovative mechanisms and addresses their replicability by other
organizations.
Criterion 5: Resources/Capabilities (15 Points)
The extent to which project personnel (including consultants and sub-contractors) are qualified
by training and experience to implement and carry out the project. The capabilities of the
applicant organization, including quality and availability of facilities to fulfill the needs and
requirements of the proposed project. For competing continuations, past performance will also
be considered.
This corresponds to the Evaluation Capacity and Organizational Information sections of the
Narrative.
Extent to which the application provides evidence of the applicant’s capacity to
conduct a comprehensive statewide evaluation of the proposed project.
Extent to which the proposed key project personnel (including any consultants and
subcontractors) possess the necessary knowledge, experience and skills in designing
and implementing health program evaluations, specifically evaluations of innovative
HIV access and retention projects.
HRSA-11-098 34
Evidence the applicant demonstrates sufficient knowledge, experience, and skills in
utilizing quality management methodology/tools/resources to improve health care and
social service delivery programs,
Extent to which the applicant describes key project personnel with experience, skills
and training in evaluating programs reaching those who are unaware of their HIV
status or those aware but out of care, including any published materials and previous
work of a similar nature.
Evidence the application describes key project personnel (including any consultants
and subcontractors) with the experience, skills, and knowledge in participating in a
multi-state evaluation of national scope.
Strength of the applicant’s proposed key personnel’s experience in writing and
publishing study findings in peer reviewed journals and in disseminating findings to
local communities, national conference and to policy makers.
Criterion 6: Support Requested (10 Points)
The reasonableness of the proposed budget for each year of the project period in relation to the
objectives, the complexity of the research activities, and the anticipated results. The extent to
which costs, as outlined in the budget and required resources sections, are reasonable given the
scope of work. The extent to which key personnel have adequate time devoted to the project to
achieve project objectives.
This corresponds to the Budget, Budget Justification, and Staffing Plan sections.
i. Budget and Budget Justification (5 Points)
Strength of the applicant’s line item budgets for each year of the project period (in
Attachment 1) and their appropriateness to the proposed work plan.
Strength and clarity of the application’s budget justification’s support for each line
item.
Evidence the line item budgets specify allocations for staffing in percentages of full-
time equivalents (FTEs) that are adequate for the proposed activities for each year of
the project.
If applicable, strength of rationale for significant changes in subsequent years’
budgets.
The extent to which contracts for proposed subcontractors and consultants are clearly
described in terms of contract purposes; how costs are derived; and that payment
mechanisms and deliverables are reasonable and appropriate.
Evidence the budgets allocate sufficient support to meet the travel expenses
associated with assisting staff from participating organizations to attend the statewide
collaboration meetings, grantee meetings in Washington, DC; and other proposed
trainings or workshops.
Evidence the budget allocates no more than 10 percent of its total to support HIV
testing activities.
ii. Staffing Plan (5 Points)
The extent to which the application’s staffing plan is consistent with the project
description and project activities (in Attachment 2).
HRSA-11-098 35
Evidence the applicant’s staffing plan includes key personnel with the skills,
knowledge, education and training required to successfully implement all of the
project activities throughout the project as described in the work plan.
Extent to which the time allocated for key staff consistent with their expected
workload and goals and objectives of the project.
Evidence the applicant’s staffing plan includes, at a minimum, a half-time (50 percent
full-time equivalent) statewide evaluator to design and oversee the implementation of
the statewide evaluation and coordinate the multi-state evaluation activities.
Strength and appropriateness of the job descriptions for key staff (in Attachment 3).
Strength and appropriateness of the biographical sketches (in Attachment 4)
2. Review and Selection Process
The Division of Independent Review is responsible for managing objective reviews within
HRSA. Applications competing for Federal funds receive an objective and independent review
performed by a committee of experts qualified by training and experience in particular fields or
disciplines related to the program being reviewed. In selecting review committee members,
other factors in addition to training and experience may be considered to improve the balance of
the committee, e.g., geographic distribution. Each reviewer is screened to avoid conflicts of
interest and is responsible for providing an objective, unbiased evaluation based on the review
criteria noted above. The committee provides expert advice on the merits of each application to
program officials responsible for final selections for award.
Applications that pass the initial HRSA eligibility screening will be reviewed and rated by a
panel based on the program elements and review criteria presented in relevant sections of this
program announcement. The review criteria are designed to enable the review panel to assess
the quality of a proposed project and determine the likelihood of its success. The criteria are
closely related to each other and are considered as a whole in judging the overall quality of an
application.
3. Anticipated Announcement and Award Dates
It is anticipated that awards will be announced prior to the start date of September 1, 2011.
VI. Award Administration Information
1. Award Notices
Each applicant will receive written notification of the outcome of the objective review process,
including a summary of the expert committee’s assessment of the application’s merits and
weaknesses, and whether the application was selected for funding. Applicants who are selected
for funding may be required to respond in a satisfactory manner to Conditions placed on their
application before funding can proceed. Letters of notification do not provide authorization to
begin performance.
The Notice of Award sets forth the amount of funds granted, the terms and conditions of the
award, the effective date of the award, the budget period for which initial support will be given,
HRSA-11-098 36
the non-Federal share to be provided (if applicable), and the total project period for which
support is contemplated. Signed by the Grants Management Officer, it is sent via e-mail to the
applicant’s Authorized Organization Representative, and reflects the only authorizing document.
It will be sent prior to the start date of September 1, 2011.
2. Administrative and National Policy Requirements
Successful applicants must comply with the administrative requirements outlined in 45 CFR Part
74 Uniform Administrative Requirements for Awards and Subawards to Institutions of Higher
Education, Hospitals, Other Nonprofit Organizations, and Commercial Organizations or 45 CFR
Part 92 Uniform Administrative Requirements For Grants And Cooperative Agreements to State,
Local, and Tribal Governments, as appropriate.
HRSA grant and cooperative agreement awards are subject to the requirements of the HHS
Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of
award. This includes, as applicable, any requirements in Parts I and II of the HHS GPS that
apply to the award. The HHS GPS is available at http://www.hrsa.gov/grants/. The general
terms and conditions in the HHS GPS will apply as indicated unless there are statutory,
regulatory, or award-specific requirements to the contrary (as specified in the Notice of
Award).
Cultural and Linguistic Competence
HRSA is committed to ensuring access to quality health care for all. Quality care means
access to services, information, materials delivered by competent providers in a manner that
factors in the language needs, cultural richness, and diversity of populations served. Quality
also means that, where appropriate, data collection instruments used should adhere to culturally
competent and linguistically appropriate norms. For additional information and guidance, refer
to the National Standards for Culturally and Linguistically Appropriate Services in Health Care
published by HHS. This document is available online at http://www.omhrc.gov/CLAS.
Trafficking in Persons
Awards issued under this funding opportunity announcement are subject to the requirements of
Section 106 (g) of the Trafficking Victims Protection Act of 2000, as amended (22 U.S.C.
7104). For the full text of the award term, go to http://www.hrsa.gov/grants/trafficking.html.
If you are unable to access this link, please contact the Grants Management Specialist
identified in this funding opportunity to obtain a copy of the Term.
PUBLIC POLICY ISSUANCE
HEALTHY PEOPLE 2020
is a national initiative led by the Department of Health and Human Services that sets priorities
for all HRSA programs. The initiative has two major goals: (1) to increase the quality and
years of a healthy life; and (2) to eliminate our country’s health disparities. The program
consists of 38 focus areas containing measureable objectives. HRSA has actively participated
in the work groups of all the focus areas, and is committed to the achievement of the Healthy
People 2020 goals. More information about Healthy People 2020 may be found online at
http://www.healthypeople.gov/.
HRSA-11-098 37
Smoke-Free Workplace
The Public Health Service strongly encourages all award recipients to provide a smoke-free
workplace and to promote the non-use of all tobacco products. Further, Public Law 103-227, the
Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion
of a facility) in which regular or routine education, library, day care, health care or early
childhood development services are provided to children.
3. Reporting
The successful applicant under this funding opportunity announcement must comply with the
following reporting and review activities:
a. Audit Requirements
Comply with audit requirements of Office of Management and Budget (OMB) Circular
A-133. Information on the scope, frequency, and other aspects of the audits can be found
on the Internet at http://www.whitehouse.gov/omb/circulars_default.
b. Payment Management Requirements
Submit a quarterly electronic Federal Financial Report (FFR) Cash Transaction Report
via the Payment Management System. The report identifies cash expenditures against the
authorized funds for the grant or cooperative agreement. The FFR Cash Transaction
Reports must be filed within 30 days of the end of each calendar quarter. Failure to
submit the report may result in the inability to access award funds. Go to
www.dpm.psc.gov for additional information.
c. Status Reports
1) Federal Financial Report. The Federal Financial Report (SF-425) is required within
90 days of the end of each budget period. The report is an accounting of expenditures
under the project that year. Financial reports must be submitted electronically through
EHB. More specific information will be included in the Notice of Award.
2) Progress Report(s). The awardee must submit a progress report to HRSA on a semi-
annual basis. Timely submission and HRSA approval of your Federal Financial Report
(FFR) and your Progress Report for the prior budget period initiates a new budget period
and the release of the next year’s funds. Further information on specific content will be
provided post-award.
3) Final Report(s). A final report is due within 90 days after the project period ends.
Further information on specific content will be provided post-award. The final report
must be submitted on-line by awardees in the Electronic Handbooks system at
https://grants.hrsa.gov/webexternal/home.asp.
d. Transparency Act Reporting Requirements
New awards issued under this funding opportunity announcement are subject to the
reporting requirements of the Federal Funding Accountability and Transparency Act
(FFATA) of 2006 (Pub. L. 109–282), as amended by section 6202 of Public Law 110–
252, and implemented by 2 CFR Part 170. Grant and cooperative agreement recipients
must report information for each first-tier subaward of $25,000 or more in Federal funds
and executive total compensation for the recipient’s and subrecipient’s five most highly
HRSA-11-098 38
compensated executives as outlined in Appendix A to 2 CFR Part 170 (available online at
http://www.hrsa.gov/grants/ffata.html). Competing Continuation awardees may be
subject to this requirement and will be so notified in the Notice of Award.
VII. Agency Contacts
Applicants may obtain additional information regarding business, administrative, or fiscal issues
related to this funding opportunity announcement by contacting:
Tammy Jeffs, Grants Management Specialist
Attn: Announcement # HRSA-11-098
HRSA Division of Grants Management Operations, OFAM
Parklawn Building, Room 11A-16
5600 Fishers Lane
Rockville, MD 20857
Telephone: (301) 443-5419
Fax: (301) 443-6343
Email: TJeffs @hrsa.gov
Additional information related to the overall program issues and/or technical assistance
regarding this funding announcement may be obtained by contacting
Adan Cajina, Branch Chief
Demonstration and Evaluation Branch
Attn: SPNS Systems Linkages and Access to Care for Populations at High Risk of HIV
Infection Initiative – Demonstration States (# HRSA-11-098)
HIV/AIDS Bureau, HRSA
Parklawn Building, Room 7C-07
5600 Fishers Lane
Rockville, MD 20857
Telephone: 301-443-3180
Fax: 301-594-2511
Email: ACajina@hrsa.gov
Applicants may need assistance when working online to submit their application forms
electronically. For assistance with submitting the application in Grants.gov, contact Grants.gov
24 hours a day, seven days a week, excluding Federal holidays at:
Grants.gov Contact Center
Phone: 1-800-518-4726
E-mail: support@grants.gov
VIII. Tips for Writing a Strong Application
A concise resource offering tips for writing proposals for HHS grants and cooperative
agreements can be accessed online at:
http://www.hhs.gov/asrt/og/grantinformation/apptips.html.
HRSA-11-098 39