Ryan White Part a FY15 Funding Opportunity Announcement

Ryan White Part A FY15 Funding Opportunity Announcement Grantee Webinar Questions & Answers

1. The FOA is requesting information on living PLWHA that would include PLWHA who are not part of the Ryan White Care system. Some of the information for non-Ryan White PLWHA is not available to Ryan White grantees (insurance status, ART status). If the information for non-Ryan White PLWHA is not provided will points be deducted during review?

While we are asking for as complete and comprehensive data as possible across various domains, where data is not available, describe the data that is being presented, explain why the full complement of data may not be available, and ensure that you explain fully the epidemic within your jurisdiction, how to address the needs of the population, and how it relates to the implementation plan.

2. The guidance does not give us the format requirements for the application (i.e. 12 pitch, double spaced, etc.).

Please use an easily readable font, such as Times Roman, Arial, Courier, or CG Times. The text and table portions of the application must be submitted in not less than a 12- point font and 1.0 line spacing. Applications not adhering to 12-point font requirements may be deemed non-responsive and returned. For charts, graphs, footnotes, and budget tables, applicants may use a different pitch or size font but not less than 10 pitch or size font. It is vital that the charts are legible when scanned or reproduced.

3. The Budget Narrative sample table for Attachment 12 is in legal format. Does this include Attachment 12?

This is just a sample table presented for illustrative purposes. Ensure that the entire application is submitted on 8.5 x 11 white paper, including Attachment 12.

4. The budget template does not contain the details that we like to include, such as category sub- totals, calculations showing how we reach a line item cost, etc. We do provide a summary that matches the column totals that the template shows, is that acceptable?

The budget template is application form SF-424A Budget Information- Non Construction Programs. This is an OMB approved form and cannot be altered. The budget narrative table (Attachment 12) must include, at a minimum, the columns and categories provided in the sample. Additional columns and calculations may also be added to the budget narrative table.

1 5. Can we add extra tables and graphs in Jurisdictional profile?

Additional information may be added, however, please adhere to the page limit.

6. Also is the Attachment 3 table in this webinar the format you would like or can we use our own format for the table if all the information is present?

Applicants are encouraged to use the sample template formats. Applicants may use a different format or template, however please ensure that all of the required information is included.

7. Please confirm that the Jurisdictional Profile table is not an attachment and therefore should be imbedded in the narrative.

The Jurisdictional Profile section requires two data tables. In section 1(1) of the jurisdictional profile, the table should be imbedded in the narrative. In section 1(2) of the jurisdictional profile, the table should be submitted as Attachment 3.

8. Could you guide us how Maintenance of Effort (MOE) is calculated? Applicants should refer to the Part A Ryan White Program: Maintenance of Effort Reporting Guidance 2013 for calculating the MOE. Also, consult with your Project Officer if you have further questions about calculating the MOE.

9. The guidance states we can use the RSR data as a minimum source of data but grantees do not have access the latest RSR datasets. Previously, we have asked for the datasets but have not received a response.

HRSA/HAB understands that some jurisdictions without centralized systems or data sharing agreements with funded providers may not have a complete set of RSR data. Jurisdictions should use the most recent full set of RSR data available, or if that is not available, the most complete set of non- RSR data, with a description of what it represents and why a more comprehensive set of data is unavailable.

10. Can you please review the requirements for Attachment 6? May private sources of funding also be included in Attachment 6?

2 Attachment 6 should include the dollar amount(s) and percentages of the total available funds in 2014, and the anticipated funds in 2015 for other Ryan White HIV/AIDS Program funding (Parts B, C, D, and F); federal/state and local sources of public funding; and public and private (to the extent available and as a means to provide the full picture of other available funding) HIV/AIDS-related service funds available in FY 2014 and anticipated in FY 2015. It is understood that figures for FY 2015 may represent estimates.

11. The FOA section for the Continuum of Care indicates that grantees should provide 2013 data. However, one of our state surveillance programs has pointed out that the CDC guidance for Continuum of Care strongly suggest that there be a one year delay between the end of the data reporting period and when the Continuum of Care data is pulled. If state surveillance programs follow the CDC guidance, the most recent data they would be able put into a Continuum of Care graph would be 2012. Will Ryan White grantees be penalized for presenting 2012 data, rather than the requested 2013 data?

Applicants are asked to provide the most recent complete data available to compile the Continuum of Care graph and compute outcomes, along with an explanation of the data set that was used to capture this information.

12. Is that the most up to date continuum of care diagram?

The Continuum of Care diagram presented in the FOA is an example from the Office of National HIV/AIDS Policy and is used for the purpose of this webinar to illustrate the HIV Continuum of Care.

13. Does each service category provided in the EMA have to be related to the stages of the Continuum of Care required in Attachment 9?

Applicants are asked to list the top four (4) core and two (2) support service categories that comprise the largest amounts of Part A funding on the FY2015 implementation plan. The service categories included in the HIV Care Continuum table should reflect the service categories in the implementation plan.

14. Most of the Affordable Care Act dispositions do not apply to Puerto Rico. How will this affect the evaluation of the section that is worth four (4) points?

Describe the uniqueness and limitations of the Affordable Care Act within your jurisdiction. Then describe the challenges that it poses for PLWHA within your jurisdiction.

3 15. Most funding sources have not released their FY 2015 funding amounts. Attachment 6 requires a separate column for FY15 anticipated funding amounts. Most of that will remain blank; will we lose points on that? Applicants should include estimated FY15 funding amounts as available. Points will not be deducted for not having exact funding level information.

16. Can we use the Unmet Need table format used in previous applications? The document referenced in the FAQ for Unmet Need appears to be the prevalence table.

Yes, applications should use the format from previous applications. The Unmet Need Estimate table format should be presented using the HRSA HAB Unmet Need Framework and should be presented as Attachment 4.

17. In Attachment 5, should this profile include only the profile of PLWH with co-morbidities in the EMA/TGA, or should it also include the general population with the co-morbidities as comparison?

Attachment 5 should include co-morbidity data for PLWH only, and not include a comparison to the general population.

18. Can you provide an example connecting the implementation plan with the care continuum table?

A sample of the implementation plan is included in the attachments.

19. In section 3.A.1, Uninsured and Poverty, should this include only data on PLWH who are uninsured/living in poverty or also data on the general population who are uninsured/living in poverty?

This section should include information only on PLWH who are uninsured/ living in poverty.

20. In terms of the Continuum of Care table, for Stage I. Diagnosis, would the denominator be the total number of persons in our jurisdiction who are estimated to be living with HIV but unaware of their status? Or should it be the total number of unduplicated persons tested? The example provides a very small number for the denominator and I'm unclear how it was derived.

4 The denominator will be dictated by the availability of data within the jurisdiction and could be either the total number of persons who are estimated to be living with HIV but unaware of their status, or the total number of unduplicated persons tested. Again, it will be important to describe what the data represents, and any limitations relative to a more comprehensive set of data.

21. In Attachment 6, does Part F include dental, MAI and AETC?

Applicants should include: Dental Schools, Special Projects of National Significance (SPNS) and AIDS Education and Training Centers (AETCs) in Part F within Attachment 6. Minority AIDS Initiative funding should be included in funding for Parts A and B.

22. We would like to receive clarification on a question that was included in the FOA Q&A released this week. We understand that applicants should provide the most recent complete EIIHA data available for newly diagnosed positives and previously diagnosed positives. Is it acceptable to submit complete data for the entire calendar year of 2013? Or is a 6 month period preferred?

While 6 months is preferred, it is acceptable to submit complete CY 2013 data with an explanation as to why the 6 month data is not available.

23. The FOA Q&A contained a sample of Attachment 6 and we would like to clarify what is included in the funding source for CDC. Does this include all CDC funding received by the State or only direct CDC funding to the jurisdiction?

It should include CDC funding that is available and that supports HIV activities in the jurisdiction, whether provided directly to the jurisdiction or other local organizations.

24. Section (3) c. of the Jurisdictional Profile, guidance requests that applicants describe new/emerging populations not mentioned in last year’s application. How would you advise a jurisdiction to respond that does not have an entirely new population to describe, but rather continues to focus efforts on heavily impacted populations described in the FY2014 application based on data that confirms ongoing need among these groups?

Such jurisdictions should describe the continued focus and the rationale for its continuance.

25. For 2015, the FOA has a number of sections that do not appear in the review criteria; please explain. The FY 2015 FOA does not explicitly include a 1:1 crosswalk of everything required by way of narrative, tables or attachments to elements or sub-elements of the review criteria. Applications will be judged on their overall response to the review criteria often incorporating

5 information from more than one section of the application.

26. The CDC released guidelines, Continuum of HIV Care: Guidance for Local Analyses, July 2013, to be more in line with the NHAS and we have adopted the new way of presenting and examining the continuum (PLWH, retention in care, on ART, virally suppressed in one chart; diagnoses of HIV infection, linkage to care in another chart). Can we present the data with these new guidelines without penalty or do we need to use the older version of the continuum outlined in the application? Applicants should use the continuum outlined in the application. The guidelines mentioned above are not intended to be a rigid model. In fact, the CDC guidance itself states that “The order of presentation is based on the order in which the calculation for each indicator should be made rather than the order in which the indicator appears in the graphical depiction of the continuum chart”.

27. An updated estimate of individuals who are HIV positive and unaware is requested in the FY15 EIIHA Plan, but no guidance is given for calculating the estimate. Does HRSA have guidelines or do applicants arrive at their own methodology? Applicants should use their own methodology and provide an explanation of the methodology used. The CDC is developing methodology for estimation of local estimates and does not recommend applying the national estimate to local jurisdictions.

**Revised Response from FAQ e-mail dated 7/30/2014:

Q2. The Unmet Need Section of the FOA asks for the following: Provide a table showing the percentage of Unmet Need for PLWA and PLWH for CY 2011, 2012, and 2013. Based on this table, describe the trends in your Unmet Need percentages and to what you attribute these changes (e.g. increased outreach, increased linkages to care, increased number of low income PLWH). These are the same calendar years that were requested in last year’s FOA. Is this correct, or does HRSA want Unmet Need data for CY 2012, 2013 and 2014 instead?

The years listed in the FOA (CY 2011, 2012 and 2013) are correct, this is not an error. The dates have not been duplicated from last year’s FOA which requested unmet need data from CY 2010, 2011, and 2012. This information should be presented as Attachment 4.