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Also, please review the Applicant Inquiries,
in their entirety, for responses to questions submitted via the FOA information line and FOA email. Responses to questions are grouped under the specific subject matter (individual questions may not be listed).
Yes. Partner services are included under comprehensive prevention with positives – for overall service provision for people with HIV that would enable them to reduce their transmission risk. There is a comprehensive approach to prevention with positives which includes partner services as well as linkage to and retention in care, antiretroviral therapy adherence, and behavioral change for people with HIV.
CRCS can fall under both - core required activities under Comprehensive Prevention with Positives (under the 75% of Category A funding resources) and Recommended Program Component of Evidence-based HIV Prevention Interventions for HIV-negative persons at high risk (under the 25% of funding resources).
The 10-10138 M&E plan will generally remain in place for PS12-1201; however, there will be updates to the HIV testing data requirements that will take effect in January 2012 in order to better respond to the NHAS and the program requirements of the FOA. The requirements for HIV testing funded under Category B will apply to those funded under Category A.
Percentage of funding to be distributed locally will need to be determined by the health department. The states need to allocate funds to all areas in the state with a significant portion of the epidemic but they only need to report on areas constituting 30% or greater. However, it is recommended that jurisdictions utilize surveillance and epidemiological data for decision making processes.
The focus will be to expand HIV testing through routine, opt-out testing in healthcare settings, linkages to care, and sustainability of programs (encourage reimbursement for HIV testing). It has the same focus as the previous announcements.
Yes, the activities are the same. They are categorized slightly different – grantees can apply to implement testing in health care settings (required), non-healthcare settings (optional), and service integration (optional).
The positivity rate for HIV testing in healthcare settings should be in accordance with the 2006 guidelines. Based on these 2006 guidelines, “in all health-care settings, screening for HIV infection should be performed routinely for all patients aged 13--64 years. Health-care providers should initiate screening unless prevalence of undiagnosed HIV infection in their patients has been documented to be <0.1%.”
$20 million in total per year will be available for this Category. If a proportion of those resources are not used in a particular year, e.g., the total budget for all eligible applications was less than $20 million, then the additional funds would be applied towards Category A. The time-frame for proposals may be between 1 and 4 years. Because some projects will be completed before the end of the 5-year project period, we expect to elicit new proposals during FY 2013 and FY 2014, based on availability of funds. Jurisdictions may apply for up to two proposals under Category C; however, a jurisdiction can only submit one proposal per Category C focus area per year. Each proposal submitted for Category C is limited to 10 pages.
Applicants may submit up to two proposals. For example, an applicant can submit two proposals for Category C – each one being under a different focus area. An applicant may also submit one proposal inclusive of multiple focus areas. Single-focus area proposals must be for different focus areas; however, if multiple focus areas are included within a single proposal, overlap is permitted.
Demonstration projects can last for up to four years in length within the five-year project period. This will allow grantees the potential to conduct multiple demonstration projects within the five-year project period.
The selection of Demonstration Projects will be based on score and merit. Additional funding preferences include availability of funds, geographic diversity, and DHAP priorities. Low prevalence areas will have the same chance for funding as a project proposed for a higher prevalence area. There are also tiers/ranges of funding for Category C. Projects will be funded within each tier.
The maximum funding amount is per proposal. For example, if a jurisdiction submits two proposals - both in the higher funding range of $1 million to $2 million, then the maximum amount is based on the proposal and not the jurisdiction. No individual proposal should exceed $2 million. Proposals that exceed the $2 million ceiling will be deemed ineligible and taken out of the competition. If you have a proposal that has multiple focus areas, it is still considered as one proposal and must be below the $2 million ceiling. Each ten page proposal for Category C must not exceed the $2 million ceiling.
Funds previously allocated for the perinatal supplement are now included in the core funding amount for Category A. Previously, select jurisdictions have received supplemental funding to conduct enhanced perinatal transmission prevention activities. This FOA requires that all grantees implement perinatal HIV prevention activities, under HIV testing and comprehensive prevention with positives, where appropriate, under the 75% of funding resources for required activities. The exact balance of resources allocated to perinatal prevention activities would be up to the health department’s discretion.
Jurisdictional HIV prevention planning is a coordinated health department and community engagement process that includes the development of a jurisdictional HIV prevention plan and the establishment of an HIV prevention planning group (formerly HIV Community Planning Group). Community planning has evolved into HIV prevention planning, which aims to contribute to HIV prevention through developing both targeted and broad-based collaboration among a diverse group of partners and stakeholders. Prevention planning will require the engagement of a broader group of partners and stakeholders across HIV prevention, care and treatment programs such as Care/Ryan White planning group(s) and providers, Community-Based Organizations, Community Health Centers, Federally Qualified Health Centers, other care providers from the public and private sectors, mental health and substance abuse providers, Persons Living with HIV/AIDS, educational and academia institutions, and other appropriate governmental and non-governmental entities. Prevention planning groups are expected to participate in an “engagement process” that supports prevention planning, improves the scientific basis of program decisions and increases access to care by developing a seamless system to immediately link HIV-infected individuals to a continuum and coordinated quality of care and contribute to the development of the Jurisdictional HIV Prevention Plan.
The FOA requires a jurisdictional HIV prevention plan to include the collaboration and coordination of HIV prevention, care, and treatment. Additionally, the jurisdictional plan should be used as a reference for developing the comprehensive plan. If health departments have an existing plan (e.g., ECHPP, NHAS state plan, in-house plan) that satisfies the required elements outlined within the FOA for the jurisdictional plan, then the existing plan can be used. Jurisdictions will have approximately a year to plan – from the release of this FOA to the final version of the jurisdictional HIV prevention plan being submitted to CDC within six months after start of the project period. The FOA also requires a comprehensive plan specific to program planning, monitoring and evaluation, and quality assurance activities as it relates to this FOA. The jurisdictional HIV prevention plan and comprehensive plan will need to be developed and submitted to CDC within six months after the start of the project period.
The main goal of the engagement process is to develop strategies for increasing collaboration and coordination among HIV programs across the state, jurisdiction, and tribal and local governments to reduce the rates of new HIV infections. Steps for engagement should include: determining the goals of the plan and who to engage; developing engagement and retention strategies for previous partners; developing engagement strategies for new partnering agencies; prioritizing engagement activities; creating an implementation plan; monitoring progress; and maintaining the partner relationships. The upcoming Prevention Planning Group Guidance will provide additional information on the engagement process.
As outlined in the FOA, the development of a results-oriented engagement process is considered a key element in the HIV prevention planning process. The engagement process involves working collaboratively with key stakeholders and broad-based communities to identify strategies for increasing coordination to reduce new HIV infections in the jurisdiction. We hope to post the Prevention Planning Group (PPG) Guidance and provide everyone a timeline for the partner engagement process as soon as possible. The draft PPG Guidance will be posted on the FOA website for 30 days for review and comment. The name of the guidance was changed to better reflect the new direction of HIV prevention towards high impact results and the expectation that the CDC has for the planning process to help achieve the goals of the National HIV/AIDS Strategy (NHAS) in the local jurisdiction. To accomplish these goals, planning processes must also demonstrate an enhanced commitment to improved communication, coordination, and implementation of services across the continuum of HIV prevention, care, and treatment.
No, the new levels will be
gradually implemented over five years to minimize any disruption that could
occur as a result of the cuts. This will also allow areas receiving
increases to thoughtfully scale up their programs.
The funding tables are
accessible on the webpage
here. Funding ranges (i.e., floor and ceiling) are included for each eligible jurisdiction. Funding amounts for 2012, 2013, 2014, 2015, and 2016 for Category A are anticipated and subject to available funding. The amounts listed in the funding announcement for Category B are anticipated as being available in fiscal year 2012.
Award ceilings were calculated by increasing the anticipated award amount produced by the funding formula by approximately 5%. Floors were calculated by applying an approximate 5% reduction. The funding range for those areas previously designated as only eligible for the minimum funding level is now $750,000 to $1,000,000. Ranges were used for this table because the exact funding level for each year is not presently known. More precise estimates for FY 2013 and each subsequent year will be provided at the time that applications for that funding are being prepared.
The data used as the metric for Part A funding can be found in table 21
of CDC’s 2009 Surveillance Report, found
The amount that CDC expects to be able to award each grantee is likely to be within those two figures, assuming resource levels in FY 2012 do not substantially change from FY 2011 levels. Applicants are encouraged to apply for any amount within that range. Final award amounts will be determined after applications have been reviewed and once more precise estimates of FY 2012 funding are available.
CDC’s formula did not include allocations by county, only by Metropolitan Division. Our expectation is that the state and/or city allocate resources in a manner that best addresses the epidemic in their area, using local epidemiology and practical considerations to guide resource allocation decisions. If an objective method for dividing resources would be helpful in negotiations, one approach would be to use local data on persons living with HIV/AIDS for those counties and apply the proportion attributable to each area to the funding available for the Metropolitan Division. This approach is comparable to what was used at the national level.
The FOA states that “applicants are expected to allocate programmatic and financial resources to local areas based on the burden of disease.” To ensure that resources are reaching the areas of greatest need, funded jurisdictions will be required to report annually to CDC on the amount of funding allocated and HIV prevention activities in any city or area within their jurisdiction that has 30% or more of the HIV epidemic.
The purpose of the requirement is to provide CDC with an accurate picture of how resources are being distributed to the most heavily affected areas within the state and as such, it’s necessary to have a complete accounting of the funding resources provided to the directly funded metropolitan area, including funding that comes from the state. However, in some states, the cases attributable to the directly funded city could constitute 80% or greater of the state’s entire burden of disease which would result in the state only reporting on that city. To ensure that CDC receives information about how resources are distributed to areas other than the directly funded metropolitan areas, states with these cities must deduct the number of cases attributed to the cities from the total and, using this new denominator, calculate the areas within the remainder of the state that constitute 30% or greater of the state’s epidemic or the top three areas/cities. States with directly funded municipalities should only report on the directly funded municipality if they invest any of their award in the area. If a state provides funding to a directly funded area, the state must also report on two other areas in addition to the directly funded city or cities.
If the amount of money provided to the cities in those states is at the maximum levels that is allowed by the FOA, the states would then use the balance of resources to provide HIV prevention efforts in the part of their states that is not included by the geographical bounds of the directly funded city. However, there will be flexibility for balancing resources. If funding resources are not being provided to the directly-funded city, then the state does not have to report on that city and will need to direct resources and report on the other cities that meet the criteria. If funding resources are provided to the directly funded city, then the state should report on that city as well as other cities that meet the criteria.
Jurisdictions will still be required to direct funding resources to the areas of greatest burden. CDC funding to directly-funded CBOs provides additional resources to the jurisdiction and should not be used as a replacement for services and/or resources to those areas.
If the eligible city chooses not to apply, then that should be outlined in the letter of agreement (LOA) that will be included within the state application. The LOA should outline that agreement, included with the signatures of a state representative as well as the city representative indicating that the state will apply for the city’s portion of the funding because the city elects not to apply. Additionally, if the city elects not to apply and state will apply for the funding resources for that city, then that state will include that city or (MSA) within their 30% report. The state will report on that city as well as any other city or area that meets the criteria.
Eligibility for ETP (Category B) is limited to health department jurisdictions with at least 3,000 Black/African American and Hispanic/Latino adults and adolescents (unadjusted number) living with a diagnosis of HIV infection as of year-end 2008. Because HIV data are being used for this FOA, the metric for ETP was changed as well to HIV. The 30 previously funded jurisdictions retained their eligibility, Indiana and Colorado are now included using this new metric and the major urban areas newly eligible for direct funding include Atlanta, Miami, Baltimore, and Ft. Lauderdale.
Only the eligible entities listed within the FOA can apply for Category C. Eligible jurisdictions include the 50 states and 10 cities/MSAs included in the Funding Opportunity Announcement (FOA). This does not include local county health departments, unless the county health department is identified in the FOA as the eligible entity.
Switching from a city and county to our Bonafide agent after application submission can be done; however, it can be difficult to ensure funding is appropriately transferred after the awards are processed. It is recommended that the agency to apply for the cooperative agreement using the Bonafide agency, rather than waiting, if possible.
Yes, LOAs are required for each category for which the applicant is applying. City or county health departments will be responsible for providing services to the entire MSA or specified MD. However, in the event the city or county health department is unable or unwilling to provide services for the entire MSA or MD, the state may assume responsibility for any areas left uncovered and apply for a portion of the city or county’s funding allocation commensurate with the additional responsibilities and resource needs. Because of the different required components and activities for each category or different agreements for service coverage and implementation for each category, LOAs will need to be tailored for each category. Agreements can vary in nature; however, the specific agreement related to funding, service coverage, and program implementation must be clearly outlined.
Correct. The Letter of Agreement only applies to jurisdictions that have a state and city both eligible for direct funding. States without cities eligible for direct funding do not need to provide a Letter of Agreement.
Yes. A description of the proposed program goals and objectives is required and should be included with the brief program descriptions in this submission of the narrative for each proposed components and activities.
The draft SMART objectives can be included as part of the 50 pages for Part A and the 30 pages for Part B. If necessary these objectives can be placed in an appendix so that the overall proposal does not exceed the 50 and 30 page limit for each respective Category.
Each Category has a page limit. Please ensure that the project narrative adheres to the page limit for each category. All other requested documentation should be included as attachments. Please do not count the Epi Profile towards your page limit for Category A.
Please address cover letter to Angie Tuttle, CDC Procurement and Grants Office. The cover letter should include information on all submitted categories - Category A, Category B, and each Category C proposal. The table of content should be for the entire application, to include Categories A, B, C, attachments, etc. The completed application checklist does not need to be provided with the application.
It is recommended that the applicant limit their attachments to no more than 50 attachments that total 100 pages. For example, an applicant should not submit 100 attachments that are 1-page each or 50 attachments with 100 pages each. Grants.gov does recommend limiting attachments and/or pages in megabytes (MBs) regarding the size of the entire application. Grants.gov recommends a 200MB limit which includes the required forms and any attachments. Applicants may want to check how large the attachments will be and edit the pages as appropriate. We are aware that your Epi Profile may be over 100 pages and will exceed the page limit (this is an allowable exception to the 100 page limit).
The following items are due with the application submission: Table of Content; Cover Letter; Application Form (with DUNS number included); Project Abstract (one condensed abstract that address each requested category); Project Narrative, to include Category A (50 pages), Category B, if applicable (30 pages), and Category C, if applicable (10 pages per proposal) ; City/State Letter of Agreement, if applicable; Copy of Epidemiology Profile (if available); Budget and Budget Justification (for each requested category); CDC Form 0.1113 Assurance of Compliance; and Management Plan (for each requested category), to include resumes, CVs, etc., and Appendices.
The following items are due after funding: Detailed Comprehensive Program Plan (to include information for all funded categories); Jurisdictional HIV Prevention Plan; Results of Prevention Planning Group (PPG) Engagement Process; PPG Letter of Concurrence; Capacity Building Needs Assessment (if applicable); Data Security and Confidentiality Memorandum of Understanding for Administrators and Users; Rules of Behavior for Data Systems; and Completed Syringe Services Programs (SSPs) Annual Certification Statement, if applicable.
The FOA requires a jurisdictional HIV prevention plan to include the collaboration and coordination of HIV prevention, care, and treatment. Additionally, the jurisdictional plan should be used as a reference for developing the comprehensive plan. The FOA also requires a comprehensive plan specific to program planning, monitoring and evaluation, and quality assurance activities as it relates to this FOA. The jurisdictional HIV prevention plan and comprehensive plan will need to be developed and submitted to CDC within six months after the start of the project period. What needs to be included with the application in regards to the Comprehensive Program Plan as well as the Jurisdictional HIV Prevention Plan is outlined within the project narrative on Page 62-77 of the amended FOA. In general, a brief description of proposed program goals and objectives for the proposed required activities and recommended program components will need to be included with the application. Furthermore, the upcoming guidance for the prevention planning group process will provide some clarification in regards to the prevention planning group process.
As outlined by the FOA, applicants may include additional supporting documentation as part of the appendices. As indicated, the appendices will not be counted toward the narrative page limits; however, applicants should be mindful that their respective applications will be reviewed through a structured review process and should label and reference as appropriate (by category) in the narrative and table of contents any key documents that have been placed in the appendices for the reviewer to consider in their reviews.
The following is an example of items to be included in the application submission: Table of content for the entire application (to include categories A, B, and/or C, and appendices); one cover letter for the entire application; application form; one project abstract (one condensed abstract that address each requested category); project narrative for each requested category - Category A (50 pages), Category B, if applicable (30 pages), and Category C, if applicable (10 pages per proposal); City/State letter of agreement, if applicable; copy of Epidemiology Profile (if available); budget and budget justification for each requested category; CDC Form 0.1113 Assurance of Compliance; management plan for each requested category (can be an appendix or indicated within the narrative); resumes and CVs (provided for key personnel for all requested categories), and any other supporting documentation.
You may either submit a separate detailed management plan for each category within the narrative or a separate document with all three management plans as an attachment. If you chose the latter option, please ensure that you provide a brief description of each management plan in the applicable section with instructions that leads to the detailed plan in your list of attachments.
Due to the competitive nature of this new FOA and the grants.gov policies around such FOA’s, extensions are not possible, except for extreme or emergency situations. In those cases, extensions may only be granted to the non-competitive pieces of the FOA (Category A and B). If an extension for Category A and B is required, due to an emergency, this must be requested in writing to the Procurement and Grants Office. Additionally, the application deadline was previously extended as indicated within the amended version of the FOA.
The Category C tiers have no affect on the way the application is reviewed through the objective review process. The tiers will only be used to make final funding decisions once all the reviews are complete. All proposals will be reviewed and scored based on the evaluation criteria listed in the FOA. The proposals will be ranked by score and funding preferences (identified in the FOA) may be applied. This process will produce the first list of proposals recommended for funding. Subsequently, the Project Officer assigned to the grantee will review that proposal(s) and make changes to the budget, if necessary. Once the recommended funding levels are established, the program will select applicants in rank order using the tier limits established in the FOA until all the available funds are exhausted. Please note that the number of awards listed in the FOA for funding under each tier is an “approximate” number and based on the availability and distribution of funds.
Funding for Category C will be based on score and merit. The proposed budget submitted for each proposal, score from review process, geographic diversity, DHAP priorities, as well as the availability of funding will be taken in consideration for the funding of demonstration projects.
Please include a line-item breakdown and justification for all contractors to include: name of contractor, method of selection, period of performance, scope of work, method of accountability, and itemized budget and justification.
It is recommended that the state send in separate budget narratives for each city/county jurisdiction with one summary of all budgets. The summary can be a spreadsheet of all budgets; an additional narrative is not needed for the summary. This format applies to each Category.
A budget and budget justification is requested for each category. The amounts requested for each category may be provided in one 424A form; each category should be outlined within the separate columns.
Only one SF424 form is necessary and provided; the SF424A is the budget form which is available at
www.grants.gov along with the FOA document in addition to the budget form provided. The additional budget form must be completed by hand, scanned then attached to the submission.
Yes. There will be one consolidated FOA to include activities currently funded under PS10-1001 and PS10-10138. Plans are being made to fund PS10-10138 activities for a 3-month period (October - December 2011).
Previously, ETP was funded under a separate FOA (i.e., PS07-768 and PS10-10138). In response to stakeholder feedback and recommendations to streamline program activities and reduce reporting burden, PS10-10138: Expanded Human Immunodeficiency Virus (HIV) Testing for Disproportionately Affected Populations will end on December 31, 2011. Expanded Testing Program (ETP) activities for Part A will continue under the flagship Health Department FOA PS12-1201 scheduled to begin January 1, 2012. PS10-10138 Part B activities (enhanced linkages to care) will conclude on December 31, 2011.
Grantees currently funded under PS10-10138 will receive funding for October, November, and December of 2011 under a 3-month budget period. The individual amounts awarded will be approximately 25% of the amount that would have represented level funding for a 12-month budget period under PS10-10138. A revised budget, budget narrative, and work plan that reflects the new award level and project period will be required for the 3-month period (for Part A and Part B). Grantees should only budget for the necessary funding to support the 3-month implementation period. Grantees are encouraged to work closely with their project officer and grants management specialist to ensure a smooth transition. The main concern is the uninterrupted continuation of HIV prevention activities funded by CDC.
The following is provided to clarify the current set of CDC expectations for health department grantees preparing cooperative agreement applications and to point to efforts to reduce data burden on grantees. The Program Evaluation Branch will work with each grantee and their program project officer regarding specific needs for local program monitoring and data submission. New HIV testing data requirements have been provided to current health department grantees. These requirements will be effective in January 2012. In response to the NHAS and changes in HIV prevention, new data requirements for other HIV prevention program activity (non-testing activities) are being developed. Criteria for the new requirements are: measuring progress on the NHAS; measuring progress on priority HIV prevention activities as defined by specific program announcements; and reducing grantee data reporting burden. During this period of transition to new program activities, only aggregate and qualitative data on activities other than HIV testing and partner services will be required.
CDC will be ‘sun-setting’ PEMS on January 1, 2012. CDC will provide to all grantees a user friendly, more cost efficient data system for submission of HIV testing data. Grantees will be notified in September about the transition to the new system for submitting HIV testing data. Additionally, both interim and longer term solutions for a data system for other HIV prevention data will be discussed internally and with grantees in the near future.
Grantees are expected to conduct data collection, data upload or key entry, data quality assurance, and submission of required data elements to CDC. Additionally, we expect that grantees will make every effort to utilize program monitoring data for managing their programs and making program improvements. Personnel resources should be allocated and assigned to these important program monitoring tasks. Additionally, if you have been using PEMS and will need another system to input, manage, and report data on activities other than HIV testing, you should plan to allocate resources in order to comply with the new requirements.
Under “Policy Initiatives” funds may be used to support efforts to removing barriers to the use of high quality sexual health education curricula in schools. Funds may not be used to directly fund Departments of Education (DOE). CDC’s Division of Adolescent and School Health (DASH) provides funding to state and local Departments of Education.
Biomedical interventions are the use of medical, clinical, and public health approaches designed to moderate biological and physiological factors to prevent HIV infection, reduce susceptibility to HIV and/or decrease HIV infectiousness. Biomedical interventions reduce transmission of HIV with the use of oral or topical antiretroviral medication, topical antimicrobial preparations, vaccines or surgical procedures (circumcision). Barrier methods such as male or female condoms are also considered biomedical intervention.
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