Support and Scale Up of HIV Prevention Services in Sexual Health Clinics FAQs – (CDC-RFA-PS-24-0003)

Eligibility/Application Submission Questions

1. Can a clinic that is funded under ESSHCI apply for this funding? Is it worthwhile to write an application on how this funding will be used differently?

PS-24-0003 is an open competition funding opportunity, so ESSHCI recipients are technically eligible to apply. However, when considering whether to apply for PS-24-0003, please be aware of the Phase III review factors included in the NOFO; specifically, the preference for organizations that are not currently receiving funding from any federal funding sources to provide similar sexual health services. For PS-24-0003 Phase III review, ESSHCI recipients will be considered recipients of funding for similar sexual health services.

ESSHCI and PS-24-0003 were not intended to fund the same clinical sites, as the funding opportunities have significant programmatic overlap. Even if an ESSHCI recipient is proposing to implement/expand a different set of clinical services through PS-24-0003, the required activities for both NOFOs (e.g., clinic assessment, community engagement, assessment and improvement of the patient clinic experience, etc.) would likely lead to a duplication of efforts that could be difficult to resolve.

2. Can a clinic that is approved but unfunded under ESSHCI apply for this funding?

ESSHCI approved-but-unfunded (ABU) recipients can apply for PS-24-0003. Please be aware of the Phase III review factors included in the NOFO, including the preference for applicants located in priority EHE jurisdictions.

3. Can an FQHC receiving EHE - Primary Care HIV Prevention (PCHP) funding from HRSA apply?

PS-24-0003 is an open competition funding opportunity. However, when considering whether to apply for PS-24-0003, please be aware of the Phase III review factors included in the NOFO; specifically, the preference for organizations that are not currently receiving funding from any federal funding sources to provide similar sexual health services. For PS-24-0003 Phase III review, recipients of HRSA BPHC’s EHE-PCHP awards will be considered recipients of funding for similar sexual health services.

4. Can my organization apply if our proposed clinic is not in a priority EHE jurisdiction?

PS-24-0003 is an open competition funding opportunity, so eligibility is not restricted to priority EHE jurisdictions.

When considering whether to apply for PS-24-0003, please be aware of the Phase III review factors included on page 46 of the NOFO; specifically, the preference for applicants located in priority EHE jurisdictions, and the preference for applicants proposing to serve underserved populations and priority populations that are not addressed in other applications.

Applicants not located in priority EHE jurisdictions should describe:

how their proposed clinic’s catchment area serves communities with high HIV and STI burden,
HIV and STI disparities in their jurisdiction, and
an unmet need for sexual health services, including a thorough description of the current availability of sexual health services in their catchment area with special focus on other safety net providers.

5. How long does a clinic have to be operating to be eligible to apply?

CDC expects that the proposed sexual health clinic will have been operating for a minimum of 12 months at the time of application.

6. Can my organization apply to provide services in multiple clinics/sites?

An organization can include multiple clinic sites in one application if the sites are within the proposed catchment area. To the extent possible a catchment area should conform to relevant boundaries of political subdivisions. An organization that has multiple clinic sites should clearly define their clinics’ catchment area and only apply with one application (that includes each proposed site) if the organization only has one unique identifier. Example: An organization with a main sexual health clinic and additional satellite clinics within a well-defined service area. If each clinic location has a unique identifier, you can submit separate applications. Please note that the average award is per application not number of clinic sites in each application.

7. Can a state health department submit applications for two county health departments? And should the submissions be separate or combined as one?

(Please note that this response applies to counties that are not priority EHE jurisdictions. See question #18 for guidance to state health departments with more than one priority EHE jurisdiction.)

Clinics and local health departments have the option to apply directly to PS-24-0003, so a state wouldn’t need to submit an application for multiple counties. One option would be for the state to pick one county (i.e., one proposed catchment area) to submit an application for and encourage the other county to apply directly. Another option would be for each county to apply directly. Or if both counties are unable to apply directly for any reason, the state could pick their highest priority county to apply on behalf of. There is one circumstance where we would be open to a state including two counties in their application, and that would be if they are contiguous counties or part of a metropolitan statistical area.

8. Are current sub-recipients encouraged to apply for funding on their own or should they continue to be a part of the recipient’s application? Is there any risk for a sub-recipient who applies on their own?

This decision is up to the applicant. Applications will be reviewed on their own merit. There is no risk to a sub-recipient applying directly.

9. Can a Dept of Health apply and then sub-recipient the award to internal state public health centers that fall under a different state agency? (Our state has Public Health Centers that serve as STI clinics, but they do not operate under the HIV/STD Program.)

Yes, this is acceptable. Please note that an organization can include multiple clinic sites in one application if the sites are within the proposed catchment area. To the extent possible a catchment area should conform to relevant boundaries of political subdivisions. An organization that has multiple clinic sites should clearly define their clinics’ catchment area and only apply with one application (that includes each proposed site) if the organization only has one unique identifier. Example: An organization with a main sexual health clinic and additional satellite clinics within a well-defined service area. If each clinic location has a unique identifier, you can submit separate applications. Please note that the average award is per application not number of clinic sites in each application.

10. For the letter of intent: should it come from CEO or CMO?

The letter of intent can come from either the CEO, CMO or Program Administrator.

11. Any recommendations or requirements for what should be included in the LOI?

More than anything else, we would just like to know if you are intending to apply. One page is sufficient – please note your intent to apply, include the name of your organization and location (or proposed clinic’s catchment area), and any other details you think are important.

12. How/where do we submit the LOI? Where can we find LOI requirements?

A letter of intent is requested but optional as part of the application for this NOFO. Please email your LOI to Diane Ballard at iqu0@cdc.gov by 11/29/23. One page is sufficient – please note your intent to apply, include the name of your organization and location (or proposed clinic’s catchment area), and any other details you think are important.

13. Can a nonprofit apply on behalf of multiple clinic sites?

Yes, a nonprofit organization can include multiple clinic sites in one application if the sites are within the proposed catchment area. To the extent possible a catchment area should conform to relevant boundaries of political subdivisions. An organization that has multiple clinic sites should clearly define their clinics’ catchment area and only apply with one application (that includes each proposed site) if the organization only has one unique identifier. Example: An organization with a main sexual health clinic and additional satellite clinics within a well-defined service area. If each clinic location has a unique identifier, you can submit separate applications. Please note that the average award is per application not number of clinic sites in each application.

14. Would an academic ID/HIV subspecialty clinic that is able to provide all the listed services be eligible to be the primary recipient of the funds?

Yes. Please note that this cooperative agreement requires adoption of a whole-person approach to HIV prevention and care in the clinic, with provision of comprehensive services to all people affected by HIV regardless of their HIV status.

15. Can you include more than one clinic to work with?

16. How is CDC collaborating with HRSA-HAB to implement this NOFO, particularly in the case of applicants who are Ryan White subrecipients or BPHC sites? What considerations should dually funded clinics keep in mind when applying?

HRSA is aware of the PS-24-0003 funding opportunity. PS-24-0003 is an open competition funding opportunity. However, when considering whether to apply for PS-24-0003, please be aware of the Phase III review factors included in the NOFO; specifically, the preference for organizations that are not currently receiving funding from any federal funding sources to provide similar sexual health services. For PS-24-0003 Phase III review, recipients of HRSA BPHC’s EHE-PCHP awards will be considered recipients of funding for similar sexual health services.

17. Just want to make sure application is due 1/15/24 and not 11/29/23?

Applications are due 01/15/2024 by 11:59 pm ET at www.grants.gov.

18. If a state has more than one EHE phase I county, can they complete and submit separate applications for each county?

Yes, a state can submit separate applications for each priority EHE jurisdiction. Please note that CDC anticipates at least 90% of the funds will be directed to the proposed clinic, and clinics and local health departments have the option to apply directly to PS-24-0003. Other application approaches to consider include: a) the state could pick one EHE county to submit an application for and encourage the other EHE counties to apply directly, or b) each EHE county could apply directly.

19. The workplan is not part of the 20-page limit? The NOFO states that it is. Can you please clarify?

The work plan attachment will not count toward the project narrative page limit. There is standard language in the NOFO that we are unable to edit; however, we’ve included this exception in bold on page 56 of the NOFO.

20. The applicant does not need to be a CDC 20-2010 Component C recipient to be eligible for this NOFO. Is this correct?

Correct, this application is not limited to PS20-2010 Component C recipients.

21. Are Title X recipients eligible?

PS-24-0003 is an open competition funding opportunity, so Title X recipients are eligible. Please make it clear in your application that there is no overlap between currently funded activities and the activities that you are proposing for this NOFO. As a reminder, this NOFO supports existing sexual health clinics that serve communities with high HIV and STI burden.

Applicants must affirm that the proposed sexual health clinic has the following services available onsite or provide a detailed plan to have these services available onsite within six (6) months of award:

HIV testing,
STI testing at relevant anatomical sites,
timely STI treatment, including onsite treatment for gonorrhea, chlamydia, and syphilis as recommended in CDC’s STI Treatment Guidelines (e.g., penicillin G benzathine, ceftriaxone),
recommended vaccinations (i.e., HAV, HBV, HPV, mpox), and

comprehensive in-house PrEP and nPEP services, including follow-up care and required laboratory tests.

22. Can this NOFO be used to stand up a new clinic?

No, this NOFO is intended to support existing sexual health clinics.

23. Would an organization that received HRSA Ryan White funds be eligible for this funding?

PS-24-0003 is an open competition funding opportunity, so organizations that receive HRSA Ryan White funds are eligible. Please make it clear in your application that there is no overlap between currently funded activities and the activities that you are proposing for this NOFO. As a reminder, this NOFO supports existing sexual health clinics that serve communities with high HIV and STI burden. Recipients are required to adopt of a whole-person approach to HIV prevention and care in the clinic, with provision of comprehensive services to all people affected by HIV regardless of their HIV status.

HIV testing,
STI testing at relevant anatomical sites,
timely STI treatment, including onsite treatment for gonorrhea, chlamydia, and syphilis as recommended in CDC’s STI Treatment Guidelines (e.g., penicillin G benzathine, ceftriaxone),
recommended vaccinations (i.e., HAV, HBV, HPV, mpox), and
comprehensive in-house PrEP and nPEP services, including follow-up care and required laboratory tests.

24. Is Ryan White funding considered a “similar service” for the purposes of this NOFO?

For the purposes of this NOFO, Ryan White funding will not be considered funding for similar sexual health services. Please note that this cooperative agreement requires adoption of a whole-person approach to HIV prevention and care in the clinic, with provision of comprehensive services to all people affected by HIV regardless of their HIV status.

25. Can the applicant request funding for a national focus?

No, that is not the intent of this funding opportunity.

26. Does your clinical partner have to be established before or can we use an RFA to establish that partner?

Non-clinical applicants will need to have identified their participating sexual health clinic at the time of application.

27. What page is the verification eligibility form in the NOFO?

Information about eligibility verification is included on page 31 of the NOFO and is also included here: For verification of eligibility requirements, applicants are expected to upload a document confirming that the application includes Strategies A and B, stating whether they are recipients or sub-recipients of PS20-2010 Component C funding, and stating whether they are proposing activities in a Component C clinic. Applicants should name the file “Eligibility Verification” and upload it as a PDF file to the application submitted at www.grants.gov.

28. Would an applicant be eligible if they receive state funding related to HIV prevention?

PS-24-0003 is an open competition funding opportunity, so applicants that receive state funding related to HIV prevention are eligible.

29. Is a budget template available?

No, there is not a budget template for this funding opportunity. Please refer to CDC’s Budget Preparation Guidelines for guidance on preparing a budget request.

Clinical Questions

30. What does the following funding restriction in the NOFO mean for recipients of PS-24-0003? Recipients may not use funds for clinical care except as allowed by law.

For PS-24-0003, recipients may use funds for clinical services included in the Recommendations for Providing Quality STD Clinical Services (STD QCS), with the exception of any clinical services not authorized by state law.

31. Can NOFO funds be used to pay for doxycycline when prescribed as doxy PEP?

Yes.

32. For this NOFO, what criteria are you using to determine if a clinic is a “sexual health clinic”?

Applicant must affirm that the proposed sexual health clinic has the following services available onsite or provide a detailed plan to have these services available onsite within six (6) months of award:

HIV testing,
STI testing at relevant anatomical sites,
timely STI treatment, including onsite treatment for gonorrhea, chlamydia, and syphilis as recommended in CDC’s STI Treatment Guidelines (e.g., penicillin G benzathine, ceftriaxone),
recommended vaccinations (i.e., HAV, HBV, HPV, mpox), and
comprehensive in-house PrEP and nPEP services, including follow-up care and required laboratory tests.

33. Is the ability to administer mpox vaccine a requirement?

Yes, applicants must affirm that the proposed sexual health clinic has mpox vaccine available onsite or provide a detailed plan to have mpox vaccine available onsite within six (6) months of award.

On October 25, 2023, CDC’s Advisory Committee for Immunization Practices (ACIP) unanimously recommended broader and more routine use of the mpox vaccine to prevent disease in people known to be at risk for mpox. ACIP’s recommendation has been adopted by the CDC Director. This NOFO supports improved access to the mpox vaccine.

34. If we are unable to provide one of the vaccines included in the sexual health clinic criteria, are we then ineligible? We offer all listed services except one vaccine.

We expect that an applicant’s proposed sexual health clinic has all recommended vaccinations (i.e., HAV, HBV, HPV, and mpox) available onsite or that the applicant provides a detailed plan to have these vaccinations available onsite within six (6) months of award.

Budget Questions

35. If a university based medical center is the applicant but is working closely with an FQHC in a very busy, high-incidence and prevalence area and provides all of the needed services (assessment, evaluation, coaching, training, etc.), does 90% of the funding need to go only to the clinical site?

Yes, CDC expects that at least 90% of the funds will be directed to the proposed clinic. Clinics have the option to apply directly to PS-24-0003. In this example, if the proposed clinic were to apply directly and receive an award, the clinic could consider funding the university-based medical center by including them as a contractor in their budget.

36. Can you give any examples of approved ways to fund partner organizations of the specialty STI clinics?

Please refer to CDC Budget Preparations Guidelines when developing your budget for the application. Approved ways to fund partner organizations include either including them as a consultant (individual person) or contractor (organization) in your budget. Please note that both budget categories require distinct information with your budget submission.

37. Would payment for PEP and PrEP medications for those who do not qualify for other programs be an allowable expense?

No, CDC funds cannot be used to cover the costs of antiretroviral medication, including PrEP and PEP. This funding restriction is noted on page 42 of the NOFO.

38. Can funds be used for other non-syringe-related harm reduction services (ex. naloxone, test kits, etc.) provided to support clients receiving other covered services?

Yes.

39. Can the funds be used for labs for rapid ART?

Yes.

40. Can the funds be used to subcontract with non-clinical community partners under the community engagement activity area?

Yes.

41. Funds can be used for clinical staff?

Yes, funds can be used for staff supporting NOFO activities.

42. Funding can be used to purchase a mobile STI/PrEP van to travel to high-risk communities?

Funds can be used for purchase of a mobile van. A mobile clinic van would be considered equipment, as it is over $5,000. There is no limit, but the cost should be reasonable. Please note that recipients will be expected to show a lease versus buying comparison and provide three quotes.

Funding Preference Questions

43. Will low morbidity states be considered?

Preference will not be given to low morbidity states. This funding opportunity supports the EHE initiative which is currently focusing resources on priority areas with the highest HIV burden.

44. I see priority is for clinics not funded by other federal sources for these services - presuming this may mean FQHCs, etc.? In that case, would a health department application proposing funding collaborative partners in this category be less competitive?

If you are selecting an FQHC as your proposed clinical site, please be aware of the Phase III review factors included in the NOFO; specifically, the preference for organizations that are not currently receiving funding from any federal funding sources to provide similar sexual health services. For PS-24-0003 Phase III review, recipients of HRSA BPHC’s EHE-PCHP awards will be considered recipients of funding for similar sexual health services.

45. So, clinics not in EHE jurisdictions can apply but are less likely to receive funding than those in EHE jurisdictions?

There are several Phase III review factors included on page 46 of the NOFO; the preference for applicants located in priority EHE jurisdictions is one of them, but another factor listed is the preference for applicants proposing to serve underserved populations and priority populations that are not addressed in other applications.

Applicants not located in priority EHE jurisdictions should describe:

how their proposed clinic’s catchment area serves communities with high HIV and STI burden,
HIV and STI disparities in their jurisdiction, and
an unmet need for sexual health services, including a thorough description of the current availability of sexual health services in their catchment area with special focus on other safety net providers.

46. If a jurisdiction is not included in the current list of priority EHE jurisdictions but does have high rates of STIs (other than HIV) based on national rates, would they meet priority considerations?

Applicants not located in priority EHE jurisdictions should describe:

how their proposed clinic’s catchment area serves communities with high HIV and STI burden,
HIV and STI disparities in their jurisdiction, and
an unmet need for sexual health services, including a thorough description of the current availability of sexual health services in their catchment area with special focus on other safety net providers.

47. If we are not an EHE jurisdiction, is it worth our time to apply?

Applicants not located in priority EHE jurisdictions should describe:

how their proposed clinic’s catchment area serves communities with high HIV and STI burden,
HIV and STI disparities in their jurisdiction, and
an unmet need for sexual health services, including a thorough description of the current availability of sexual health services in their catchment area with special focus on other safety net providers.

48. What is the thinking on currently funded Comp C clinics, given preference to fund clinics not currently receiving funding?

Awards for this NOFO will go out after PS20-2010 Component C has ended, so there will be no overlap between the period of performance of these cooperative agreements.

49. Can you please list what current awards are similar to this NOFO?

For the purposes of this NOFO, federal funding sources providing funding for similar sexual health services include the EHE-funded ESSHCI (PS-23-0011) award and HRSA BPHC’s EHE-PCHP awards.

Other

50. How does this cooperative agreement align with future plans for the federal EHE initiative, such as potential expansion or changing of EHE goals or jurisdictions?

PS-24-0003 reflects the current priorities of the EHE initiative. This project is flexible to grow and change so that it can accommodate adjustments based on funding and administrative priorities.

51. When writing the grant and providing clinic data, should 2022 data be visit based or individual based? For example if patient ABC came to clinic 4 times in 2022, would the patient only be counted once?

Please provide individual level data; in other words, unique patient data. This data can be used to calculate the percentages listed on page 18 of the NOFO. From the example included in the question, this would mean that if patient ABC came to the clinic 4 times in 2022, they would only be counted once.

52. Are the average awards amounts published in the NOFO per clinic or jurisdiction?

The average award is per application not number of clinic sites included in each application.

53. How many recipients can there be for this NOFO? How many awards will there be?

The approximate number of awards/recipients for this NOFO is 20.

54. What is the total budget for this NOFO?

Approximate total fiscal year funding is $20,000,000. Approximate total period of performance funding is $100,000,000.

55. Do you have to get both Awards A & B in order to be awarded any funding?

Yes, applicants are required to apply for both Strategy A and Strategy B. Both strategies will be scored together during Phase II review. Recipients of this funding will receive funding for both strategies.

56. What does EHR interoperability mean?

Electronic health record (EHR) interoperability allows patient data to be shared between different EHR systems.

57. Why did you not make the work plan template mandatory?

We strongly encourage you to use the CDC-provided template. It will benefit both you and CDC as each year this work plan format will be used.

58. If an organization is located in a priority EHE jurisdiction but also serves clients that reside outside of the EHE priority area but receive clinical services in the area, can they benefit from the funded services?

Yes.

59. Where can we find the list of priority EHE jurisdictions?

Priority EHE jurisdictions are listed here: https://www.cdc.gov/endhiv/about-ehe/index.html#jurisdictions

60. Is it recommended to partner with organizations funded through PS-23-0011?

Applicants should consider establishing, building, or maintaining working partnerships with any PS-23-0011 recipients in their jurisdiction to ensure communication, collaboration, and coordination for the delivery of comprehensive sexual health services that is consistent with CDC standards and guidance.

61. How do I get a copy of the slides from the informational webinar?

Please email Diane Ballard (IQU0@cdc.gov) to request a copy of the informational webinar slides.