fy 2015 ryan white hiv/aids program part a hiv emergency relief grant program technical assistance...

FY 2015 Ryan White HIV/AIDS Program Part A

HIV Emergency Relief Grant ProgramTechnical Assistance Call

August 12, 2014Department of Health and Human ServicesHealth Resources and Services Administration

HIV/AIDS BureauDivision of Metropolitan HIV/AIDS Programs

Speakers:Steven Young, Director Gary Cook, Deputy Director

Michael Amoh Amelia Khalil

Andrea JacksonKeisha Johnson Sera MorganHelen Rovito Theresa Jumento

Agenda

• Welcome• Purpose of Webinar• Program Information• Application Due Date and Award Date• Highlights of FY 2015 Funding

Opportunity Announcement (FOA)• Section Overview • Questions & Answers• Program Contact Information

Purpose of the Webinar

The purpose of this webinar is to provide:

• Technical assistance• General information • Answers to questions received from all

eligible metropolitan areas relative to HRSA-15-003

Program Information

• Approximate funding for FY 2015 – $618,492,359.00

• Available to 52 grantees

• Ryan White HIV/AIDS Program (RWHAP) legislation (Sec. 2603 (a)(4)) of the Public Health Service Act hold harmless will not be a factor in the FY 2015 Ryan White HIV/AIDS Program Part A awards

• Information on RWHAP and the Affordable Care Act, along with Policy Clarification Notices, can be found at http://hab.hrsa.gov/affordablecareact/

• Information on the National HIV/AIDS Strategy (NHAS) is located in the SF-424 Application Guide

Due and Award Dates

• Application Due Date September 19, 2014 by 11:59 PM EST

• Project PeriodMarch 1, 2015 – February 29, 2016

Highlights FY 2015 FOA


• Reorganized Needs Assessment

o New Sections:

Impact of Affordable Care Act (ACA)

Minority AIDS Initiative (MAI)

• Streamlined Methodology

• Modified Workplan

o New Section:

HIV Care Continuum


• Clarified Evaluation and Technical Support Capacity of Clinical Quality Management (CQM)

• Refined Organizational Information

• Review Criteria Recalculated

Section Overview

Needs

Assessment

Jurisdictional Profile• Describe the population of persons with HIV/AIDS

using epidemiological data

• In section 1(1) of the jurisdictional profile, provide both HIV and AIDS incidence and prevalence for calendar years (CY) 2011, 2012, and 2013

• Sample table below illustrates how data may be presented in the FOA:

Section OverviewNeeds Assessment

CY 2011 CY 2012 CY 2013

Incidence Prevalence Incidence Prevalence Incidence Prevalence

HIV

AIDS

Demonstrated Need• 5 sections: Unmet Need, Early Identification of

Individuals with HIV/AIDS (EIIHA), Unique Service Delivery Challenges, the Minority AIDS Initiative (MAI) and Impact of Funding

• “New/Emerging Populations”o Include in FY 2015 FOA only if significant changes/ new

communities were noted from previous FOAs

• Unmet Needo Comprised of 3 sections:

CY 2013 Unmet Need estimate (Attachment 4) Unmet Need trends (2011, 2012, 2013) Description of how Unmet Need data are considered

during planning and decision making process


Minority AIDS Initiative

• New section in FY1205 FOA• Three (3) components:

1. Identify minority populations living with HIV and the specific sub-groups

2. Describe how MAI funds were considered during the planning process and service categories funded; describe how services differ from Part A services

3. Describe two (2) funded MAI activities


Early Identification of Individuals with HIV/AIDS (EIIHA)

1. Legislation2. EIIHA Components

a) EIIHA Datab) EIIHA FY 2015 Plan

3. EIIHA Scoring4. FY 2013 Progress Report (not

part of the FY 2015 FOA)


EIIHA - Part A Legislation• Part A Legislation Section 2602 (b)(4)(A)(B)(C)(D):

o “…shall determine size and demographics of the estimated population of individuals with HIV/AIDS who are unaware of their HIV status”

o “determine the needs of…individuals with HIV/AIDS who do not know their HIV status”

o “develop a comprehensive plan…that includes – ““a strategy, coordinated as appropriate with other

community strategies and efforts, including discrete goals, a timetable, and appropriate funding, for identifying individuals with HIV/AIDS who do not know their HIV status, making such individuals aware of such status, and enabling such individuals to use the health and support services”


EIIHA Components

• EIIHA for FY 2015 will have 2 components:

1. EIIHA Data2. FY 2015 EIIHA Plan


• Select 3 target populations from FY 2014 EIIHA Plan

• Provide data from January 1, 2014 – June 30, 2014 (or most recent 6-month period)

• Definitions are outlined in the FOA• Data collection, analysis, usage


EIIHA

EIIHA• Describe the planned activities for FY 2015• Include all populations for the EIIHA Plan• Describe how the overall FY 2015 EIIHA Plan

contributes to the NHAS and White House Continuum of Care Initiativeo Link:

http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order- hiv-care-continuum-initiative.

• Describe how the EIIHA Plan for FY 2014 influenced the development of the plan for FY 2015


• Select target populations for FY 2015 (may be previously described populations)

• Describe plans to present, discuss, and/or disseminate the EIIHA Plan and outcomes of your plan activities to stakeholders (e.g., poster presentations, journal articles, presentations to planning bodies)


EIIHA

EIIHA Scoring

• EIIHA section will be scored the same as in past FOAso 33 points total

EIIHA Data – 14 points EIIHA FY 2015 plan – 19 points


EIIHA Reporting DatesFunding Opportunity Announcements

Progress Reports Progress report due date

FY 2015 FOAEIIHA Data – January 1-June 30, 2014

FY 2015 Progress ReportEIIHA Data – January 1-December 31, 2014

2016

FY 2014 FOAEIIHA Data-January 1-June 30, 2013

FY 2014 Progress ReportEIIHA Data-January 1-December 31, 2013

July 30, 2015

FY 2013 FOAEIIHA Data-Partial 2012

FY 2013 Progress ReportJanuary –December 2012

July 30, 2014


Impact of Funding

• Expanded section in FY15 FOA

• Impact of the Affordable Care Act1. Uninsured and poverty2. Impact of insurance expansion3. Outreach and enrollment 4. Marketplace options5. Successes/Outcomes


Impact of Funding

• Impact and response to reduction in Ryan White HIV/AIDS Program formula funding

• Impact of co-morbidities on the cost and complexity of providing care

• Coordination of services and funding streams


Section Overview

Methodolo

gy

Planning councils (PC) and planning bodies (PB) must respond to the following:

1.FY 2014 formula, supplemental and MAI funds are being expended in keeping with PC or PB priorities2.All Conditions of Award relative to the PC or PB have been addressed 3.Priorities were established by PC or PB in keeping with approved processes4.Annual PC or PB training took place – include dates5.PC or PB membership is reflective of the EMA/TGA

** Include plan and timeline for addressing each vacancy

Section OverviewLetter of Concurrence

Section OverviewCommunity Input Process

Community Input Process

• Description of priority setting and resource allocation process (PSRA)

See a-j, pg. 19

• How data from Part A and other Federal programs was used during the PSRA processes

• How these data may be linked to future health outcomes

Section Overview

Workplan

U.S. HIV Care Continuum

Source: http://aids.gov/federal-resources/policies/care-continuum/

Section OverviewWorkplan

HIV Care Continuum

• Provide a graph which depicts the RWHAP Part A HIV Care Continuum in the EMA/TGA

o Include baseline data for CY 2013 or the most recent calendar year for each stage of the HIV Care Continuum

o Use Ryan White Services Report (RSR) data or any available data as a baseline for Ryan White HIV/AIDS Program-eligible individuals

o Clearly cite data sets used

o Clearly describe the numerator and denominator


HIV Care Continuum

Narrative which addresses how the HIV Care Continuum will be used in:

• Planning, prioritizing, targeting and monitoring resources

• Reducing health disparities

• Reducing challenges and barriers around data sharing and collaboration with local, state and Federal partners


Implementation Plan

• Two components:

o Service Category Tableo HIV Care Continuum Table

• Both sections are included as Attachment 9



Attachment 9

SAMPLE FORM

Ryan White Part A Implementation Plan: HIV Care Continuum

Grantee Name: Big City EMA Fiscal Year: 2015

* HHS Measures can be found at http://www.aids.gov/pdf/hhs-common-hiv-indicators.pdf ** HAB Core performance measures can be found at: http://hab.hrsa.gov/deliverhivaidscare/coremeasures.pdf

Stages of the HIV Care Continuum

HIV Care Continuum Goal

Outcome Service Category (One or more may apply)

I. Diagnosed Increase in the percentage of clients who are aware of their HIV Status

HIV Positivity* Late HIV Diagnosis*

Early Intervention Services

Baseline: Numerator/Dominator, % 7/10 70%

Target: Numerator/Dominator, % 9/10 90%

II. Linked to Care Increase in the percentage of clients linked to care

Linkage to HIV Medical Care*

Outpatient Medical Care Medical Case Management Medical Transportation

Baseline: Numerator/Dominator, % 67/100 67%


III. Retained in Care Increase in the percentage of clients retained in care

Retention in HIV Medical Care* HIV Medical Visit Frequency**

Outpatient Medical Care Medical Case Management Medical Transportation Baseline: Numerator/Dominator, %

58/100 58% Target: Numerator/Dominator, % 72/100 72%

IV. Prescribed ART Increase in the percentage of clients with access to prescribed HIV/AIDS medications consistent with PHS Treatment Guidelines

Antiretroviral Therapy (ART) Among Persons in HIV Medical Care* Prescription of HIV Antiretroviral Therapy **

Outpatient Medical Care Medical Case Management Medical Transportation Baseline: Numerator/Dominator, %

76/100 76% Target: Numerator/Dominator, % 92/100 92%

V. Virally Suppressed Increase in the percentage of clients with a viral load of <200

Viral Load Suppression Among Persons in HIV Medical Care* HIV Viral Load Suppression**

Outpatient Medical Care Medical Case Management Medical Transportation Treatment Adherence Counseling

Baseline%: 45/100 45%



Section Overview

Resolution

of

Challenges

Resolution of Challenges

• Discuss challenges encountered in integrating the HIV Care Continuum into the planning and implementation of your Part A program

• Describe approaches used to resolve these challenges

Section Overview

Organizatio

nal

Information

• Grantee Administration

• Grantee Accountabilityo Program Oversighto Fiscal Oversight

• 3rd Party Reimbursement

• Maintenance of Effort

• Budget and Budget Justification Narrative

Section OverviewOrganizational

Information

Budget Justification Narrative – Attachment 12•Specific, detailed justifications for all allocated items in the program-specific line item budget

•Clearly state how each object class category’s efforts and/or activities make a contributing impact to support the Part A HIV service delivery system

•Applicants are strongly encouraged to use the suggested template, Budget Justification Narrative (Attachment 12), to respond to the Budget Justification Narrative section of the FOA. A sample of the suggested template is attached and will be available for download during the webinar


Information

Budget Narrative

Under the Personnel Object Class Category, all costs mustinclude the name, position title, and FTE allotment.

1)Description of how the amounts requested for line item in the budget will support the achievement of the proposed objectives 2) Clearly explain how each activity impacts the Part A HIV service delivery system


Information


Information

Cost Categories - Salary Limitations Requirement (Appropriations Act 2013)

Section Overview

Evaluation &

Technical

Support

Capacity

Section OverviewEvaluation and Technical Support

Capacity

• CQM section has four components:

1. CQM Infrastructure2. CQM Program Performance Measures3. CQM Program Quality Improvement4. Data for Program Reporting

Clinical Quality Management

Review Criteria

Review Criteria

1

Criterion Points Subsets

1. Need 67 Jurisdictional Profile: 7 Demonstrated Need: 7 EIIHA : 33 Unique Service Delivery Challenges: 2 MAI: 6 Impact of Funding: 12

2. Response 15 Planning & Resource Allocation: 6Care Continuum and Implementation Plan: 8Resolution of Challenges: 1

3. CQM 5 Infrastructure, Performance measurement & QI: 5

4. Resources/ Capabilities

10 Program Organization: 2 Program Accountability: 8

5. Support Requested

3 Budget and MOE: 3

TOTAL 100

Review Criteria 2014 FOA 2015 FOAC1: Need 34 67

Includes EIIHA

C2: Response 13 15C3: Evaluative Measures 5 5

C4: Resources/Capabilities

10 10

C5: Support Requested 5 3

C6: EIIHA 33 N/ATOTAL 100 100

Review Criteria

Review Criteria

• Worth 33 points by legislative mandate

• Focus on 3 targeted populations

• Data (a-g) = 14 points** Use January 1 – June 30 data**

• EIIHA Plan = 19 points

EIIHA

Review Criteria

New Items:Impact of the Affordable Care Act – 4 points

Minority AIDS Initiative – 6 points

HIV Care Continuum and Implementation Plan – 8 points

Items NOT Scored:

HIV Care Continuum Table

Applicants will not be penalized for not having access to the most recently requested data

Reporting Requirements

Reporting Requirements

FY 2014 Part A Grant Requirements Calendar FY 2013 Requirements Contents Submission

Due to EHB Requirement Type

FY 2013 Annual Progress Report

Annual Progress Report Format & WICY Table

July 30, 2014 Reporting Requirement

Federal Financial Report, FFR (SF 425)

FY 2013 Final FFR and Carry Over July 30, 2014 Condition

FY 2013 Part A & MAI FINAL Expenditure Report

FY 2013 Part A & MAI Expenditure Table July 30, 2014 Reporting Requirement

Final FY 2013 MAI Annual Report

Final FY 2013 MAI Annual Report for period 3/1/2013 to 2/28/2014

January 31, 2015 Reporting Requirement

FY 2014 Requirements Contents Submission

Due to EHB Requirement Type

FY 2014 Program Term Report REVISED: SF 424A, Budget Narrative, Implementation Plan, CLC, CRC, & FY 2014 Part A & MAI Planned Allocation Table, Planning Council Roster, LPAP Profile (new) (Send Planning Council Co Chairs signed letter endorsing the allocations and program priorities)

August 15, 2014 Reporting Requirement

Final FY 2014 MAI Annual Plan Final FY 2014 MAI Annual Plan for the use of the Part A MAI funds for period 3/1/2014 to 2/28/2015


Unobligated Balances (UOB) UOB Estimates and Estimated Carryover December 31, 2014 Reporting Requirement Ryan White Services Data Report (RSR)

Ryan White Services Data Report (RSR) March 30, 2015 Reporting Requirement

Federal Financial Report, FFR (SF 425)

FY 2014 Final FFR and Carry Over July 30, 2015 Condition

FY 2014 Part A & MAI Final Expenditure Table

FY 2014 Part A & MAI Final Expenditure Table


Final FY 2014 Part A Annual Progress Report

Final FY 2014 Part A Annual Progress Report & Expenditure for WICY (see NOA for additional details)


MAI Annual Report FY 2014 MAI Annual Report January 31, 2016 Reporting Requirement

Questions & Answers

Program Contacts

HAB/DMHAP Contact Steven R. Young, MSPHDirector, Division of Metropolitan HIV/AIDS Programs5600 Fishers Lane, 09W03Rockville, Maryland 20857Email: [email protected]: (301) 443-6745Fax: (301) 443-8143

Please continue to submit specific questions through your assigned Project Officer. These will be combined with others with answers posted and circulated to all eligible areas.

Technical Assistance Website: http://www.careacttarget.org

fy 2015 ryan white hiv/aids program part a hiv emergency relief grant program technical assistance...

Documents

foa slide

application guide slide

hiv care continuum slide

highlights fy

unmet need data

hivaids eiiha

workplan o new section

awards information