Ryan White HIV/AIDS Program States/Territories Part B Supplemental Grant Program

decline or disruption of services related to the decline in the amount of formula funding.  Such a decline in funding compares the amount of formula funding received in the current fiscal year (FY) to the amount received in FY 2006, and a State’s assertion that such decline has had an impact on services available to all individuals with HIV/AIDS identified and eligible in the State.  The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) awards priority funding based on this calculation to States for which a priority award is appropriate.  The RWHAP Part B Supplemental funding is used to assist States and Territories in developing and/or enhancing access to a comprehensive continuum of high quality care and treatment services for low-income individuals and families living with HIV.  As such, it supports the National HIV/AIDS Strategy (NHAS) goals of:  reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.  In July 2013, the President issued an Executive Order “HIV Care Continuum Initiative” which is intended to accelerate improvements in HIV prevention and care in the United States.  Additional information regarding the NHAS and the HIV Care Continuum may be found at: http://www.whitehouse.gov/sites/default/files/onap_nhas_improving_outcomes_dec_2013.pdf. Applicants must demonstrate the severity of the HIV/AIDS epidemic in the State/Territory, using quantifiable data on epidemiology, co-morbidities, cost of care, the service needs of emerging populations, unmet need for core medical services, and unique service delivery challenges.  Applicants must explain why supplemental funding is necessary to provide HIV care and treatment services for people living with HIV (PLWH) in the State/Territory.  Applicants must describe how supplemental funding will support viral suppression and achieve positive client level health outcomes. As required in the Ryan White HIV/AIDS Program legislation, Section 2620(b) of the PHS Act, information to be used to demonstrate need for the FY 2015 application includes the following: 1)      The current prevalence of HIV/AIDS; 2)      The unmet need for HIV-related services as determined by Section 2617(b) of the PHS Act; 3)      An increasing need for HIV/AIDS-related services based on increases in the number of living cases of HIV/AIDS; 4)      Increases in the number of living cases of HIV/AIDS within new or emerging subpopulations; 5)      Relevant factors related to the cost and complexity of delivering health care to individuals with HIV/AIDS in the eligible area; 6)      The impact of co-morbid factors, including co-occurring conditions inclusive of high rates of sexually transmitted infections (STIs), Hepatitis, Tuberculosis, substance use, severe mental illness, and other co-morbid factors; 7)      The prevalence of homelessness; 8)      The prevalence of individuals who were released from Federal, State, or local prisons during the preceding three years, and had HIV/AIDS on the date of their release; 9)      Relevant factors that limit access to health care including geographic variation, adequacy of health insurance coverage and language barriers; and 10)  Impact of a decline in the amount of RWHAP Part B funding received on services available to all individuals with HIV/AIDS identified and eligible for RWHAP services. A comprehensive HIV/AIDS continuum of care includes the provision of the following core medical services:  outpatient and ambulatory health services, ADAP medications, AIDS pharmaceutical assistance (local), oral health care, early intervention services, health insurance premium and cost sharing assistance, home health care, medical nutrition therapy, hospice services, home and community-based health services, mental health services, medical case management, treatment adherence services, and substance abuse outpatient care as well as appropriate supportive services that assist PLWH in accessing treatment of HIV infection that is consistent with the Department of Health and Human Services (HHS) Treatment Guidelines.  The guidelines provide standards of care recommendations for antiretroviral treatment, including prophylaxis and treatment of opportunistic infections.  The current HHS Treatment Guidelines are available at http://www.aidsinfo.nih.gov. Comprehensive HIV/AIDS care also includes access to the following support services: case management (non-medical), child care services, emergency financial assistance, food bank/home delivered meals, health education/risk reduction, housing services, legal services, linguistic services, medical transportation services, outreach services, psychosocial support services, referral for health care/supportive services, rehabilitation services, respite care, residential substance abuse services and treatment adherence counseling. Important Notes: The following information will assist in understanding and completing this year’s application: ·         On December 26, 2013, the Office of Management and Budget (OMB) published new guidance for Federal award programs, OMB Uniform Guidance:  Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Guidance).  The Guidance was implemented by the HHS as 45 CFR Part 75 effective December 26, 2014.  The Guidance supersedes and streamlines requirements from OMB Circulars A-21, A-87, A-110, A-122, A-89, A-102 and A-133 and the guidance in Circular A-50 on Single Audit Act follow-up.   It is a key component of a larger Federal effort to more effectively focus Federal award resources on improving performance and outcomes while ensuring the financial integrity of taxpayer dollars.  The effective date of 45 CFR 75 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards was December 26, 2014, and the requirements are applicable to awards issued on or after that date.  For non-Federal entities that are nonprofit organizations or institutions of higher education, there is a one-year grace period for implementation of the procurement standards in 45 CFR 75.316 through 75.325. ·         Recipients not meeting the 75 percent core medical services expenditure requirement will be subject to the financial penalty associated with this requirement.  Recipients may submit a core medical services waiver in accordance with the Federal Register Notice, Vol. 78, No.101, dated Friday, May 24, 2013, and may be found at http://www.gpo.gov/fdsys/pkg/FR-2013-05-24/pdf/2013-12354.pdf.  The HAB Policy 13-07, Federal Register Notice and Sample Letters can all be found at http://hab.hrsa.gov/manageyourgrant/policiesletters.html.