Ryan White HIV/AIDS Program Part A HIV Emergency Relief Grant Program

of the services and gaps in the HIV Care Continuum within a jurisdiction or service area, planning bodies and recipients may identify specific service categories to fund. Funded service categories should facilitate improvements at specific stages of the HIV Care Continuum.  Comprehensive HIV/AIDS care consists of core medical services and supportive services that meet the criteria of enabling individuals and families living with HIV/AIDS to access and remain in primary medical care to improve their medical outcomes. HRSA/HAB recognizes that Part A EMAs and TGAs must use grant funds to support and further develop and/or expand systems of care to meet the needs of PLWH within the EMA/TGA and strengthen strategies to reach minority populations.  HAB requires EMAs/TGAs to collect data to support identification of need, for planning purposes, and to validate the use of RWHAP funding.  A comprehensive application should reflect how those data were used to develop and expand the system of care in EMA/TGA jurisdictions.  Needs assessments conducted by individual jurisdictions should also review/reference relevant needs assessments conducted by other HIV/AIDS programs, such as HRSA’s Bureau of Primary Health Care, Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and the U.S. Department of Housing and Urban Development (HUD). Ongoing CDC initiatives, as well as HAB’s efforts with recipients to estimate and address unmet need of those aware of their HIV status and the newer requirement to identify and bring into care persons in their jurisdictions who are unaware of their positive HIV status, should result in many more PLWH entering into the EMA/TGA care system.  The EMA/TGA planning process must ensure that essential core medical services have been adequately funded to meet the needs of those already in care and those being newly linked to care. As of November 2014, the CDC estimates more than 1.2 million people are living with HIV and 1 in 7 (14 percent) are not aware of their HIV status.  The ultimate goal within the United States (U.S.) is to inform all HIV-positive persons of their status and bring them into care in order to improve their health status, prolong their lives, and slow the spread of the epidemic in the U.S. through enhanced prevention efforts.  Important Notes: ·         In accordance with the RWHAP legislation (Sec. 2603 (a)(4)) of the PHS Act hold harmless will not be a factor in the FY 2016 RWHAP Part A awards. ·         Information on Ryan White and the Affordable Care Act, along with Policy Clarification Notices can be found at http://hab.hrsa.gov/affordablecareact/. ·         Greater emphasis has been placed on the HIV Care Continuum.  Applicants are expected to include a graph illustrating the HIV Care Continuum in the EMA/TGA and an explanation of how the HIV Care Continuum is utilized in your jurisdiction.  Refer to the Needs Assessment Section IV.2.ii for requirements. ·         The Unmet Need requirements in this funding announcement have been updated and included in Section IV.2.ii. Needs Assessment 3) b. Unmet Need.  Please review carefully when preparing this section of your application. The following information will assist in understanding and completing this year’s grant application: ·         As an applicant and current recipient, you are required to have implemented the Part A National Monitoring Standards at the grant recipient and provider/subrecipient levels.  HRSA has developed and distributed guidelines outlining the responsibilities of HRSA, the grant recipient, and provider/subrecipient staff.  The National Monitoring Standards can be found at: http://hab.hrsa.gov/manageyourgrant/granteebasics.html. ·         Women, Infants, Children and Youth (WICY) waiver requests are no longer part of the application process.  The WICY waiver reporting format was revised to allow recipients to submit a waiver request and provide supporting data with the annual progress report. ·         Part A funds are subject to Section 2604(c) of the PHS Act which requires that not less than 75 percent of the funds remaining after reserving funds for administration and clinical quality management be used to provide core medical services that are needed in the EMA/TGA for individuals with HIV/AIDS who are identified and eligible under the RWHAP.  Core medical services are listed in section 2604(c)(3) of the PHS Act, and support services allowed under Part A are limited to services that are needed for individuals with HIV/AIDS to achieve their medical outcomes, as defined by the RWHAP.  The most recent service definitions can be found in the latest version of the National Monitoring Standards, located at http://hab.hrsa.gov/manageyourgrant/granteebasics.html.  The burden is on the applicant to accurately propose plans and projections using the most recent versions of the Standards and definitions that are posted when an application is submitted. ·         Applicants seeking a waiver to the core medical services requirement must submit a waiver request either with this grant application, at any time up to the application submission, or up to four months after the start of the grant award for FY 2016.  Submission should be in accordance with the information and criteria published by HRSA in 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.  Sample letters may be found at http://hab.hrsa.gov/affordablecareact/samplereqwaiverletters.pdf.  In addition, recipients are advised that an FY 2016 Part A waiver request must include funds awarded under the Minority AIDS Initiative (MAI).  A waiver request that does not include MAI will not be considered.  If submitting with the application, a core medical services waiver request should be included as Attachment 9. ·         EMA/TGA Agreements and Compliance Assurances are included (Appendix A) with this funding opportunity announcement (FOA), and require the signature of the CEO, or the CEO’s designee; this document should be included as Attachment 2.