U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESHealth Resources and Services Administration

HIV/AIDS BureauDivision of Community Based Programs

Ryan White HIV/AIDS Program Part DGrants for Coordinated HIV Services and Access to Research

for Women, Infants, Children, and Youth (CSWICY)Youth Services Initiative

Announcement Type: Non-Competing ContinuationAnnouncement Number HRSA 5-H12-10-001

Catalog of Federal Domestic Assistance (CFDA) No. 93.153

FUNDING OPPORTUNITY ANNOUNCEMENT

Fiscal Year 2010

Application Due Date in Grants.gov: February 22, 2010Supplemental Information Due Date in EHBs: March 8, 2010

Date of Release: January 7, 2010Date of Issuance: January 7, 2010

Hanna EndalePublic Health AnalystDivision of Community Based ProgramsHRSA, HIV/AIDS Bureau5600 Fishers Lane, Room 7A-21Rockville, MD 20857Telephone: 301/443-1326Fax: 301/443-1884

Authority: Title XXVI of the Public Health Service (PHS) Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (P.L. 111-87).

Table of Contents

I. FUNDING OPPORTUNITY DESCRIPTION.........................................................................................................2

Purpose 2II. AWARD INFORMATION....................................................................................................................................9

1. Type of Award 92. Summary of Funding 9III. ELIGIBILITY INFORMATION.......................................................................................................................10

1. Eligible Applicants 102. Cost Sharing/Matching 103. Other 10IV. APPLICATION AND SUBMISSION INFORMATION..................................................................................12

1. Address to Request Application/Summary Progress Report Package 122. Content and Form of Application Submission 12

I. APPLICATION FACE PAGE (GRANTS.GOV) 16II. TABLE OF CONTENTS 16III. APPLICATION CHECKLIST (GRANTS.GOV) 16IV. BUDGET (EHBS) 16V. BUDGET JUSTIFICATION (EHBS) 20VI. STAFFING PLAN AND PERSONNEL REQUIREMENTS (EHBS) 22VII. ASSURANCES AND CERTIFICATIONS 23VIII. PROJECT ABSTRACT (GRANTS.GOV) 23IX. PROGRAM NARRATIVE (FULL NARRATIVE AND ATTACHMENTS IN EHBS) 24X. PROGRAM SPECIFIC FORMS, IF APPLICABLE 32XI. ATTACHMENTS 32

3. Submission Dates, Times, and Requirements 33V. APPLICATION REVIEW INFORMATION.....................................................................................................34

VI. AWARD ADMINISTRATION INFORMATION.............................................................................................34

1. AWARD NOTICES..............................................................................................................................................34

2. PERFORMANCE REVIEW...............................................................................................................................36

VII. POST AWARD REPORTING.........................................................................................................................36

VIII. CONTACT INFORMATION AND ASSISTANCE......................................................................................37

IX. TIPS TO WRITING A STRONG APPLICATION

APPENDIX A - HRSA's Electronic Submission Guide

APPENDIX B – Part D AgreementAPPENDIXC – Sample Program Coordinator Position Description

HRSA 5-H12-10-001 2

I. Funding Opportunity Description

PurposeA non-competing continuation application is required for continuation of grant funding for a second or subsequent budget period within an approved project period. The continuation application, also referred to as a summary progress report, submits the budget request for the next year of funding and serves as the primary source of information regarding activities, accomplishments, outcomes, and obstacles related to achieving project outcomes during the current budget period. It also provides documentation necessary to justify continuation of the project.

Section 2671 of the Public Health Service Act, 42 U.S.C. § 300ff-71, establishes Grants for Coordinated Services and Access to Research for Women, Infants, Children, and Youth (CSWICY). The Youth Services Initiative is intended to address the unique issues of HIV infected youth ages 13-24. The purpose of this funding is to continue to develop youth sensitive programs, which identify HIV-infected youth, bring them into and retain them in coordinated, comprehensive, culturally, and linguistically competent, youth-centered care.

Title XXVI of the Public Health Service (PHS) Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Ryan White HIV/AIDS Program) reauthorized this program. 

The purpose of the Youth Services Initiative (YSI) is to provide funding to existing Part D YSI grantees to improve access to youth-centered primary medical care and support services. Part D funds will be used for the principal purpose of providing primary medical care and support services to youth with HIV/AIDS when payments are unavailable from other sources. This means all Part D YSI grantees are expected to provide, directly or through contracts or through memoranda of understanding, primary medical care to the clients they serve. By primary medical care we mean outpatient or ambulatory care, including behavioral health, nutrition, and dental care. By specialty care, we mean specialty HIV care and specialty medical care such as dermatology, radiology, obstetrics, and gynecology.

Under the 2009 Act, grantees are no longer required to use Part D funds to provide primary medical care services when payments for such services are available from other sources. The 2009 Act also permits Part D grantees to enter into memoranda of understanding with providers to provide primary medical care services, in addition to providing care directly, or through contracts for services (see section 2671 (a) and (i) of the Public Health Service Act (42 USC 300ff-71)).

When Primary medical care is provided through memoranda of understanding, grantees must provide a copy of the MOUs signed by both parties to HRSA within 30 days of award. Contracts and MOUs must document the total number of patients served, the number of pregnant and non-pregnant women, children, and youth to be served by the program.

In addition to the mandatory outpatient or ambulatory care provision required under Part D, funds may also be used for the following support services:

1) Family-centered care including case management.2) Referrals for additional services, including:

a. Referrals for inpatient hospital services, treatment for substance abuse, and mental health services, and

b. Referrals for other social and support services, as appropriate.3) Additional services necessary to enable the patient and the family to participate in the

program established by the applicant including services designed to recruit and retain youth with HIV.

4) The provision of information and education on opportunities to participate in HIV/AIDS-related clinical research.

Youth Services Initiative programs must show that, in developing their programs, they have taken into account the profound physical, emotional, mental, and social changes characteristic of the transition from adolescence to adulthood. Because of developmental issues, programs must design different interventions for younger youth (ages 13-19) and for older youth (ages 20-24).

BackgroundThe Title IV programs started in 1988 as the Pediatric AIDS Demonstration Projects. The projects originally served infected infants and children, infected pregnant women, and their families. They provided supportive care to families to help infected children receive medical care. Beginning in 1994, Congress funded these projects under Title IV of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. In 1999, in response to the alarming growth of HIV-infected youth being identified, the HIV/AIDS Bureau (HAB) funded a Youth Initiative, which currently supports 17 youth specific programs across the Nation. In 2006, Congress funded the Title IV programs (now referred to as Part D) under Title XXVI of the Public Health Service Act as amended by the Ryan White HIV/AIDS Treatment Modernization Act of 2006 (Ryan White HIV/AIDS Program). The Ryan White HIV/AIDS Treatment Extension Act of 2009 (P.L. 111-87) reauthorized this program.

Part D Youth Services Initiative programs focus on providing coordinated, comprehensive, culturally competent, youth-centered medical care, as well as supportive services that help youth obtain the care they need. This means all Part D Youth Services Initiative grantees are expected to provide primary medical care to the clients they serve directly or through contracts or through memoranda of understanding. The projects are expected to conduct case finding in order to bring infected youth into care. Once enrolled in care, specific efforts must be made to retain these individuals in care. Grantees are expected to provide care, treatment, and support services or create a network of medical and social service providers, who collaborate to provide services. Currently, there are a total of 98 Part D programs, including the 17 in the Youth Services Initiative.

The Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) and HAB are committed to meeting the national goals and principles described below. As you complete your non-competing continuation application, consider how your program supports and helps to implement these goals and principles.

National Goal Healthy People 2010 is a HHS-led national activity for setting health priorities. Grants funded under this guidance will meet Healthy People 2010 objectives by expanding

counseling and testing and increasing the number of primary care programs that provide comprehensive HIV services. Information on Healthy People 2010 can be found at the following Web site: http://www.health.gov/healthypeople/document/ .

HRSA Goal The goal for all HRSA programs is to assure access to high quality health care and reduce disparities in health outcomes for recipients of services in HRSA-funded programs. The result is that all persons who need care have equal access to high quality health care, regardless of the payment source.

HAB Guiding PrinciplesHAB has identified four factors that have significant implications for HIV/AIDS care services and treatment. These should be considered as your application and program are developed and refined:

The HIV/AIDS epidemic is growing among traditionally underserved and hard-to-reach populations;

The quality of emerging HIV/AIDS therapies can make a difference in the lives of people living with HIV disease;

Changes in the economics of health care are affecting the HIV/AIDS care network; and

Outcomes are a critical component of program performance.

HAB Expectations:HAB has five expectations for all Part D programs. Every Part D project will:

1) Develop, expand, and support a comprehensive, coordinated, culturally competent, family-centered system of HIV care. This will increase access to care for all target groups. The care in this system must be comprehensive, culturally and linguistically competent, family-centered, and coordinated.

2) Educate clients about research and research opportunities. Inform all clients about the benefits of participation, and how to enroll in research.

3) Involve consumers as partners in their own care. Involve them in planning, implementing, and evaluating the project.

4) Recruit and retain women in care. For women of childbearing age, this includes care to prevent the transmission of HIV from mother to infant.

5) Find individuals who are infected but not receiving primary medical care, or who are at high risk of infection. In addition to providing primary medical care to these individuals, the project must educate those who are not infected to prevent infection.

An applicant for Part D funding must be able to provide medical care directly or through contracts or through memoranda of understanding. In addition to the required medical care, grantees are strongly expected to provide support services and information and education about HIV/AIDS-related clinical research.

Medical Care:Part D programs must assure their clients receive state-of-the-art medical care. This is primary medical care (including behavioral health, nutrition, and dental care), special HIV care and specialty medical care (such as OB/GYN, dermatology and radiology). You must show how you ensure this care is of high quality and consistent with the most recent Public Health Service Adult and Adolescent Treatment Guidelines. The Public Health Adolescent Treatment Guidelines can be found at the following Web site: http://www.aidsinfo.nih.gov/Guidelines/Default.aspx?MenuItem=Guidelines. Your program must be designed to adapt to the different time schedules youth have, the lack of transportation, and the needs for youth to bond with their providers before they will accept and adhere to a treatment regimen.

Supportive Services:Part D Youth Services Initiative programs must make sure their youth receive the help they need to use the medical care. You will do this through supportive services. These include:

Case management Transportation Childcare Family advocacy Support groups Other services, such as counseling and testing and translation services

Information and Education about HIV/AIDS-Related Clinical Research:Part D programs are expected to inform and educate their Part D clients and/or their parents about opportunities to participate in HIV/AIDS-related clinical research. This means the project must have a staff person who knows about research activities, how a client becomes a participant in research activities, and the benefits of being in a research project. This staff person is encouraged to meet with each client to provide information about being part of a research project.

Prevention of New Infections by Working With Persons Diagnosed with HIV and Their Partners:We encourage you to incorporate the “Recommendations for Incorporating HIV Prevention into Medical Care of Persons Living with HIV” into your program. These recommendations were developed jointly by the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), the National Institutes of Health (NIH), and the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA). They were published by CDC as the Morbidity and Mortality Weekly Report, July 18, 2003, Volume 52, Number RR-12 (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5212a1.htm). (Please note: An erratum has been published for this article.)

These recommendations describe how health care providers can help to reduce the number of new HIV infections by:  

Screening patients for behavioral risk through interviews or questionnaires regarding sexual and needle-sharing behaviors and screening for Sexually Transmitted Infections (STIs) and pregnancy.

Offering behavioral interventions to change knowledge, attitudes, and behaviors

to reduce personal risk of transmitting or acquiring other STIs. Providing partner counseling and referral services (PCRS) this includes partner

notification and suggests offering services that can help the sex and needle-sharing partners of HIV-infected patients.

 To order copies of the recommendations, please call the National Prevention Information Network (NPIN) at (800) 458-5231 or visit the NPIN Website at www.cdcnpin.org.

We also encourage you to incorporate into your program the Advancing HIV/AIDS Prevention (AHP) initiative developed by the CDC to further decrease perinatal transmission. These strategies encourage clinicians to offer rapid HIV testing to women in labor with an unknown HIV status (www.cdc.gov/HIV/projects/perinatal). Finally, in addition to the above, we encourage you to provide education on abstinence. To obtain guidance in providing abstinence education, please refer to the Community-Based Abstinence Education Program from the Administration of Children and Families, U.S. Department of Health and Human Services, at http://www.acf.hhs.gov/programs/fysb/content/abstinence/community.htm.

Program ReviewsHRSA evaluates its programs through the use of the Government Performance and Results Act (GPRA), the Performance Assessment Rating Tool (PART) and through the Office of Regional Operations (ORO) formerly the Office of Performance Review (OPR), Performance Review Protocol. HAB has identified specific measures under GPRA and PART to evaluate the performance of grantees.

The GPRA measure relevant to Part D programs is:

Strategy II- Improve Health OutcomesPerformance Goal: Expand the Availability of Health Care, Particularly to Underserved, Vulnerable and Special Needs Populations

1) Increase the number of female clients provided comprehensive services, including appropriate services before or during pregnancy, to reduce perinatal transmission.

PART measures look at performance of Ryan White grantees across all programs. The overarching Ryan White HIV/AIDS Program PART measures are:

Strategy I- Improve Access to Health Care 1) Increase by 2 percent every second year the number of persons provided services through

the Ryan White HIV/AIDS Treatment Modernization Act program, and2) Increase by 2 percent annually the number of persons who learn their serostatus from

Ryan White HIV/AIDS Program programs.

Strategy II- Improve Health Outcomes1) Serve a proportion of racial/ethnic minorities in Ryan White HIV/AIDS-funded programs

that exceeds their representation in national AIDS prevalence data, as reported by the CDC, by a minimum of 5 percentage points annually (e.g., if 15 percent of overall AIDS

cases are among racial/ethnic minorities, 20 percent of Ryan White HIV/AIDS Program funded clients will be racial/ethnic minorities).

2) Serve a proportion of women in Ryan White HIV/AIDS-funded programs that exceeds their representation in national AIDS prevalence data reported by the CDC, by a minimum of 5 percentage points (e.g., if 15 percent of overall AIDS cases are among women, 20 percent of Ryan White HIV/AIDS-funded clients will be women).

Strategy III- Improve the Quality of Health Care1) Increase by 5 percentage points annually the number of Ryan White HIV/AIDS program-

funded primary medical care providers that will have implemented a quality management program.

2) Increase the proportion of new Ryan White HIV/AIDS program HIV-infected clients who are tested for CD4 count and viral load.

ORO’s Performance Review Protocol is used to conduct objective grantee performance reviews, State-level reviews, and community-level reviews HRSA-wide. Through systematic pre-site and on-site analysis using the Performance Review Protocol, ORO works collaboratively with grantees and HRSA/HAB to measure program performance, analyze the factors impacting performance, and identify effective strategies and partnerships to improve program performance, with a particular focus on outcomes. Performance reviews begin with a pre-site visit review of established program performance measures (i.e., GPRA and PART measures can be included as performance measures that are used to determine grantee performance). The protocol for performance reviews is available on HRSA’s Web site at http://www.hrsa.gov/performancereview/. Performance reviews are coordinated through HRSA’s ten Regional Divisions located in Boston, New York, Philadelphia, Atlanta, Chicago, Kansas City, Dallas, Denver, San Francisco, Seattle as well as a sub-regional office in Puerto Rico.

Division of Community Based Programs (DCBP) Program Related Site Visits The purpose of a program-related site visit is to assess the progress of each grantee and provide guidance and technical assistance to address areas of deficiency or areas in need of improvement. There are two primary types of DCBP program-related site visits: the Initial site visit and the Diagnostic site visit.

The Initial site visit is routinely conducted for newly funded Part D programs within the first year of funding. An assessment tool is used to evaluate overall clinical, administrative, fiscal, MIS, support services, consumer involvement, and implementation of the proposed work plan. The focus is on clarifying program expectations and evaluating compliance with program requirements. The site visit team typically consists of clinical, administrative, and fiscal consultant reviewers, selected by DCBP staff. The team may or may not be accompanied by the Project Officer (PO).

A Diagnostic Compliance site visit is designed to follow-up on specific concerns identified by either an objective review committee during a competitive review cycle, the grantee, the PO, or a previous site visit team. This site visit is primarily conducted to inform grantees about their status in complying with the legislative mandates, program requirements, and/or expectations. The site visit provides an opportunity to reassess program objectives, changes in the fiscal environment (such as addition or loss of other funds), and changes in clinical treatment for HIV.

If a grantee has received a Diagnostic Compliance site visit, it should list the findings and actions taken to address these findings in this application. Grantees who have not received a site visit should specifically state so. Omission or misrepresentation of critical information will be grounds for disqualification of your application.

Clinical Quality Management The Ryan White HIV/AIDS Program requires grantees to establish clinical quality management (CQM) programs to:

Assess the extent to which HIV health services are consistent with the most recent HHS (formerly Public Health Service) guidelines for the treatment of HIV disease and related opportunistic infections, and

Develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV health services.

The Institute of Medicine (IOM) study, “Measuring What Matters” (2003) stated more needed to be done to measure and improve the quality of care provided by Ryan White Programs.

HRSA/HAB has developed a definition of quality consistent with the definitions of the IOM report that fulfills the quality goals of the legislation. For HAB, “Quality is the degree to which a health or social service meets or exceeds established professional standards and user expectations.” Evaluations of the quality of care must consider (1) the quality of inputs, (2) the quality of the service delivery process, and (3) the quality of outcomes, in order to continuously improve systems of care for individuals and populations. Since the IOM report was released, HAB has developed and released a set of clinical performance measures. The HAB Clinical Performance Measures for Adults & Adolescents includes a total of 25 measures broken into three groups. Grantees are encouraged to select the most appropriate measures and use them in their quality management plan.

Additional information can be found at http://hab.hrsa.gov/special/habmeasures.htm.

Every grantee is required to have or establish a clinical quality management program to assess and improve the quality of the services delivered under the Ryan White HIV/AIDS Program. Current CQM practices note improved outcomes where a senior leader is involved in the CQM process. The HRSA/HAB expects grantees to demonstrate real involvement from senior leadership.

For all subcontractors, vendors, and providers, a mechanism must be in place to ensure care and services meet HHS guidelines (available at http://www.aidsinfo.nih.gov/), standards of care or best practices, as applicable, based on services funded.

Any effective CQM program will be able to document five key characteristics:

1) Use a systematic process. The process should include clearly identified leadership and accountability, and allocate sufficient dedicated resources to support the activities.

2) Establish benchmarks. Data and measurable outcomes should be used to determine progress toward relevant, evidence-based benchmarks.

3) Be focused. Linkages, efficiencies, and provider and client expectations should be a primary focus for addressing outcome improvement.

4) Be adaptable. The process should be continuous, adaptive to change and able to fit within the framework of other programmatic quality assurance and quality improvement activities, (i.e., JCAHO, Medicaid, and other HRSA programs).

5) Result in improved outcomes. Data collected should be fed back into the quality management process to assure that goals are accomplished and improved outcomes are realized.

If others in your network provide primary medical care for your clients via subcontract or through memoranda of understanding, you must make sure that they also have CQM systems in place. As part of your subcontract or memoranda of understanding, delineate expectations regarding quality management to include monitoring of performance measures, quality improvement projects and regular reporting. HAB also encourages grantees to conduct continuous quality improvement activities for administrative, educational and fiscal components of their organizations.

Applicants may wish to expand their knowledge of quality management. The following sites can provide entry points:

HRSA/HAB Quality Manual: http://hab.hrsa.gov/tools/QM/index.htm

HRSA/HAB Quality Tools: http://hab.hrsa.gov/special/qualitycare.htm

The National Quality Center:

http://www.nationalqualitycenter.org

HIVQUAL-US Program: http://www.hivguidelines.org/Content.aspx?PageID=51

II. Award Information

1. Type of Award

Funding will be awarded in the form of a grant.

2. Summary of Funding

Funding available under this announcement is for current Part D Youth Services Initiative grantees with budget periods that end on August 31, 2010. The budget request may not exceed the award amount from FY09 before any carryover adjustments, as noted in the FY 2009 Part D Notice of Grant Award (NGA). The budget amount requested should include any on-going expansion funds. One-time funds should not be included. The funding level can also be verified by contacting the Grants Management Specialist identified on your Notice of Grant Award.

The approved level of funding will be dependent upon the availability of appropriated funds, satisfactory progress, adequate justification for all projected costs, and a determination that continued funding is in the best interest of the government. Inadequate justification and/or progress may result in the reduction of approved funding levels.

Funding for subsequent years is dependent on the availability of appropriated funds, satisfactory grantee performance, and a determination that continued funding is in the best interest of the Federal government.

III. Eligibility Information

1. Eligible Applicants

Eligibility for this funding opportunity is limited to the current awardees requesting support for a second or subsequent budget period within a previously approved project period for Ryan White HIV/AIDS Program Part D Youth Services Initiative (YSI). These grantees have a budget period that ends August 31, 2010 but their project periods DO NOT end on August 31, 2010.

2. Cost Sharing/Matching

No cost sharing or matching funds are required.

3. Other

Federal funds shall not be used to take the place of current funding for activities described in the application. The grantee must agree to maintain non-Federal funding for grant activities at a level that is not less than expenditures for such activities during the fiscal year prior to receiving the grant.

Any application that fails to satisfy the deadline requirements referenced in Section IV.3 will be considered non-responsive, which could lead to a delay or lapse in funding.

Minority AIDS Initiative (MAI): Beginning in Fiscal Year 2000, Congress designated a portion of Ryan White HIV/AIDS Program Part D Coordinated Services for Women, Infants, Children, Youth and Families funding for the Minority AIDS Initiative (MAI). This initiative recognizes that many racial and ethnic minority communities carry a heavier burden of HIV and AIDS than other communities. The goal of MAI is to help reduce this burden by:

Increasing the number of persons from racial and ethnic populations receiving HIV care, and;

Increasing the number of persons from racial and ethnic populations who stay in Care.

The Division of Community Based Programs (DCBP) is responsible for the distribution of MAI funds for Part D programs. In FY 2003, DCBP may have funded your program under the MAI. Programs were selected for funding under the MAI either because they were

targeting and/or serving racial or ethnic minority communities as described in their applications, and/or through a grant process where the applicant elected MAI funds to target these communities. Beginning in FY 2005, the amount of MAI funds that were part of a grantee’s award was noted in the Notice of Grant Award (NGA), in the “Remarks” section. In FY2009 NGAs, the amount of MAI funds may be noted under the “Grant Specific Terms” section.

Medicaid Provider Status and Clinic Licensure: Grantees must document Medicaid provider status for all primary care providers and case management agencies. Grantees must also document for their primary care providers and case management agencies that they are fully licensed to provide clinical and case management services as required by their State and/or local jurisdiction. If clinic licensure is not required in your jurisdiction, describe how that can be confirmed in State regulation or other information. Documentation should be in the form of a table that identifies all providers’ Medicaid numbers and clinic licensure status, if applicable (Attachment 1). This information is required each year.

Part D Youth Services Initiative grantees are not required to be Medicaid providers if they do not provide direct patient care. However, those subcontractors that provide HIV primary care as part of the Part D program must be Medicaid Eligible and are to be included in the table discussed above. You must also be sure that Medicaid billable services are billed to Medicaid. Ryan White HIV/AIDS Program funds are expected to be used as funding of last resort; after billing Medicaid, other private, public health insurance resources, and after billing clients for allowable costs using a sliding fee scale.

Drug Discounts: If your program provides medications for patients, you may be able to get lower prices for your drugs through HRSA’s Healthcare Systems Bureau 340B Drug Pricing Program. If you have questions regarding the Drug Pricing Program, please contact Kathleen McGee, Senior Program Management Officer, at (301) 594-0318 or 1-800-628-6297 or by email: kmcgee@hrsa.gov. Her address is:

HRSA/HSBOffice of Pharmacy Affairs5600 Fishers LaneRoom 10C-03Rockville, MD 20857

Limitation on the Use of FundsGrantees may not use more than 10% of amounts received for administrative expenses.

IV. Application and Submission Information

1. Address to Request Application/Summary Progress Report Package

Application Materials

HRSA requires grantees/awardees to submit their Non-Competing Continuation application (also known as Summary Progress Report) electronically through Grants.gov. All grantees/awardees must submit in this manner unless they obtain a written exemption from this requirement in advance by the Director of HRSA’s Division of Grants Policy. Grantees/awardees must request an exemption in writing from DGPWaivers@hrsa.gov, and provide details as to why they are technologically unable to submit electronically through the Grants.gov portal. Your email must include the HRSA Announcement Number for which you are seeking relief, the Name, Address, and telephone number of the Organization and the Name and telephone number of the Project Director as well as the Grants.gov Tracking Number (GRANTXXXX) assigned to your submission along with a copy of the “Rejected with Errors” notification you received from Grants.gov. As noted, HRSA and its Grants Application Center (GAC) will only accept paper applications from grantees/awardees that received prior written approval.

Grantees/awardees must submit proposals according to the instructions in Appendix A, using this guidance in conjunction with theSF-424. These forms contain additional general information and instructions for grant applications, proposal narratives, and budgets. These forms may be obtained by:

(1) Downloading from http://www.hrsa.gov/grants/forms.htm

Or

(2) Contacting the HRSA Grants Application Center at:910 Clopper Road, Suite 155 SouthGaithersburg, MD 20878Telephone: 877-477-2123HRSAGAC@hrsa.gov

Refer to Appendix A for application and submission instructions for your non-competing continuation application.

2. Content and Form of Application Submission

Refer to Appendix A, Section 2.3 and 5 for detailed application submission instructions. These instructions must be followed.

The total size of all uploaded files may not exceed the equivalent of 80 pages when printed by HRSA, or a file size of 10 MB. This 80-page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support. Standard forms are NOT included in the page limit.

Applications that exceed the specified page and file size limits will be deemed non-compliant. All non-compliant applications will need to be resubmitted to comply with the instructions. This may result in a delay in issuing the Notice of Award or a lapse in funding.

Application Format Requirements

Application for funding must consist of the following documents in the following order:

SF-424 Short Form – Table of ContentsSF-424 Short Form – Table of Contents

It is mandatory to follow the instructions provided in this section to ensure that your application can be printed efficiently and consistently for review.It is mandatory to follow the instructions provided in this section to ensure that your application can be printed efficiently and consistently for review. Failure to follow the instructions may make your application non-compliant. Non-compliant noncompeting applications will have to be resubmitted to Failure to follow the instructions may make your application non-compliant. Non-compliant noncompeting applications will have to be resubmitted to

comply with the instructions.comply with the instructions. For electronic submissions no Table of Contents is required. HRSA will construct an electronic Table of Contents in the order specified.For electronic submissions no Table of Contents is required. HRSA will construct an electronic Table of Contents in the order specified.

Application Section Form Type Instruction HRSA/Program GuidelinesApplication for Federal Assistance (SF-424)

Form Pages 1, 2 3, & 4 (if applicable). Not counted in the page limit

Project Summary/Abstract Attachment Can be uploaded on page 2 of SF-424 - Box 15.

Required attachment. Counted in the page limit. Refer to guidance for detailed instructions. Provide table of contents for this document.

Additional Congressional District Attachment Can be uploaded on page 2 of SF-424 - Box 16.

If applicable; not counted in the page limit.

HHS Checklist Form PHS-5161 Form Pages 1 & 2 of the HHS checklist. Not counted in the page limit.

After successful submission of the above forms in Grants.gov, and subsequent processing by HRSA, you will be notified by HRSA confirming the After successful submission of the above forms in Grants.gov, and subsequent processing by HRSA, you will be notified by HRSA confirming the successful receipt of your application and requiring the Project Director and Authorizing Official to review and submit additional information in the successful receipt of your application and requiring the Project Director and Authorizing Official to review and submit additional information in the HRSA EHBs. Your application will not be considered submitted unless you review the information submitted through Grants.gov and enter and submitHRSA EHBs. Your application will not be considered submitted unless you review the information submitted through Grants.gov and enter and submit the additional information required through the HRSA EHBs. Refer to the HRSA Electronic Submission Guide provided in Appendix A, Section 2 of thisthe additional information required through the HRSA EHBs. Refer to the HRSA Electronic Submission Guide provided in Appendix A, Section 2 of this guidance for the complete process and instructions.guidance for the complete process and instructions.

Note the following specific information related to your submission. Understand that for your non-competitive application, only the forms mentioned in the Table of Contents listed above are submitted through Grants.gov. All supplemental information will be submitted through the HRSA EHBs.

Instructions for developing the following attachments are contained in Chapter IV.2.xi. Each attachment should constitute a single document, even if it provides several types of information. If an attachment contains several pages or more, it should have its own table of contents. Table of content pages are not counted in page limit/electronic size constraints. It is important to use the outlined sequence because the HRSA Grants Application Center will use this order to prepare an electronic table of contents for the entire application. Unless otherwise indicated, these are all counted in the page limit.

Attachment Number Attachment Description (Program Guidelines)Attachment 1 Documentation of Medicaid provider status and Licensure (Required of all applicants and subcontractors, where

appropriate.) Attachment 2 Latest negotiated indirect cost agreement (if applicable). Attachment 3 Position Descriptions for New Personnel. Merge similar documents into one attachment. Attachment 4 Biographical Sketches of New Personnel. Merge similar documents into one attachment. Attachment 5 Staffing Plan NarrativeAttachment 6 Progress Report on current Work PlanAttachment 7 Contracts Attachment 8 Work Plan for upcoming budgetAttachment 9 Network Providers ChartAttachment 10 Part D Agreement (found in Appendix B of this Guidance)

i. Application Face Page (Grants.gov)Use Application Form SF-424 provided with the application package. Complete according to instructions provided in the form itself. The Catalog of Federal Domestic Assistance Number is 93.153.

DUNS NumberYou must include the DUNS number in item 8c on the application face page. Note: A missing or incorrect DUNS number is the primary reason for applications being "Rejected with Errors" by Grants.Gov.Note: All applicant organizations are required to register annually with the Federal Government’s Central Contractor Registry (CCR) in order to do electronic business with the Federal Government. Information about registering with the CCR can be found athttp://www.ccr.gov.

ii. Table of ContentsThe application should be presented in the order of the Table of Contents provided earlier. Again, for electronic applications no Table of Contents is necessary as it will be generated by the system. (Note: the Table of Contents will not be counted in the page limit.)

iii. Application Checklist (Grants.gov)Use the HHS Checklist Form PHS-5161 included with the application package.

iv. Budget (EHBs)By completing the Budget Information Section in HRSA EHBs, you are completing the SF-424A - Budget Information for Non-Construction Programs form. Please complete Sections A through F, and then provide a line item budget for each grant year using the budget categories in the SF 424A.

Part D Youth Services Initiative (YSI) Budget: Part D funds are for the purpose of providing youth-centered care involving outpatient and ambulatory care (directly or through contracts or through memoranda of understanding). The Part D Program now divides the allowable costs among three (3) Part D Cost Categories. The categories are Service Delivery Costs, Clinical Quality Management Costs, and Administrative Costs.

Service Delivery Costs are those costs associated with providing youth-centered care which includes access to primary medical care and support services for HIV-infected. Service Related Costs may include:

Salaried personnel, contracted personnel or visit fees associated with the provision of primary medical care, specialty and subspecialty care, referrals for health and support services, and adherence monitoring/education services. (Types of providers typically included under service related are OB/GYN physicians, mid-level providers, nurses, pharmacists, dentists, dental hygienists, radiologists, lab technicians, dermatologists, medical assistants, intake receptionists, nutritionists, behavioral health/substance abuse service professionals, referral coordinators, medical and family-centered case managers, specialists and sub-specialists);

Lab, x-ray, and other diagnostic tests; Medical/dental equipment and supplies;

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Youth-centered care family advocacy; Outreach to recruit and retain youth with HIV or at-risk of contracting HIV. Services associated with the provision of information and education on

opportunities to participate in HIV/AIDS-related clinical research; Electronic Medical Records; Patient education, in conjunction with medical care; Transportation for clinical care provider staff to provide care; Patient advocates to maintain access to care; Patient transportation to medical appointments; and Translation services, including interpretation services for deaf persons.

Clinical Quality Management Costs are those costs required to maintain a clinical quality management (CQM) program that provides medical services which are consistent with the most recent HHS guidelines for the treatment of HIV/AIDS and related opportunistic infections; that develops strategies for ensuring that such services are consistent with the guidelines; and that ensures that improvements in the access to and quality of HIV health services are addressed. CQM costs may include:

Continuous Quality Improvement (CQI) activities; Clinical quality management coordination; Data collection for clinical quality management purposes; Consumer Involvement to improve services; Staff training/technical assistance (including travel and registration) to improve

services –this includes the Annual Clinical Update and the biennial All Grantee Meeting; and

Participation in Statewide Coordinated Statement of Need process and local planning bodies and other local meetings.

Administrative Costs are those costs not directly associated with service provision. By law, no more than 10 percent of your Federal Part D budget can be allocated to administrative costs. Staff activities that are administrative in nature should be allocated to administrative costs. Additionally, the administrative costs for sub-contractors under the Part D grants do not lose their administrative nature by being part of a contract, and are included in the limitation of administrative costs. Examples of Administrative activities subject to the 10 percent cap include:

Routine grant administration and monitoring activities, including the receipt and disbursal of program funds; administrative staff (executive and clerical); accounting and billing functions; preparation of routine programmatic and financial reports; and compliance with grant conditions and audit requirements;

Contracts for services awarded as part of the grant – such as development of RFPs, review of proposals, and monitoring contracts through onsite visits;

Costs which could qualify as either indirect or direct costs but are charged as direct costs, such as: rent, occupancy, utilities, computer hardware and software (unrelated to electronic medical records or CQM), telecommunications (telephones, toll-free lines, cell phones, pagers, fax, internet), and postage;

Liability insurance; Office supplies; Audits; and Payroll-Accounting services.

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The budget period is for ONE year, from September 1, 2010 to August 31, 2011.

The Part D budget is composed of the following: (1) Standard Form 424A for Non-Construction Programs, provided with the application package; (2) the Line-Item Budget; and (3) the Budget Justification. Include only your request for Federal Part D funds in these items. You may describe other funding sources for your HIV program (such as in-kind resources, private donations, other grant funds, etc.) in the section titled “Organizational Capabilities and Experience.”

Standard Form 424APlease note that these instructions have changed. The Standard Form 424A asks for financial information about your budget. This form is used for Non-Construction Programs only. Please provide only the Part D Federal dollars, which may include MAI funding, you are proposing for this project period. The SF-424A must reflect the budget totals identified in the line item budget and the budget justification narrative.

If you anticipate that there will be unobligated balances (UOB) of funds at the completion of the current budget period, include the high estimate of the amount in this continuation application. The estimate of the UOB amount should be placed in SF-424A, Section A – Budget Summary in Line 1, Columns C and D. This unobligated balance estimate should not be listed on the face sheet as the federal amount requested nor included in the budget and budget narrative justification.

For current grantees, the amount requested cannot include any approved carryover funds. The CFDA Number should read 93.153. Columns C and D should be left blank. Please pay special attention to these items:

SF-424A, Section A, Budget Summary, Line 1: title Line 1 “Service Delivery in column (a) and include the CFDA number 93.153 in column (b).” In columns (e) and (g) include the Part D project costs for service delivery. Do not include administrative or clinical quality management costs. Columns c, d, and f should be left blank.

SF-424 A, Section A, Budget Summary, Line 2: title Line 2 “Clinical Quality Management.” In columns (e) and (g) include the Part D clinical quality management costs for the project. Do not include administrative costs.

SF-424 A, Section A, Budget Summary, Line 3: title Line 3 “Administrative.” In columns (e) and (g) include the Part D administrative costs, but do not include indirect costs based on a federally negotiated indirect cost rate. Not more than 10 percent may be used for administrative costs. This limitation is statutorily imposed per Section 2671 (h)(1). Cell 3e must not exceed 10 percent of the total Part D funds requested.

SF-424A, Section B, Budget Categories, Column 1: title Column 1 “Service Delivery.” Represent all costs associated with the provision of service delivery by the identified object class categories. The total amount should equal that listed in Section A, Cell 1g.

SF-424A, Section B, Budget Categories, Column 2: title Column 2 “Clinical Quality Management.” Present the total of clinical quality management costs

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by the identified object class categories. The total amount should equal that listed in Section A, Cell 2g.

SF-424A, Section B, Budget Categories, Column 3: title Column 3 “Administrative.” Present the total administrative costs by the identified object class categories. The total amount should equal that listed in Section A, Cell 3g.

SF-424A, Section B, Budget Categories, Column 5: present the total Part D costs of the project. The total amount, Cell 5k, should equal that listed in Section A, Cell 5g.

SF-424A, Section B, Budget Categories, Line 7: for the purposes of this budget, leave this section blank.

SF-424A, Section C, Non-Federal Resources: leave blank.

SF-424A, Section D, Forecasted Cash Needs: leave blank.

SF-424A, Section E, Budget Estimates of Federal Funds Needed for Balance of the Project, Line 16 & 20: Project the budget estimates for the remaining four (4) of the five (5) year project period in cells 16b, 16c, 16d, & 16e. These amounts should also repeat in cells 20b, 20c, 20d, & 20e.

SF-424A, Section F, Other Budget Information, Line 21: This does not need to be completed since a separate line item budget is required, therefore, Line 21 does not need to be completed.

SF-424A, Section F, Other Budget Information, Line 22: Enter the total amount of indirect costs requested and show how the amount is calculated. HAB allows indirect costs only if your organization has negotiated an Indirect Cost Rate that has been approved to cover the budget period. (See Indirect Cost under Budget Justification).

Line-Item BudgetYour budget period is for one year, from 9/1/2010 – 8/31/2011, while your project period is for up to 5 years. You must provide a consolidated budget that reflects all costs for proposed activities, including those for network subcontractors. The line-item budget should list costs separately for each line item category. It is recommended that you present your line item budget in table format, listing the program category costs (Service Delivery Costs, Clinical Quality Management Costs and Administrative Costs) across the top and object class categories (Personnel, Fringe Benefits, etc) in a column down the left hand side. The amount requested on the SF-424A and the amount listed on the line-item budget should match. Under Personnel, please list each position by title and name, with annual salary, FTE, and salary charged to the grant. Equipment, supplies and contractual should each have individual items listed separately. The budget must represent no more than the approved base funding as noted in the most recent (FY 2009) Part D Notice of Grant Award (NGA) before any carryover adjustments and should include any on-going expansion funds. The budget must be well justified and relate to the activities proposed in your application. The budget must reflect the primary medical care services provided, either directly or through contracts or memoranda of understanding.

Subcontracts

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You must also provide an itemized budget and a narrative justification for each subcontract. Separate program budgets must be established with network subcontractors and care must be taken to ensure there is no duplication of effort. Provide a separate line-item budget for each network subcontractor using the same format as that of the consolidated line-item budget for the grantee of record. The line-item budget for each subcontractor should list costs separately for each line item, utilizing the same object class categories (Personnel, Fringe Benefits, etc) as those for the consolidated budget in a column down the left hand side. Administrative costs of subcontractors should be itemized in the line-item budget and budget justification narrative, and should be part of the 10% limitation of the total Part D award (and are subject to the 10% limitation on administrative costs of the total Part D award). The total amount listed in each network subcontractor budget should match the total amount listed for that agency on the grantee of record consolidated line-item budget.

v. Budget Justification (EHBs)Provide a narrative that explains the amounts requested for each line in the budget. The budget justification should specifically describe how each item will support the achievement of proposed objectives. The budget period is for ONE year. Line item information must be provided to explain the costs entered in Application Form SF-424A. The budget justification must clearly describe each cost element, the calculation for the cost and explain how each cost contributes to meeting the project’s objectives/goals. Be very careful showing how each item in the “other” category is justified. The budget justification MUST be concise. Do NOT use the justification to expand the project narrative. Caps on expenses: all caps/statutory limitations regarding administrative expense must be followed.

Include the following in the Budget Justification narrative:

Personnel Costs: Personnel costs should be explained by listing each staff member who will be supported from funds, name (if possible), position title, percent full-time equivalency, and annual salary.

Fringe Benefits: List the components that comprise the fringe benefit rate, for example health insurance, taxes, unemployment insurance, life insurance, retirement plan, and tuition reimbursement. The fringe benefits should be directly proportional to that portion of personnel costs that are allocated for the project.

Travel: List travel costs according to local and long distance travel. For local travel, the mileage rate, number of miles, reason for travel, and staff member/consumers completing the travel should be outlined. The budget should also reflect the travel expenses associated with participating in meetings and other proposed trainings or workshops.

The Ryan White HIV/AIDS Program All Grantees Meeting is scheduled every other year. Grantees are expected to include in their budgets travel expenses for up to three (3) persons to attend this meeting. The HIV/AIDS Bureau will also sponsor every year a Clinical Update Meeting for Ryan White HIV/AIDS Program grantees. Grantees are expected to send one clinical care provider to the Annual HIV Clinical Update Meeting. Be sure to allocate funds for this meeting. You are allowed to use

HRSA 5-H12-10-001 21

Part D funds to send staff and consumers to meetings and trainings that are important for the roles they play (for example, research meetings, the Bureau’s quality improvement initiative, and Pediatric AIDS Clinical Trials Group meetings). All funds allocated for travel to professional meetings, conferences, and trainings should be listed under Clinical Quality Management.

Equipment: List equipment costs and provide justification for the need of the equipment to carry out the program’s goals. Extensive justification and a detailed status of current equipment must be provided when requesting funds for the purchase of computers and furniture items that meet the definition of equipment (a unit cost of $5000 and a useful life of one or more years).

Supplies: List the items that the project will use. In this category, separate office supplies from medical and educational purchases. Office supplies could include paper, pencils, and the like: medical supplies are syringes, blood tubes, plastic gloves, etc., and educational supplies may be pamphlets and educational videotapes. Remember, they must be listed separately.

Contracts: Applicants and/or grantees are responsible for ensuring that their organization and or institution has in place an established and adequate procurement system with fully developed written procedures for awarding and monitoring all contracts. Applicants and/or grantees must provide a clear explanation as to the purpose of each contract, how the costs were estimated, and the specific contract deliverables. . Categorize all contract costs according to type (e.g., translation services, transportation, childcare, consultants). If the contract is for a full time professional, provide justification for contracting instead of using an employee of the grantee institution. Treat payments to clients for performance of activities, such as client advocacy or peer education, the same as consultant payments only when they are working less than 0.5 FTE. Provide name of contractor, time spent working with the project, and rate of pay.

Provide a clear explanation as to the purpose of each contract, how the costs were estimated, and the specific contract deliverables.

Other: Put all costs that do not fit into any other category into this category and provide an explanation of each cost in this category. In some cases, grantee rent, utilities, and insurance fall under this category if they are not included in an approved indirect cost rate.

Indirect Costs: Indirect costs are those costs incurred for common or joint objectives which cannot be readily identified but are necessary to the operations of the organization, e.g., the cost of operating and maintaining facilities, depreciation, and administrative salaries. For institutions subject to OMB Circular A-21, the term “facilities and administration” is used to denote indirect costs. If an organization applying for an assistance award does not have an indirect cost rate, the applicant may wish to obtain one through HHS’s Division of Cost Allocation (DCA). Visit DCA’s Web site at: http://rates.psc.gov/ to learn more about rate agreements, the process for applying for them, and the regional offices, which negotiate them.

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If your program has an approved indirect cost rate and you have included indirect costs in your budget, you must include a copy of the latest negotiated cost agreement that covers the period for which funds are requested must be submitted as an attachment to the application (Attachment 2).

Indirect costs must match the federally approved indirect cost agreement. The administrative costs for sub-contractors under the Part D grants do not lose their administrative nature by being part of a contract, and are included in the limitation in administrative costs.

If you anticipate that there will be unobligated balances (UOB) of funds at the completion of the current budget period, include the high estimate of the amount in this continuation application. The estimate of the UOB amount should be placed in SF-424A, Section A – Budget Summary in Line 1, Columns C and D. This unobligated balance estimate should not be listed on the face sheet as the federal amount requested nor included in the budget and budget narrative justification.

If the UOB is needed to complete the project objectives, you must request to use the UOB as carryover for your project in the new budget period. You may request to use the UOB with the electronic submission of the Financial Status Report (FSR) or by submitting a prior approval request through the Electronic Handbooks within 30 days of the electronic FSR submission.  The request to use the UOB shall include a letter of explanation of why the funds were not spent and why the carryover is needed, a revised budget, and a budget justification. If submitting the request through the prior approval process, the electronic submission of the FSR must be received by HRSA.  

vi. Staffing Plan and Personnel Requirements (EHBs)If staffing changes have occurred during the current budget period, provide a staffing plan and justification that includes education, experience qualifications, and rationale for the amount of time being requested for the new key staff position(s). Key staff is defined as those with direct responsibility for the Part D program, including those within subcontract agencies. At a minimum, key staff will include the Program Coordinator, primary clinicians, the CQM/CQI lead, staff responsible for providing research education, and staff coordinating supportive services, at the grantee of record site and for subcontractors. If there is a primary liaison at each subcontract agency responsible for the coordination of services, include these staff members. All applicants must present a staffing plan.

Position descriptions that include the roles, responsibilities, and qualifications of new key project staff, including those located within subcontract agencies, must be included in Attachment 3.

Copies of biographical sketches for any new/additional key employed personnel that will be assigned to work on the proposed project must be included in Attachment 4. Biographical sketches are brief paragraph descriptions of each key employee and should include education, experience, qualifications, and accomplishments in HIV care, length of time involved in HIV care, training and credentials. Note that biographical sketches take the place of Curriculum Vitae (CV). Therefore you are not required to submit CVs. If you do not have any staff changes, please indicate this.

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The staffing narrative justification should be included as Attachment 5 under the heading “Staffing Plan.” The justification should discuss why the staff listed as part of this program are necessary, including the rationale behind the amount of time being requested. As part of this section, also reference any Position Descriptions and Biographical Sketches included as Attachments.

The HAB Part D program recommends that you have a Program Coordinator for at least .50 FTE. A sample position description for the Program Coordinator is found in Appendix C of this guidance. We expect the Program Coordinator to have fiscal and programmatic authority for the management of the Part D program and serve as the contact person for all Part D staff. You should also have a person designated to educate Part D clients on research and research opportunities.

You are encouraged to hire consumers as staff in positions for which they are qualified. Programs have found that hiring consumers in the workplace helps keep them focused on the needs of people living with HIV/AIDS. The HAB can provide technical assistance that will help grantees work with consumers as staff.

vii. Assurances and Certifications

1) Assurances and Certifications (SF-424, Block 21)Review the 18 assurances listed and select “I Agree” to certify that the assurances and certifications have been read and that the applicant agrees to comply with the requirements of form SF-424B upon award of funds.

2) Disclosure of Lobbying ActivitiesIf “Yes” for lobbying activities was selected in the certifications section, then the Disclosure of Lobbying Activities must be completed. viii. Project Abstract (Grants.gov)Provide a summary of the application. Because the abstract is often distributed to provide information to the public and Congress, please prepare this so that it is clear, accurate, concise, and without reference to other parts of the application. It must include a brief description of the proposed grant project including the needs to be addressed, the proposed services, and the population group(s) to be served.

Please place the following at the top of the abstract: Project Title Applicant Name Address Contact Phone Numbers (Voice, Fax) E-Mail Address Web Site Address, if applicable

Describe in the abstract four major areas as follows:

1) Organizational DescriptionProvide a description of your agency or institution. The type of organization (hospital, community health center, or AIDS Service Organization); how long it has been in the

HRSA 5-H12-10-001 24

community; and how long it has served persons living with HIV/AIDS. Describe the funding sources of your agency and the amount of funding requested for this grant.

2) Profile of Services and Client BaseProvide an overview of your program, including the services you provide, the geographic service area served, the needs to be addressed, and the numbers of HIV/AIDS-infected youth you have served. Describe the demographics of the target population and the demographics of your staff, including the percentage of racial/ethnic minority populations you served in 2009. Discuss how many persons you expect to serve by the end of this project period.

3)ChallengesDiscuss any challenges you face or expect to face in serving the targeted population and how you propose to deal with some of these challenges.

4)Network CoordinationProvide a brief overview of your Part D network. Describe the number of providers in your network, the services provided by your network, and the number of patients served by the network partners in 2009. Describe how providers participate in the planning and coordination of services.

The project abstract must be single-spaced and limited to one (1) page in length.

ix. Program Narrative (Full narrative and attachments in EHBs)A non-competing continuation application (or summary progress report) is required for the second or subsequent budget period of the approved project period. The Program Narrative contains eight (8) sections: 1) Progress Report, 2) Changes in Service Delivery System, 3) Current and Projected Sources of Funding, 4) Minority AIDS Initiative, 5) Work Plan, and 6) Evaluation, 7) Clinical Quality Management Update, and 8) Issues of Concern /Technical Assistance Needs.

If you have participated in a performance review by HRSA’s Office of Regional Operations (ORO) formerly the Office of Performance Review (OPR), please provide a summary of your Action Plan activities, describe how the activities have been integrated into your grant program and/or operations, and provide a status update on the activities and/or outcomes achieved. Providing an update on Action Plan activities in your progress report eliminates the need to track the Action Plan separately and integrates the planned improvements into the grant award process.

Use the following section heading for the Narrative:

1) Progress Report 2) Changes in Service Delivery System, 3) Current and Projected Sources of Funding4) Minority AIDS Initiative5) Work Plan6) Evaluation 7) Clinical Quality Management Update 8) Issues of Concern/Technical Assistance Needs.

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1) Progress ReportThe progress report summarizes the major accomplishments of your program during the 2009 budget period. A complete Progress Report has five (5) parts:a. Progress Report on work plan (may be included as an attachment);b. Status report on program efforts to recruit and retain youth in care; c. Status report on efforts to educate clients in research opportunities;d. Status report on consumer involvement; ande. Clinical update.

a. Progress Report on Work PlanYou may use the format of your approved work plan for your progress report and add a column entitled “Progress to Date.” Include as Attachment 6.

Use quantitative information whenever possible (please use numbers, not percentages). Within the update on your work plan include data on the people you serve. Specifically you must report on the total, unduplicated number of clients you served during the 2009 budget period. Describe the people you serve by age, gender, sexual orientation, and race/ethnicity.

Be sure to include information particularly relevant to the Part D Youth Services Initiative, such as:

How case finding is conducted and the type of venues where case finding activities that target high-risk youth are performed.

The services provided to enroll and retain youth in care, especially those who are pregnant. Briefly describe how your project makes these services available.

b. Status Report on Efforts to Recruit and Retain Youth in Care In this section, describe your efforts to recruit and retain youth in care over the last calendar year. At a minimum, you should answer the following questions:

How did you make HIV counseling and testing available for all youth? Did you have any targeted and/or unique efforts to ensure that youth are tested for

HIV? What did you do? Provide information on youth specific peer-counseling. How did your project link all youth who tested positive for HIV to medical care? How did your project provide prenatal care for infected women? How did your project teach youth about drugs that can reduce the chance of HIV

transmission, make sure drugs are offered, and address adherence to treatment issues?

For young women who are pregnant, o Tell us how you coordinated obstetric and Primary HIV care and how you

continued primary care after delivery. o Tell us how you provided pediatric care to their exposed, infected, and affected

children, and how you linked families among prenatal, primary medical and pediatric care providers.

o Tell us of your work with your local AETC to teach consumers and providers how to help reduce HIV transmission from mother to child.

c. Status Report on Efforts to Educate Clients on Research Opportunities

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Part D programs must provide their patients and clients with information and education on opportunities to participate in HIV/AIDS-related clinical research. In this section, describe your efforts to educate clients, including youth, about research opportunities over the last calendar year. At a minimum, you should answer the following questions:

Describe the process used to teach patients and clients about research. Describe the research opportunities made available to youth in your project. Describe how you will identify youth who would be appropriate participants in

research projects.

d. Status Report on Consumer InvolvementDescribe, in detail, what you did to involve consumers in your program over the last calendar year.

Describe the kinds of things consumers did to be involved in planning, implementing and evaluating your project.

Describe any specific methods in obtaining consumer feedback from youth. Describe the methods you used to keep youth informed and how you provide feedback

on their suggestions. If your project has a Consumer Advisory Board, discuss how you have been successful

and how you have not. Describe how you supported youth participation. Identify committees, advisory groups, panels and boards in which consumers are serving.

Include information about how you prepared youth for participation and the kinds and frequency of training you provided.

Provide information on the type of support and supervision you offered your active consumers.

Identify consumers who fill any leadership or staff positions in your program. Describe barriers that kept consumers from helping you plan, implement, or evaluate

your project. Tell us what you did to overcome these barriers and encourage participation. Describe your efforts to teach consumers about their disease and its management.

Who provided education about HIV? How often? Also describe how your project worked with medical personnel to make sure they help

consumers become full partners in their care.

e. Clinical UpdateDescribe your efforts to ensure that all medical services are provided in accordance with Public Health Service (PHS) guidelines and that all program service providers adhere to the best clinical practices and these are incorporated in the day-to-day provision of services.

2) Changes in Service Delivery SystemProvide a brief description of changes in your service delivery system and significant changes to the program.

In this section, describe any important changes in the project since your last application. You should also include any anticipated major changes for the remainder of the current budget period of the grant, i.e., through August 31, 2010. Briefly state how you are responding to these changes. Describe any changes in the following areas:

HRSA 5-H12-10-001 27

Changes in key staff including staff turnover and positions vacant for a long period of time Major changes in the way you are spending funds, e.g., new or discontinued

contractors, reduction or increase in staff, consumer items, etc. Changes to services provided Changes in the targeted population(s), e.g. decrease in number of youth being served

due to reductions in perinatal transmission Facing a major change in the health care environment of your service area that

changed the way your project works Changes in service delivery -- New contracts should be included as Attachment 7.

If HAB or ORO conducted a site visit of your program during the past year, you must report on the findings and recommendations as provided in the site visit report. Describe your progress in addressing the recommendations and any changes that have taken place in your program as a result of the site visit.

3) Current and Projected Sources of FundingProvide the following information and include a brief explanation if necessary.

The percentage of the HIV/AIDS program’s personnel budget that is funded using Part D Youth Services Initiative funds.

The amount of program income (i.e. Medicare/Medicaid billing, other third party payers, private insurance, etc.) generated in the current budget period.

How the funds generated from program income are used to enhance the HIV program. Include information about other grants and contracts including Part A, B C, and D

(non-Youth), other Federal grants and state and local funding.

4) Minority AIDS Initiative If your 2009 Notice of Grant Award (NGA) lists MAI funds, your application must include a description of the MAI population(s) served by your program.

If you received MAI funding on the 2009 NGA, please state the amount. Also, note the racial and ethnic minority groups you specially serve. If your program serves one particular group because of geography, you must still respond to this section. For each target population, you must describe briefly these items: The specific ethnic or minority group your program serves Outreach your program does to recruit infected members of that group How you identify infected persons who are members of that group How you enroll these persons in care after you have identified them as infected How you retain these persons in care after they are enrolled

Also, provide the following data for each racial/ethnic or minority group, this information can be provided in table format: Number enrolled in care at the beginning of the budget year Number newly identified during the budget year Number newly enrolled during the budget year Number enrolled at the end of the budget year

HRSA 5-H12-10-001 28

In addition, provide information on risk factors specific to each targeted population. Identify trends that occurred over the last year as your organization has experienced increases or decreases among specific groups (e.g., a 10 percent increase in the number of young men seeking services).

5) Work Plan

a. Work PlanProvide the work plan for the upcoming year. Using the goals and objectives in your last application as a base, describe major activities including goals, objectives, key action steps, staff/program responsible, and evaluation methods for the next one year budget period. All objectives should be written in time-framed, measurable terms and should

emphasize the provision of comprehensive coordinated HIV services and access to research for HIV-infected youth and their affected family members.

You must tell how many youth you believe you will serve in the next budget period. If your project receives MAI expansion funds, i.e., to identify, bring into, and retain in

service persons of color, please discuss how you plan to continue providing services with these funds by incorporating any specific activity related to the recruitment and/or retention of ethnic/racial minorities into your work plan.

You may want to use a table format to present this information. If you do, include it as Attachment 8.

Your work-plan must include objectives that describe your efforts providing your clients with information regarding prevention of exposure to HIV/AIDS, hepatitis B and hepatitis C, clinical complications from co-infection, testing, and the availability of clinical care and hepatitis B vaccine.

If your project receives MAI funds, i.e., to identify, bring into, and retain in service persons of color, please discuss how you plan to continue providing services with these funds by incorporating any specific activity related to the recruitment and/or retention of ethnic/racial minorities into your work plan.

Making Your Work Plan Specific, Time-Framed, and Measurable:

Your Work Plan objectives must be specific, time-framed and measurable. Information is provided below about how to write a Problem Statement, Goal, Objective, Action Step, and Evaluation Method that may assist you in writing your Work Plan.

The Problem Statement (also called the Statement of Need) helps you design your Goals and Objectives. Relate these to the mission of your organization and to the goals of the Part D Program.

Goals are generally broad statements, which describe the long-term benefits you seek.

Objectives should identify your target population(s), state what will change, how much change will occur and by when. The objective should lead to measurable outcomes that will make it easy for you to report on progress made. If you use either numbers or

HRSA 5-H12-10-001 29

percentages in your objectives, be clear about where you are starting from (the baseline number).

Are your Objectives realistic? Give yourself a target you can reach. Do not commit to an objective that is out of reach. For example, can you really achieve 100 percent compliance with clients attending appointments? Remember that objectives should contain “action verbs” such as the following phrases: “to enroll…” “to provide…”; and “to reduce.” Keep your objectives simple and obtainable, in accordance with the program expectations.

Action Steps describe the specific activities undertaken to accomplish your Objectives. Action Steps should flow logically from your Problem Statement, Goal and Objectives. They should clearly describe your program activities as well as the sequence of activities, and they should be reasonable. Remember to build in start-up time for new initiatives. How long does it really take to recruit and hire someone in your system?

Person Responsible: specify the individual(s) responsible for accomplishing each action step by what date.

Evaluation Method: The purpose of evaluation is to measure the results of your program. Evaluation is also a tool that provides information and feedback so that you can make appropriate adjustments to your program during the project period. Effective evaluation methods will help your organization determine the extent to which your objectives have been accomplished, as well as, the extent to which this is attributable to your program or intervention. Your Evaluation Method is how you will measure whether or not a particular Objective has been achieved.

Remember, your work plan should be a tool that will help you actively manage your program by measuring progress, identifying necessary changes, and quantifying your accomplishments.

b. Network Providers ChartDescribe the agencies, organizations, and groups that are part of your project. Identify and define the work to be done by each agency supported by the project. To do this, include the name of the provider, services provided, number of clients served by each network provider, and the geographic areas your network member will serve. Also, identify and quantify the work to be done by agencies not funded by the project, which are part of the network. Indicate if the provider will receive Part D funds. Use a chart to depict this information and include it as Attachment 9.

Describe how the requested funds will lead to the improvement of overall patient outcomes for your target population in relation to the needs identified through the local and State processes. Identify the amount of money (percent of funds) directed towards services.  Provide at least 3 patient outcomes that are related to these services provided and are consistent with the State plan. These outcomes can be related to another component of the program such as MAI.

c. Culturally and Linguistically Competent Care

HRSA 5-H12-10-001 30

Describe how you recruit and retain staff and volunteers with demonstrated experience and familiarity with the culture and literacy level of your target population. Explain how you ensure that the network partners are taking cultural differences into consideration and how the cultures and languages of the groups you serve are reflected among the providers of services.

6) Evaluation In this section, describe the methods by which you evaluate the outcomes of your program. Also, describe the current management information system (MIS) used by your program. See the following sections for further explanation.

a. EvaluationThe purpose of evaluation is to measure the results of your program. Evaluation is also a tool that provides information and feedback so that you can make appropriate adjustments to your program during the project period. Effective evaluation methods will help your organization determine the extent to which your objectives have been accomplished, as well as, the extent to which this is attributable to your program or intervention.

Describe how you use evaluation to measure the impact of your program. Describe how you use evaluation to help you determine the extent to which your objectives have been accomplished. Explain how you use evaluation to tell others about the program and to document the need for further funding. Explain how you use evaluation to garner support for your program from the community.

You may want to refer to the evaluation section of the HAB website for information: http://hab.hrsa.gov/report_studies.htm.

b. Management Information SystemDescribe the current management information system (MIS) and its capacity to track the data needed to measure attainment of goals and objectives. If you do not have one, describe the system you propose to develop and how it will be implemented.

Your system must also capture the following variables: The number of youth provided services Epidemiological and demographic data on the youth receiving services Exposure and diagnostic categories The clinical status summary on the youth receiving services Service utilization data Prevention and case finding activities summary

Describe how staff, consumers, providers and agencies receive feedback about the project and how the information is used to modify the program. Also, indicate your technical assistance needs in this area.

HRSA 5-H12-10-001 31

7) Clinical Quality Management UpdateDescribe your Clinical Quality Management program. Specifically identify the person in your staffing plan that will lead the CQM activities for this grant. This person may or may not be supported by the grant funds. Your HIV program’s Quality Management Plan could be a useful resource.

Infrastructure: a. Describe the program’s quality goals.b. Describe the quality management infrastructure, including the key leaders and

quality committee. c. Describe the resources dedicated to quality management activities. d. Describe the role of network providers in the QM program.e. Describe the role of consumers in the Quality Management program. f. Describe how the program monitors the effectiveness of the quality

management infrastructure and the quality improvement activities. Performance Measurement:

a. Identify the clinical indicators used to measure performance. b. Describe the data collection plan and process (e.g. frequency, key activities,

responsible staff)c. Describe the process for reporting and disseminating the results and findings.d. Describe how data are used for quality improvement activities.

Quality Improvement:a. Describe the quality management approach to systemizing quality

improvement activities. b. Identify the areas for improvement your program identified over the last year.c. Provide an example of a quality improvement project that your program

implemented. i. Outline the team leader, staff involved, team responsibilities, and

resources allocated for the project.ii. Describe the process/tools used to implement the quality improvement

project. iii. Describe the role of leadership in the project. iv. Describe the intervention, results, and the outcome of the QI project. v. Describe how the changes made to the program have been sustained

over time.

8) Issues of Concern and Requests for Technical AssistanceInclude a description of any issues of concern affecting your program and any technical assistance needs you may have. Describe any current or anticipated problems in implementing your Part D Youth Services Initiative program for the current budget period. If similar problems were discussed in the last application, provide an update of any action taken to correct or resolve the problems. If future problems or delays are anticipated, describe these problems and the actions you plan to take to address the problems. Provide a detailed description of any technical assistance needs your program may have that HAB may address or any identified topics of technical assistance the agency requires.

x. Program Specific Forms

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Applicants must complete the Part D Agreement (see Appendix B) and submit it electronically as Attachment 10 with the application. On item 21 of the SF-424 you will be agreeing to comply with them.

If you have received prior written approval to submit a paper application, you will need to sign the Part D Agreement and include it in your application. Include the Part D Agreement as Attachment 10. The Part D Agreement will count toward the 80-page limit.

xi. Attachments (in EHBs)Provide attachments needed to support your non-competing continuation application. Up to 20 attachments may be uploaded. Note that these are supplementary in nature, and are not intended to be a continuation of the project narrative. Be sure each attachment is clearly labeled and attached as follows:

Attachment 1: Documentation of Medicaid provider status and Clinic Licensure Include documentation of Medicaid Provider status and current licensure to provide clinical services. Documentation for this application should be in the form of a table that identifies all providers’ Medicaid number and clinic licensure status, if applicable (see Eligibility Information, “Other” Section for details).

Attachment 2: Negotiated Indirect Cost Rate, if applicable Provide a copy of latest negotiated indirect cost rate agreement, if you are requesting indirect costs in the budget.

Attachment 3: Position descriptions for new personnelKeep each to one page in length. Only include for staff added since the last application.

Attachment 4: Copies of biographical sketches for any new/additional key personnel. More than one biographical sketch can be included on one page. In the event that a biographical sketch is included for an identified individual who is not yet hired, please include a letter of commitment from that person with the biographical sketch.

Attachment 5: Staffing Plan Narrative Justification

Attachment 6: Progress Report on Work Plan

Attachment 7: ContractsProvide sample contracts that describe working relationships between your agency and other agencies and programs cited in the proposal. The documents should describe the roles of subcontractors and their deliverables with dates that indicate length of the agreement. Provide no more than two (2) contract samples.

Attachment 8: Work Plan for upcoming budget period

Attachment 9: Network Providers Chart

HRSA 5-H12-10-001 33

Provide a chart that depicts the network providers including the name of the provider, services provided, number of clients served or number of units of service provided by each network provider, and the geographic areas your network providers will serve.

Attachment 10: Part D Agreement (see Appendix B)

3. Submission Dates, Times, and Requirements

The non-competing continuation application due date in Grants.gov is, February 22, 2010 by 8:00 P.M. E.T. The due date to complete all other required information in the HRSA EHBs is by 5:00 P.M. E.T. 2 weeks after the Grants.gov due date, or March 8, 2010.

Applications will be considered as having been formally submitted and having met the deadline if: (1) the application has been successfully transmitted electronically by your organization’s Authorizing Organization Representative (AOR) through Grants.gov and it has been successfully validated by Grants.gov on or before the deadline date and time; and (2) the Project Director has entered the HRSA EHBs to review and complete the application and the AOR submits the additional information for the non-competing continuation application on or before the deadline date and time.

It is incumbent on applicants to ensure that the AOR is available to submit the application to Grants.gov by the published due date.  Therefore, you are urged to submit your application in advance of the deadline.  If your application is rejected by Grants.gov due to errors, you must correct the application and resubmit it to Grants.gov before the deadline date and time.

Late applications: Applications that do not meet the criteria delineated in Appendix A are considered late applications. This may cause a delay in issuing the Notice of Award or a lapse in funding.

The Chief Grants Management Officer (CGMO) or designee may authorize an extension of published deadlines when justified by circumstances such as natural disasters (e.g., floods or hurricanes) or other disruptions of services, such as a prolonged blackout. The CGMO or designee will determine the affected geographical area(s).

Instructions on how to register and apply, tutorials and frequently asked questions (FAQs) are available on the Grants.gov web site at www.grants.gov. Assistance is also available from the Grants.gov help desk at support@grants.gov or by phone at 1-800-518-4726, 24 hours a day, 7 days a week, excluding Federal holidays.

V. Application Review Information

1. Review Process

Non-competing continuation applications are not subject to independent objective review procedures and do not compete with new or competing continuation applications for funds.

HRSA 5-H12-10-001 34

They are, however, reviewed by grants management officials (business and financial review) and program staff (technical review and analysis of performance measures) to determine if the grantee: 1) performed satisfactorily; 2) is in compliance with statutory/regulatory requirements; and 3) that proposed costs are allowable and reasonable. The following criteria are used during the review process:

• The estimated costs to the Government of the project are reasonable considering the level and complexity of activity and the anticipated results.

• The project personnel or prospective fellows are well qualified by training and/or experience for the support sought, and the applicant organization has adequate facilities and manpower.

• In so far as practical, the proposed activities (scientific or other), if well executed, are capable of attaining project objectives.

• The project objectives are capable of achieving the specific program objectives defined in the program announcement and the proposed results are measurable.

• The method for evaluating proposed results includes criteria for determining the extent to which the program has achieved its stated objectives and the extent to which the accomplishment of objectives can be attributed to the program.

• In so far as practical, the proposed activities, when accomplished, are replicable, national in scope and include plans for broad dissemination.

2. Anticipated Award Date

The anticipated date of award is September 1, 2010.

VI. Award Administration Information

1. Award Notices

The Notice of Award sets forth the amount of funds granted, the terms and conditions of the grant, the effective date of the grant, the budget period for which initial support will be given, the non-Federal share to be provided (if applicable), and the total project period for which support is contemplated. Signed by the Grants Management Officer, it is sent to the applicant agency’s Authorized Representative, and reflects the only authorizing document. It will be sent prior to the start date of September 1, 2010.

2. Administrative and National Policy Requirements

Successful applicants must comply with the administrative requirements outlined in 45 CFR Part 74 (non-governmental) or 45 CFR Part 92 (governmental), as appropriate.

HRSA grant awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable to the grant based on recipient type and purpose of award.

HRSA 5-H12-10-001 35

This includes, as applicable, any requirements in Parts I and II of the HHS GPS that apply to the award. The HHS GPS is available at http://www.hrsa.gov/grants/. The general terms and conditions in the HHS GPS will apply as indicated unless there are statutory, regulatory, or award-specific requirements to the contrary (as specified in the Notice of Award).

Cultural and Linguistic CompetenceHRSA is committed to ensuring access to quality health care for all. Quality care means access to services, information, materials delivered by competent providers in a manner that factors in the language needs, cultural richness, and diversity of populations served. Quality also means that, where appropriate, data collection instruments used should adhere to culturally competent and linguistically appropriate norms. For additional information and guidance, refer to the National Standards for Culturally and Linguistically Appropriate Services in Health Care published by HHS. This document is available online at http://www.omhrc.gov/CLAS.

Trafficking In PersonsAwards issued under this guidance are subject to the requirements of Section 106 (g) of the Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104). For the full text of the award term, go to http://www.hrsa.gov/grants/trafficking.htm. If you are unable to access this link, please contact the Grants Management Specialist identified in this guidance to obtain a copy of the Term.

Smoke-Free WorkplaceThe Public Health Service strongly encourages all award recipients to provide a smoke-free workplace and to promote the non-use of all tobacco products. Further, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility ) in which regular or routine education, library, day care, health care or early childhood development services are provided to children.

HRSA Guidance on Preparations for the 2nd Phase of the Novel H1N1 InfluenzaHRSA has been working with HHS, other Federal agency partners, grantees and grantee associations to get ready for the upcoming flu season.  “H1N1 Guidance for HRSA Grantees,” which can be found at www.hrsa.gov/h1n1/, is voluntary guidance intended primarily for HRSA-funded direct service grantees and their sub grantees and contractors, although other HRSA grantees may also find the information useful.  This guidance may also be of interest to eligible 340B entities and HRSA’s cooperative agreement partners.

HRSA is providing this to help HRSA–funded programs plan how to best protect their workforce and serve their communities.  HRSA will continue to monitor evolving pandemic preparedness efforts and work to provide guidance and information to grantees and grantee associations as it becomes available.  Products and updates in support of H1N1 pandemic response efforts will be posted to www.hrsa.gov/h1n1/ as soon as they are released.

3. On-Site ReviewsThe Office of Regional Operations (ORO), formerly the Office of Performance Review (OPR), serves as the regional component of HRSA by providing leadership on HRSA’s mission, goals, priorities and initiatives in the regions, States and Territories. ORO will provide assistance to grant recipients in partnership with HRSA program leaders within the

HRSA 5-H12-10-001 36

Bureaus/Offices in the conduct of site visits in addressing compliance with program requirements and evaluating performance against established Bureau/Office metrics. Bureaus/Office program leaders will determine which programs to visit and will enlist the assistance of ORO regional components in the pre-planning and conduct of those visits. As part of this effort, HRSA recipients may be asked to participate in an on-site visit to their HRSA funded program(s) by a review team from one of the ten ORO regional divisions and, if required, staff from the Bureau/Office making the award.

ORO works collaboratively with grantees and HRSA Bureaus/Offices to ensure that recipients are able to adequately address the identified performance measures based on the type of program(s). ORO will also seek to identify, collect, and disseminate leading/innovative practices.

These visits will also provide an opportunity for HRSA recipients to offer direct feedback to the agency about the impact of HRSA policies on program implementation and performance within communities and States.

VII. POST AWARD REPORTING

Grantees/Awardees must comply with the following reporting and review activities:

a. Audit RequirementsComply with audit requirements of Office of Management and Budget (OMB) Circular A-133. Information on the scope, frequency, and other aspects of the audits can be found on the Internet at www.whitehouse.gov/omb/circulars;

b. Payment Management RequirementsSubmit a quarterly electronic PSC-272 via the Payment Management System. The report identifies cash expenditures against the authorized funds for the grant. Failure to submit the report may result in the inability to access grant funds. The PSC-272 Certification page should be faxed to the PMS contact at the fax number listed on the PSC-272 form, or it may be submitted to the:

Division of Payment ManagementHHS/ASAM/PSC/FMS/DPMPO Box 6021Rockville, MD 20852Telephone: (877) 614-5533

HRSA 5-H12-10-001 37

c. Status Reports1) Submit a Financial Status Report. A financial status report is required within 90 days of the end of each budget period. The report is an accounting of expenditures under the project that year. Financial Status Reports must be submitted electronically through EHB. Note that any unexpended balances that the grantee anticipates needing to complete the scope of approved activities should be explicitly requested at the time the FSR is submitted. Funds not explicitly requested, or determined not to be needed, will be offset in a subsequent year.

2) The project’s final report and any products developed through the grant are to be provided to the Grants Management Specialist in the Division of Grants Management Operations listed below within 90 days of the end of the project period.

Joi GrymesGrants Management SpecialistHRSA/DGMO/HSB5600 Fishers Lane, Room 11A-02Rockville, MD 20857Telephone: (301) 443-2632 Fax: (301)594-6096 E-mail: jgrymes@hrsa.gov

The Division of Grants Management Operations will forward these materials to the Project Officer.

3) Submit Progress Reports (non-competing continuation applications) on specific dates prior to the end of the project period. The non-competing continuation application will include a progress report, the budget for the upcoming budget period, and revised work plan.

4) Submit an aggregate Ryan White HIV/AIDS Program Data Report (RDR) via the HRSA EHBs for each direct service provider annually. The RDR is due in March and should report on services provided during the previous calendar year.

5) Submit grantee, service provider, and Client Level Data on a semi-annual basis (January through June and July through December) via the HRSA EHBs. HAB has received OMB approval for this process, and information was published in the Federal Register in late Spring of 2008.

6) Submit an Allocation Report, to be due 60 days after the start of the budget period, and an Expenditure Report, to be due 90 days after the end of the budget period. These reports account for the allocation and then expenditure of all grant funds according to the specific core medical services, support services, clinical quality management, and administration. Data for these reports would be uploaded to a secure HRSA server via the HRSA EHBs. The forms to report this information for all parts of the Ryan White Program were approved by the Office of Management and Budget on May 1, 2008, OMB Number 0915-0318.

HRSA 5-H12-10-001 38

7) Submit, every 2 years, to the lead State agency for Part B (Title II), audits consistent with Office of Management and Budget Circular A-133, regarding funds expended in accordance with this title and include necessary client level data to complete unmet need calculations and the Statewide coordinated statements of need process.

VIII. AGENCY CONTACTS

Grantees are encouraged to request assistance, if needed, when developing their non-competing continuation applications. Grantees/Awardees may obtain additional iformation regarding business, administrative, or fiscal issues related to this grant announcement by contacting:

Joi GrymesGrants Management SpecialistHRSA/DGMO/HSB5600 Fishers Lane, Room 11A-02Rockville, MD 20857Telephone: (301) 443-2632 Fax: (301)594-6096 E-mail: jgrymes@hrsa.gov

Grantees may obtain additional information related to the overall program issues by contacting

Hanna EndalePublic Health AnalystParklawn Building, Room 7A-305600 Fishers LaneRockville, Maryland 20857Telephone: (301) 443-1326Fax: (301) 443-1884E-mail: hendale@hrsa.gov

Grantees may need assistance when working online to submit their non-competing continuation application forms electronically. For assistance with submitting the application in Grants.gov, contact Grants.gov, Call Center, 24 hours a day, 7 days a week, excluding Federal holidays:

Grants.gov Contact CenterPhone: 1-800-518-4726E-mail: support@grants.gov

Grantees may need assistance when working online to submit the remainder of their non-competing continuation information electronically through HRSA’s Electronic Handbooks (EHBs). For assistance with submitting the remaining information in the HRSA EHBs, contact the HRSA Call Center, Monday-Friday, 9:00 A.M. to 5:30 P.M. E.T.:

HRSA Call CenterPhone: (877) Go4-HRSA or (877) 464-4772

HRSA 5-H12-10-001 39

Fax: (301) 998-7377E-mail: CallCenter@HRSA.GOV

IX. TIPS TO WRITING A STRONG APPLICATION

A concise resource offering tips for writing proposals for HHS grants and cooperative agreements can be accessed online at: http://www.hhs.gov/asrt/og/grantinformation/apptips.html.

HRSA 5-H12-10-001 40

GUIDANCE APPENDICES

Appendix A: Electronic Submission User Guide

Appendix B: Part D Agreement

Appendix C: Sample Program Coordinator Position Description

HRSA 5-H12-10-001 41

APPENDIX A: HRSA ELECTRONIC SUBMISSION GUIDE

Table of Contents

1.1. INTRODUCTIONINTRODUCTION................................................................................................................................................................42

1.1. Document Purpose and Scope............................................................................................421.2. Document Organization and Version Control....................................................................42

2.2. PROCESS OVERVIEWPROCESS OVERVIEW....................................................................................................................................................43

2.1.. New Competing Applications (Entire Submission Through Grants.gov; no verification required within HRSA EHBs).....................................................................43

2.2.. New Competing, Competing Continuation, and Competing Supplement Applications (Submitted Using Both Grants.gov and HRSA EHBs; verification required within HRSA EHBs)..........................................................................................................................43

2.3. Non-Competing Continuation Application..........................................................................44

3.3. REGISTERING AND APPLYING THROUGH GRANTS.GOVREGISTERING AND APPLYING THROUGH GRANTS.GOV......................................................................45

3.1. REGISTER – Applicant/Grantee Organizations Must Register With Grants.gov (if not already registered).................................................................................45

3.2. APPLY - Apply through Grants.gov....................................................................................46

4.4. VALIDATING AND/OR COMPLETING AN APPLICATION IN THE HRSA ELECTRONIC VALIDATING AND/OR COMPLETING AN APPLICATION IN THE HRSA ELECTRONIC HANDBOOKSHANDBOOKS.............................................................................................................................................................................49

4.1. Register - Project Director and Authorizing Official Must Register with HRSA EHBs (if not already registered)..........................................................................................................49

4.2. Verify Status of Application..................................................................................................504.3. Validate Grants.gov Application in the HRSA EHBs........................................................504.4. Manage Access to the Application......................................................................................514.5. Check Validation Errors........................................................................................................514.6. Fix Errors and Complete Application..................................................................................514.7. Submit Application in HRSA EHBs.....................................................................................51

5.5. GENERAL INSTRUCTIONS FOR APPLICATION SUBMISSIONGENERAL INSTRUCTIONS FOR APPLICATION SUBMISSION.............................................................52

5.1. Narrative Attachment Guidelines........................................................................................525.2. Application Content Order (Table of Contents).................................................................535.3. Page Limit...............................................................................................................................54

6.6. CUSTOMER SUPPORT INFORMATIONCUSTOMER SUPPORT INFORMATION...............................................................................................................54

6.1. Grants.gov Customer Support.............................................................................................546.2. HRSA Call Center..................................................................................................................546.3. HRSA Program Support.......................................................................................................54

7.7. FAQSFAQS.........................................................................................................................................................................................55

7.1. Software..................................................................................................................................557.2. Application Receipt................................................................................................................587.3. Application Submission.........................................................................................................617.4. Grants.gov..............................................................................................................................61

HRSA Electronic Submission Guide 42 Version 1.4 – August 2009

1.1.IntroductionIntroduction

1.1.1.1.Document Purpose and ScopeDocument Purpose and Scope

The purpose of this document is to provide detailed instructions to help applicants and grantees submit new competing, competing continuation, competing supplements, and most Non-Competing Continuation applications electronically to HRSA through Grants.gov (and HRSA EHBs, where applicable). All applicants must submit in this manner. This document is intended to be the comprehensive source of information related to the electronic grant submission processes and will be updated periodically. This document does not replace program guidance provided in funding opportunity announcements.

NOTE: In order to view, complete and submit an application package, you will need to download the NOTE: In order to view, complete and submit an application package, you will need to download the compatible version of Adobe Reader software. All applicants must use the Adobe Reader version 8.1.1 compatible version of Adobe Reader software. All applicants must use the Adobe Reader version 8.1.1 or later version to successfully submit an application.or later version to successfully submit an application.

1.2.1.2.Document Organization and Version ControlDocument Organization and Version Control

This document contains SEVEN (7) sections. Following is the summary:

Section Description

1. Introduction Describes the document’s purpose and scope.2.2. Process Overview-

- New Competing Application through Grants.gov only(no verification required within HRSA EHBs)

- New Competing, Competing Continuation, and Competing Supplement Applications (submitted using both Grants.gov and HRSA EHBs (with HRSA EHBs Verification)

- Non-Competing Continuation Application

Provides detailed instructions to applicant organizations and institutions submitting a new competing application using Grants.gov that does not require HRSA EHBs verification.

Provides detailed instructions for those grantees submitting new competing, competing continuation, and competing supplement applications through Grants.gov and HRSA EHBs that require HRSA EHBs verification.

Provides detailed instructions to existing HRSA Grantees on submitting a Non-Competing Continuation application through Grants.gov and HRSA EHBs; verification required within EHBs.

3.3. Registering and Applying through Grants.gov

Provides detailed instructions to enable applicants/grantees to register and apply electronically using Grants.gov in the submission of grant applications.

4.4. HRSA Electronic Handbooks

Provides detailed instructions and important guidance on registering an individual and/or organization, verifying the status of applications, validating grants.gov application in the EHB, managing access to the application, checking

HRSA Electronic Submission Guide 43 Version 1.4 – August 2009

and correcting validation errors, completing and submitting the application.

5 General Instructions for Application Submission

Provides instructions and important policy guidance regarding application format requirements and submission.

6. Customer Support Information

Provides contact information to address technical and programmatic questions.

7. Frequently Asked Questions (FAQs)

Provides answers to frequently asked questions by various categories

This document is under version control. Please visit http://www.hrsa.gov/grants to retrieve the latest published version.

2.2.Process OverviewProcess Overview

2.12.1 New Competing Applications (Entire Submission Through New Competing Applications (Entire Submission Through Grants.gov; no verification required within HRSA EHBs)Grants.gov; no verification required within HRSA EHBs)

NOTE: Use the program guidance to determine if verification in HRSA EHBs is required. NOTE: Use the program guidance to determine if verification in HRSA EHBs is required. If If verification is requiredverification is required, you should refer to , you should refer to Section 2.2Section 2.2. If verification is not required, continue . If verification is not required, continue reading this section.reading this section.

Following is the process for submitting a New Competing Application through Grants.gov:

1. HRSA will post all New Competing announcements on Grants.gov (http://www.grants.gov).

2. Once the program guidance is available, applicants should search for the announcement in Grants.gov ‘Find Grant Opportunities.’ (http://www.grants.gov/applicants/find_grant_opportunities.jsp) or ‘Apply for Grants’ (http://www.grants.gov/Apply).

3. Download the application package and instructions from Grants.gov. The program guidance is also part of the instructions that must be downloaded.

4. Save a copy of the application package on your computer and complete all the forms based on the instructions provided in the program guidance.

5. Submit the application package through Grants.gov (requires registration).6. Track the status of your submitted application using Track My Status at Grants.gov until

you receive email notifications that your application has been received and validated by Grants.gov and received by HRSA.

2.22.2 New Competing, Competing Continuation, and Competing New Competing, Competing Continuation, and Competing Supplement Applications (Submitted Using Both Grants.gov Supplement Applications (Submitted Using Both Grants.gov and HRSA EHBs; verification required within HRSA EHBs)and HRSA EHBs; verification required within HRSA EHBs)

NOTE: You should review program guidance to determine if verification in HRSA EHBs is NOTE: You should review program guidance to determine if verification in HRSA EHBs is required. required. If verification is NOT required If verification is NOT required, you should refer to , you should refer to Section 2.1 aboveSection 2.1 above. If verification is . If verification is required, continue reading this section.required, continue reading this section.

Following is the process for submitting a Competitive Application through Grants.gov with verification required within HRSA Electronic Handbooks (EHBs):

HRSA Electronic Submission Guide 44 Version 1.4 – August 2009

1. HRSA will post all Competing Continuation and Competing Supplemental announcements on Grants.gov (http://grants.gov/search). Announcements are typically posted at the beginning of the fiscal year. However, program guidances are not generally available until later. New Competing applications that require verification within EHBs are posted throughout the year. For more information, visit http://www.hrsa.gov/grants.

2. When a program guidance becomes available, applicants should search for the announcement in Grants.gov under ‘Apply for Grants’ (http://www.grants.gov/Apply). Since eligibility for Competing Continuation and Competing Supplemental funding is limited to current grantees, those announcements will not appear under Grants.gov ‘Find Grant Opportunities.’

3. Download the application package and instructions from Grants.gov. The program guidance is also part of the instructions that must be downloaded. Note the Announcement Number as it will be required later in the process.

4. Save a copy of the application package on your computer and complete all the standard forms based on the instructions provided in the program guidance.

5. Submit the application package through Grants.gov (requires registration). Note the Grants.gov Tracking Number as it will be required later in the process.

6. Track the status of your submitted application using Track My Status at Grants.gov until you receive email notifications that your application has been received and validated by Grants.gov and received by HRSA.

7. HRSA EHBs software pulls the application information into EHBs and validates the data8. HRSA notifies the Project Director, Authorizing Official (AO), Business Official (BO) and

application point of contact (POC) by email to check HRSA EHBs for results of HRSA validations and enter supplemental information required to process the competing continuation or supplemental application. Note the HRSA EHBs tracking number from the email.

9. The application in HRSA EHBs is validated by a user from the grantee organization by providing three independent data elements--Announcement Number, Grants.gov Tracking Number and HRSA EHBs Tracking Number.

10. The AO verifies the pending application in HRSA EHBs, fixes any validation errors, and makes necessary corrections. Supplemental forms are completed. AO submits the application to HRSA.

2.3.2.3.Non-Competing Continuation ApplicationNon-Competing Continuation Application

The following is the process for submitting a Non-Competing Continuation application through Grants.gov and HRSA EHBs; verification required within HRSA EHBs:

1. HRSA will communicate the Non-competing announcement number to the Project Director (PD) and authorizing official (AO) listed on the most recent Notice of Grant Award (NGA) via email. The announcement number will be required to search for the announcement/funding opportunity when applying in Grants.gov.

2. Search for the announcement/funding opportunity in Grants.gov under ‘Apply for Grants.’ Since eligibility is limited to current grantees, the announcement will not appear under Grants.gov ‘Find Grant Opportunities.’

3. Download the application package and instructions from Grants.gov. The program guidance is part of the instructions that must be downloaded.

4. Save a copy of the application package on your computer and complete all the forms based on the instructions provided in the program guidance.

HRSA Electronic Submission Guide 45 Version 1.4 – August 2009

5. Submit the application package through Grants.gov (requires registration).6. Track the status of your submitted application using Track My Status at Grants.gov until

you receive email notifications that your application has been received and validated by Grants.gov and received by HRSA.

7. The HRSA Electronic Handbooks (EHBs) software pulls the application information into EHBs and validates the data. HRSA sends an email to the PD, AO, business official (BO), and application point of contact (POC) to review the application in the HRSA EHBs for validation errors and enter additional information, including in some cases, performance measures, necessary to process the Non-Competing Continuation.

8. The PD logs into the HRSA EHBs to enter all additional information necessary to process the application. The PD must also provide the AO submission rights for the application.

9. The AO verifies the application in HRSA EHBs, fixes any remaining validation errors, makes necessary corrections, and submits the application to HRSA (requires registration in EHBs).

3.3.Registering and Applying Through Grants.govRegistering and Applying Through Grants.gov

Grants.gov requires a one-time registration by the applicant organization and annual updating. If you do not complete the registration process and update it annually, you will not be able to submit an application.

The five-step registration process must be completed by every organization wishing to apply for a HRSA grant opportunity. The process will require some time (anywhere from five business days to a month). Therefore, first-time applicants or those considering applying at some point in the future should register immediately. Registration with Grants.gov provides the representatives from the organization the required credentials necessary to submit an application.

3.1.3.1.REGISTER – Applicant/Grantee Organizations Must Register REGISTER – Applicant/Grantee Organizations Must Register With Grants.gov (if not already registered)With Grants.gov (if not already registered)

If an applicant/grantee organization has already completed Grants.gov registration for HRSA or another Federal agency, skip to the next section.

For those applicant organizations still needing to register with Grants.gov, detailed registration information can be found on the Grants.gov “Get Registered” Web site (http://www.grants.gov/applicants/get_registered.jsp). These instructions will walk you through the following five basic registration steps:

Step 1: Obtain a Data Universal Number System (DUNS) numberA DUNS number is a unique number that identifies an organization. It has been adopted by the Federal government to help track how Federal grant money is distributed. Ask your grant administrator or chief financial officer to provide your organization’s DUNS number. If your organization does not have a DUNS number, you may request one online at http://fedgov.dnb.com/webform or call the special Dun & Bradstreet hotline at 1-800-705-5711 for the US and US Virgin Islands (1-800-234-3867 for Puerto Rico) to receive one free of charge. Note: A missing or incorrect DUNS number is the primary reason for applications being “Rejected for Errors” by Grants.gov.

Step 2: Register with the Central Contractor Registration (CCR)HRSA Electronic Submission Guide 46 Version 1.4 – August 2009

The CCR is the central government repository for organizations working with the Federal government. Check to see if your organization is already registered at the CCR Web site. If your organization is not registered, identify the primary contact who should register your organization. Visit the CCR Web site at http://www.ccr.gov to register online or call 1-888-227-2423 to register by phone. CCR Registration must be renewed annually.

- Designate the organization’s E-Business Point of Contact (E-BIZ POC) - Create the organization’s CCR “Marketing Partner ID Number (MPIN)” password.

The E-BIZ POC will use the MPIN to designate Authorized Organization Representatives (AORs) through Grants.gov

The CCR Registration must become active before you can proceed to step 3.

Step 3: Creating a Username & Password- AORs must create a short profile and obtain a username and password from the

Grants.gov Credential Provider- AORs will only be authorized for the DUNS number with which they registered in the

Grants.gov profile

Step 4: AOR Authorization- The E-Business POC uses the DUNS number and MPIN to authorize your AOR

status- Only the E-BIZ POC may authorize AORs

Step 5: Track AOR Status- Using your username and password from Step 3, go to Grants.gov’s ‘Applicant Login’ to

check your AOR status at https://apply07.grants.gov/apply/loginhome.jsp.

In addition, allow for extra time if an applicant does not have a Taxpayer Identification Number (TIN) or Employer Identification Number (EIN). The CCR validates the EIN against Internal Revenue Service records, a step that will take an additional one to five business days.

Additional assistance regarding the complete registration process is available at Grants.gov at http://www.grants.gov/applicants/get_registered.jsp. Grants.gov provides a variety of support options through online Help including Context-Sensitive Help, Online Tutorials, FAQs, Training Demonstrations, User Guides (http://www.grants.gov/assets/ApplicantUserGuide.pdf), and Quick Reference Guides.

Please direct questions regarding Grants.gov registration to the Grants.gov Call Center at: 1-800-518-4726. Call Center hours of operation are 24 hours a day, 7 days a week, excluding Federal holidays.

NOTE: It is highly recommended that this registration process be completed at least two weeks prior to NOTE: It is highly recommended that this registration process be completed at least two weeks prior to the submittal date of your organization’s first Grants.gov submission.the submittal date of your organization’s first Grants.gov submission.

3.2.3.2.APPLY - Apply through Grants.govAPPLY - Apply through Grants.gov

The Grants.gov/Apply feature includes a simple, unified application process to enable applicants to apply for grants online. The information applicants need to understand and execute the steps can be found at Grants.gov Apply for Grants (http://www.grants.gov/applicants/apply_for_grants.jsp). Step 2 ‘Complete the Grant

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Application Package’ includes a narrated online tutorial on how to complete a grant application package using Adobe. The site also contains an Applicant User Guide at http://www.grants.gov/assets/ApplicantUserGuide.pdf.

3.2.1. Find Funding OpportunityIf you are submitting a new competing application, search for the announcement in Grants.gov Find Grant Opportunities (http://www.grants.gov/applicants/find_grant_opportunities.jsp) and select the announcement for which you wish to apply. Refer to the program guidance for eligibility criteria.

NOTE: All new competing announcements should be available in Grants.gov FIND! When funding NOTE: All new competing announcements should be available in Grants.gov FIND! When funding opportunities are released, announcements are made available in Grants.gov APPLY.opportunities are released, announcements are made available in Grants.gov APPLY.

If you are submitting a competing continuation, competing supplement, or Non-Competing Continuation application, search for the announcement in Apply For Grants (http://www.grants.gov/Apply). Enter the announcement number communicated to you in the field Funding Opportunity Number. (Example announcement number: 5-S45-10-001)

NOTE: Non-Competing Continuations and announcements with restricted eligibility are NOTE: Non-Competing Continuations and announcements with restricted eligibility are notnot available available under the Find Grant Opportunities function in Grants.gov.under the Find Grant Opportunities function in Grants.gov.

3.2.2. Download Application PackageDownload the application package and instructions. Application packages are posted in Adobe Reader format. To ensure that you can view the application package and instructions, you should download and install the Adobe Reader application.

For more information on using Adobe Reader, please refer to Section 7.1.2.

NOTE: Please review the system requirements for Adobe Reader at NOTE: Please review the system requirements for Adobe Reader at http://www.grants.gov/help/download_software.jsphttp://www.grants.gov/help/download_software.jsp..

3.2.3. Complete the Grant Application PackageComplete the application using both the built-in instructions and the instructions provided in the program guidance. Ensure that you save a copy of the application on your computer. For assistance with program guidance related questions, please contact the program officer listed on the program guidance.

NOTE: Competing continuations, competing supplements, and Non-Competing Continuations should NOTE: Competing continuations, competing supplements, and Non-Competing Continuations should provide their 10-digit grant number (box 4b from NGA) in the Federal Award Identifier field (box 5b in provide their 10-digit grant number (box 4b from NGA) in the Federal Award Identifier field (box 5b in SF424 or box 4 in SF424 R&R).SF424 or box 4 in SF424 R&R). You may complete the application offline – you are not required to You may complete the application offline – you are not required to be connected to the Internet.be connected to the Internet.

3.2.4. Submit ApplicationOnce you have downloaded the application package, completed all required forms, and attached all required documents—click the “Check Package for Errors” button and make any necessary corrections.

In Adobe Reader, click on the ‘Save and Submit’ button when you have done all of the above and are ready to send your completed application to Grants.gov.

Review the provided application summary to confirm that the application will be submitted to the program for which you wish to apply. To submit, the AOR must login to Grants.gov and

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enter their user name and password. Note: the same DUNS number, AOR user name, and password must be used to complete and submit your application. Once you have logged in, your application package will automatically be uploaded to Grants.gov. A confirmation screen will appear once the upload is complete. Note that a Grants.gov Tracking Number will be provided on this screen (GRANTXXXXX). Please record this number so that you may refer to it for all subsequent help.

Please direct questions regarding application submission to the Grants.gov Call Center at: 1-800-518-4726. Call Center hours of operation are 24 hours a day, 7 days a week, excluding Federal holidays.

NOTE: The AOR must be connected to the Internet and must have a Grants.gov username and NOTE: The AOR must be connected to the Internet and must have a Grants.gov username and password tied to the correct DUNS number in order to submit the application package.password tied to the correct DUNS number in order to submit the application package.

3.2.5. Verify Status of Application in Grants.govOnce Grants.gov has received your submission, Grants.gov will send email messages to the PD, AO, and the POC listed in the application advising of the progress of the application through the system. You should receive up to four emails. The first will confirm receipt of your application by the Grants.gov system (“Received”), and the second will indicate that the application has either been successfully validated (“Validated”) by the system prior to transmission to the grantor agency or has been rejected due to errors (“Rejected with Errors”). An application for HRSA funding must be both received and validated by Grants.gov by the application deadline.

If your application has been rejected due to errors, you must correct the application and resubmit it to Grants.gov before the closing date. If you are unable to resubmit because the opportunity has since closed, you must contact the Director of the Division of Grants Policy, within five (5) business days from the closing date, via email at DGPWaivers@hrsa.gov and thoroughly explain the situation. Your email must include the HRSA Announcement Number, the name, address, and telephone number of your organization, and the name and telephone number of the project director, as well as the Grants.gov Tracking Number (GRANTXXXXXX) assigned to your submission, along with a copy of the “Rejected with Errors” notification you received from Grants.gov. HRSA is very strict in adhering to application deadlines and electronic submission requirements. Extensions for competitive funding opportunities are only granted in the rare event of a natural disaster or validated technical system problem on the side of either Grants.gov or the HRSA Electronic Handbooks (EHBS) that prevented a timely application submission.

You can check the status of your application(s) anytime after submission by logging into Grants.gov and clicking on the ‘Track My Application’ link on the left side of the page. This link will also be included in the confirmation email that you receive from Grants.gov.

If there are no errors, the application will be downloaded by HRSA. Upon successful download to HRSA, the status of the application will change to “Received by Agency” and the contacts listed in the application will receive a third email from Grants.gov. Once your application is received by HRSA, it will be processed to ensure that the application is submitted for the correct funding announcement, with the correct grant number (if applicable), and applicant/grantee organization. Upon this processing, which is expected to take up to two to three business days, HRSA will assign a unique tracking number to your application. This tracking number will be posted to Grants.gov and the status of your application will be changed to “Agency Tracking Number Assigned.” You will receive the fourth email in which

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Grants.gov will relay the Agency Tracking Number. Note the HRSA tracking number and use it for all correspondence with HRSA.

4.4. Validating and/or Completing an Application in the HRSA Validating and/or Completing an Application in the HRSA Electronic HandbooksElectronic Handbooks

Learn how to register, verify data, validate information, manage access to your application, fix errors, and complete your application in EHBs. For assistance in registering with, or using HRSA EHBs, call the HRSA Call Center at 1-877-464-4772 between 9:00 am to 5:30 p.m. ET or email callcenter@hrsa.gov.

4.1.4.1.Register - Project Director and Authorizing Official Must Register - Project Director and Authorizing Official Must Register with HRSA EHBs (if not already registered)Register with HRSA EHBs (if not already registered)

In order to access a Non-Competing Continuation, a competitive continuation, or a competitive supplement in HRSA EHBs, existing grantee organizations must register within the EHBs. The purpose of the registration process is to collect consistent information from all users, avoid collection of redundant information, and allow for the unique identification of each system user.

Note that registration within HRSA EHBs is required only once for each user. Note that HRSA EHBs now allow the user to use his/her single username and

associate it with more than one organization.

Registration within HRSA EHBs is a two-step process. In the first step, individual users from an organization who participate in the grants process must create individual system accounts. In the second step, the users must associate themselves with the appropriate grantee organization. To find your organization record, use the 10-digit grant number from the Notice of Grant Award (NGA) belonging to your grant. Note that since all existing grantee organization records are already in EHBs, there is no need to create a new one.

To complete the registration quickly and efficiently we recommend that you have the following information readily available:

1. Identify your role in the grants management process. HRSA EHBs offer the following three functional roles for individuals from applicant/grantee organizations:

Authorizing Official (AO), Business Official (BO), and Other Employee (for Project Directors, assistant staff, AO designees and others).

For more information on functional responsibilities, refer to the HRSA EHBs online help.

2. Ensure you have the 10-digit grant number from the latest NGA belonging to your grant (Box 4b on NGA). You must use the grant number to find your organization during registration. All individuals from the organization working on the grant must use the same grant number to ensure correct registration.

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In order to access a Non-Competing Continuation, competitive continuation, or a competitive supplement application, the Project Director and other participants must register the specific grant and add it to their respective portfolios. This step is required to ensure that only authorized individuals from the organization have access to grant data. Project Directors will need the latest Notice of Grant Award (NGA) in order to complete this additional step. Again, note that this is a one-time requirement.

The Project Director must give the necessary privileges to the AO and other individuals who will assist in the submission of grant applications using the administer feature in the grant handbook. The Project Director should also delegate the “Administer Grant Users” privilege to the AO.

Once you have access to your grant handbook, use the appropriate link under the deliverables section to access your application.

Note that registration with HRSA EHBs is independent of Grants.gov registration.

For assistance in registering with HRSA EHBs, call the HRSA Call Center at 1-877-464-4772 between 9:00 am to 5:30 p.m. ET or email callcenter@hrsa.gov.

IMPORTANT: You must use your HRSA EHBs Tracking Number or your 10-digit grant number (box 4b IMPORTANT: You must use your HRSA EHBs Tracking Number or your 10-digit grant number (box 4b from NGA) to identify your organization. from NGA) to identify your organization.

4.2.4.2.Verify Status of ApplicationVerify Status of Application

HRSA will send an email to the PD, AO, POC, and the BO – all listed on the submitted application, to confirm that the application was successfully received. The PD listed on the most recent NGA, if different from the PD listed on the application will also receive an email notification. Therefore, it is important to ensure that email addresses are correct.

NOTE: Grantees should check HRSA EHBs within two to three business days from submission within NOTE: Grantees should check HRSA EHBs within two to three business days from submission within Grants.gov for availability of your application.Grants.gov for availability of your application.

4.3.4.3.Validate Grants.gov Application in the HRSA EHBsValidate Grants.gov Application in the HRSA EHBs

The HRSA EHBs include a validation process to ensure that only authorized individuals from an organization are able to access the organization’s competing applications. The first user who seeks access to any competing application needs to provide the following information:

Data Element Source ExampleAnnouncement Number

From submitted Grants.gov application

HRSA-10-061 or 10-016

Grants.gov Tracking Number

From submitted Grants.gov application

GRANT00059900

HRSA EHBsApplication Tracking Number

From email notification sent to PD, AO, BO, and POC listed on application.

25328

Note that the source of each data element is different and knowledge of the three numbers together is considered sufficient to provide that individual access to the application.

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To validate the grants.gov application, log in to the EHBs and click on the ‘View Applications’ link, then click on the ‘Add Grants.Gov Application’ link (this is only visible for grant applications that require supplemental forms).

At this point, you will be presented with a form, which will require the numbers specified in the table above in order to validate your grants.gov application.

NOTE: The first individual who completes this step should use the ‘Peer Access’ feature to share the NOTE: The first individual who completes this step should use the ‘Peer Access’ feature to share the application with other individuals from the organization. It is recommended that the AO complete this application with other individuals from the organization. It is recommended that the AO complete this step.step.

4.4.4.4.Manage Access to the ApplicationManage Access to the Application

You must be registered in HRSA EHBs in order to access the application. To ensure that only authorized individuals from the organization gain access to the application, you must follow the process described earlier.

The PD, using the Administer Users feature in the grant handbook, must give the necessary privileges to the AO and other individuals who will assist in the submission of applications. Project Directors must also delegate the ‘Administer Grant Users’ privilege to the AO so that future administration can be managed by the AO.

The individual who validated the application must use the ‘Peer Access’ feature to share this application with other individuals from the organization. This is required if you wish to allow multiple individuals to work on the application in HRSA EHBS.

Once you have access to your grant handbook, use the appropriate link under the deliverables section to access your grant application.

4.5.4.5.Check Validation ErrorsCheck Validation Errors

HRSA EHBs will validate the application received through Grants.gov. All validation errors are recorded and displayed to the applicant. To view the validation errors use the ‘Grants.gov Data Validation Comments’ link on the application status page in HRSA EHBs.

4.6.4.6.Fix Errors and Complete ApplicationFix Errors and Complete Application

Applicants must review the errors in HRSA EHBs and make necessary corrections. If so noted in the funding opportunity announcement, applicants must also complete the detailed budget and other required forms in HRSA EHBs and assign an AO who must be a registered user in the HRSA EHBs. HRSA EHBs will show the status of each form in the application package and the status of all forms must be “Complete” in the summary page before the HRSA EHBs will allow the application to be submitted.

4.7.4.7.Submit Application in HRSA EHBsSubmit Application in HRSA EHBs

4.7.1. Non-Competing Continuations - When completing and submitting a Non-Competing Continuation, you must have the ‘Submit Non-Competing Continuation’ privilege.

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The Project Director must give this privilege to the AO or a designee. Once all forms are complete, the application must be submitted to HRSA.

NOTE: You will have two weeks from the date the application was due in Grants.gov for submission of NOTE: You will have two weeks from the date the application was due in Grants.gov for submission of the remaining information in HRSA EHBs. The new due date will be listed in HRSA EHBs.the remaining information in HRSA EHBs. The new due date will be listed in HRSA EHBs.

Performance Measures for Non-Competing Continuation Applications – For applications that require submittal of performance measures electronically through the completion of program specific data forms, instructions will be provided both in the program guidance and through an email notifying grantees of their responsibility to provide this information; and providing instruction on how to do so.

4.7.2. New Competing, Competing Continuation, and Competing Supplement Applications Submitted Using Both Grants.gov and HRSA EHBs - After the Grants.gov application is pulled into EHBs and validated, the AO verifies the pending application in HRSA EHBs, fixes any validation errors, and makes necessary corrections. Supplemental forms are completed. The application must then be submitted by the AO assigned to the application within HRSA EHBs. (The designee of the AO can also submit the application.) The completed application must be submitted to HRSA by the due dates listed within the program guidance.

NOTE: You must submit the application by the due date listed within the program guidance. There are NOTE: You must submit the application by the due date listed within the program guidance. There are two deadlines within the guidance – one for submission within Grants.gov and the second for submission two deadlines within the guidance – one for submission within Grants.gov and the second for submission within HRSA EHBswithin HRSA EHBs..

Performance Measures for All Competitive Applications - Many HRSA guidances include specific data forms and require performance measure reporting. If the completion of performance measure information is indicated in this guidance, successful applicants receiving grant funds will be required, within 30 days of the Notice of Grant Award (NGA), to register in HRSA’s Electronic Handbooks (EHBs) and electronically complete the program specific data forms that appear in this guidance. This requires the provision of budget breakdowns in the financial forms based on the grant award amount, the project abstract and other grant summary data, and objectives for the performance measures.

5.5.General Instructions for Application SubmissionGeneral Instructions for Application Submission

The following guidelines are applicable to all submissions unless otherwise noted. Failure to follow the instructions may make your application non-compliant. Non-compliant applications will not be given any consideration and the particular applicants will be notified. It is mandatory to follow the instructions provided in this section to ensure that your application can be printed efficiently and consistently for review.

5.1.5.1. Narrative Attachment GuidelinesNarrative Attachment Guidelines

5.1.1. Font Please use an easily readable typeface, such as Times Roman, Arial, Courier, or CG Times. The text and table portions of the application must be submitted in not less than 12- point and 1.0 line spacing. Applications not adhering to 12-point font requirements may be returned. For charts, graphs, footnotes, and budget tables, applicants may use a different pitch or size

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font, not less than 10 pitch or size font. However, it is vital that when scanned and/or reproduced, the charts are still clear and readable.

Please do not submit organizational brochures or other promotional materials, slides, films, clips, etc. 

5.1.2. Paper Size and MarginsFor duplication and scanning purposes, please ensure that the application can be printed on 8 ½” x 11” white paper. Margins must be at least one (1) inch at the top, bottom, left and right of the paper. Please left-align text.

5.1.3. NamesPlease include the name of the applicant and 10-digit grant number (if competing continuation, competing supplement, or Non-Competing Continuation) on each page.

5.1.4. Section HeadingsPlease put all section headings flush left in bold type.

5.1.5. Page NumberingDo not number the standard OMB approved forms. Please number each attachment page sequentially. Reset the numbering for each attachment. (Treat each attachment/document as a separate section.)

5.1.6. Allowable Attachment or Document TypesThe following attachment types are supported in HRSA EHBs. Even though grants.gov may allow you to upload various types of attachments, it is important to note that HRSA only accepts the following types of attachments. Files with unrecognizable extensions may not be accepted or may be corrupted, and will not be considered as part of the application:

.DOC - Microsoft Word

.RTF - Rich Text Format

.TXT - Text

.WPD - Word Perfect Document

.PDF - Adobe Portable Document Format

.XLS - Microsoft Excel

File Attachment Names o Limit file attachment name to under 50 characterso Do not use any special characters (e.g., -, %, /, #, ) or spacing in the file name or for

word separation -- The exception is underscore ( _ )Note- your application will be ‘rejected’ by Grants.gov if you use special characters or attachment names greater than 50 characters

5.2.5.2. Application Content Order (Table of Contents)Application Content Order (Table of Contents)

HRSA uses an automatic numbering approach that will ensure that all applications will look the same when printed for objective review.

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HRSA uses two standard packages from Grants.gov. • SF 424 (otherwise known as 5161) – For service delivery programs• SF 424 R&R – For research and training programs

For each package, HRSA has defined a standard order of forms and that order is available within the program guidance. The program guidance also provides applicants with explicit instructions on where to upload specific documents.

5.3.5.3. Page LimitPage Limit

When your application is printed, the narrative documents may not exceed 80 pages in length unless otherwise stated in the funding opportunity announcement. These narrative documents include the abstract, project and budget narratives, and any other attachments such as letters of support required as a part of the guidance. This 80-page limit does not include the OMB approved forms. Note that some program funding opportunity announcements may require submission of OMB approved program specific forms as attachments. These attachments will not be included in the 80-page limit.

Applicants must follow the instructions provided in this section and ensure that they print out all attachments on paper and count the number of pages before submission.

NOTE: Applications that exceed the specified limits will be deemed non-compliant. Non-compliant NOTE: Applications that exceed the specified limits will be deemed non-compliant. Non-compliant competing applications will not be given any consideration and the particular applicants will be notified. competing applications will not be given any consideration and the particular applicants will be notified. Non-compliant non-competing applications will have to be resubmitted in order to comply with the page Non-compliant non-competing applications will have to be resubmitted in order to comply with the page limits.limits.

6.6.Customer Support InformationCustomer Support Information

6.1.6.1. Grants.gov Customer SupportGrants.gov Customer Support

Please direct ALL questions regarding Grants.gov to Grants.gov Call Center at: 1-800-518-4726. Call Center hours of operation are 24 hours a day, 7 days a week, excluding Federal holidays.

Please visit the following URL for additional support on the Grants.gov Web site: http://www.grants.gov/help/help.jsp.

6.2.6.2. HRSA Call CenterHRSA Call Center

For assistance with or using HRSA EHBs, call 1-877-464-4772 between 9:00 am to 5:30 p.m. ET or email callcenter@hrsa.gov.

Please visit HRSA EHBs for online help. Go to: https://grants.hrsa.gov/webexternal/home.asp and click on ‘Help’

6.3.6.3. HRSA Program SupportHRSA Program Support

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For assistance with program guidance related questions, please contact the program contact listed on the program guidance. Do not call the program contact for technical questions related to either Grants.gov or HRSA EHBs.

7.7.FAQsFAQs

7.1.7.1. SoftwareSoftware

7.1.1. What are the software requirements for using Grants.gov?Applicants will need to download Adobe Reader. For information on Adobe Reader, go to http://www.grants.gov/help/download_software.jsp#adobe811.

7.1.2. Adobe ReaderThe Adobe Reader screen is shown in Figure 1 below.

Figure 1: Adobe Reader Screen

Figure 2: The Adobe Reader Toolbar

1. Submit – Click to submit the application package to Grants.gov (not available until all mandatory documents have been completed and the application has been saved).

2. Save – Click to save the application package to your local computer.3. Print – Click to print the application package.4. Check Package for Errors – Click prior to submitting the application package to ensure

there are no errors.

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Adobe Reader toolbar

Mandatory Documents

1 2 3 4

Documents that you must include in your application package are listed under Mandatory Documents. Refer to Figure 3 below.

Figure 3: Working with Mandatory Documents (Adobe Reader)

1. Under Mandatory Documents, select the document you want to work on.2. Click on the ‘Move Form to Complete’ button.3. Select the document under Mandatory Documents for Submission and click on the

‘Open Form’ button. (Note: depending on your version of Adobe Reader, the forms may open automatically when you click on the document name.)

When you open a document for viewing or editing, Adobe Reader opens the document at the bottom of the main application page. Refer to Figure 4 below.

Figure 4: An Open Form in Adobe Reader

Note that the buttons are attached to the top of the page and move with the page. Click on the ‘Close Form’ button to save and close the form.

Special Note: Working with Earlier Versions of Adobe ReaderIt is highly recommended that you remove all earlier versions of Adobe Reader prior to installing the latest version of Adobe Reader. Do this by using ‘Add or Remove Programs’ from Control Panel in Windows.

If it is necessary that you keep older versions of Adobe Reader on your computer, you should

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1 2

3

Adobe Reader opens documents at the bottom of the application

Close Form button

Required fields

be aware that the program will unsuccessfully attempt to open application packages with the earlier, incompatible version. Use the following workaround to avoid this problem.

Figure 5: Downloading from Grants.gov

1. From the Grants.gov download page, right-click on the Download Application Package link and select ‘Save Target As…’ from the menu.

2. Save the target on your computer (preferably to the Desktop) as an Adobe Acrobat Document.

Figure 6: Selecting Open with Adobe Reader

3. Right-click the icon.4. Select ‘Open With’ > ‘Adobe Reader 8.1’ from the menu.

7.1.3 Can I download Adobe Reader onto my computer?There are software applications that allow you to successfully navigate the Grants.gov pages and complete your application. These applications can be found at: http://www.grants.gov/help/download_software.jsp#811#adobe811. However, depending on your organization’s computer network and security protocols you may not have the necessary permissions to download software onto your workstation. Contact your IT department or system administrator to download the software for you or give you access to this function.

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Right-click the download link.

Select Save Target As…

Right-click the icon and select Open With > Adobe Reader 8.1.

7.1.4. Is Grants.gov Macintosh compatible?Yes. For details, please visit http://www.grants.gov/help/general_faqs.jsp .

7.1.5. What are the software requirements for HRSA EHBs?HRSA EHBs can be accessed over the Internet using Internet Explorer (IE) v5.0 and above and Netscape 4.72 and above. IE 6.0 and above is the recommended browser. HRSA EHBs are 508 compliant.

HRSA EHBs use pop-up screens to allow users to view or work on multiple screens. Ensure that your browser settings allow for pop-ups.

In addition, to view attachments such as Word and PDF, you will need the appropriate viewers.

7.1.6. What are the system requirements for using HRSA EHBs on a Macintosh computer?

Mac users are requested to download the latest version of Netscape for their OS version. It is recommended that Safari v1.2.4 and above or Netscape v7.2 and above be used.

Note that Internet Explorer (IE) for Mac has known issues with SSL and Microsoft is no longer supporting IE for Mac. HRSA EHBs do not work on IE for Mac.

7.2.7.2. Application ReceiptApplication Receipt

7.2.1. When do I need to submit my application?Competing Submissions:Applications must be submitted to Grants.gov by 8:00 p.m. ET on the due date. An application for HRSA funding must be both received and validated by Grants.gov by the application deadline.

For applications that require verification in HRSA EHBs (refer to program guidance), Verification must be completed and applications submitted in HRSA EHBs by 5:00 p.m. ET on the due date mentioned in the guidance. This supplemental due date is different from the Grants.gov due date.

Non-competing Submissions:Applications must be submitted to Grants.gov by 8:00 p.m. ET on the due date. An application for HRSA funding must be both received and validated by Grants.gov by the application deadline.

7.2.2. What is the receipt date (the date the application is electronically received by Grants.gov or the date the data is received by HRSA)?

Competing Submissions:The submission/receipt date is the date the application is electronically received by Grants.gov. An application for HRSA funding must be both received and validated by Grants.gov by the application deadline.

For applications that require verification in HRSA EHBs (refer to program guidance), the submission/receipt date will be the date the application is submitted in HRSA EHBs.

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Non-competing Submissions:The submission/receipt date will be the date the application is submitted in HRSA EHBs.

Applications must be verified and submitted in HRSA EHBs by 5:00 p.m. ET on the due date. (Two (2) weeks after the due date in Grants.gov.) Refer to the program guidance for specific dates.

7.2.3 Once my application is submitted, how can I track my application and what emails can I expect from Grants.gov and HRSA?

You can check the status of your application(s) anytime after submission by logging into Grants.gov and clicking on the 'Track My Application’ link on the left side of the page. This link will also be included in the confirmation email that you receive from Grants.gov.

When you submit your competing application in Grants.gov, it is first received and then validated by Grants.gov. Typically, this takes a few hours but it may take up to 48 hours during peak volumes. You should receive four emails from Grants.gov.

The first will confirm receipt of your application by the Grants.gov system (“Received”), and the second will indicate that the application has either been successfully validated (“Validated”) by the system prior to transmission to the grantor agency or has been rejected due to errors (“Rejected with Errors”). An application for HRSA funding must be both received and validated by Grants.gov by the application deadline.

Subsequently, the application will be downloaded by HRSA. This happens within minutes of when your application is successfully validated by Grants.gov and made available for HRSA to download. On successful download at HRSA, the status of the application will change to “Received by Agency” and you will receive a third email from Grants.gov.

After this, HRSA processes the application to ensure that it has been submitted for the correct funding announcement, with the correct grant number (if applicable) and grantee/applicant organization. This may take up to 3 business days. Upon this processing HRSA will assign a unique tracking number to your application. This tracking number will be posted to Grants.gov and the status of your application will be changed to “Agency Tracking Number Assigned;” you will receive a fourth email from Grants.gov.

For applications that require verification in HRSA EHBs, you will also receive an email from HRSA confirming the successful receipt of your application and asking the PD and AO to review and resubmit the application in HRSA EHBs.

If is suggested that you check the respective systems if you do not receive any emails within the specified timeframes.

NOTE: Refer to FAQ 7.2.5 below for a summary of emails.NOTE: Refer to FAQ 7.2.5 below for a summary of emails.

7.2.4. If a resubmission is required due to technological problems encountered using the Grants.gov system and the closing date has passed, what should I do?

You must contact the Director of the Division of Grants Policy, within five (5) business days from the closing date, via email at DGPWaivers@hrsa.gov and thoroughly explain the situation. Your email must include the HRSA Announcement Number, the Name, Address, and telephone number of the Organization, and the Name and telephone number of the Project Director, as well as the Grants.gov Tracking Number (GRANTXXXXXXXX) assigned

HRSA Electronic Submission Guide 60 Version 1.4 – August 2009

to your submission, along with a copy of the “Rejected with Errors” notification you received from Grants.gov. Extensions for competitive funding opportunities are only granted in the rare event of a natural disaster or validated technical system problem on the side of either Grants.gov or the HRSA Electronic Handbooks (EHBS) that prevented a timely application submission. An application for HRSA funding must be both received and validated by the application deadline.

7.2.5 Can you summarize the emails received from Grants.gov and HRSA EHBs and identify who will receive the emails?

Submission Type Subject Timeframe Sent By RecipientNon-Competing Continuation

“Submission Receipt” Within 48 hours

Grants.gov

AOR

“Submission Validation Receipt” OR“Rejected with Errors”

Within 48 hours

Grants.gov

AOR

“Grantor Agency RetrievalReceipt”

Within hours of second email

Grants.gov

AOR

“Agency Tracking NumberAssignment”

Within 3 business days

Grants.gov

AOR

“Application Ready for Verification”

Within 3 business days

HRSA AO, BO, SPOC, PD

Competing Application (without verification in HRSA EHBs)

“Submission Receipt” Within 48 hours

Grants.gov

AOR

“Submission Validation Receipt” OR“Rejected with Errors”

Within 48 hours

Grants.gov

AOR

“Grantor Agency Retrieval Receipt”

Within hours of second email

Grants.gov

AOR

“Agency Tracking NumberAssignment”

Within 3 business days

Grants.gov

AOR

HRSA Electronic Submission Guide 61 Version 1.4 – August 2009

Submission Type Subject Timeframe Sent By RecipientCompeting Application (with verification in HRSA EHBs)

“Submission Receipt” Within 48 hours

Grants.gov

AOR

“Submission Validation Receipt” OR“Rejected with Errors”

Within 48 hours

Grants.gov

AOR

“Grantor Agency Retrieval Receipt”

Within hours of second email

Grants.gov

AOR

“Agency Tracking Number Assignment”

Within 3 business days

Grants.gov

AOR

“Application Ready for Verification”

Within 3 business days

HRSA AO, BO, SPOC, PD

7.3.7.3. Application SubmissionApplication Submission

7.3.1 How can I make sure that my electronic application is presented in the correct order for objective review?

Follow the instructions provided in Section 5 to ensure that your application is presented in the correct order and is compliant with all the requirements.

7.47.4 Grants.govGrants.gov

For a list of frequently asked questions and answers maintained by Grants.gov, please visit the following URL: http://www.grants.gov/applicants/applicant_faqs.jsp.

Grants.gov offers several tools and numerous user guides to assist applicants that are interested in applying for grant funds. To view the many applicant resources available through grants.gov please visit the following URL: http://www.grants.gov/applicants/app_help_reso.jsp.

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Appendix B: Part D Agreement

Ryan White HIV/AIDS Program of 2009 Part D

The authorized representative of the applicant must include a copy of this agreement form with the grant application. This agreement lists the program assurances that must be satisfied in order to qualify for a Part D grant, as required by section 2671.

I, the authorized representative of _________________________________ in applying for a grant under Part D of Title XXVI, Public Health Service Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009, P.L. 111-87, 42 U.S.C. 300ff-71, hereby agree that:

As required in section 2671 subsection (c) - Coordination with Other Entities:

(1) The applicant will coordinate activities under the grant with other providers of health care services under this Act, and under Title V of the Social Security Act, including programs promoting the reduction and elimination of the risk of HIV/AIDS for youth;

(2) The applicant will participate in the statewide coordinated statement of need under part B (where it has been initiated by the public health agency responsible for administering grants under part B) and in revisions of such statements; and

(3) The applicant will every 2 years submit to the lead State agency audits regarding funds expended in accordance with this Title and shall include necessary client-level data to complete unmet need calculations and Statewide coordinated statements of need process.

I understand I can obtain a copy of the Title XXVI, PHS Act Part D at (http://www.thomas.loc.gov ) to gain full knowledge of its contents.

Name: __________________________________________Date:_______________

Title: __________________________________________

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APPENDIX C – Program Coordinator Position Description

Position OverviewManage, coordinate and participate in all planning and administrative activities related to the Ryan White HIV/AIDS Program Part D program, particularly in the development and maintenance of the network of coordinated, comprehensive and culturally and linguistically competent services for women, infants, children, and youth; the preparation of grant proposals, including budgets; and the general management of the grant activities.

Essential Job FunctionsServe as the primary contact person to HRSA. Establish, expand and maintain a viable network among community-based organizations in a specific geographic area, to plan and deliver comprehensive, coordinated, and culturally and linguistically competent medical care and support services to HIV-infected women, infants, children, and youth and their affected family members.

Plan, develop, and implement goals and objectives of the Part D program in conjunction with other staff and network members. Evaluate program objectives on an ongoing basis and make adjustments in the Work Plan, as needed.

Implement changes to existing policies and procedures. Participate in establishing and maintaining communication with other Ryan White HIV/AIDS Program-funded programs in the specific geographic area, including nursing personnel, physicians, health care professionals and community organizations regarding program objectives, policies and procedures.

Monitor programs to ensure the effective utilization of consumers as staff, including fair remuneration, training and supervision, appropriate support, compliance with the Americans with Disabilities Act and the like.

Monitor program expenditures to ensure the effective utilization, possibly through allocation and reallocation, of the entire grant award. Determine fiscal requirements and prepare grant proposals including budgetary recommendations; manage and authorize expenditures of program funds for program-supported expenditures.

Compile and maintain records, reports and documentation of program activities for use in program reporting and evaluation.

RequirementsA Master Degree in health administration, public health or public administration with emphasis on health services; five years progressive experience in program management and community organizing with experience in developing and managing community-based health care services. Good interpersonal skills; self-direction, and good communications skills.

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