Ryan White Part A HIV Emergency Relief Grant Program

This announcement solicits applications for the Ryan White Part A HIV Emergency Relief Grant Program. Part A funds provide direct financial assistance to an Eligible Metropolitan Area (EMA) or a Transitional Grant Area (TGA) that has been severely affected by the HIV epidemic. Formula and Supplemental grants assist eligible program areas in developing or enhancing access to a comprehensive continuum of high quality, community-based care for low-income individuals and families with HIV. A comprehensive continuum of care includes the 13 core medical services specified in law, and appropriate support services that assist People Living With HIV (PLWH) in accessing treatment for HIV/AIDS infection that is consistent with the Department of Health and Human Service (HHS) Treatment Guidelines. (See http://www.aidsinfo.nih.gov). Comprehensive HIV/AIDS care beyond these core services may include supportive services that meet the criteria of enabling individuals and families living with HIV/AIDS to access and remain in primary medical care to improve their medical outcomes. HRSA/HAB recognizes that Part A EMAs and TGAs must use grant funds to support and further develop and/or expand systems of care to meet the needs of PLWH within the EMA/TGA and strengthen strategies to reach minority populations. HAB has required EMAs/TGAs to collect data to support identification of need, for planning purposes, and to validate the use of Ryan White HIV/AIDS Program funding. A comprehensive application should reflect how those data were used to develop and expand the system of care in their jurisdictions. Grantees should review/reference relevant needs assessments conducted by other HIV/AIDS programs such as HRSA s Bureau of Primary Health Care, CDC, Substance Abuse and Mental Health Services Administration (SAMHSA), and the U.S. Department of Housing Urban Development. Ongoing CDC initiatives, as well as HAB efforts with grantees to estimate and address Unmet Need of those aware of their HIV status and the newer requirement to identify and bring into care persons in their jurisdictions that are unaware of their positive HIV status, should result in many more PLWH entering into the EMA/TGA care system. The EMA/TGA planning process must ensure that essential core medical services have been adequately funded to meet the needs of both those already in care and those being linked to care as a result of increased efforts to bring both the aware and previously unaware into care. As of March 2013, the CDC estimates more than 1.1 million people are living with HIV and 1 in 5 people do not know their HIV status. The ultimate United States (U.S.) Public Health goal is to inform all HIV positive persons of their status and bring them into care in order to improve their health status, prolong their lives and slow the spread of the epidemic in the U.S. through enhanced prevention efforts. A list of CDC initiatives can be found at http://www.cdc.gov/hiv/topics/prev_prog/index.htm. Important Notes: The Ryan White legislation (SEC. 2603 [[]300ff-13] (a) (4)) included a hold harmless clause for Part A programs for fiscal years 2010 to 2013 only. Therefore, pending the further direction of statutory provisions and/or appropriations language hold harmless will not be a factor in the FY 2014 Ryan White Part A awards. Information on Ryan White and the Affordable Care Act along with Policy Clarification Notices can be found at http://hab.hrsa.gov/affordablecareact/. The Early Identification of Individuals with HIV/AIDS (EIIHA) requirements in this funding announcement have been updated and streamlined. Please review carefully when preparing this section of your application. Information on National HIV/AIDS Strategy (NHAS) is located in the SF-424 Application Guide. The following information will assist in understanding and completing this year s grant application: National Monitoring Standards: Grantees are required to have implemented the Part A National Monitoring Standards at both the grantee and provider/sub-recipient levels. HRSA has developed and distributed guidelines outlining the responsibilities of HRSA, the grantee, and provider staff. The National Monitoring Standards were updated April 2013 and can be found at: http://hab.hrsa.gov/manageyourgrant/granteebasics.html. Grantees are required to submit Women, Infants, Children and Youth (WICY) Waiver Requests with their application as outlined in the Part A and Part B Ryan White HIV/AIDS Program Guidelines for Implementing the Minimum Expenditure Requirement to Provide Services to Women, Infants, Children and Youth previously distributed to grantees. This includes joint Part A and Part B WICY Waiver Requests. The WICY Waiver request, together with the required WICY Waiver Assurances contained in the Guidelines, should be uploaded as Attachment 12. The assurances must be signed by the Chief Elected Official (CEO) or the CEO s officially delegated authority. Part A funds are subject to Section 2604(c) of the PHS Act, which requires that not less than 75 percent of the funds be used to provide core medical services that are needed in the EMA/TGA for individuals with HIV/AIDS who are identified and eligible under the Ryan White HIV/AIDS Program. Core medical services and support services allowed under Part A are limited to services that are needed for individuals with HIV/AIDS to achieve their medical outcomes as defined by the Ryan White HIV/AIDS Program. The most recent service definitions can be found in the Ryan White Services Report Instructions Manual that is available online at: http://hab.hrsa.gov/manageyourgrant/clientleveldata.html. Applicants seeking a waiver to the core medical services requirement must submit a waiver request either with this grant application, at any time up to the application submission, or up to four months after the grant award for FY 2014. Submission should be in accordance with the information and criteria published by HRSA in the Federal Register Notice, Vol. 78, No. 101, dated Friday, May 24, 2013, and may be found at http://www.gpo.gov/fdsys/pkg/FR-2013-05-24/pdf/2013-12354.pdf. In addition, grantees are advised that a FY 2014 Part A waiver request must include funds awarded under the MAI. A waiver request that does not include MAI will not be considered. If submitting with the application, a core medical services waiver request should be included as Attachment 8. EMA/TGA Agreements and Compliance Assurances are included (Appendix A) with this FOA and require the signature of the CEO, or of his or her designee. This document should be included as Attachment 2.