Funding Opportunity Announcement (FOA) PS15-1502 – New, Non-research, Domestic Comprehensive High-Impact HIV Prevention Projects for Community-Based Organizations CDC-RFA-PS15-1502 National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention Effective date: September 3, 2014 Centers for Disease Control and Prevention Version 2.0 Issued 08/30/2013 Amendment I is made September 29, 2014 to the following:  Part II: Section A. Funding Opportunity Description; 2. CDC Project Description: “newly identified” is revised to “newly diagnosed” (pages 10, 16, 23, and 31)  Part II: Section A. Funding Opportunity Description; 2. CDC Project Description: “must be referred to or provided required and recommended prevention and essential support services.” is revised to “must be provided or referred to one or more of the required and recommended prevention and essential support services.” (pages 11 and 32)  Part II: Section A. Funding Opportunity Description; 2. CDC Project Description: “health department jurisdiction’s Comprehensive HIV Prevention Plan…” is revised to “health department’s Jurisdictional HIV Prevention Plan…” (pages 13 and 29)  Part II: Section A. Funding Opportunity Description; 2. CDC Project Description: “each FOA performance target described…” is revised to “each FOA performance measure described…” (page 15)  Part II: Section A. Funding Opportunity Description; 2. CDC Project Description: “meet and/or exceed all FOA performance targets” is revised to “meet and/or exceed all FOA performance measures.” (page 15)  Part II: Section C. Eligibility Information; 1. Eligible Applicants: New York, NY-NJ- PA MSA was revised to include the Newark Division (page 39)  Part II: Section C. Eligibility Information; 1. Eligible Applicants: “San Juan-Caguas- Guaynabo, PR” was revised to “Puerto Rico*” (page 39)  Part II: Section C. Eligibility Information; 1. Eligible Applicants: the footnote “*U.S. dependent area not considered an MSA” was revised to “*Area not considered to be an MSA, but eligible for funding under PS15-1502” (page 39)  Part II: Section C. Eligibility Information; 1. Eligible Applicants: hyperlink updated to http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_Surveillance_Report_vol_23.pdf#Page =75. (page 40)  Part II: Section D. Application and Submission Information; 12. Budget Narrative: “itemized budget narrative reflective of the integrated screening activities to be provided” revised to “itemized budget to support these activities...” (page 48)  Part II: Section F. Award Administration Information; 2. Administrative and National Policy Requirements: deleted AR-7: Executive Order 12372 Amendment II is made October 28, 2014 to the following:  Part II Section C. Eligibility Information; 1. Clarification on required 501(c)(3) documents. The following sentence was added “If applying as a CBO HIV Prevention Partnership, the lead applicant organizations must submit a Federal 501(c)(3) Internal Revenue Service tax exemption certificate for the lead applicant organization and each of the CBO HIV Prevention Partnership members.”  Part II Section E. Application Review Information; b. Phase II Review: scoring section revised for clarification and assigning of point values.  Part II Section H. Other Information: the following was added “(required for lead applicant organization only”) Page i Contents Part I. Overview Information .......................................................................................................... 2 A. Federal Agency Name ......................................................................................... 2 B. Funding Opportunity Title .................................................................................. 2 C. Announcement Type .......................................................................................... 2 D. Agency Funding Opportunity Number ............................................................... 2 E. Catalog of Federal Domestic Assistance (CFDA) Number .................................. 2 F. Dates ................................................................................................................... 2 G. Executive Summary ............................................................................................ 2 Part II. Full Text ............................................................................................................................... 4 A. Funding Opportunity Description ....................................................................... 4 B. Award Information ........................................................................................... 37 C. Eligibility Information ....................................................................................... 37 D. Application and Submission Information ......................................................... 42 E. Application Review Information ....................................................................... 53 F. Award Administration Information .................................................................. 57 G. Agency Contacts ............................................................................................... 62 H. Other Information ............................................................................................ 62 I. Glossary ............................................................................................................ 66 Template for all FOAs (new, non-research, domestic) Page 1 Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the “Send Me Change Notifications Emails” link to ensure they receive notifications of any changes to PS15-1502. Applicants also must provide an email address to www.grants.gov to receive notifications of changes. A. Federal Agency Name: Centers for Disease Control and Prevention (CDC) B. Funding Opportunity Title: Comprehensive High-Impact HIV Prevention Projects for Community-Based Organizations C. Announcement Type: New—Type 1 This announcement is only for non-research domestic activities supported by CDC. If research is proposed, the application will not be considered. Research for this purpose is defined at http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health- research-nonresearch.pdf. D. Agency Funding Opportunity Number: CDC-RFA-PS15-1502 E. Catalog of Federal Domestic Assistance (CFDA) Number: 93.939 HIV Prevention Activities --Non-Governmental Organization Based F. Dates: 1. Letter of Intent (LOI) Deadline: September 17, 2014 2. Application Deadline: November 14, 2014, 11:59 p.m. U.S. Eastern Standard Time, on www.grants.gov Informational conference call for potential applicants: To obtain a schedule of the pre- application and technical assistance activities or additional information related to this funding opportunity announcement, please visit http://www.cdc.gov/hiv/policies/funding/announcements/ps15-1502/index.html. G. Executive Summary: 1. Summary Paragraph: The Centers for Disease Control and Prevention announces the availability of fiscal year 2015 funds for a cooperative agreement program for community-based organizations (CBOs) to develop and implement High-Impact Human Immunodeficiency Virus (HIV) Prevention Programs in the following two categories: Category A: HIV prevention services for members of racial/ethnic minority communities. These services must focus on members at greatest risk of acquiring and transmitting HIV infection. Examples of these minority communities include, but are not limited to, Black/African Americans, Hispanics/Latinos, American Indians/Alaskan Natives, Asian, and Native Hawaiian/Other Pacific Islanders. Category B: HIV prevention services for members of groups at greatest risk for acquiring and transmitting HIV infection, regardless of race/ethnicity. Examples include, but are not limited to, HIV-positive persons, men who have sex with men (MSM), injection drug users (IDUs), and Page 2 transgender persons. Community-based organizations are uniquely positioned to complement and extend the reach of HIV prevention efforts implemented by state and local health departments and education agencies to support the optimization of services across public, private, and other community- based organizations to achieve objectives of increased identification of HIV infection, referral for pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) services, earlier entry to HIV care, and increased consistency of care. The High-Impact HIV Prevention Program model for HIV-positive and high-risk HIV-negative persons will consist of the following required program components: (1) formalized collaborations; (2) program promotion, outreach, and recruitment; (3) targeted HIV testing; (4) HIV prevention for HIV- positive persons; (5) HIV prevention for high-risk HIV-negative persons; (6) condom distribution; and (7) HIV and organizational planning. The purpose of this program is to implement comprehensive HIV prevention programs to reduce morbidity, mortality, and related health disparities. In accordance with the National HIV/AIDS Strategy (http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf) and CDC’s High-Impact HIV Prevention (HIP) approach (http://www.cdc.gov/hiv/strategy/hihp/index.htm), this FOA focuses on HIV in the nation by reducing new infections, increasing access to care, and promoting health equity. These goals will be achieved by enhancing community-based organizations’ capacities to increase HIV testing, link HIV-positive persons to HIV medical care, increase referrals to Partner Services (PS), provide prevention and essential support services for HIV-positive persons and high-risk persons with unknown/negative serostatus, and increase program monitoring and accountability. Standard performance measures for HIV prevention programs that are consistent with the focus of the National HIV/AIDS Strategy on improving performance and accountability are included in this FOA. Eligible Applicants (select one): Limited competition a. FOA Type (select one): Cooperative agreement b. Approximate Number of Awards: up to 100 c. Total Project Period Funding: $210,000,000 d. Average One Year Award Amount: $400,000 e. Number of Years of Award: 5 years f. Approximate Date When Awards will be Announced: June 1, 2015 g. Cost Sharing and /or Matching Requirements: N/A Page 3 Part II. Full Text A. Funding Opportunity Description 1. Background For over 30 years, Human Immunodeficiency Virus (HIV) has been an epidemic, affecting millions globally. According to the CDC, by the end of 2010 an estimated 1,144,500 persons aged 13 years and older were living with HIV infection in the U.S., including 180,900 (15.8%) persons who are unaware of their infection.1 Over the past 10 years, deaths among persons in the U.S. living with HIV have declined, the number of people living with HIV has increased, and the number of new HIV infections has remained stable with approximately 50,000 new infections annually.2 Since the late 1980s, CDC has formally partnered with community-based organizations (CBOs) to expand the impact and reach of HIV prevention in affected communities. Because of their accessibility, history, and credibility in the community, CBOs are recognized and remain important partners in providing comprehensive high-impact HIV prevention services to people living with and at greatest risk for HIV infection. Through this new funding cycle, CDC is seeking to develop new and enhance existing strategies for community-based HIV prevention programs. In addition, the CDC seeks to enhance programming to achieve the goals and milestones of the National HIV/AIDS Strategy (NHAS) and CDC’s High-Impact Prevention (HIP) approach. a. Statutory Authorities: This program is authorized under sections 317(k)(2) and 318 of the Public Health Service Act, 42 U.S.C. sections 241(a) and 247(c), as amended. b. Healthy People 2020: This FOA addresses the “Healthy People 2020” focus area of HIV. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22 c. Other National Public Health Priorities and Strategies: The National HIV/AIDS Strategy and CDC Division of HIV/AIDS Prevention (DHAP) Strategic Plan: This FOA aligns with the National HIV/AIDS Strategy and CDC DHAP Strategic Plan to (1) reduce the number of people who become infected with HIV; (2) increase access to care and optimize health outcomes for people living with HIV; and (3) reduce HIV-related health disparities. Minority AIDS Initiative (MAI): This FOA is supported in part with MAI base funds included in the CDC appropriation. This FOA will support the development of community-based comprehensive high-impact HIV prevention services for people living with and at greatest risk of HIV infection, including African Americans/Blacks; Latinos/Hispanics; all races/ethnicities of gay, bisexual, and other MSM; injection drug users (IDUs); and transgender persons. Page 4 CDC Winnable Battles: This FOA supports CDC’s efforts to keep pace with emerging public health challenges and address the leading causes of death and disability through Winnable Battles. These are public health priorities with large-scale impact on health and with known, effective strategies to address them. HIV Prevention is one of six Winnable Battles that have been chosen based on the magnitude of the health problem and our ability to make significant progress in improving outcomes. The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) is committed to a future free of these diseases. NCHHSTP accomplishes its mission by working with a diverse range of community, local, state, and national partners to increase access to, and uptake of, effective prevention interventions; promote healthy living; and support improved quality of life throughout one’s lifespan. For more information regarding NCHHSTP’s mission and core values, see the Other Information section. The FOA activities support the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention in achieving its overarching goals as defined in the NCHHSTP Strategic Plan 2010-2015 (http://www.cdc.gov/nchhstp), including reducing health disparities http://healthypeople.gov/2020/about/DisparitiesAbout.aspx), implementing program collaboration and service integration (PCSI) (http://www.cdc.gov/nchhstp/programintegration/docs/207181- C_NCHHSTP_PCSI%20WhitePaper-508c.pdf, and Prevention Through Health Care (http://www.cdc.gov/nchhstp/PreventionThroughHealthCare/index.htm). All FOA activities must also be consistent with current and future CDC-supported programmatic guidance and recommendations. See the Other Information section for more detailed information. d. Relevant Work: This FOA builds upon previous and current HIV prevention programs for community- based organizations, including: CDC-RFA-PS10-1003, “HIV Prevention Projects for Community-Based Organizations” http://www.cdc.gov/hiv/policies/funding/announcements/PS10-1003/index.html CDC-RFA-PS13-1310, “HIV Prevention Projects for the Commonwealth of Puerto Rico and the United States Virgin Islands” http://www.cdc.gov/hiv/policies/funding/announcements/PS13-1310/index.html CDC-RFA-PS11-1113, “HIV Prevention Projects for Young Men of Color Who Have Sex with Men and Young Transgender Persons of Color” http://www.cdc.gov/hiv/policies/funding/announcements/PS11-1113/index.html FOA activities will support current and future CDC HIV prevention programs and initiatives. See the Other Information section for additional detail. Page 5 2. CDC Project Description a. Approach: The following logic model provides a high-level visual depiction of CDC’s programmatic approach, including relationships between program strategies and outcomes. For more information, see the Evaluation and Performance Measurement section. To further understand the contextual factors influencing this programmatic approach, see CDC’s Imperatives for High- Impact HIV Prevention in the Other Information section of this FOA. Page 6 CDC-RFA-PS15-1502 Program Logic Model: Comprehensive High-Impact HIV Prevention Projects for Co mmunity-Based Organizations (CBOs) Strategies and Activities Short-term Outcomes Long-term Outcomes Project Overview Targeted HIV Testing  Reduce HIV transmission  Provide an overview describing how the proposed program complements  Increase in number of target from PLWH the jurisdiction’s Comprehensive HIV Prevention Plan and meets the population members tested for needs of the target population HIV  Increase the number of  Increase in HIV-positive persons HIV-positive persons Formalized Collaborations who are aware of their infection with suppressed viral  Establish service agreements with medical care providers and prevention load and essential support services providers to maximize reach, increase HIV Prevention with HIV-positive Persons coordination and collaboration, and support provision of comprehensive  Increase in HIV-positive persons  Reduce HIV incidence HIV prevention and treatment services and prevention and essential who receive HIV medical care among HRN persons support services providers  Increase in HIV-positive persons who receive medication  Increase the number of Program Promotion, Outreach, and Recruitment adherence services partners of HIV-positive  Promote the program to the target population  Increase in HIV-positive persons persons who are aware  Conduct outreach to recruit the target population into the program who receive Partner Services of their risk for HIV and  Increase in HIV-positive persons are tested for HIV who are provided or referred to Targeted HIV Testing a HIP behavioral intervention  Increase the number of  Conduct HIV testing among persons at high risk for HIV infection that reduces sexual or drug- HRN persons who  Complementary Services related risks related to the receive and use PrEP o Conduct Couples HIV Testing and Counseling (CHTC) transmission of HIV infection and/or nPEP, as o Conduct integrated screening for STDs, viral hepatitis, and TB  Increase in HIV-positive persons appropriate who receive required and Comprehensive HIV Prevention with HIV-positive Persons recommended prevention and  Increase HIV-positive and Linkage to HIV Medical Care essential support services HRN persons’ access to  Link newly diagnosed HIV-positive persons to HIV medical care facilitated through trained care and improved  Re-engage previously diagnosed, out-of-care HIV-positive persons in HIV navigators health outcomes medical care  Promote retention of HIV-positive persons in HIV medical care HIV Prevention with High-risk HIV-negative  Increase the number of  Promote use of antiretroviral therapy (ART) Persons HIV-positive and HRN Navigation and Prevention and Essential Support Services  Increase in HRN persons who persons who use are aware of their risk for HIV condoms consistently and  Train navigators (e.g., community health workers, peer advocates, infection correctly outreach workers) to provide referrals to (or provide) prevention and  Increase in HRN persons who essential support services receive required and  Refer HIV-positive persons to required and recommended prevention and recommended prevention and essential support services (e.g., medication adherence support, Partner essential support services Services [PS], High-Impact Prevention [HIP] behavioral intervention, STD facilitated through trained screening, housing services) or provide these services navigators  Increase in HRN persons who Comprehensive HIV Prevention with High-risk HIV-negative (HRN) are referred to Pre-Exposure Persons Prophylaxis (PrEP) and/or Non- Navigation and Prevention and Essential Support Services Occupational Post-Exposure  Train navigators (e.g., community health workers, peer advocates, Prophylaxis (nPEP), as outreach workers) to provide referrals to (or provide) prevention and appropriate essential support services  Refer HRN persons to required and recommended prevention and HIV Prevention with HIV-positive and HRN essential support service providers (e.g., STD screening, housing services, Persons PrEP and/or nPEP, as appropriate) or provide these services  Increase in HIV-positive and HRN persons who are offered Condom Distribution condoms  Offer condoms to HIV-positive and HRN persons HIV and Organizational Planning  Develop or revise an organizational strategic plan that incorporates the proposed program to provide a continuum of HIV prevention and care services  Participate in the jurisdiction’s HIV planning process Impacts: Reduced HIV transmission, Increased access to care and improved health outcomes for people living with HIV/AIDS (PLWHA) Italicized components of the logic model will be measured in the program. Page 7 i. Problem Statement: In 2011, an estimated 49,273 people were diagnosed with HIV infection in the United States. Overall, an estimated 1,155,792 people in the United States have been diagnosed with HIV and AIDS.3 HIV and AIDS disproportionally affects some populations, especially persons identified as gay, bisexual, and other men who have sex with men (MSM) of all races and ethnicities. In 2010, the estimated number of new HIV infections among MSM was 29,800, a 12% increase from the 26,700 new infections among MSM in 2008.2 In addition, despite ongoing targeted HIV prevention programs, racial and ethnic minority groups continue to experience the most severe burden of HIV. Blacks/African Americans and Hispanics/Latinos represent a small percentage of the U.S. population, but accounted for 44% and 21% respectively of new infections in 2010.1,2 Toward the successful implementation of the National HIV/AIDS Strategy, CDC’s Division of HIV/AIDS Prevention works in partnership with other federal operating divisions; state, tribal, local, and territorial health departments; community-based organizations; health care organizations; and other stakeholders to better coordinate and implement state and local responses to HIV and AIDS. Building individual competencies, organizational capacities, and supportive structural environments among these partners are key strategies for the effective promotion, delivery, and sustainability of HIV prevention programs and services, particularly for people living with and at greatest risk of HIV infection including African Americans/Blacks; Latinos/Hispanics; all races/ethnicities of gay, bisexual, and other MSM; IDUs; and transgender persons. ii. Purpose: The purpose of this program is to implement comprehensive HIV prevention programs to reduce morbidity, mortality, and related health disparities in accordance with the National HIV/AIDS Strategy (http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf) and CDC’s High-Impact HIV Prevention approach (http://www.cdc.gov/hiv/strategy/hihp/index.htm). This FOA focuses on addressing the national HIV epidemic by reducing new infections, increasing access to care, and promoting health equity. The aforementioned will be achieved by enhancing community-based organizations’ capacities to increase HIV testing, link HIV-positive persons to HIV medical care, increase referrals to Partner Services (PS), provide prevention and essential support services for HIV-positive persons and high-risk persons with unknown/negative serostatus, and increase program monitoring and accountability. Standard performance measures for HIV prevention programs that are consistent with the focus of the National HIV/AIDS Strategy on improving performance and accountability are included in this FOA. iii. Outcomes: The program is expected to demonstrate measurable progress among its target populations toward addressing the short-term outcomes depicted in the FOA logic model. Potential indicators that quantify these outcomes are described in the section entitled CDC Evaluation Page 8