HIV/AIDS Bureau Division of State HIV/AIDS Programs (DSHAP)

1. HIV/AIDS BureauDivision of State HIV/AIDS Programs (DSHAP) Ryan White HIV/AIDS Program Part BTechnical Assistance Webinar October 31, 2013 FY 2014 ADAP ERF Funding Opportunity Announcement HRSA-14-049

2. To provide leadership and support to States/Territories for developing and ensuring access to quality HIV prevention, health care and support services. DSHAP Mission

3. Agenda

4. Presenter Heather Hauck Director Division of State HIV/AIDS Programs

5. Announcements & Updates

6. Announcements Important Deadlines: • Ryan White Part B HIV Care Grant Program FOA: Deadline December 9, 2013 Part B/ADAP (X07) Reporting Requirements: • Interim FFR SF-425 due: Nov. 28, 2013 • Grantees are unable to submit the report because the portal in EHB is missing • ADAP Quarterly Report (AQR): due January 31, 2014 • Unobligated Balances (UOB) & Estimated Carryover: due January 31, 2014

7. Announcements • FY 2012 ADAP ERF (X09) FFR • Due into EHB January 30, 2014 • Carryover Request due into EHB January 30, 2014 • Budget Period July 1, 2012 – September 29, 2013 is not eligible for carryover • Budget Period August 1, 2012 – September 29, 2013 is eligible for carryover • Budget Period September 1, 2012 – September 29, 2013 is eligible for carryover

8. Announcements Upcoming Technical Assistance Activities: • Webinar on Changes to HAB Performance Measure Portfolio: November 6, 2013 1:00 – 2:00 pm EST • Webinar on RSR Basics: November 6, 2013 2:00 – 3:00 pm EST • Rescheduled Webinar on Enhancing Linkages to HIV Care in Jail Settings: November 19, 2013 1:30 pm EST

9. Core Medical Services Waiver http://www.gpo.gov/fdsys/pkg/FR-2013-10-25/pdf/2013-25276.pdf Effective: September 23, 2013

10. Questions

11. Funding Opportunity Announcement: HRSA-14-049 FY 2014 Limited New CompetitionAIDS Drug Assistance Program (ADAP) Emergency Relief Funds (ERF)

12. Objectives To provide pre-application technical assistance to applicants of the FY 2014 ADAP ERF Funding Opportunity Announcement.

13. Summary of Funding • Approximately $40 million – $75 million in ADAP ERF to fund up to 59 grantees • Applicants may apply for a ceiling amount up to $11 million per year • Project period of one (1) year starting April 1, 2014 • Application due date in grants.gov – November 25,201311:59 p.m. EST

14. FY 2014 FOA Changes • FY 2014 ADAP ERF budget period (April 1, 2014 – March 31, 2015) • New HRSA FOA template – please follow the specific headers in each section • The SF-424 Application Guide is available at http://www.hrsa.gov/grants/apply/applicationguide/ • Information on the National HIV/AIDS Strategy (NHAS) is located in the SF-424 Application Guide

15. Purpose • For States/Territories that can demonstrate need for additional resources to prevent, reduce or eliminate waitlists or implement “cost cutting” and/or “cost-saving” measures

16. Purpose • States with waiting list must use all funding awarded to remove clients from the waiting list. • States that did not report a waiting list, must use funding to address “cost-cutting measures” and/or support the implementation of “cost-saving” measures during the project period to prevent a waiting list.

17. Purpose Cost-saving measures: • Improved systems and procedures for back billing Medicaid • Improved client recertification • Part B structural or operational changes such as collection of rebates, expanding insurance assistance Cost-cutting measures : • Reductions in ADAP financial eligibility below 300% of FPL • Capped enrollment • Formulary reductions with respect to ARVs • Restrictions with respect to ADAP insurance eligibility criteria (i.e.,< 300% FPL)

18. Purpose • HRSA has prioritized the following cost-containment strategies through its monitoring and technical assistance efforts: • Purchase of insurance, collection of rebates, back billing of Medicaid, CMS data-sharing agreements for TrOOP expenditures, six-month re-certification, and controlling ADAP administrative costs.

19. Eligibility • All 50 states, the District of Columbia, Commonwealth of Puerto Rico and U.S. Virgin Islands are eligible to apply if there has been a reported ADAP waiting list and/or cost containment measures since CY 2011.

20. Cost Sharing/Matching • Cost Sharing/Matching is NOTrequired for this program.

21. Project Narrative • New HRSA template: follow the headings and subheadings as the structure has been significantly reorganized. • Example: Resolution of Challenges, Evaluation and Technical Support Capacity

22. Introduction & Project Abstract • Introduction: • Briefly describe how the State/Territory will utilize ADAP ERF funds addressing a waiting list and/or cost cutting and/or cost savings measures • Project Abstract: • See section 4.1.ix of HRSA’s SF-424 Application Guide

23. Needs Assessment • ADAP State/Territory Profile: • Submit as Attachment 1. • Appendix A: provides a description • ADAP profile for Fiscal Years 2011 & 2012 • Sample format http://hab.hrsa.gov/adapprofile

24. Methodology • Average Client Costs: • Medication and insurance assistance cost per client • FY 2014 ADAP ERF budget period (April 1, 2014 – March 31, 2015) • States must provide step by step calculations and clearly identify all data elements required to complete the calculations • Examples listed on pgs. 7-9 of FOA

25. Methodology • Previously awarded applicants: • If the amount requested in this application is different from your program’s last awarded amount, please describe the factors which account for this difference.

26. Methodology • ORC Reviewers will review and determine: • Whether the average client cost calculation submitted by applicants follow instructions provided; • Whether the calculations are correct; if incorrect, the error will be identified along with its impact on the applicant’s calculations; • Whether the applicant’s plan and budget request reflect their average cost calculations; and • If applicable, whether in preparing the plan and budget, the applicant utilized the most recent number of individuals on the State’s waiting list reported to HRSA.

27. Work Plan • Planned Services & Implementation Plan: • Applicants may use table format similar to FY 2014 Part B Implementation Plan • Submit as Attachment 4. • The Implementation Plan estimated costs should be based on the Average Monthly Client Medication Cost and/or Average Monthly Client Cost for Insurance Assistance for ADAP ERF budget period (April 1, 2014 – March 31, 2015) • All cost calculations & budget amounts are subject to review by the ORC.

28. Resolution of Challenges • Describe specific actions taken to avoid, reduce, or eliminate a waiting list. • The measures listed in the FOA (page 11) are examples of some required and some possible measures.

29. Evaluation • Provide a brief description of the anticipated impact of specific ADAP ERF funded activities on proposed or currently implemented cost containment and waitlist elimination. • Provide a brief description of the methods in place to evaluate the effectiveness of the ADAP ERF Implementation Plan.

30. Organizational Information • Agency Oversight • Management/Administration of the ADAP • Organizational chart (Attachment 6) • Budget • See instructions in section 4 HRSA’s SF-424 Application Guide • In Section B of SF-424A the budget categories are Waiting List and Cost Containment

31. Summary of Attachments • Attachment 1: ADAP Profile • Attachment 2: Position Description for key personnel • Attachment 3: Biographical Sketches for key personnel • Attachment 4: Implementation Plan • Attachment 5: Agreements and Compliance Assurances • Attachment 6: ADAP Organizational Chart • Attachment 7-15: Other Relevant documents

32. Application and Submission • HRSA requires applicants for this funding opportunity announcement to apply electronically through Grants.gov. • Applicants must download the SF424 application package associated with this funding opportunity following the directions provided at Grants.gov. • Application due date in grants.gov – November 25,201311:59 p.m. EST

33. Application Format Requirements • The total size of all uploaded files may not exceed the equivalent of 40 pages when printed by HRSA. The 40-page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support. • Attachments must be clearly labeled (see pg. 15 of the FOA).

34. Application Review Information

35. Agency Contacts • Program issues and/or technical assistance regarding this funding announcement may be obtained by contacting: Heather Hauck, Tel: 301-443-6547 Fax: 301-443-8143, Email: hhauck@hrsa.gov • Business, administrative, or fiscal issues related to this funding opportunity announcement by contacting: Karen Mayo, Tel: (301) 443-3555 Fax: (301) 594-4073, E-mail: KMayo@hrsa.gov

36. Application Assistance • Applicants may need assistance when working online to submit their application forms electronically. Applicants should always obtain a case number when calling for support. For assistance with submitting the application in Grants.gov, contact Grants.gov 24 hours a day, seven days a week, excluding Federal holidays at: Grants.gov Contact Center Telephone: 1-800-518-4726 (International Callers, please dial 606-545-5035) E-mail: support@grants.gov iPortal: http://grants.gov/iportal

37. Questions