U.S. Department of Health and Human Services

**Health Resources and Services Administration**

*HIV/AIDS Bureau*

*Division of Community Based Programs*

***Ryan White HIV/AIDS Program Part D***

***Grants for Coordinated HIV Services and Access to Research for Women,
Infants, Children, and Youth (CSWICY)***

*Competing Continuation and New Proposals for*

*Existing Service Areas*

*Announcement \# HRSA-08-082*

**Catalog of Federal Domestic Assistance (CFDA) No. 93.153**

**PROGRAM GUIDANCE**

Fiscal Year *2008*

**Application Due Date in Grants.gov: *March 21, 2008***

**Date of Issuance*: January 25, 2008***

> *Maria C. Rios, MD, MPH*
>
> *Branch Chief, Northeastern Region*
>
> *Division of Community Based Programs*
>
> *HRSA, HIV/AIDS Bureau*
>
> *5600 Fishers Lane, Room 7A-30*
>
> *Rockville, MD 20857*
>
> *Telephone: 301/443-0493*

*Fax: 301/443-1839*

Authority: Public Health Service Act, Section 2671, (42 USC 300ff-71)

[]{.mark}

[]{.mark}

**Guidance Table of Contents**

[I. Funding Opportunity Description
2](#i.-funding-opportunity-description)

[Purpose 2](#purpose)

[Background 2](#background)

[II. Award Information 2](#ii.-award-information)

[1. Type of Award 2](#type-of-award)

[2. Summary of Funding 2](#summary-of-funding)

[III. Eligibility Information 2](#iii.-eligibility-information)

[1. Eligible Applicants 2](#eligible-applicants)

[2. Cost Sharing/Matching 2](#cost-sharingmatching)

[3. Other 2](#other)

[IV. Application and Submission Information
2](#iv.-application-and-submission-information)

[1. Address to Request Application Package
2](#address-to-request-application-package)

[Application Materials 2](#application-materials)

[2. Content and Form of Application Submission
2](#content-and-form-of-application-submission)

[Application Format Requirements 2](#application-format-requirements)

[Application Format 2](#application-format)

[i. Application Face Page 2](#application-face-page)

[ii. Table of Contents 2](#table-of-contents)

[iii. Application Checklist 2](#iii.-application-checklist)

[iv. Budget 2](#budget)

[v. Budget Justification 2](#budget-justification)

[vi. Staffing Plan and Personnel Requirements
2](#staffing-plan-and-personnel-requirements)

[vii.Assurances 2](#assurances)

[viii.Certifications 2](#certifications)

[ix. Project Abstract 2](#project-abstract)

[x. Program Narrative 2](#program-narrative)

[xi. Program Specific Forms 2](#program-specific-forms)

[xii. Attachments 2](#attachments)

[3. Submission Dates and Times 2](#submission-dates-and-times)

[4. Intergovernmental Review 2](#intergovernmental-review)

[5. Funding Restrictions 2](#funding-restrictions)

[6. Other Submission Requirements 2](#other-submission-requirements)

[V. Application Review Information
2](#v.-application-review-information)

[1. Review Criteria 2](#review-criteria)

[2. Review and Selection Process 2](#review-and-selection-process)

[3. Anticipated Announcement and Award Dates
2](#anticipated-announcement-and-award-dates)

[VI. Award Administration Information 2](#__RefHeading___Toc177183613)

[1. Award Notices 2](#award-notices)

[2. Administrative and National Policy Requirements
2](#administrative-and-national-policy-requirements)

[3. Reporting 2](#__RefHeading___Toc177183616)

[VII. Agency Contacts 2](#vii.-agency-contacts)

[VIII. Tips for Writing a Strong Application
2](#viii.-tips-for-writing-a-strong-application)

[APPENDIX A: HRSA's Electronic Submission User Guide
2](#appendix-a-hrsas-electronic-submission-user-guide)

[1. Introduction 2](#introduction)

[1.1 Document Purpose and Scope 2](#document-purpose-and-scope)

[1.2 Document Organization and Version Control
2](#document-organization-and-version-control)

[2. Noncompeting Continuation Application
2](#noncompeting-continuation-application)

[2.1 Process Overview 2](#process-overview)

[2.2 Grantee Organization Needs to Register With Grants.gov (if not
already registered) -- See Appendix B
2](#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b)

[2.3 Project Director and Authorizing Official Need to Register with
HRSA EHBs (if not already registered)
2](#project-director-and-authorizing-official-need-to-register-with-hrsa-ehbs-if-not-already-registered)

[2.4 Apply through Grants.gov 2](#apply-through-grants.gov)

[2.5 Verify in HRSA Electronic Handbooks
2](#verify-in-hrsa-electronic-handbooks)

[3. Competing Application 2](#competing-application)

[3.1 Process Overview 2](#process-overview-1)

[3.2 Grantee Organization Needs to Register With Grants.gov (if not
already registered) -- See Appendix B
2](#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b-1)

[3.3 Apply through Grants.gov 2](#apply-through-grants.gov-1)

[4. General Instructions for Application Submission
2](#general-instructions-for-application-submission)

[4.1 Narrative Attachment Guidelines
2](#narrative-attachment-guidelines)

[4.2 Application Content Order (Table of Contents)
2](#application-content-order-table-of-contents)

[4.3 Page Limit 2](#page-limit)

[5. Customer Support Information 2](#customer-support-information)

[6. FAQs 2](#faqs)

[6.1 Software 2](#software)

[6.2 Application Receipt 2](#application-receipt)

[6.3 Application Submission 2](#application-submission)

[6.4 Grants.gov 2](#grants.gov)

[Appendix B -- Registering and Applying Through Grants.gov
2](#appendix-b-registering-and-applying-through-grants.gov)

[APPENDIX C\--Service Areas 2](#appendix-c--service-areas)

[APPENDIX D \--Coordinator Position Description
2](#appendix-d---coordinator-position-description)

[Appendix E- Part D Agreement 2](#appendix-e--part-d-agreement)

# I. Funding Opportunity Description

## Purpose

> Section 2671 of the Public Health Service (PHS) Act, as amended, (42
> U.S.C. 300ff-71), establishes Grants for Coordinated Services and
> Access to Research for Women, Infants, Children, and Youth. The
> purpose of this funding is to improve access to primary medical care
> and support services for HIV-infected women, infants, children, and
> youth through the provision of coordinated, comprehensive, culturally
> and linguistically competent, family-centered services.
>
> Funds will be used for the purpose of providing family-centered care
> involving outpatient or ambulatory care for women, infants, children,
> and youth with HIV/AIDS.
>
> Additional Support Services for Patients and Families: Funds awarded
> under this section may 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.

## Background

> The 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 Resource 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.
>
> Part D grant funds are for the purpose of providing family centered
> care involving outpatient or ambulatory care (directly or through
> contracts) for women, infants, children, and youth with HIV/AIDS. This
> means all Part D grantees are expected to directly provide or contract
> for the provision of primary medical care to the clients they
> serve**.** The projects are expected to do case finding in order to
> bring infected people into care. Once in care, specific efforts must
> be made to retain 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 supply
> services. Currently, there are a total of 91 Part D programs,
> including the 17 in the Youth Initiative.
>
> The Department of Health and Human Services (DHHS), Health Resources
> and Services Administration (HRSA) and HAB are committed to meeting
> the national goals and principles described below. As you complete
> your application, consider how your program supports and helps to
> implement these goals and principles.
>
> [National Goal]{.underline}
>
> Healthy People 2010 is a DHHS-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 website: <http://www.health.gov/healthypeople/document/>.
>
> [HRSA Goal]{.underline}
>
> 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 Principles]{.underline}
>
> HAB 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.

> []{.mark}
>
> **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 funds must be able to offer directly or
> through contracts:

-   Medical care

-   Supportive services

-   Information and education about HIV/AIDS-related clinical research

### Medical Care:

> Part D programs must assure their patients and 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 make sure this care is of high quality and
> consistent with the most recent Public Health Service Guidelines. The
> Public Health Service Guidelines can be found at the following
> website: <http://www.aids.gov/treatment/guidelines>.

### Supportive Services:

> Part D programs must make sure their patients and clients 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 required 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
> 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 person is encouraged to meet with each client
> to talk 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]{.underline}](http://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](http://www.cdc.gov/HIV/projects/perinatal))
>
> Finally, in addition to the above, we encourage you to provide
> education on behavioral change with an emphasis on abstinence. To
> obtain guidance in providing abstinence education, please refer to the
> "Sexual Cessation Model" published by the Medical Institute for Sexual
> Health (<http://www.medinstitute.org/>).
>
> **Program Reviews**
>
> HRSA 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 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 Outcomes**
>
> Performance 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 person
    provided services through the Ryan White HIV//AIDS Treatment
    Modernization Act program, and

2.  Increase by 2 percent annually the number of persons who learn their
    serostatus from Ryan White HIV/AIDS Program programs.

**Strategy II. Improve Health Outcomes**

1.  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 Care**

1.  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.

> OPR'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, OPR 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 website 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 site visit is designed to follow-up on specific concerns
> identified by 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 meeting 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 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.

**Quality Improvement**

> Quality has been part of the Ryan White legislation since its
> reauthorization in 2000. The Amendments of 2000 require all Ryan White
> HIV/AIDS programs to establish quality management programs to:

-   Assess the extent to which HIV health services are consistent with
    the most recent 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 2000 reauthorization of the RWCA also mandated a study by the
> Institute of Medicine (IOM) about Allocation, Planning and Quality
> Assessment for the CARE Act. The findings were released in "Measuring
> What Matters" in 2003. The report recognized HRSA/HAB\'s efforts in
> the area of clinical quality management (CQM), which had been underway
> for several years at the time of the report\'s release. However, it
> went on to state that more needed to be done to measure and improve
> the quality of care provided by RWCA grantees.
>
> (For additional information, go to
> <http://hab.hrsa.gov/special/aboutquality.htm>
>
> and <http://hab.hrsa.gov/reports/report_08_04.htm>)
>
> 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.
>
> 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 of 2006. It should
> systematically measure achievement of program objectives and impact of
> the program and track work plan activities and accomplishments.
> Current CQM practices note improved outcomes where a senior leader is
> involved in CQM. HRSA/HAB expects grantees to demonstrate real
> involvement from senior leadership.
>
> For all subcontractors and vendors a mechanism must be in place to
> ensure care and services meet PHS guidelines, standards of care or
> best practices, as applicable, based on services funded.
>
> As part of an internal quality management program, a Clinical Quality
> Improvement (CQI) Program must also be established that incorporates
> continuous review of internally selected performance indicators of
> administrative and training related processes and activities.
>
> 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.

> Applicants may wish to expand their knowledge of CQM and CQI programs.
> 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.ihi.org/IHI/Topics/HIVAIDS/TheNationalQualityCenterNQC.htm>
>
> **HIVQUAL Project:**
>
> [[http://www.hivguidelines.org]{.underline}](http://www.hivguidelines.org/)

# II. Award Information

##  1. Type of Award

> Funding will be provided in the form of a grant.

## 2. Summary of Funding

> HRSA will provide funding for Federal fiscal year 2008. Approximately
> \$17,874,003 is expected to be available annually to fund 23 grantees.
> Awards, on a competitive basis, will be for a one‑year budget period,
> although project periods may be approved for up to five years. Current
> grantees must apply for no more than their base award, as noted in the
> FY 2007 Part D Notice of Grant Award (NGA). This base award is the
> amount before the rescission and is listed on Item #13 of the NGA.
> Funding beyond the first year is dependent on the availability of
> appropriated funds for Part D in subsequent fiscal years, grantee
> satisfactory performance, and a decision that continued funding is in
> the best interest of the Federal government.

# III. Eligibility Information

## 1. Eligible Applicants

> This competition is open to Part D grantees with project periods
> ending July 31, 2008, and new organizations proposing to replace the
> current grantee. New organizations proposing to replace the current
> grantee must demonstrate that they have the capability to serve the
> same clients as the grantee they are proposing to replace; that they
> will serve the exact same geographic service area, and that they have
> the capability to serve the target population in a comprehensive,
> culturally competent, linguistically appropriate and family-centered
> manner. In addition, new applicants need to include a transition plan
> in their application that clearly documents how they will absorb the
> current grantees' clients if funding is awarded. A list of current
> Part D grantees with project periods ending July 31, 2008, and their
> service areas is included in **Appendix C.**
>
> Eligible organizations are public or private nonprofit entities that
> provide directly or through contracts primary medical care for
> HIV-positive women, infants, children, and youth. Organizations may
> include State and local governments, their agencies, and Indian Tribes
> or tribal organizations with or without Federal recognition.
> Faith-based and community-based organizations are eligible to apply.

## 2. Cost Sharing/Matching

No cost sharing or matching funds are required.

## 3. Other 

> Applications that exceed the FY07 base award amount will be considered
> non-responsive and will not be considered for funding under this
> announcement.
>
> Any application that fails to satisfy the deadline requirements
> referenced in *Section IV.3* will be considered non-responsive and
> will not be considered for funding under this announcement.
>
> **HAB Expectations Post Award**
>
> Clinical care must be provided to patients within 90 days from award
> start date. First time Part D award recipients or new members of an
> existing network funded to provide care must be able to comply with
> this requirement. Ability to provide clinical care includes hiring
> clinical staff, providing HIV primary care, and having the capability
> to bill for services.

**Cultural and Linguistic Competence**

> HRSA 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 factor 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 the
> U.S. Department of Health and Human Services. This document is
> available online at
> [[http://www.omhrc.gov/CLAS.]{.underline}](http://www.omhrc.gov/CLAS.)
>
> **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

-   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 and 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
> on the Notice of Grant Award (NGA).]{.underline}
>
> **Medicaid Provider Status and Clinic Licensure:**
>
> All applicants, including current grantees, should document Medicaid
> provider status for all primary care providers and case management
> agencies. Applicants, including current grantees, should 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. [This
> information is required each year]{.underline}**. Documentation should
> be in the form of a table that identifies all providers' Medicaid
> numbers and clinic licensure status, if applicable (Attachment 2).**
>
> Part D grantees are not required to be Medicaid providers if they do
> not provide direct patient care. However, those network
> providers/organizations 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 the 340B program of HRSA's
> Healthcare Systems Bureau. If you have questions regarding the Drug
> Pricing Program, contact Kathleen McGee, Senior Program Management
> Officer, by calling either (301) 594-0318 or 1-800-628-6297 or by
> sending an email to kmcgee@hrsa.gov. In addition, you may write her at
> this address:
>
> HRSA/HSB
>
> Office of Pharmacy Affairs
>
> 5600 Fishers Lane
>
> Room 10C-03
>
> Rockville, MD 20857

# IV. Application and Submission Information

## 1. Address to Request Application Package

## Application Materials

> The application and submission process has changed significantly. HRSA
> is ***requiring*** applicants for this funding opportunity to apply
> electronically through Grants.gov. All applicants ***must*** submit in
> this manner unless the applicant is granted a written exemption from
> this requirement in advance by the Director of HRSA's Division of
> Grants Policy. Grantees must request an exemption in writing from
> <DGPWaivers@hrsa.gov>, and provide details as to why they are
> technologically unable to submit electronically though the Grants.gov
> portal. Make sure you specify the announcement number for which you
> are seeking relief. As indicated in this guidance, **HRSA and its
> Grants Application Center (GAC) will only accept paper applications
> from applicants that received prior written approval.**
>
> Refer to **Appendix A** for detailed application and submission
> instructions. Pay particular attention to Section 3, which provides
> detailed information on the competitive application and submission
> process.
>
> Applicants must submit proposals according to the instructions in
> Appendix A, using this guidance in conjunction with Public Health
> Service (PHS) Application Form 5161-1. These forms contain additional
> general information and instructions for grant applications, proposal
> narratives, and budgets. These forms may be obtained from the
> following sites by:

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

> Or

\(2\) Contacting the HRSA Grants Application Center at:

> The Legin Group, Inc.
>
> 910 Clopper Road
>
> Suite 155 South
>
> Gaithersburg, MD 20878
>
> Telephone: 877-477-2123
>
> <HRSAGAC@hrsa.gov>
>
> Instructions for preparing portions of the application that must
> accompany Application Form 5161-1 appear in the "Application Format"
> section below.

## 2. Content and Form of Application Submission

## Application Format Requirements

> **SEE APPENDIX A, SECTION 4 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, approximately 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 limits (approximately 10 MB,
> or that exceed 80 pages when printed by HRSA) will be deemed
> non-compliant. All non-compliant applications will be returned to the
> applicant without further consideration.**

## Application Format

> Applications for funding must consist of the following documents in
> the following order:

SF 424 Non Construction -- 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.

-   Failure to follow the instructions may make your application
    non-compliant. Non-compliant applications will not be given any
    consideration and those particular applicants will be notified.

-   For electronic submissions, applicants only have to number the
    electronic attachment pages sequentially, resetting the numbering
    for each attachment, i.e., start at page 1 for each attachment. Do
    not attempt to number standard OMB approved form pages.

-   For electronic submissions no table of contents is required for the
    entire application. HRSA will construct an electronic table of
    contents in the order specified.

-   When providing any electronic attachment with several pages, add
    table of content page specific to the attachment. Such page will not
    be counted towards the page limit.

-   For paper submissions (when allowed), number each section
    sequentially, resetting the page number for each section. i.e.,
    start at page 1 for each section. Do not attempt to number standard
    OMB approved form pages.

-   For paper submissions ensure that the order of the forms and
    attachments is as specified below.

  ------------------------------------------------------------------------------
  **Application       **Form       **Instruction**          **HRSA/Program
  Section**           Type**                                Guidelines**
  ------------------- ------------ ------------------------ --------------------
  Application for     Form         Pages 1, 2 & 3 of the    Not counted in the
  Federal Assistance               SF-424 face page.        page limit
  (SF-424)                                                  

  Project             Attachment   Can be uploaded on page  Required attachment.
  Summary/Abstract                 2 of SF-424 - Box 15     Counted in the page
                                                            limit. Refer
                                                            guidance for
                                                            detailed
                                                            instructions.
                                                            Provide table of
                                                            contents specific to
                                                            this document only
                                                            as the first page

  Additional          Attachment   Can be uploaded on page  As applicable to
  Congressional                    2 of SF 424 - Box 16     HRSA; not counted in
  District                                                  the page limit

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

  Project Narrative   Form         Supports the upload of   Not counted in the
  Attachment Form                  Project Narrative        page limit
                                   document                 

  Project Narrative   Attachment   Can be uploaded in       Required attachment.
                                   Project Narrative        Counted in the page
                                   Attachment form.         limit. Refer
                                                            guidance for
                                                            detailed
                                                            instructions.
                                                            Provide table of
                                                            contents specific to
                                                            this document only
                                                            as the first page

  SF-424A Budget      Form         Page 1 & 2 to supports   Not counted in the
  Information -                    structured budget for    page limit
  Non-Construction                 the request of Non       
  Programs                         construction related     
                                   funds                    

  SF-424B             Form         Supports assurances for  Not counted in the
  Assurances -                     non construction         page limit
  Non-Construction                 programs                 
  Programs                                                  

  Disclosure of       Form         Supports structured data Not counted in the
  Lobbying Activities              for lobbying activities. page limit
  (SF-LLL)                                                  

  Other Attachments   Form         Supports up to 15        Not counted in the
  Form                             numbered attachments.    page limit
                                   This form only contains  
                                   the attachment list      

  Attachment 1-15     Attachment   Can be uploaded in Other Refer to the
                                   Attachments form 1-15    attachment table
                                                            provided below for
                                                            **specific**
                                                            sequence. Counted in
                                                            the page limit
  ------------------------------------------------------------------------------

-   To ensure that attachments are organized and printed in a consistent
    manner, follow the order provided below. Note that these
    instructions may vary across programs.

-   Evidence of Non Profit status and invention related documents, if
    applicable, must be provided in the other attachment form.

-   Additional supporting documents, if applicable, can be provided
    using the available rows. Do not use the rows assigned to a specific
    purpose in the program guidance.

-   Merge similar documents into a single document. Where several pages
    are expected in the attachment, ensure that you place a table of
    content cover page specific to the attachment. Table of content page
    will not be counted in the page limit.

+-------------+--------------------------------------------------------+
| *           | **Attachment Description (Program Guidelines)**        |
| *Attachment |                                                        |
| Number**    |                                                        |
+=============+========================================================+
| Attachment  | Documentation of Medicaid provider status and          |
| 1           | Licensure (Required of all applicants).                |
+-------------+--------------------------------------------------------+
| Attachment  | Latest negotiated indirect cost agreement (if          |
| 2           | applicable).                                           |
+-------------+--------------------------------------------------------+
| Attachment  | Staffing Plan Narrative Justification                  |
| 3           |                                                        |
+-------------+--------------------------------------------------------+
| Attachment  | Position Descriptions for Key Personnel/Positions.     |
| 4           | Merge similar documents into one attachment. Where     |
|             | several pages are expected in the attachment, ensure   |
|             | that you place a table of contents cover page specific |
|             | to the attachment. The table of contents page will not |
|             | be counted in the page limit.                          |
|             |                                                        |
|             | ALSO                                                   |
|             |                                                        |
|             | Biographical Sketches of Key Personnel. Merge similar  |
|             | documents into one attachment. Where several pages are |
|             | expected in the attachment, ensure that you place a    |
|             | table of contents cover page specific to the           |
|             | attachment. The table of contents page will not be     |
|             | counted in the page limit.                             |
+-------------+--------------------------------------------------------+
| Attachment  | Map of Service Area                                    |
| 5           |                                                        |
+-------------+--------------------------------------------------------+
| Attachment  | Network Provider Chart                                 |
| 6           |                                                        |
+-------------+--------------------------------------------------------+
| Attachment  | Memoranda of Agreement/Understanding                   |
| 7           |                                                        |
+-------------+--------------------------------------------------------+
| Attachment  | Letters of Support from Part A, Part B Programs &      |
| 8           | Consumer Letters of Support                            |
+-------------+--------------------------------------------------------+
| Attachment  | Work Plan                                              |
| 9           |                                                        |
+-------------+--------------------------------------------------------+
| Attachment  | Project Organizational Chart                           |
| 10          |                                                        |
+-------------+--------------------------------------------------------+
| Attachment  | Part D Agreement                                       |
| 11          |                                                        |
+-------------+--------------------------------------------------------+

> Note the following specific information related to your submission.

***Application Format***

## Application Face Page 

> Use Public Health Service (PHS) Application Form 5161-1, provided with
> the application package. Prepare this page according to instructions
> provided in the form itself. For information pertaining to the Catalog
> of Federal Domestic Assistance, the Catalog of Federal Domestic
> Assistance Number is 93.*153*
>
> **DUNS Number**
>
> All applicant organizations are required to have a Data Universal
> Numbering System (DUNS) number in order to apply for a grant from the
> Federal Government. The DUNS number is a unique nine-character
> identification number provided by the commercial company, Dun and
> Bradstreet. There is no charge to obtain a DUNS number. Information
> about obtaining a DUNS number can be found at
> <http://www.hrsa.gov/grants/dunsccr.htm> or call 1-866-705-5711.
> Please include the DUNS number item 8c on the application face page.
> Applications ***will not*** be reviewed without a DUNS number.
>
> Additionally, the applicant organization is required to register 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
> at.<http://www.hrsa.gov/grants/dunsccr.htm>

## Table of Contents

> The 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

> Use Form 5161-1, provided with the application package.

## Budget

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".

> **Administrative Expenses**
>
> Within the Part D program, applicants cannot use more than 10 percent
> of the award amount for administrative expenses.
>
> The term 'administrative expenses' means funds that are to be used by
> grantees for grant management and monitoring activities, including
> costs related to any staff or activity unrelated to services and
> indirect costs. Administrative costs also include rent, utilities and
> telephone services, as well as other costs not directly related to
> patient care. Administrative expenses are separate from those of
> indirect costs.
>
> **Standard Form 424A**
>
> Please 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 SF424A must reflect the budget totals
> identified in the line item budget and the budget 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 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 Budget**
>
> Your **[budget period is for one year]{.underline},** from 8/1/2008 --
> 7/31/2009, while your project period is for up to five 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 SF424A 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. For current grantees, **the budget must represent
> no more than the approved base funding as noted in the most recent (FY
> 2007) Part D Notice of Grant Award (NGA).** The budget must be well
> justified and relate to the activities proposed within your
> application. The budget must reflect the primary medical care services
> provided, either directly or through contracts.
>
> **Subcontracts**-**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. 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.

## Budget Justification

> Provide a narrative that explains the amounts requested for each
> category in the line-item budget for the grantee's consolidated
> budget. Provide information to explain the costs entered in each line
> item. The budget justification must clearly describe each cost element
> and explain how each cost contributes to meeting the project's
> objectives/goals. The budget justification MUST be concise. Do NOT use
> the justification to expand the project narrative.
>
> **Subcontracts**-**You must also provide a narrative justification for
> each subcontract. Provide a justification for each network
> subcontractor using the same format as that of the justification for
> the grantee of record.** Information on the specific services
> contracted must be provided.
>
> **For the subcontractors, you may include the justification directly
> after each item in the line-item budget. Therefore, you could include
> the justification for each category along with the line-item budget
> instead of as a separate document.**
>
> **Budget for Multi-Year Grant Award**

This announcement is inviting applications for project periods up to
five years. Awards, on a competitive basis, will be for a one‑year
budget period, although project periods may be for up to five years.
Applications for continuation grants funded under these awards beyond
the one-year budget period but within the five-year project period will
be entertained in subsequent years on a non-competitive basis, subject
to availability of funds, satisfactory progress of the grantee, and a
determination that continued funding would be in the best interest of
the Government.

> Include the following in the Budget Justification narrative:
>
> [Personnel Costs]{.underline}: List each staff person who will be
> supported by Federal funds, identify their name (if possible),
> position title, percent full time equivalency, annual salary or hourly
> salary and amount of time affiliated with the project, and the exact
> amount requested for each project year.
>
> [Fringe Benefits]{.underline}: List the components that comprise the
> fringe benefit rate, for example health insurance, taxes, unemployment
> insurance, life insurance, retirement plan, tuition reimbursement. The
> fringe benefits must be directly proportional to that portion of
> personnel costs that are allocated for the project.
>
> [Travel]{.underline}: List travel costs according to local and long
> distance travel. Specify the mileage rate, number of miles, reason for
> travel, and staff member/consumers completing the travel for local
> travel. Also include 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 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]{.underline}: Equipment is defined as an item of property
> that has an acquisition cost of \$5,000 or more per unit and an
> expected service life of at least one (1) year. List all items that
> meet this requirement and justify each item's cost in the budget
> justification section. Please provide additional justification for the
> purchase of computers and furniture items that meet the definition of
> equipment. The items listed under this category must be necessary to
> carry out the project's goals and objectives.
>
> Please note, most computer devises and digital accessories do not meet
> the Federal equipment definition, therefore these costs should be
> reallocated to the supplies category.
>
> [Supplies]{.underline}: List the items that the project will use. In
> this category, list office, medical, and educational purchases
> separately. Office supplies could include paper, pencils, etc.;
> medical supplies such as syringes, blood tubes, examination gloves,
> etc., and educational supplies may be pamphlets and educational
> videotapes. Explain how the amounts were developed. For example,
> "Medical supplies are based on 3,600 encounters at \$2.50 per
> encounter for a total of \$9,000".
>
> [Contractual]{.underline}: To the best extent possible, all
> subcontract budgets and justifications should be standardized, and
> contract budgets should be presented by using the same object class
> categories contained in the Standard Form 424A. 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.
>
> [Other]{.underline}: Put all costs that do not fit into any other
> category into this category and provide an explanation of each cost in
> this category. Do not list "other" or "miscellaneous expenses" as a
> cost item. Identify and justify all costs. In some cases, grantee
> rent, utilities, and insurance fall under this category if they are
> not included in an approved Federal Negotiated indirect cost rate.
> ***If you are allocating funds for professional membership dues/fees
> this need to be well justified and detailed and must be listed under
> CQM.***
>
> [Indirect Costs]{.underline}: Indirect costs are 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 website
> at: [http://rates.psc.gov](http://rates.psc.gov/) to learn more about
> rate agreements, the process for applying for them, and the regional
> offices, which negotiate them.
>
> *Do not use this application as a means to apply for an indirect rate
> cost agreement.*
>
> Indirect costs are awarded only to organizations that have a
> federally-negotiated indirect cost rate agreement that covers the
> activities to be funded. 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 3**).
>
> **Please Note:** Administrative expenses are funds that are to be used
> by grantees for grant management and monitoring activities, including
> costs related to any staff or activity unrelated to service or
> indirect costs. Applicants must identify administrative expenses in
> their proposed budgets. **A grantee may not use more than 10 percent
> of amounts received under Part D for administrative expenses**.
> **Administrative expenses should not be duplicative of indirect costs
> requested in the application therefore; you cannot charge the grant
> for administrative expenses as direct costs if those costs, such as
> rent, utilities, telecommunications, and administrative staff, are
> included in your indirect cost rate.**

## Staffing Plan and Personnel Requirements

> Applicants must present a staffing plan. The staffing plan consists
> of; 1) A narrative justification for the plan that includes a
> rationale for the amount of time being requested for each staff
> position; 2) Position Descriptions, and 3) Copies of Biographical
> Sketches for any key employed personnel.
>
> 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 them also.
>
> The narrative justification should be included as **Attachment 3**
> under the heading of 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, you should also reference any Position Descriptions and
> Biographical Sketches to be included as Attachments.
>
> Include position descriptions as **Attachment 4**. Position
> descriptions are to be comprised of roles, responsibilities, and
> qualifications of [key]{.underline} project staff for this grant,
> including those located within subcontract agencies.
>
> Also, include biographical sketches as **Attachment 4.** Biographical
> sketches are brief paragraph descriptions of each key employee and
> should include education, experience, qualifications, 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) and you are not required to submit
> CVs]{.underline}.
>
> Part D recommends that you have a Program Coordinator (PC) for at
> least .50 FTE. A sample position description for the Project
> Coordinator can be found in **Appendix D**. We expect the PC to have
> fiscal and programmatic authority for the management of the Part D
> program and to be the contact person for 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.

## Assurances

> Please include all assurances (SF 424B- Assurances for Non
> Construction Programs) required in Application Form 5161-1, provided
> with the application package. You must also include the Part D
> Agreement (included as Appendix E with this guidance), which includes
> specific assurances for this program. Applicants applying through
> grants.gov should read and understand the Part D agreement. 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 all assurances and include them
> with your application. They will not count toward the page limit.

## Certifications

> Please include all certifications required in Application Form 5161-1,
> provided with the application package. Applicants applying through
> grants.gov should read and understand the Certifications. On item 21
> of the SF 424 you will certify the statements contained in the list of
> Certifications. If you have received prior written approval to submit
> a paper application, you will need to sign the Certifications and
> include it in your application. It will not count toward the page
> limit

## Project Abstract

> 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.
>
> Remember to write the abstract after you have written your
> application. This section provides a description of your project and
> your organization. **The project abstract must be single-spaced and
> limited to one page in length.**
>
> **Place the following information at the top of the abstract:**

-   Project Title (FY 2008 Part D Competing Continuation)

-   Applicant Name

-   City, State

-   Contact Telephone Number

-   Contact E-mail Address

> Describe in the abstract four major areas as follows:

1.  **Organizational Description**

> Provide 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 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 Base**

> Provide an overview of your program, services you provide, scope of
> current HIV-related activities specific to the target population, the
> geographic service area served, and the needs to be addressed.
>
> Provide the total number of HIV/AIDS women, infants, children, and
> youth your Part D program has served (including those served by the
> network partners) in 2007. Describe the demographics of the target
> population, including the percentage of racial/ethnic minority
> populations you serve. Discuss how many persons you expect to serve by
> the end of the first year of this project period. Describe the
> demographics of your staff.

3.  **Challenges**

> Discuss 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 Coordination**

> Provide 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 2007.
> Describe how providers participate in the planning and coordination of
> services.

## Program Narrative

> This section provides a comprehensive framework and description of all
> aspects of the proposed program. It must be succinct, self-explanatory
> and well organized so that reviewers can understand the proposed
> project. Please follow the instructions here closely. Remember that a
> group of outside reviewers will rate your proposal. Their rating guide
> is the Review Criteria. This rating guide is based on the required
> sections of the narrative.
>
> The Program Narrative contains eight (8) sections. Use the following
> section headers for the Narrative:

1.  Introduction

2.  Needs Assessment

3.  Methodology

4.  Work Plan

5.  Resolution of Challenges

6.  Evaluation

7.  Clinical Quality Management (CQM)

8.  Organizational Information

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1.  **Introduction**

> This section should describe briefly the purpose of the proposed
> project. You should discuss why your agency is in need of Part D funds
> and why you are the appropriate entity to receive the funds.

2.  **Needs Assessment**

> This section outlines the needs of your community and will provide
> information on the impact of HIV/AIDS in your community. In this
> section you will define your service area, provide information on the
> rate of HIV/AIDS in your service area, describe the target
> population(s) to be served, the medical and social support needs of
> the people you serve or propose to serve and any unmet health needs.
> Make sure to include a description for each of the key target groups;
> women, infants, children and youth.
>
> There are four (4) components in this section:

#####  HIV Seroprevalence and Surrogate Markers

#####  Social Context of HIV/AIDS

#####  Target Populations

#####  Local HIV Service Delivery System

> **a. HIV Seroprevalence and Surrogate Markers**
>
> Provide the number of people living with AIDS (AIDS prevalence) and
> the number of new AIDS cases diagnosed (AIDS incidence) during
> calendar years 2004 and 2005 for women, infants, children and youth in
> your targeted service area. If you have AIDS data available for
> calendar year 2006 you may include that information. Highlight any
> groups that show a rapid growth in AIDS cases. If you are in a State
> that reports data on new HIV infections, you may also include that
> information.
>
> Provide information on the rates of surrogate markers such as
> syphilis, gonorrhea, tuberculosis, and substance abuse for the target
> population(s). You may use other measures that show the impact of
> HIV/AIDS on your community. You should show how your community
> compares to other communities, or the nation.
>
> You must show the impact of the HIV epidemic on the women, infants,
> children, and youth, in your proposed service area. Be sure to provide
> descriptive numbers. You may want to present this information in the
> form of a table with a narrative explanation of the data. Be very
> thorough and show all the important variables, i.e., seroprevalence,
> surrogate markers, age, gender, and exposure.
>
> You must note the source of all data provided (State Department of
> Health, CDC, etc.).
>
> **b. Social Context of HIV/AIDS**
>
> Describe the racial, ethnic, social and economic characteristics of
> the people you serve or propose to serve. Focus on issues that relate
> to providing HIV care. Data presented in narrative form must include
> the following information:

-   The percentage of the racial/ethnic minority populations you propose
    to serve

-   The percentage of the target population that is homeless

-   The percentage of the target population that is uninsured

-   The percentage of the target population using illegal drugs and/or
    alcohol

-   The percentage of the target population that is unemployed

-   The percentage of the target population whose primary language is
    not English

-   The percentage of the target population that live below the Federal
    Poverty Level

> The statistics that you include must be specific to the area from
> which the majority of the proposed clients will be drawn. You may also
> include a description of other relevant characteristics of the target
> populations that affect their access to primary care. These factors
> may include citizenship status, education, and access to
> transportation.
>
> Compare the rates of the target populations in your community to those
> of the general population in your service area.
>
> **c. Target Population**
>
> All Part D programs must serve four groups of infected people. The
> target populations are HIV infected women, HIV infected and exposed
> infants, HIV infected children, and HIV infected youth. If your
> project does not plan to serve ALL of these groups, you must explain
> why this is appropriate. If one group is currently well served by
> other providers you must identify the organizations that serve that
> group and tell us how you know clients are being served and do not
> need your services. You must describe how your project will work with
> these organizations to coordinate services for the target population.
>
> Provide the following information for each Part D target population
> listed above:

-   Number of clients served between August 1, 2007 - July 31, 2008

-   Total number of clients projected to be served between

> August 1, 2008 -- July 31, 2009
>
> If you target or serve racial/ethnic minority groups and/or if your
> award for 2007 lists MAI funds include a description of the
> racial/ethnic minority population(s) served by your program. 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

> In addition, provide information on risk factors specific to each
> targeted population (women, children and youth). Identify trends that
> occurred over the last three years (2005-2007) as your organization
> has experienced increases or decreases among specific groups (e.g., a
> 10 percent increase in the number of women seeking services).
>
> **[Current Grantees Only:]{.underline}**
>
> If you are a current Part D grantee, list the amount of MAI funding
> your program received on the 2007 NGA. If your program serves one
> particular group because of geography, you must still answer the
> questions below. Please do not use this section for any additional
> demographic information about the communities your program serves.
>
> For the 8/1/2007 -- 7/31/2008 budget period, provide the following
> data for each racial/ethnic or minority group. This information can be
> provided in table format with racial/ethnic minority group listed
> along the top and the categories below along the left side:

-   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

> **d. HIV Service Delivery System**
>
> *Description of Service System*
>
> You must describe services available to women, infants, children, and
> youth living with HIV in your service area. We recommend you use a
> chart format to present this information, and a brief narrative that
> explains the chart. Include the following:

1.  Describe Federal, state, and local private funding sources for HIV
    prevention and care available in the community.

-   Identify all Federal, State, and local funding sources including
    providers funded by Maternal and Child Health Block Grants (Title V
    of Social Security), the Centers for Disease Control and Prevention
    (CDC), National Institutes of Health (NIH), Substance Abuse and
    Mental Health Services Administration (SAMHSA), and the State
    Children's Health Insurance Program (SCHIP).

-   For each Title of the Ryan White HIV/AIDS Program Parts, A, B, C, D,
    D Youth, Dental Reimbursement, Community Based Dental Partnerships,
    or Special Projects of National Significance (SPNS)), specify the
    amount of funding provided by these organizations.

2.  Describe the locations, type, and current way that HIV services
    (both prevention and care) are provided within the proposed service
    area for your target population.

    -   Describe both public and private organizations that provide HIV
        services.

    -   Indicate if there are other Ryan White HIV/AIDS Program funded
        primary care programs located in, or providing services to, the
        target community.

    -   Attach an area map as **Attachment 6** that shows the proposed
        service area. Your location and the location of all proposed
        network providers/partners [must]{.underline} be indicated on
        the map.

3.  Describe significant barriers that impact access to care for your
    target population. What services, medical and social support, are
    not available to the targeted population in your service area? What
    barriers exist for your population in accessing care? For example,
    available services may be inaccessible due to distance, culture,
    eligibility requirements, etc.

4.  Describe current unmet health needs and gaps in HIV primary care
    services for the targeted populations within the proposed service
    area.

-   Discuss the populations, which are not currently being served and/or
    define what services are not available.

-   Provide a brief description of the impact the gaps in services have
    on your clients.

> Discuss the number and characteristics of persons who know they are
> HIV-infected but who are not receiving HIV primary medical care. HAB
> is working to develop methods to help grantees assess the number of
> persons who know they are HIV-infected but who are not receiving HIV
> primary medical care. More information about measuring unmet need may
> be found at <http://hab.hrsa.gov/tools/needs/> and
> <http://hab.hrsa.gov/tools/unmetneed/>.
>
> *Changes to Service Delivery System*
>
> Describe any changes made to the state and local health care system
> recently, and any upcoming changes. Describe the impact of these
> changes on the care of HIV-infected women, infants, children, and
> youth within your service area and your program.

3.  **Methodology**

    Use this section to describe methods that will be used to meet
    program requirements and expectations of this grant announcement.
    Describe the primary care and supportive services your organization
    will provide. The minimal information you should provide in each of
    the six (6) sections is described below. You may provide additional
    information that will help reviewers to understand how your services
    are delivered and the policies and procedures that ensure that your
    program maintains professional standards of care.

##### a. Culturally and Linguistically Competent Care

> Describe the cultural and linguistic groups served by your project.
> Please include their race/ethnicity in your description. Tell us 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. Describe how
> you recruit and retain staff with demonstrated experience and
> familiarity with the culture and literacy level of your target
> population.

##### b. Coordinated, Comprehensive Systems of Care

> Describe 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 (primary care and/or supportive services),
> number of clients served by each network provider, and the geographic
> areas your network member will serve. In addition, identify and
> quantify the work to be done by agencies not funded by the project but
> which form part of the network. Use a chart to depict this information
> for each network provider and include it as **Attachment 6**. In
> narrative form, tell us how each network provider is part of planning
> and coordinating services of the network. Include any services that do
> not yet have a provider identified. Tell us what you plan to do to be
> sure those services are provided.
>
> Tell us how these multiple providers work together to coordinate care
> for clients and their affected family members. Describe how the
> project facilitates collaboration and coordination of patient care.
> Describe both formal and informal methods. Describe the processes
> used, such as case conferences, routine meetings, or other methods and
> tell how these are documented. Tell us the frequency and purpose of
> your meetings, the plans you have to identify barriers to care and
> gaps in service, and what you plan to do to respond to these newly
> identified needs. Describe the methods used to determine the needs of
> individual patients. Also, discuss how you track and monitor referrals
> and what you do when a referral does not work. In this section you
> must provide precise information and evidence of the provision of
> primary medical care either directly or through contracts.
>
> Describe how the project serves members of a family in which several
> individuals are infected. Explain what you do to maintain continuity
> of care for them as a family. For example, how do you serve an
> infected woman and her infected and uninfected children, or an
> infected single father and his infected child? Tell how you coordinate
> services to make it easier for the family. Explain arrangements made
> for transportation and childcare.
>
> Include one to two **sample** signed copies of contracts or Memoranda
> of Agreement (MOA) or Memoranda of Understanding (MOU) as **Attachment
> 7**. It is not necessary to provide the complete MOA/MOU. However, the
> statement of work or the cover page that states the specific
> responsibilities for each partner should be provided.
>
> Describe your participation in the assessment and planning activities
> that go on in your area. Tell about your participation in the
> Statewide Comprehensive Statement of Need (SCSN). Tell us what you do
> to make sure that your project is consistent with the SCSN. Also
> include letters of support from the Part A and if applicable the Part
> B program in your area as **Attachment 8**.
>
> Describe how the proposed activities for the Part D program relate to
> the local and statewide priorities set-forth through each respective
> planning process. In the description, include the specific HIV-needs
> identified for your service area by these planning bodies.
>
>  
>
> 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. Strategies to Recruit and Retain Women 

> All HIV infected women are entitled to receive Part D services. Since
> the lives of women may include families and children, services must be
> designed taking this into consideration. Part D programs must show how
> they work to identify and bring women into care, and how they keep
> them in care. Please describe services available for women and efforts
> to recruit and retain women in care. At a minimum, you should answer
> the following questions:

-   How do you make HIV counseling and testing available for all women?
    Describe efforts for women who are pregnant separately.

-   Do you have any targeted and/or unique efforts to ensure that women
    are tested for HIV? What do you do?

-   How does your project link or provide primary medical care services
    to all women who test positive for HIV?

-   How does your project provide prenatal care for infected women?

-   How does your project teach women about drugs that can reduce the
    chance of HIV transmission, make sure drugs are offered, and address
    adherence to treatment issues?

> For women who are pregnant, tell us how you coordinate obstetric and
> Primary HIV care and how you continue primary care after delivery.
> Tell us how you provide pediatric care to their exposed, infected, and
> affected children, and how you link families among prenatal, primary
> medical and pediatric care providers. Tell us of your work with your
> local AETC to teach providers how to help reduce HIV transmission from
> mother to baby.

##### d. Research

> Part D programs must provide their patients and clients with
> information and education on opportunities to participate in
> HIV/AIDS-related clinical research. The law requires that you teach
> clients and patients about research. Describe the process to be used
> to teach patients and clients about research. Describe the research
> opportunities available to clients and patients in your project.
> Describe how you will identify women, infants, children, and youth who
> would be appropriate participants in research projects.

##### e. Case Finding

> Describe how your program meets the goal of finding HIV-infected
> individuals from the target population not in care and bringing them
> into the system. Describe how your project does case finding and how
> those clients are connected to the care system. Include a description
> of how you find patients lost-to-care including the tracking system
> you use. Tell us about specific techniques you use to reach
> challenging populations. If your program funds counseling and testing
> (C&T) sites describe how you make sure that the linkage to care is
> part of their scope of work.
>
> Describe how you tell other providers about your project. How will you
> make sure infected infants, women, children, and youth know about the
> services you provide? Tell us how you educate your specific target
> groups about HIV testing.

##### f. Consumer Involvement

> Describe, in detail, what you do to involve consumers in your program.
> Describe the kind of involvement consumers have in planning,
> implementing and evaluating your project. Describe the methods you use
> to keep them informed and provide feedback on their suggestions. If
> your project has a Consumer Advisory Board, discuss how you have been
> successful and how you have not. Tell how you support their
> participation. Identify committees, advisory groups, panels and boards
> in which consumers are or will be serving. Include information about
> how you prepare consumers for participation and the kinds and
> frequency of training you provide. Provide information on the type of
> support and supervision you offer your active consumers. Identify
> consumers that fill any leadership or staff positions in your program.
> Describe barriers that keep consumers from helping you plan,
> implement, or evaluate your project. Tell us what you do to overcome
> these barriers and encourage participation. Describe how you have
> incorporated caregivers, for example affected male caregivers, in your
> consumer activities.
>
> Describe your efforts to teach consumers about their disease and its
> management. Who provides education about HIV? How often? Also describe
> how your project works with medical personnel to make sure they help
> consumers become full partners in their care.
>
> You may attach letters from consumers as part of **Attachment 8** (no
> more than two). If you include letters of support from consumers or
> consumer groups, have them describe the level and impact of their
> participation within the Part D program. Also, have them indicate that
> their letters of support are being used with their permission.

4.  **Work Plan**

> In the work plan, describe the primary care and supportive services
> you propose to provide. The services you propose should address the
> needs identified in your needs assessment and the Part D Program
> Expectations described earlier in this guidance. 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.
>
> Your work plan should include the problem/need, goal, objectives, key
> action steps, evaluation/outcome methods, person responsible, and date
> anticipated to achieve each objective. [You may want to use a table
> format to present this information (**Attachment 9**)]{.underline}.
>
> While the goals are to be written for your entire proposed five-year
> project period, the work plan objectives should be written for one
> year only. Key action steps should provide the elements necessary to
> accomplish the corresponding objective.
>
> **All objectives should be related to the provision of comprehensive
> coordinated HIV services and access to research for HIV-infected
> women, infants, children, youth and their affected family members.**
> You should use the objectives to fully describe the services your
> program will provide. Objectives should be written in time-framed and
> measurable terms providing numbers for targeted outcomes where
> applicable, not just percentages.
>
> **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.**
>
> **Your workplan must also include objectives aimed at the provision of
> primary medical care either directly or through contracts by your
> organization / network.**
>
> When indicating person responsible, be sure to include the name of
> network providers involved in the accomplishment of the objective and
> associated key action steps.
>
> [All current and new applicants]{.underline} should incorporate any
> specific activity related to the recruitment and/or retention of
> ethnic/racial minorities into their work plan.
>
> ***New Applicants Only:***
>
> New applicants proposing to replace an existing grantee must include a
> transition plan describing how they will absorb the current grantees'
> clients. At a minimum, include a description in narrative form of:

-   how you will identify and notify the current grantee's clients of
    the availability of your HIV services,

-   how you will assist clients in making new appointments, and

-   the timeline for accomplishing the enrollment of these clients into
    your program.

> You must describe how you will transition services for the target
> population and insure continuity of care from the current grantee to
> your program.
>
> ***Minority AIDS Initiative Funds (MAI)* (For current grantees
> only):**
>
> Beginning in FY 2005, the amount of MAI funds that were part of a
> grantee's award was noted on the Notice of Grant Award (NGA). If your
> project receives MAI expansion funds, i.e., to identify, bring into,
> and retain in service persons of color, please discuss how you met
> your goals and how you plan to continue providing services with these
> funds. If your program does not receive MAI funding please explicitly
> state so.
>
> Wherever appropriate, present a summary of specific training, and /or
> learning experiences to develop knowledge and appreciation of how
> culture and language influences health literacy improvement and the
> delivery of high quality, effective and predictably safe healthcare
> services.

5.  **Resolution of Challenges**

> Discuss challenges that are likely to be encountered in designing and
> implementing the activities described in the work plan, and approaches
> that will be used to resolve such challenges. Also discuss any
> challenges your organization has had in the provision of services to
> the targeted populations (infants, children, women, and youth) and how
> you have addressed these challenges. Include information on changes to
> services provided. In addition, describe any changes that have
> occurred in your program over the last 3 years (2005-2007).
>
> Wherever appropriate, describe the program's or institution's past
> performance in recruiting and retaining health care providers,
> faculty, staff and students with demonstrated experience serving the
> specific target population and familiarity with the culture of the
> particular target group.
>
> ***For Current Grantees Only:***
>
> Discuss any objectives you did not reach in your previous project
> period. Explain why you did not reach them and what your project will
> do by the end of your current project period, July 31, 2008, to
> address this. If you have met all of your objectives explicitly state
> so.
>
> You should include in this discussion any findings from any site visit
> performed within the last three-year project period from either the
> Office of Performance Review (OPR) or from the Division of Community
> Based Programs (DCBP). Include the type of site visit, date performed,
> list of findings related to the Part D program, and what your program
> has done to address the findings. Describe any changes that have taken
> place in your program as a result of the site visit. Also, describe
> any changes that occurred in your program during the last three-year
> project period.

6.  **Evaluation**

    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.

    Describe how you use evaluation to measure the impact of your
    program. Describe how you use evaluation to help in determining 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>.

7.  **Clinical Quality Management**

> **HAB Quality Expectations**

HAB has defined quality as follows:

"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."

A grantee under Part D shall implement a clinical quality management
program to assess the extent to which HIV health services provided to
patients under the grant are consistent with the most recent Public
Health Service guidelines for the treatment of HIV/AIDS and related
opportunistic infection, and as applicable, to 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 purpose of a Clinical Quality Management (CQM) program is to ensure
that you have a system in place for evaluating how your system works and
making changes where necessary. If others in your network provide
primary care for your clients via subcontract, you must make sure that
they have CQM systems in place as well. Include monitoring, CQM, and
regular reporting in your subcontracts.

> The three-fold purpose of CQM is to ensure that:

1.  Funded services adhere to established HIV clinical practice
    standards and Public Health Service (PHS) guidelines;

2.  Strategies for improvements to quality medical care include vital
    health-related supportive services in achieving appropriate access
    and adherence with HIV medical care; and

3.  Available demographic, clinical, and health care utilization
    information is used when developing and adapting programs to address
    changing trends in the epidemic.

All Part D CQM programs must include clinical goals and outcomes.
Examples of clinical outcomes you may choose to measure include, but are
not limited to the following:

-   Change in the number of patients with CD4+ (cells/mm^3^) counts
    under 350;

-   Change in the number of patients with viral load (HIV-1 RNA
    copies/mL) counts under 10,000;

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-   Change in the number of patients on highly active antiretroviral
    therapy (HAART) who received adherence counseling/intervention at
    their last visit;

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-   Use of prophylaxis for *pneumocystis carinii* pneumonia (PCP) and/or
    *mycobacterium avium complex* (MAC) at a prescribed point in time
    among active patient load;

-   Change in the number of female patients receiving pap smears in the
    last six months;

-   Change in the frequency or duration of hospitalizations;

-   Change in the average waiting time for first appointment; and

-   Change in the percent of patients with visit(s) in the last three
    months.

    In addition to clinical outcomes, your CQM program also must have:

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-   Designated leaders and accountability;

-   Routine data collection and analyses of data on measurable outcomes;

-   A system for ensuring that data are fed back into your
    organization's quality improvement process to assure that goals are
    accomplished; and

-   Consistency, to the extent possible, with other programmatic
    Continuous Quality Improvement (CQI) activities such as the Joint
    Commission on the Accreditation of Healthcare Organizations (JCAHO)
    and other Ryan White HIV/AIDS Program funded programs.

> HAB also encourages grantees to conduct CQI for the administrative and
> fiscal components of their organizations. We can provide technical
> assistance in this area to your project. Indicate your technical
> assistance needs in this area.
>
> **Clinical Quality Management Program Requirements**:
>
> Describe 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 fund. Your description should at a minimum include:

-   The composition of the staff that participate in quality
    improvement/management activities.

-   The formalized mechanisms used by your program to implement quality
    improvement (e.g., CQM committee, how often they meet, meeting
    minutes).

-   The indicators established, or tracked or to be established in
    measuring the success of your program.

-   The strategy used to collect data, including how data are collected,
    what data are collected, and results. This is focused on your
    currently identified needs. HRSA/HAB will identify measures in the
    near future that will be required.

-   The process used to provide feedback, implement changes within your
    program or receive new funding.

-   The specific activities implemented among Service/Provider
    Organizations to assess the existence and outcomes of their clinical
    quality management programs.

-   The role of consumers in the Clinical Quality Management program.

-   The impact of your program (i.e. populations served, community) how
    successful have you been?

> Discuss how your Clinical Quality Management program has worked to
> improve the care or services your program provides.

-   Discuss how an item or measure was identified as needing
    improvement.

-   What process did you use to analyze the cause of this situation?

-   What process did you use to design an intervention?

-   How did you test the intervention?

-   What did you measure to demonstrate change? Was there a change? Do
    you consider this an improvement?

-   What were your next steps?

-   Did you re-measure this? If you did, what did it show?

> **Management Information Systems (MIS)**: Describe 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 individuals provided services;

-   Epidemiological and demographic data on the population receiving
    services;

-   Exposure and diagnostic categories;

-   The clinical status summary on the population receiving services;

-   Service utilization data; and

-   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.

8.  **Organizational Information**

> Provide information on the applicant agency's current mission and
> structure, type of agency,
>
> scope of current activities, and an organizational chart, and describe
> how these all contribute to the ability of the organization to conduct
> the program requirements and meet program expectations. Describe the
> mission of your organization, and tell us how a Part D project matches
> this mission. Explain why your organization and your network are the
> right group to lead a Part D project. Describe other local, state,
> federal, and private funding sources received to support your HIV
> program. Discuss the accounting system you use, and the internal
> controls in place to protect your finances.
>
> Wherever appropriate, describe the program's or institution's
> strategic plan, policies, and initiatives that demonstrate a
> commitment to providing culturally and linguistically competent health
> care and developing culturally and linguistically competent health
> care providers, faculty, staff, and program participants. This
> includes participation in, and, support of programs that focus on
> cross-cultural health communication approaches as strategies to
> educate health care providers serving diverse patients, families, and
> communities.
>
> Describe your staff's experience in providing culturally competent and
> linguistically appropriate care. Present a summary of specific
> training, and/or learning experiences to develop knowledge and
> appreciation of how culture and language influences health literacy
> improvement and the delivery of high quality, effective and
> predictably safe healthcare services. Describe the in-service training
> you provide for staff and consumers, including the schedule of
> training.
>
> If you are currently funded by Part D, describe any staff changes that
> have occurred in the previous project period. Discuss the structure of
> your organization. Provide an organizational chart for the Part D
> program as **Attachment 10**. (If your Part D program is part of a
> larger organization, you do not need to provide an organizational
> chart that includes the whole organization; just the Part D
> project)**.** On this chart, outline the professional roles of grantee
> staff (including consumer staff) and the liaison at each network
> provider site, and the reporting relationships.
>
> Provide the number of clients your program is capable of serving, and
> describe your experience in providing care to the targeted
> populations, your community leadership, and other strengths that show
> that you can lead a Part D project.
>
> New organizations proposing to replace the current grantee must
> demonstrate that they have the capability to serve at least the same
> clients as the grantee they are proposing to replace, that they will
> serve the exact same geographic service area, and that they have the
> capability to serve the target population in a comprehensive,
> culturally competent and linguistically appropriate, and
> family-centered manner.
>
> []{.mark}

## Program Specific Forms

> Applicants must complete the Part D Agreement (see **Appendix E**) and
> submit it electronically as **Attachment 11** 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
> 11.**

**The Part D Agreement [will count toward the 80-page
limit.]{.underline}**

## Attachments

> Please provide the following items to complete the content of the
> application. Please 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.

1)  **Attachment 1: Documentation of Medicaid provider status and Clinic
    Licensure**

> Include documentation of Medicaid Provider status and
> [current]{.underline} 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).

2)  **Attachment 2: Negotiated Indirect Cost Rate**

> Provide a copy of [latest]{.underline} negotiated indirect cost rate
> agreement, if you are requesting indirect costs in the budget.

3)  **Attachment 3: Staffing Plan Narrative**

4)  **Attachment 4: Position Descriptions for Key Personnel/Positions**

**Position Descriptions for Key Personnel/Positions**

> Keep each PD to one page in length, if possible. Item 6 in the Program
> Narrative section of the PHS 5161-1 Form provides some guidance on
> items to include in a job description.
>
> **Biographical Sketches of Key Personnel**
>
> Include biographical sketches for persons occupying the key positions,
> not to exceed three pages in length. 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.

5)  **Attachment 5: Map of Service Area**

Provide a map that depicts the proposed service sites of all network
providers and your agency.

6)  **Attachment 6: Network Provider Chart**

> 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.

7)  **Attachment 7: Memoranda of Agreement/Understanding**

> Provide sample MOAs or MOUs 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) MOA/MOU samples

8)  **Attachment 8: Letters of Support From Part A/Part B Programs and
    Consumer Letters of Support**

    -   Provide letters of support from Part A and Part B, if
        applicable.

    -   Provide no more than (2) support letters from consumers (Not a
        Requirement).

> ***All Letters of support must be dated. You may list support letters
> on one page***.

9)  **Attachment 9: Work Plan**

10) **Attachment 10: Project Organizational Chart**

> Provide a one-page figure that depicts the organizational structure of
> the project, including subcontractors and other significant
> collaborators.

11) **Attachment 11: Part D Agreement**

##  3. Submission Dates and Times

**Application Due Date**

The due date for applications under this grant announcement is ***March
21, 2008** at 8:00 P.M. ET*. Applications will be considered as meeting
the deadline if they are E marked on or before the due date. Please
consult Appendix A, Section 3 for detailed instructions on submission
requirements.

> The Chief Grants Management Officer (CGMO) or a higher-level designee
> may authorize an extension of published deadlines when justified by
> circumstances such as acts of God (e.g. floods or hurricanes),
> widespread disruptions of mail service, or other disruptions of
> services, such as a prolonged blackout. The authorizing official will
> determine the affected geographical area(s).
>
> Applications must be submitted by 8:00 P.M. ET. **To ensure that you
> have adequate time to follow procedures and successfully submit the
> application, we recommend you register immediately in Grants.gov (see
> Appendix B) and complete the forms as soon as possible, as this is a
> new process and may take some time.**
>
> **Please refer to Appendix B for important specific information on
> registering, and Appendix A, Section 3 for important information on
> applying through Grants.gov.**
>
> **Late applications:**
>
> Applications which do not meet the criteria above are considered late
> applications. Health Resources and Services Administration (HRSA)
> shall notify each late applicant that its application will not be
> considered in the current competition.

## 4. Intergovernmental Review

> Part D programs are subject to the provisions of Executive Order
> 12372, as implemented by 45 CFR 100. Executive Order 12372 allows
> States the option of setting up a system for reviewing applications
> from within their States for assistance under certain Federal
> programs. Application packages made available under this guidance will
> contain a listing of States which have chosen to set up such a review
> system, and will provide a State Single Point of Contact (SPOC) for
> the review. Information on states affected by this program and State
> Points of Contact may also be obtained from the Grants Management
> Officer listed in the AGENCY Contact(s) section, as well as from the
> following Web site: <http://www.whitehouse.gov/omb/grants/spoc.html>.
>
> All applicants other than federally recognized Native American Tribal
> Groups should contact their SPOC as early as possible to alert them to
> the prospective applications and receive any necessary instructions on
> the State process used under this Executive Order.
>
> Letters from the State Single Point of Contact (SPOC) in response to
> Executive Order 12372 are due sixty days after the application due
> date.

## 5. Funding Restrictions

> Applicants responding to this announcement may request funding for a
> project period of up to five years. Awards to support programs beyond
> the first budget year will be contingent upon Congressional
> appropriation, satisfactory progress in meeting the project's
> objectives, and a determination that continued funding would be in the
> best interest of the government.
>
> Funds under this announcement may not be used for the following
> purposes:

-   Construction is not allowable, unless it is minor alterations to an
    existing facility, to make it more suitable for the purposes of the
    grant program. In such cases previous authorization must be sought.

-   Entertainment costs are not allowable. This includes the cost of
    amusements, social activities, and related incidental costs.

-   Fundraising expenses are not allowable.

-   Lobbying expenses are not allowable.

-   Hiring of a consultant to write the application and other pre-award
    costs are not allowable.

-   Foreign travel is not allowable.

-   Other non-allowable costs can be found in the Cost Principles
    located at <http://www.hhs.gov/grantsnet/lawsregs/index.htm>.

## 6. Other Submission Requirements 

> As stated in Section IV.1, except in rare cases HRSA will no longer
> accept applications for grant opportunities in paper form. Applicants
> submitting for this funding opportunity are ***required*** to submit
> ***electronically*** through Grants.gov. To submit an application
> electronically, please use the
> [http://www.Grants.gov](http://www.Grants.gov/) apply site. When using
> Grants.gov you will be able to download a copy of the application
> package, complete it off-line, and then upload and submit the
> application via the Grants.gov site.
>
> As soon as you read this, whether you plan on applying for a HRSA
> grant later this month or later this year, it is incumbent that your
> organization ***immediately register*** in Grants.gov and become
> familiar with the Grants.gov site application process. If you do not
> complete the registration process you will be unable to submit an
> application. The registration process can take up to one month, so you
> need to begin immediately.
>
> To be able to successfully register in Grants.gov, it is necessary
> that you complete all of the following required actions:
>
> • Obtain an organizational Data Universal Number System (DUNS) number
>
> • Register the organization with Central Contractor Registry (CCR)
>
> • Identify the organization's E-Business POC (Point of Contact)
>
> • Confirm the organization's CCR "Marketing Partner ID Number (M-PIN)"
> password
>
> • Register an Authorized Organization Representative (AOR)
>
> • Obtain a username and password from the Grants.gov Credential
> Provider
>
> Instructions on how to register, tutorials and FAQs are available on
> the Grants.gov web site at [www.grants.gov](http://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.
>
> More specific information, including step-by-step instructions on
> registering and applying, can be found in Appendix B of this guidance.
>
> **Formal submission of the electronic application:** Applications
> completed online are considered formally submitted when the
> Authorizing Official electronically submits the application to HRSA
> through Grants.gov.
>
> Applications will be considered as having met the deadline if the
> application has been successfully transmitted electronically by your
> organization's Authorizing Official through Grants.gov on or before
> the deadline date and time.
>
> **It is incumbent on applicants to ensure that the AO is available to
> submit the application to HRSA by the application due date. We will
> [not]{.underline} accept submission or re-submission of incomplete,
> rejected, or otherwise delayed applications after the deadline.**
>
> **Again, please understand that we will not consider additional
> information and/or materials submitted after your initial application.
> You must therefore ensure that all materials are submitted together.
> Further information on the HRSA electronic submission policy can be
> obtained at
> [http:/www.hrsa.gov/grants/electronicsubmission.htm](http://www.hrsa.gov/grants/electronicsubmission.htm).**

# V. Application Review Information 

## 1. Review Criteria

> Procedures for assessing the technical merit of grant applications
> have been instituted to provide for an objective review of
> applications and to assist the applicant in understanding the
> standards against which each application will be judged. Critical
> indicators have been developed for each review criterion to assist the
> applicant in presenting pertinent information related to that
> criterion and to provide the reviewer with a standard for evaluation.
> Omission or misrepresentation of critical information will be grounds
> for disqualification of your application. Review criteria are outlined
> below with specific detail and scoring points.
>
> Review Criteria are used to review and rank applications. Points will
> be allocated based on the extent to which the proposal addresses each
> of the criteria listed below.

The Part D Competing Continuation guidance application has 6 review
criteria.

> **Criterion 1: Need (25 Points Total)**
>
> This item relates to the extent to which the application describes the
> problem and associated contributing factors to the problem.
>
> This corresponds to both the **Introduction** and **Needs Assessment**
> sections of the Narrative.

**Introduction (5 Points)**

-   Does the applicant clearly describe the purpose of the project?

-   Does the applicant explain why their agency is in need of Part D
    funds and why they are the appropriate agency to receive the funds?

**Needs Assessment (20 Points)**

-   ***HIV Seroprevalence and Surrogate Markers* (5 Points)**

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-   Are data sources documented and provided from reliable sources?

-   Does the applicant include the number of AIDS cases for the two
    calendar years (CY 2004 and CY 2005)?

-   Does the applicant include the number of new AIDS cases diagnosed
    for the two calendar years (CY 2004 and CY 2005)?

-   Does the applicant clearly describe the rates of surrogate markers
    for the target population(s)?

-   Are the data provided specific to the proposed service area and
    target population(s)?

    -   ***Social Context of HIV/AIDS* (5 Points)**

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-   Have the socio-demographic characteristics of the target population
    in the proposed service area (e.g., race, homelessness, uninsured
    status, etc.,) been sufficiently and clearly described?

-   Has information on the percent of racial/ethnic minority populations
    to be served been provided?

-   Are data specific to the proposed geographic service area?

-   Have relevant geographic, social, economic, and cultural barriers to
    care been clearly and completely addressed?

-   Was a comparison between the general population and target
    population(s) provided?

    -   ***Target Populations* (5 Points)**

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-   Is the target population(s) clearly identified?

-   Has the applicant provided data for all of the Part D targeted
    groups they are to serve?

-   If the applicant does not plan to serve All Part D target groups
    (women, infants, children, youth) do they explain why?

-   Does the applicant identify organizations that are serving any of
    the target groups and sufficiently described how their project will
    work with these organizations?

-   Are data provided on the number of clients served in the current
    budget year (2007-2008) clearly presented?

-   Are data provided on the total number of clients projected to be
    served in the upcoming year (2008-2009) clearly presented?

-   Does the applicant provide clear information on how they identify
    and recruit racial/ethnic minority populations served?

-   Does the applicant provide clear information on how they enroll and
    retain racial/ethnic minority populations served?

-   Does the applicant provide information on risk factors specific to
    each targeted population?

-   Has the applicant sufficiently described trends in
    increases/decreases in services over the last three years
    (2005-2007)?

> *For Current Grantees Only:*

-   Does the applicant provide information on whether they received MAI
    funding in 2007?

-   Does the applicant provide complete data on the number of
    racial/ethnic minority populations enrolled at the beginning of the
    budget year, newly identified and enrolled, and total enrolled at
    the end of the budget year?

    -   ***HIV Service Delivery System*** **(5 Points)**

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-   Is a clear description of the type, location, and current way that
    HIV services are delivered within the proposed service area
    provided?

-   Does the applicant provide comprehensive data on the amount and type
    of Federal, state, and local private funding for HIV prevention and
    care including CDC, SAMHSA, Maternal and Child Health Block Grants,
    and SCHIP for their service area?

-   Does the applicant provide data on the amount and type of funding
    received from Ryan White HIV/AIDS Program Parts A, B, C, D, Dental
    Reimbursement, Community Based Dental Partnership, and the Special
    Projects of National Significance (SPNS) for their service area?

-   Does the applicant clearly describe the services available to women,
    infants, children, and youth with HIV?

-   Does the applicant clearly describe any significant gaps or barriers
    to care for the target population(s) and the impact it has had on
    the clients?

-   Does the applicant clearly discuss the number and characteristics of
    those within the target population who are HIV-infected and not in
    care?

-   Has the applicant provided information on recent changes within the
    state and local health care system and how they affect the services
    provided within the service area and their program?

-   Has an area map that indicates the proposed service area, the
    location of the applicant organization, and the location of other
    HIV primary care providers been included as attachments to the
    application?

> **Criterion 2: Response (37 Points Total)**
>
> This item relates to the extent to which the proposed project responds
> to the "Purpose" included in the program description, the clarity of
> the proposed goals and objectives, and their relationship to the
> identified project. It also relates to the extent to which the
> activities described in the application are capable of addressing the
> problem and attaining the project objectives.
>
> This corresponds to the **Methodology, Work Plan** and **Resolution of
> Challenges** sections of the Narrative.
>
> **Methodology (20 Points)**

-   ***Culturally and Linguistically Competent* *Care* (2 Points)**

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-   Does the applicant describe the cultural and linguistic groups
    served by the project?

-   Does the applicant describe how they and network partners will
    ensure that cultural and linguistic differences are taken into
    consideration in the provision of services?

-   Does the applicant clearly describe how they recruit and retain
    staff with demonstrated experience and familiarity with the culture
    and literacy level of their target population?

    -   ***Coordinated, Comprehensive Systems of Ca**re* **(7 Points)**

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-   Does the applicant clearly describe a network of providers that will
    provide comprehensive, coordinated, family-centered care including
    those not funded by the Part D program?

-   Does the applicant fully provide information on number of clients
    served and geographic service area for each network provider in
    chart format?

-   Does the applicant clearly describe how multiple providers will work
    together to coordinate care for a patient, client, or their affected
    family?

-   Does the applicant clearly describe how the project will track and
    monitor referrals?

-   Does the applicant clearly describe how the project serves members
    of a family when several are infected and maintain continuity of
    care for family members?

-   Does the grantee provide at least one sample agreement detailing the
    responsibilities of the subcontracted network provider?

-   Does the applicant clearly describe how the proposed activities
    relate to the needs identified for their service area through the
    local and State-wide planning processes and how the activities will
    improve overall patient outcomes?

-   Does the applicant include information on the estimated percentage
    amount of the funds in the budget that will be directed towards
    services?

-   Does the applicant include at least 3 patient outcomes related to
    services that are consistent with the State plan?

-   Does the applicant provide precise information and evidence of the
    provision of primary medical care either directly or through
    contracts? **(This item accounts for 3 points of the total of 7
    points for this section)**

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-   ***Strategies to Recruit and Retain Women* (3 points)**

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-   Does the applicant clearly describe how the project will make HIV
    counseling and testing available to all women?

-   Does the applicant clearly describe how the project will link or
    provide medical services to all women who test positive for HIV?

-   Does the applicant clearly describe how the project will teach women
    about the drugs that can reduce HIV transmission including adherence
    treatment issues?

-   Does the applicant clearly describe how the project will coordinate
    prenatal, primary medical and pediatric care?

-   Does the applicant clearly describe how the project will provide
    pediatric care to their children?

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-   Does the applicant clearly describe how the project will work with
    AETC to teach providers on how to reduce perinatal transmission?

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-   ***Research* (2 points)**

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-   Does the applicant clearly describe how they will educate all
    patients and clients about research opportunities?

-   Does the applicant clearly describe how women, infants, children,
    and youth will be identified as appropriate participants in research
    projects?

-   Does the applicant provide clear information on the research
    opportunities available to clients/patients?

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-   ***Case Finding* (3 points)**

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-   Does the applicant clearly explain how the project identifies
    infected people from the target populations and brings them into
    care?

-   If the applicant is funding counseling and testing sites, does the
    applicant fully describe how they ensure linkage into care?

-   Does the applicant provide a clear description of how it locates
    clients lost to care and how they are reconnected to the care
    system?

-   Does the applicant describe how they advertise their services to
    other providers and to infected women, and youth?

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-   ***Consumer Involvement* (3 points)**

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-   Does the applicant describe in detail how consumers are involved in
    the planning, implementation, and evaluation of the project?

-   Does the applicant fully describe the kinds of things consumers do
    to be involved in the planning, implementation and evaluation of the
    project?

-   Does the applicant clearly describe the methods used to keep
    consumers informed and provide feedback on consumer suggestions?

-   Does the applicant fully describe barriers to consumer involvement
    and what they do to overcome those barriers?

-   Does the applicant clearly describe the types of consumer
    participation available to clients such as committees, advisory
    groups, panels, and boards?

-   Does the applicant fully describe how consumers are taught about
    their HIV disease and management, including who teaches them and how
    often?

> **Work Plan (15 Points)**

-   Do the goals of the proposed program address each of the Part D
    expectations?

-   Does the work plan include clearly written Problem Statements,
    Goals, Objectives and Key Action Steps?

-   Do the objectives relate to the provision of comprehensive
    coordinated HIV services for each of the targeted Part D
    populations?

-   Are the objectives time-framed and measurable?

-   Do the key action steps contribute directly to meeting each of the
    objectives?

-   Are evaluation methods included for each objective?

-   Does the applicant include the name of the person responsible and/or
    the name of the network providers involved in the accomplishment of
    the objective and associated key action steps?

-   Does the applicant include objectives that describe efforts to
    provide their clients with information regarding prevention of
    exposure to HIV/AIDS, hepatitis B and hepatitis C, clinical
    complications from co-infection, testing, clinical care and the
    availability of hepatitis B vaccine?

-   Does the applicant include objectives aimed at the provision of
    primary medical care either directly or through contracts? **(This
    item accounts for 5 points of the total of 15 points for this
    section)**

> *For New Applicants Only:*

-   Does the new applicant provide a complete description of how they
    will identify and notify the current grantee's clients of the
    availability of their new HIV services?

-   Does the new applicant provide a clear description of how they will
    assist clients in making new appointments?

-   Does the new applicant provide a full and complete timeline for
    accomplishing the enrollment of clients from the existing grantee
    into the new program?

> *For Current Grantees Which Receive MAI Funding [Only]{.underline}:*

-   Does the applicant include information on MAI-related activities?

-   Does the applicant clearly describe how they met their MAI goals?

-   Does the applicant clearly describe their plan to continue providing
    services with MAI funds?

> **Resolution of Challenges (2 Points)**

-   Did the applicant clearly describe challenges they expect to face in
    implementing the activities described in the work plan?

-   Did the applicant clearly describe how they propose to resolve the
    challenges described?

-   Did the applicant clearly describe challenges they have had in the
    provision of services to the target population and how they have
    addressed these challenges?

-   [If the applicant is a current grantee]{.underline}, do they
    describe site visit findings and changes that have taken place as a
    result of the findings?

> **Criterion 3: Resources/Capabilities (8 Points Total)**
>
> This item relates to the extent to which program personnel are
> qualified by training and/or experience to implement and carry out the
> programs. Also relates to the capabilities of the applicant
> organization, and quality and availability of facilities and personnel
> to fulfill the needs and requirements of the proposed project.
>
> This corresponds to the **Organizational Information** section of the
> Narrative and the **Staffing Plan.**
>
> **Organizational Information (4 Points)**

-   Does the applicant clearly and fully describe the experience they
    possess that will allow them to effectively perform the proposed
    activities?

-   Does the applicant clearly describe the staff's experience in
    providing culturally competent and linguistically appropriate care?

-   Does the applicant provide information on the agency's annual budget
    and Federal, state, and local funding they receive for their HIV
    program?

-   Does the applicant clearly describe the in-service training provided
    to staff and consumers?

-   Does the applicant include a clear organizational map?

-   Does the applicant include a full description of their fiscal and
    accounting systems?

-   If the applicant is proposing to replace an existing grantee, does
    the applicant demonstrate that they have the capability to serve at
    least the same clients as the grantee they are proposing to replace,
    that they will serve the exact same geographic service area, and
    that they have the capability to serve the target population in a
    comprehensive, culturally competent, family-centered, and
    linguistically appropriate manner?

-   ***For current grantees only***: Did the grantee provide a clear
    discussion of whether they met most of their objectives? If they did
    not meet all of their objectives, did the grantee provided a
    reasonable explanation for why it was unable to meet them.

> **Staffing Plan and Personnel Requirements (4 Points)**

-   Does the applicant identify a Project Coordinator?

-   Does the applicant provide position descriptions for key staff
    (i.e., Program Director/Coordinator, Medical Director, Research
    Coordinator/Educator, etc.) in the Attachments?

-   Does the applicant provide biographical sketches for key staff
    including those from subcontractor network partners that include
    education, experience and qualifications?

-   Does the proposal describe a clear staffing plan narrative
    justification consistent with the project description?

> **Criterion 4: Evaluative Measures (10 Points Total)**
>
> This item relates to the effectiveness of the method proposed to
> monitor and evaluate the project results. Evaluative measures must be
> able to assess to what extent the program objectives have been met and
> the quality of care provided. .
>
> This corresponds to the **Clinical Quality Management** (**CQM and
> MIS)** section and a portion of the **Evaluation** section of the
> Narrative.
>
> **Clinical Quality Management (6 Points)**

-   Does the application include a systematic Clinical quality
    management process with identified leadership, accountability and
    dedicated resources?

-   Does the applicant clearly define the quality indicators for medical
    care?

-   Does the applicant clearly define the quality indicators for support
    services?

-   Does the quality management plan fully describe how consumers will
    be involved in the CQM program?

-   Does the applicant fully discuss how quality indicators will be used
    to improve medical care or support services?

-   Does the applicant thoroughly describe the process used to improve
    the services/care provided beginning with the identification of a
    measure through the measurement findings?

```{=html}
<!-- -->
```
-   Does the applicant clearly describe their current management
    information system, and its capacity to track needed data?

> **Evaluation (4 Points)**

-   Does the applicant clearly describe their evaluation plan?

-   Does the plan clearly describe the evaluation methods to be used to
    measure how the program will meet its goals and objectives?

> **Criterion 5: Impact (5 Points Total)**
>
> This item relates to the extent and effectiveness of plans for
> dissemination of project results and/or the extent to which project
> results may be national in scope and/or degree to which the project
> activities are replicable, and/or the sustainability of the program
> beyond the Federal Funding.
>
> This corresponds to a portion of the **Evaluation** section of the
> Narrative.
>
> **Evaluation (5 Points)**

-   Does the applicant clearly describe how they will use the evaluation
    plan to help measure the impact of the project?

-   Does the applicant describe how evaluation will be used to inform
    others of their program and request additional funding?

> **Criterion 6: Support Requested (15 Points Total)**
>
> This criterion relates to how reasonable the proposed budget is in
> relation to the objectives, the complexity of the activities, number
> of patients, and the anticipated results.
>
> **Budget** and **Budget Justification** sections **(10 Points)**

-   Does the application include an SF 424A form with the correct
    program budget categories?

-   Does the application include a complete and clear line item budget
    and a budget justification with the correct program budget
    categories?

-   Does the budget list items that correspond to and are appropriate
    for the proposed activities?

-   Does the budget clearly lists staff with names where appropriate?

-   Does the budget justification clearly provide calculations for all
    categories?

-   Does the applicant include itemized subcontractor budgets for
    network providers?

-   Do the amounts on the SF 424A match those provided on the line-item
    budget?

-   Does the applicant adhere to the 10 percent cap for administrative
    expenses?

> **Provision of medical care (5 points)**

-   Does the applicant's budget clearly reflect the primary medical care
    services provided either directly or through contracts

-   For new applicants: Does the budget clearly reflect
    [how]{.underline} primary medical care is to be provided either
    directly or through contracts?

## 2. Review and Selection Process

> The Division of Independent Review is responsible for managing
> objective reviews within HRSA. Applications competing for Federal
> funds receive an objective and independent review performed by a
> committee of experts qualified by training and experience in
> particular fields or disciplines related to the program being
> reviewed. In selecting review committee members, other factors in
> addition to training and experience may be considered to improve the
> balance of the committee, e.g., geographic distribution. Each reviewer
> is screened to avoid conflicts of interest and is responsible for
> providing an objective, unbiased evaluation based on the review
> criteria noted above. The committee provides expert advice on the
> merits of each application to program officials responsible for final
> selections for award.
>
> Applications that pass the initial HRSA eligibility screening will be
> reviewed and rated by a panel based on the program elements and review
> criteria presented in relevant sections of this program announcement.
> The review criteria are designed to enable the review panel to assess
> the quality of a proposed project and determine the likelihood of its
> success.  The criteria are closely related to each other and are
> considered as a whole in judging the overall quality of an
> application.

## 3. Anticipated Announcement and Award Dates

> Awards are expected to be announced by August 1, 2008.

[]{#__RefHeading___Toc177183613 .anchor}

# VI. Award Administration Information

## 1. Award Notices

> Each applicant will receive written notification of the outcome of the
> objective review process, including a summary of the expert
> committee's assessment of the application's merits and weaknesses, and
> whether the application was selected for funding. Applicants who are
> selected for funding may be required to respond in a satisfactory
> manner to Conditions placed on their application before funding can
> proceed. Letters of notification do not provide authorization to begin
> performance.
>
> The Notice of Grant 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 August 1, 2008.

## 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 the purpose of award. This includes, as applicable,
> any requirements in Parts I and II of the HHS GPS that apply to the
> award, as well as any requirements of Part IV. 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).

**PUBLIC POLICY ISSUANCE**

[]{.mark}

**HEALTHY PEOPLE 2010**

> **Healthy People 2010** is a national initiative led by HHS that sets
> priorities for all HRSA programs. The initiative has two major goals:
> (1) To increase the quality and years of a healthy life; and (2)
> Eliminate our country's health disparities. The program consists of 28
> focus areas and 467 objectives. HRSA has actively participated in the
> work groups of all the focus areas, and is committed to the
> achievement of the Healthy People 2010 goals.
>
> Applicants must summarize the relationship of their programs and
> identify which of their programs objectives and/or sub-objectives
> relate to the goals of the Healthy People 2010 initiative.
>
> Copies of the Healthy People 2010 may be obtained from the
> Superintendent of Documents or downloaded at the Healthy People 2010
> website: [http://www.health.gov/healthypeople/document]{.underline}/.
>
> The 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.

[]{.mark}

## 3. Reporting

> The successful applicant under this guidance must comply with the
> following reporting and review activities:

a.  **Audit Requirements**

> Comply 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](http://www.whitehouse.gov/omb/circulars);

b.  **Payment Management Requirements**

> Submit 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 Management
>
> HHS/ASAM/PSC/FMS/DPM
>
> PO Box 6021
>
> Rockville, MD 20852
>
> Telephone: (877) 614-5533;

c)  **Status Reports**

> 1\. Submit an SF-269 **Financial Status Report**. A financial status
> report is required within 90 days of the end of each grant year. The
> report is an accounting of expenditures under the project that year.
> More specific information will be included in the award notice;

2\. Submit an **Annual Data Report**. Grantees are required to submit a
data report on or before March 15 each year; and

> 3\. Submit a **non-competing continuation application** on specified
> dates prior to the end of each budget period prior. The non-competing
> continuation application will include a progress report, budget for
> the upcoming budget period, and revised work plan.
>
> d\) **Performance Review**
>
> HRSA's Office of Performance Review (OPR) serves as the agency's focal
> point for reviewing and enhancing the performance of HRSA funded
> programs within communities and States. As part of this agency-wide
> effort, HRSA grantees will be required to participate in a performance
> review of their HRSA funded program(s) by an on-site review team from
> one of the ten OPR regional divisions. Grantees should expect to
> participate in a performance review at some point during their project
> period. When a grantee receives more than one HRSA grant, each of the
> grantee's HRSA funded programs will be reviewed during the same
> performance review.
>
> The purpose of performance review is to improve the performance of
> HRSA funded programs. Through systematic pre-site and on-site
> analysis, OPR works collaboratively with grantees and HRSA
> Bureaus/Offices 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. Upon completion of the performance review, grantees will
> be required to prepare an Action Plan that identifies key actions to
> improve program performance as well as addresses any identified
> program requirement issues. In addition, performance reviews also
> provide an opportunity for grantees to offer direct feedback to the
> agency about the impact of HRSA policies on program implementation and
> performance within communities and States.
>
> For additional information on performance reviews, please visit:
> <http://www.hrsa.gov/performancereview>.

#  VII. Agency Contacts

> Applicants may obtain additional information regarding business,
> administrative, or fiscal issues related to this grant announcement by
> contacting:
>
> Donna Marx
>
> Grants Management Specialist
>
> Health Services Branch
>
> HRSA, Division of Grants Management Operations
>
> Parklawn Building, Room 11A-02
>
> 5600 Fishers Lane
>
> Rockville, Maryland 20857
>
> Telephone: (301) 594-4245
>
> Fax: 301-594-6096
>
> dmarx@hrsa.gov

Additional information related to the overall program issues may be
obtained by contacting:

Ruth Roman

HRSA, HIV/AIDS Bureau

Division of Community Based Programs

Northeastern Regional Branch

Parklawn Building, Room 7A-30

5600 Fishers Lane

Rockville, MD 20857

Telephone: 301-443-0947

Fax: 301-594-1839

Email: rroman@hrsa.gov

# VIII. Tips for Writing a Strong Application

[]{.mark}

> **Include DUNS Number.** You must include a DUNS Number to have your
> application reviewed. Applications ***will not*** be reviewed without
> a DUNS number. To obtain a DUNS number, access
> [www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or call
> 1-866-705-5711. Please include the DUNS number in item 8c on the
> application face page.
>
> **Keep your audience in mind.** Reviewers will use only the
> information contained in the application to assess the application. Be
> sure the application and responses to the program requirements and
> expectations are complete and clearly written. Do not assume that
> reviewers are familiar with the applicant organization, service area,
> barriers to health care, or health care needs in your community. Keep
> the review criteria in mind when writing the application.
>
> **Start preparing the application early.** Allow plenty of time to
> gather required information from various sources.
>
> **Follow the instructions in this guidance carefully.** Place all
> information in the order requested in the guidance. Avoid the risk of
> having reviewers hunt through your application for information.
>
> **Be brief, concise, and clear.** Make your points understandable.
> Provide accurate and honest information, including candid accounts of
> problems and realistic plans to address them. If any required
> information or data is omitted, explain why. Make sure the information
> provided in each table, chart, attachment, etc., is consistent with
> the proposal narrative and information in other tables. Your budget
> should reflect back to the proposed activities, and all forms should
> be filled in accurately and completely.
>
> **Be organized and logical.** Many applications fail to receive a high
> score because the reviewers cannot follow the thought process of the
> applicant or because parts of the application do not fit together.
>
> **Be careful in the use of attachments.** Do not use the attachments
> for information that is required in the body of the application. Be
> sure to cross-reference all tables and attachments to the appropriate
> text in the application. Be sure to upload the attachments in the
> order indicated in the forms.
>
> **Carefully proofread the application.** Misspellings and grammatical
> errors will impede reviewers in understanding the application. Be sure
> that page limits are followed. Limit the use of abbreviations and
> acronyms, and define each one at its first use and periodically
> throughout application. Make sure you submit your application in final
> form, without markups.
>
> **Print out and carefully review an electronic application to ensure
> accuracy and completion.** When submitting electronically, print out
> the application before submitting it to ensure appropriate formatting
> and adherence to page limit requirements. **Check to ensure that all
> attachments are included in your electronic submission before sending
> the application forward.**
>
> **Ensure that all information is submitted at the same time. We will
> not consider additional information and/or materials submitted after
> your initial submission, nor will we accept e-mailed applications or
> supplemental materials once your application has been received.**

# APPENDIX A: HRSA's Electronic Submission User Guide

User Guide Table of Contents

> 1\. INTRODUCTION
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 1.1. DOCUMENT PURPOSE AND
> SCOPE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 1.2. DOCUMENT ORGANIZATION AND VERSION
> CONTROL\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 2\. NONCOMPETING CONTINUATION
> APPLICATION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.1. PROCESS
> OVERVIEW\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/) (IF NOT ALREADY
> REGISTERED)...................................................................................................\...\...\...\...\...
>
> 2.3. PROJECT DIRECTOR AND AUTHORIZING OFFICIAL NEED TO REGISTER WITH
> HRSA EHBS
>
> (IF NOT ALREADY REGISTERED)
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.4. APPLY THROUGH [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.4.1 Find Funding
> Opportunity\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.4.2 Download Application Package
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 2.4.3 Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.4.4 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.4.5 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.5. VERIFY IN HRSA ELECTRONIC HANDBOOKS
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.1 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 2.5.2 Manage Access to Your Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.3 Check Validation
> Errors\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.4 Fix Errors and Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 2.5.5 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 3\. COMPETING
> APPLICATION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 3.1. PROCESS
> OVERVIEW\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 3.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/) NOT ALREADY
> REGISTERED)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3. APPLY THROUGH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.1 Find Funding
> Opportunity\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.2 Download Application
> Package\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.3 Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 3.3.4 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 3.3.5 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4\. GENERAL INSTRUCTIONS FOR APPLICATION
> SUBMISSION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.1. NARRATIVE ATTACHMENT
> GUIDELINES\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.1.1
> Font\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.1.2 Paper Size and
> Margins\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 4.1.3
> Names\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 4.1.4 Section Headings
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 4.1.5 Page
> Numbering\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 4.1.6 Allowable Attachment or Document
> Types\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 4.2. APPLICATION CONTENT ORDER (TABLE OF
> CONTENTS)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 4.3. PAGE
> LIMIT\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 5.0 CUSTOMER SUPPORT INFORMATION
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 5.1.1 Grants.gov Customer
> Support\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 5.1.2 HRSA Call
> Center\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 5.1.3 HRSA Program
> Support\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 6.0
> FAQs\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.1.
> SOFTWARE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.1.1 What are the software requirements for using
> Grants.gov?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.1.2 Why can\'t I download PureEdge Viewer onto my
> machine?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What
> do I do if I use only a
> Macintosh?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> \...\...\...\...\...\...\.....
>
> 6.1.4 What are the software requirements for HRSA
> EHBs?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 6.1.5 What are the system requirements for using HRSA EHBs on a
> Macintosh computer?\...\...\...\...\...\...\....
>
> 6.2. APPLICATION RECEIPT
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...

6.2.1 What will be the receipt date\--the date the application is
stamped as received by Grants.gov

> or the date the data is received by HRSA?
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.2.2 When do I need to submit my application?
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.2.3 What emails can I expect once I submit my application? Is email
> reliable? \...\...\...\...\...\...\...\...\...\...\...\...\...
>
> 6.2.4 If a resubmission is required because of Grants.gov system
> problems, will these be
>
> considered
> \"late\"?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
>
> 6.3. APPLICATION
> SUBMISSION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....

6.3.1 How can I make sure that my electronic application is presented in
the right order for

> objective
> review?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
>
> 6.4 GRANT.GOV
> HELP\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....

# 1. Introduction

## 1.1 Document Purpose and Scope {#document-purpose-and-scope .unnumbered}

Major changes are coming to HRSA's Grant Application Process. For
guidances released/posted on or after January 1, 2006, HRSA will no
longer accept applications for grant opportunities on paper. Applicants
submitting new and competing continuations and a selected number of
noncompeting continuation applications will be required to submit
electronically through Grants.gov. All applicants must submit in this
manner unless the applicant is granted a written exemption from this
requirement in advance by the Director of HRSA's Division of Grants
Policy.

The purpose of this document is to provide detailed instructions to help
applicants and grantees submit applications electronically to HRSA
through Grants.gov. The document is intended to be the comprehensive
source of all information related to the new processes that HRSA and its
customers have to adopt and will be updated periodically. This document
is not meant to replace program guidance documents for funding
announcements.

## 1.2 Document Organization and Version Control {#document-organization-and-version-control .unnumbered}

This document contains 5 sections apart from the Introduction. Following
is the summary:

  ------------------------------ ----------------------------------------
  **Section**                    **Description**

  Noncompeting Continuation      Provides detailed instructions to
  Application                    existing HRSA grantees for applying
                                 electronically using Grants.gov for all
                                 noncompeting announcements

  Competing Application          Provides detailed instructions to
                                 applicant organizations for applying
                                 electronically using Grants.gov for all
                                 competing announcements

  General Instructions for       Provides instructions and important
  Application Submission         policy guidance on application format
                                 requirements

  Customer Support Information   Provides contact information to address
                                 technical and programmatic questions

  Frequently Asked Questions     Provides answers to frequently asked
  (FAQs)                         questions by various categories
  ------------------------------ ----------------------------------------

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

# 2. Noncompeting Continuation Application

## 2.1 Process Overview {#process-overview .unnumbered}

Following is the process for submitting a noncompeting continuation
application through Grants.gov:

1.  HRSA will communicate noncompeting announcement number to the
    project director (PD) and authorizing official (AO) via email. The
    announcement number will be required to search for the announcement
    in Grants.gov.

2.  Search for the announcement in Grants.gov Apply
    (<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 local 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 at Grants.gov until
    you receive a notification from Grants.gov that your application has
    been received by HRSA.

7.  HRSA Electronic Handbooks (EHBs) software pulls the application
    information into EHBs and validates the data against HRSA's business
    rules.

8.  HRSA notifies the project director, authorizing official, business
    official (BO) and application point of contact (POC) by email to
    check HRSA EHBs for results of HRSA validations and enter additional
    information, including in some cases performance measures, necessary
    to process the noncompeting continuation.

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

## 2.2 Grantee Organization Needs to Register With Grants.gov (if not already registered) -- See Appendix B {#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b .unnumbered}

Grants.gov requires a **one-time** registration by the applicant
organization. This is a three step process and should be completed by
any organization wishing to apply for grant. If you do not complete this
registration process you will not be able to submit an application. The
registration process will require some time (anywhere from 5 business
days to a month). Therefore, applicants or those considering applying at
some point in the future should register immediately. Registration with
Grants.gov provides the individuals from the organization the required
credentials in order to apply.

If an applicant organization has already completed Grants.gov
registration for another Federal agency, this section can be skipped.

For those applicant organizations still needing to register with
Grants.gov, registration information can be found on the Grants.gov Get
Started website (<http://www.grants.gov/GetStarted>). To be able to
successfully register in Grants.gov, it is necessary that you complete
all of the following required actions:

-   Obtain an organizational Data Universal Number System (DUNS) number

-   Register the organization with Central Contractor Registry (CCR)

-   Identify the organization's E-Business POC (Point of Contact)

-   Confirm the organization's CCR "Marketing Partner ID Number (M-PIN)"
    password

-   Register an Authorized Organization Representative (AOR)

```{=html}
<!-- -->
```
-   Obtain a username and password from the Grants.gov Credential
    Provider

-   Register the username and password with Grants.gov

-   Get authorized as an AOR by your organization

In addition, if an applicant does not have a Taxpayer Identification
Number (TIN) or Employer Identification Number (EIN), allow for extra
time. Beginning Oct. 30, 2005, the CCR also validates the EIN against
Internal Revenue Service records, a step that will take one to two
business days.

Please direct questions regarding Grants.gov registration to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

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

## 2.3 Project Director and Authorizing Official Need to Register with HRSA EHBs (if not already registered) {#project-director-and-authorizing-official-need-to-register-with-hrsa-ehbs-if-not-already-registered .unnumbered}

In order to access your noncompeting continuation application 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 for each
organization they represent.**

Registration within HRSA EHBs is a two-step process. In the first step,
individual users from an organization who participate in the grants
process such as applying for noncompeting continuations 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 already exist within 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 handy:

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.  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.

In order to access the noncompeting application, the project director
and other participants have to register the specific grant and add it to
their respective portfolios. This step is required to ensure that only
the authorized individuals from the organization have access to grant
data. **Project directors will need the last released 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
authorizing official and other individuals who will assist in the
noncompeting continuation application submission using the administer
feature in the grant handbook. The project director should also delegate
the "Administer Grant Users" privilege to the authorizing official.

Once you have access to your grant handbook, use the "Noncompeting
Continuations" link under the deliverables section to access your
noncompeting application.

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

For assistance in registering with HRSA EHBs, call 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>.

-   You must use your 10-digit grant number (box 4b from NGA) to
    identify your organization.

## 2.4 Apply through Grants.gov {#apply-through-grants.gov .unnumbered}

### 2.4.1 Find Funding Opportunity {#find-funding-opportunity .unnumbered}

Search for the announcement in Grants.gov **Apply**
(<http://www.grants.gov/Apply>).

Enter the announcement number communicated to you in the field *Funding
Opportunity Number*. (Example announcement number: 5-S45-06-001)

-   Noncompeting announcements are not available in Grants.gov FIND!

### 2.4.2 Download Application Package {#download-application-package .unnumbered}

Download the application package and instructions. In order to view
application package and instructions, you will also need to download and
install the PureEdge Viewer (<http://www.grants.gov/DownloadViewer>).
This small, free program will allow you to access, complete, and submit
applications electronically and securely.

-   Please review the system requirements for PureEdge Viewer on the
    Grants.gov website.

### 2.4.3 Complete Application {#complete-application .unnumbered}

Complete 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 local computer.

-   Ensure that you provide your 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)

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance.

-   You can complete the application offline -- you do not have to be
    connected to the Internet.

### 2.4.4 Submit Application {#submit-application .unnumbered}

The \"Submit\" button on the application package cover page will become
active after you have downloaded the application package, completed all
required forms, attached all required documents, and saved your
application package. Click on the \"Submit\" button once you have done
all these things and you 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 you wish to apply for. To submit, you
will be asked to Log into Grants.gov. 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. 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 Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

-   You must be connected to the Internet and must have a Grants.gov
    username and password to submit the application package.

### 2.4.5 Verify Status of Application {#verify-status-of-application .unnumbered}

Once Grants.gov has received your submission, Grants.gov will send email
messages to advise you of the progress of your application through the
system. Over the next 24 to 48 hours, you should receive two 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").

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the HRSA Call Center** at 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>. You may be asked to provide a copy of the
"Rejected with Errors" notification you received from Grants.gov.

You can check the status of your application(s) anytime after
submission, by logging into Grants.gov using the black \'Applicants\'
link at the top of any page, and clicking on the \'Check Application
Status\' link.

If there are no errors, the application will be downloaded by HRSA. On
successful download at HRSA, the status of the application will change
to "Received by Agency" and you will receive an additional email from
Grants.gov. Subsequently within two to three business days the status
will change to "Agency Tracking Number Assigned."

-   It is recommended that you check the status of your application in
    Grants.gov until the status is changed to "Agency Tracking Number
    Assigned".

## 2.5 Verify in HRSA Electronic Handbooks {#verify-in-hrsa-electronic-handbooks .unnumbered}

For assistance in registering with or using HRSA EHBs, call 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>.

-   Grant Project Director must be registered in HRSA EHBs and have
    access to the specific grant for which the noncompeting application
    is being submitted for further actions.

### 2.5.1 Verify Status of Application {#verify-status-of-application-1 .unnumbered}

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 and 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". Note the HRSA tracking number and use it for all
correspondence with HRSA. At this point, your application is ready for
review and submission in HRSA EHBs.

You should also receive an email from HRSA EHBs confirming the
successful receipt of your application at HRSA. The email is sent to the
project director, authorizing official, point of contact for the
application and the business official -- all from the submitted
application. The email is also sent to the current project director
listed on the NGA. Because email is not always reliable, please check
the HRSA EHBs or Grants.gov to see if the application is available for
review in HRSA EHBs.

-   Because email is not reliable, check HRSA EHBs within two to three
    business days from submission within Grants.gov for availability of
    your application.

### 2.5.2 Manage Access to Your Application {#manage-access-to-your-application .unnumbered}

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

The project director, using the Administer feature in the grant
handbook, must give the necessary privileges to the authorizing official
and other individuals who will assist in the submission of the
noncompeting continuation application. Project directors must also
delegate the "Administer Grant Users" privilege to the authorizing
official so that future administration can be managed by the authorizing
official.

Once you have access to your grant handbook, use the "Noncompeting
Continuations" link under the deliverables section to access your
noncompeting application.

### 2.5.3 Check Validation Errors {#check-validation-errors .unnumbered}

HRSA EHBs will apply HRSA's business rules to 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.

### 2.5.4 Fix Errors and Complete Application {#fix-errors-and-complete-application .unnumbered}

Applicants must review the errors in HRSA EHBs and make necessary
changes. Applicants must also complete the detailed budget and other
required forms in HRSA EHBs and assign an AO registered in HRSA EHBs to
the application. HRSA EHBs will show the status of each form in the
application package and all forms must be complete before submission.

### 2.5.5 Submit Application {#submit-application-1 .unnumbered}

To submit an application, you must have the 'Submit Noncompeting
Continuation' privilege. This privilege must be given by the project
director to the authorizing official or a designee. Once all forms are
complete, the application can be submitted to HRSA.

-   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.

# 3. Competing Application

## 3.1 Process Overview {#process-overview-1 .unnumbered}

Following is the process for submitting a competing application through
Grants.gov:

1\. HRSA will post all competing announcements on Grants.gov FIND
(<http://grants.gov/search/>). Announcements are typically posted at the
beginning of the fiscal year when HRSA releases its annual Preview,
although program guidances are generally not available until later. For
more information visit <http://www.hrsa.gov/grants>.

2\. When program guidance is available, search for the announcement in
Grants.gov Apply (<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 local 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 at Grants.gov until
you receive a notification from Grants.gov that your application has
been received by HRSA.

## 3.2 Grantee Organization Needs to Register With Grants.gov (if not already registered) -- See Appendix B {#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b-1 .unnumbered}

Grants.gov requires a **one-time** registration by the applicant
organization. This is a three step process and should be completed by
any organization wishing to apply for grant. If you do not complete this
registration process you will not be able to submit an application. The
registration process will require some time (anywhere from 5 business
days to a month). Therefore, applicants or those considering applying at
some point in the future should register immediately. Registration with
Grants.gov provides the individuals from the organization the required
credentials in order to apply.

If an applicant organization has already completed Grants.gov
registration for another Federal agency, this section can be skipped.

For those applicant organizations still needing to register with
Grants.gov, registration information can be found on the Grants.gov Get
Started website (<http://www.grants.gov/GetStarted>). To be able to
successfully register in Grants.gov, it is necessary that you complete
all of the following required actions:

-   Obtain an organizational Data Universal Number System (DUNS) number

-   Register the organization with Central Contractor Registry (CCR)

-   Identify the organization's E-Business POC (Point of Contact)

-   Confirm the organization's CCR "Marketing Partner ID Number (M-PIN)"
    password

-   Register an Authorized Organization Representative (AOR)

```{=html}
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```
-   Obtain a username and password from the Grants.gov Credential
    Provider

-   Register the username and password with Grants.gov

-   Get authorized as an AOR by your organization

In addition, if an applicant does not have a Taxpayer Identification
Number (TIN) or Employer Identification Number (EIN), allow for extra
time. Beginning Oct. 30, 2005, the CCR also validates the EIN against
Internal Revenue Service records, a step that will take one to two
business days.

Please direct questions regarding Grants.gov registration to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

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

## 3.3 Apply through Grants.gov {#apply-through-grants.gov-1 .unnumbered}

### 3.3.1 Find Funding Opportunity {#find-funding-opportunity-1 .unnumbered}

Search for announcements in Grants.gov **FIND**
(<http://grants.gov/search/>) and select the announcement that you wish
to apply for. Refer to the program guidance for eligibility criteria.

Please visit <http://www.hrsa.gov/grants> to read annual HRSA Preview.

-   All competing announcements should be available in Grants.gov FIND!
    When program guidance is release, announcements are made available
    in Grants.gov APPLY.

### 3.3.2 Download Application Package {#download-application-package-1 .unnumbered}

Download the application package and instructions. In order to view
application package and instructions, you will also need to download and
install the PureEdge Viewer (<http://www.grants.gov/DownloadViewer>).
This small, free program will allow you to access, complete, and submit
applications electronically and securely.

-   Please review the system requirements for PureEdge Viewer on the
    Grants.gov website.

### 3.3.3 Complete Application {#complete-application-1 .unnumbered}

Complete 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 local computer.

-   If you are applying for a competing continuation or a supplemental
    grant, ensure that you provide your 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)

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance.

-   You can complete the application offline -- you do not have to be
    connected to the Internet.

### 3.3.4 Submit Application {#submit-application-2 .unnumbered}

The \"Submit\" button on the application package cover page will become
active after you have downloaded the application package, completed all
required forms, attached all required documents, and saved your
application package. Click on the \"Submit\" button once you have done
all these things and you 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 you wish to apply for. To submit, you
will be asked to Log into Grants.gov. 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. 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 Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
excluding Federal holidays.

-   You must be connected to the Internet and must have a Grants.gov
    username and password to submit the application package.

### 3.3.5 Verify Status of Application {#verify-status-of-application-2 .unnumbered}

Once Grants.gov has received your submission, Grants.gov will send email
messages to advise you of the progress of your application through the
system. Over the next 24 to 48 hours, you should receive two 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").

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the Director of the Division of Grants Policy**
via email at <DGPClearances@hrsa.gov> and thoroughly explain the
situation; include a copy of the "Rejected with Errors" notification.

You can check the status of your application(s) anytime after
submission, by logging into Grants.gov using the black \'Applicants\'
link at the top of any page, and clicking on the \'Check Application
Status\' link.

If there are no errors, the application will be downloaded by HRSA. On
successful download at HRSA, the status of the application will change
to "Received by Agency" and you will receive an additional 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 the Grants.gov and the status of your application will be changed to
"Agency Tracking Number Assigned". Note the HRSA tracking number and use
it for all correspondence with HRSA.

-   It is recommended that you check the status of your application in
    Grants.gov until the status is changed to "Agency Tracking Number
    Assigned".

# 4. General Instructions for Application Submission

-   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 applications will not be given any
    consideration and the particular applicants will be notified.

## 4.1 Narrative Attachment Guidelines {#narrative-attachment-guidelines .unnumbered}

-   The following guidelines are applicable to both electronic and paper
    submissions (when allowed) unless otherwise noted.

### 4.1.1 Font  {#font .unnumbered}

Please use an easily readable serif typeface, such as Times Roman,
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.
Do not use colored, oversized or folded materials. For charts, graphs,
footnotes, and budget tables, applicants may use a different pitch or
size 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 include organizational brochures or other promotional
materials, slides, films, clips, etc. 

### 4.1.2 Paper Size and Margins {#paper-size-and-margins .unnumbered}

For 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.

### 4.1.3 Names {#names .unnumbered}

Please include the name of the applicant and 10-digit grant number (if
competing continuation, supplemental or noncompeting continuation) on
each page.

### 4.1.4 Section Headings {#section-headings .unnumbered}

Please put all section headings flush left in bold type.

### 4.1.5 Page Numbering {#page-numbering .unnumbered}

**Electronic Submissions**

For electronic submissions, applicants only have to number the
electronic attachment pages sequentially, resetting the numbering for
each attachment, i.e., start at page 1 for each attachment.

Do not number the standard OMB approved form pages.

**Paper Submissions (When allowed)**

Do 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.)

### 4.1.6 Allowable Attachment or Document Types {#allowable-attachment-or-document-types .unnumbered}

**Electronic Submissions**

The following attachment types are supported in HRSA EHBs. Even though
grants.gov may allow you to upload any type of attachment, it is
important to note that HRSA only accepts the following types of
attachments:

.DOC - Microsoft Word

.RTF - Rich Text Format

.TXT - Text

.WPD - Word Perfect Document

.PDF - Adobe Portable Document Format

.XLS - Microsoft Excel

## 4.2 Application Content Order (Table of Contents) {#application-content-order-table-of-contents .unnumbered}

When applications were submitted in paper, it was easy to direct the
applicants to prepare a table of contents and make it as a part of the
application. Applicants did not have any problem in preparing the
package that included standard forms as well as attachments. All the
pages were numbered sequentially. Preparation instructions were given in
the program guidance. With the transition to electronic application
receipt, this process has changed significantly. HRSA is using an
approach that will ensure that regardless of the mode of submission
(electronic or paper when exemptions are granted), all applications will
look the same when printed for objective review.

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 (programs previously
using the 398 or the 6025 and 2590 application packages)

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

If you are applying on paper (when allowed), you must use the program
guidance for the order of the forms and all other applicable guidelines.

## 4.3 Page Limit {#page-limit .unnumbered}

HRSA prints your application for review regardless of whether it is
submitted electronically or by paper (when allowed).

When your application is printed, the narrative documents may not exceed
80 pages in length unless otherwise stated in the program guidance.
These narrative documents include the abstract, project and budget
narratives, and any other attachments such as appendices, 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 guidances 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.

-   Applications, whether submitted electronically or on paper, 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.
    Non-compliant noncompeting applications will have to be resubmitted
    to comply with the page limits.

# 5. Customer Support Information

### 5.1.1 Grants.gov Customer Support {#grants.gov-customer-support .unnumbered}

Please direct ALL questions regarding Grants.gov to Grants.gov Contact
Center at Tel.: 1-800-518-4726. Contact Center hours of operation are
Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time, excluding
Federal holidays.

Please visit the following support URL for additional material on
Grants.gov website.

<http://www.grants.gov/CustomerSupport>

### 5.1.2 HRSA Call Center {#hrsa-call-center .unnumbered}

For assistance with or using HRSA EHBs, call 877-GO4-HRSA (877-464-4772)
between 9:00 am to 5:30 pm 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'

### 5.1.3 HRSA Program Support {#hrsa-program-support .unnumbered}

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.

# 6. FAQs

## 6.1 Software {#software .unnumbered}

### 6.1.1 What are the software requirements for using Grants.gov? {#what-are-the-software-requirements-for-using-grants.gov .unnumbered}

Applicants will need to download the PureEdge viewer. Grants.gov website
provides the following information:

**System Requirements:**

For PureEdge Viewer to function properly, your computer must meet the
following system requirements:

Windows 98, ME, NT 4.0, 2000, XP\
500 Mhz processor\
128 MB of RAM\
40 MB disk space\
Web browser: Internet Explorer 5.01 or higher, Netscape Communicator
4.5 - 4.8, Netscape 6.1, 6.2, or 7

If you do not have a Windows operating system, you will need to use a
Windows Emulation program.

Please visit <http://www.grants.gov/DownloadViewer> for all details and
any updates.

### 6.1.2 Why can't I download PureEdge Viewer onto my machine? {#why-cant-i-download-pureedge-viewer-onto-my-machine .unnumbered}

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.

### 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What do I do if I use only a Macintosh? {#i-have-heard-that-grants.gov-is-not-macintosh-compatible.-what-do-i-do-if-i-use-only-a-macintosh .unnumbered}

Grants.gov is aware of the issues facing Macintosh users who apply for
Federal grants electronically. Grants.gov has provided the following
response regarding this issue on its website at
<http://www.grants.gov/MacSupport>:

> *Grants.gov recognizes that support to users of Non-Windows operating
> systems and the PureEdge Viewer is often required across a distinct
> segment of the grant applicant community. Although at this time, the
> PureEdge Viewer is only available for Windows based installs,
> Grants.gov offers support for Non-Windows platforms.*
>
> *Grants.gov is working with PureEdge in the development of a
> Non-Windows compatible viewer. PureEdge has committed to providing a
> platform independent viewer by November 2006. Information related to
> the Non-Windows compatible viewer will be posted to this webpage
> (http://www.grants.gov/MacSupport). Please bookmark this page and
> return at your convenience for more details.*

Grants.gov and NIH have partnered to provide free access to Citrix
servers for Macintosh Users who are looking for an alternative to using
PC emulation software with the PureEdge forms. A Citrix server
connection allows Macintosh users to remotely launch a Windows session
on their own machines by using the free Citrix client application.
Applicants will need to download and install the free Citrix client
application in order to work. This service is now available for use.

Grants.gov website states:

> *Beginning December 20, 2005, non-Windows users will be able to
> download and complete the PureEdge forms by taking advantage of the
> free Citrix server. Non-Windows users are also able to submit
> completed grant applications via the Citrix environment.*

For details, please visit <http://www.grants.gov/MacSupport>

### 6.1.4 What are the software requirements for HRSA EHBs? {#what-are-the-software-requirements-for-hrsa-ehbs .unnumbered}

HRSA EHBs can be accessed over the Internet using Internet Explorer (IE)
v5.0 and above and Netscape 4.72 and above. HRSA EHBs are 508 compliant.

IE 6.0 and above is the recommended browser.

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
appropriate viewers.

### 6.1.5 What are the system requirements for using HRSA EHBs on a Macintosh computer?  {#what-are-the-system-requirements-for-using-hrsa-ehbs-on-a-macintosh-computer .unnumbered}

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.

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

## 6.2 Application Receipt {#application-receipt .unnumbered}

### 6.2.1 What will be the receipt date\--the date the application is stamped as received by Grants.gov or the date the data is received by HRSA? {#what-will-be-the-receipt-date--the-date-the-application-is-stamped-as-received-by-grants.gov-or-the-date-the-data-is-received-by-hrsa .unnumbered}

**Competing Submissions:**

The submission/receipt date will be the date the application is received
by Grants.gov.

**Noncompeting Submissions:**

The submission/receipt date will be the date the application is
submitted in HRSA EHBs.

### 6.2.2 When do I need to submit my application? {#when-do-i-need-to-submit-my-application .unnumbered}

**Competing Submissions:**

Applications must be submitted to Grants.gov by 8 PM ET on the due date.

**Noncompeting Submissions:**

Applications must be submitted to Grants.gov by 8 PM ET on the due date.

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

### 6.2.3 What emails can I expect once I submit my application? Is email reliable? {#what-emails-can-i-expect-once-i-submit-my-application-is-email-reliable .unnumbered}

**Competing Submissions:**

When you submit your noncompeting application in Grants.gov, it is first
received and validated by Grants.gov. Typically, this takes a few hours
but it may take up to 48 hours during peak volumes. You should receive
two 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").

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 another email from Grants.gov.

Because email is not reliable, you must check the respective systems if
you do not receive any emails within the specified timeframes.

**Noncompeting Submissions:**

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

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 another email from Grants.gov.

Subsequently, it is processed by HRSA to ensure that the application is
submitted for the correct funding announcement, with the correct grant
number and grantee organization. This may take up to 3 business days. At
this point you will 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.

Because email is not reliable, you must check the respective systems if
you do not receive any emails within the specified timeframes.

-   For more information refer to sections 2.4 and 2.5 in this guide

### 6.2.4 If a resubmission is required because of Grants.gov system problems, will these be considered \"late\"? {#if-a-resubmission-is-required-because-of-grants.gov-system-problems-will-these-be-considered-late .unnumbered}

**Competing Submissions:**

No. But you must **contact the Director of the Division of Grants
Policy** via email at <DGPClearances@hrsa.gov> and thoroughly explain
the situation. Include a copy of the "Rejected with Errors" notification
you received from Grants.gov.

**Noncompeting Submissions:**

No. But you must **contact the HRSA Call Center** at 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>. You may be asked to provide a copy of the
"Rejected with Errors" notification you received from Grants.gov.

## 6.3 Application Submission {#application-submission .unnumbered}

### 6.3.1 How can I make sure that my electronic application is presented in the right order for objective review? {#how-can-i-make-sure-that-my-electronic-application-is-presented-in-the-right-order-for-objective-review .unnumbered}

Follow the instructions provided in section 4.2 to ensure that your
application is presented in the right order and is compliant with all
the requirements.

## 6.4 Grants.gov {#grants.gov .unnumbered}

For a list of frequently asked questions and answers maintained by
Grants.gov please visit the following URL:

<http://www.grants.gov/GrantsGov_UST_Grantee/!SSL!/WebHelp/GrantsGov_UST_Grantee.htm#index.html>

# Appendix B -- Registering and Applying Through Grants.gov

**Prepare to Apply through Grants.gov:**

HRSA, in providing the grant community a single site to Find and Apply
for grant funding opportunities, is [requiring]{.underline} applicants
for this funding opportunity to apply electronically through Grants.gov.
By using Grants.gov you will be able to download a copy of the
application package, complete it off-line, and then upload and submit
the application via the Grants.gov site. You may [not]{.underline}
e-mail an electronic copy of a grant application to us.

Please understand that we will not consider additional information
and/or materials submitted after your initial application. You must
therefore ensure that all materials are submitted together.

Note: Except in rare cases, paper applications will NOT be accepted for
this grant opportunity. If you believe you are technologically unable to
submit an on-line application you MUST contact the Director of the
Division of Grants Policy, at <DGPWaivers@hrsa.gov> and explain why you
are technologically unable to submit on-line. Make sure you specify the
announcement number you are requesting relief for. HRSA and its Grants
Application Center (GAC) will only accept paper applications from
applicants that received prior written approval.

In order to apply through Grants.gov the Applicant must register with
Grants.gov. This is a three step process that must be completed by any
organization wishing to apply for a grant opportunity. The registration
process will require some time. Therefore, applicants or those
considering applying at some point in the future should register
**[immediately]{.underline}**. Registration in Grants.gov does not
require the organization to apply for a grant; it simply provides the
organization the required credentials so that the organization may apply
for a grant in the future. Registration is required only once.

**[REGISTRATION:]{.underline}**

GET STARTED NOW AND COMPLETE THE ONE-TIME REGISTRATION PROCESS TO BEGIN
SUBMITTING GRANT APPLICATIONS AS SOON AS YOU READ THIS.

You don't need to be registered to search or to begin selecting,
downloading and completing grant applications. Registration is required
to submit applications. Therefore, it is essential that your
organization be registered prior to attempting to submit a grant
application or your organization will not be able to do so. **Be sure to
complete the process early as the registration process may take some
time (anywhere from 5 days to 1 month).**

**There are three steps to the registration process:**

Step 1: Register your organization

Step 2: Register yourself as an Authorized Organization Representative

Step 3: Get authorized by your organization to submit grants

These instructions will walk you through the three basic registration
steps. Additional assistance is available at Grants.gov at
[www.grants.gov](../www.grants.gov). Individual assistance is available
at [http://www.grants.gov/Support](http://www.grants.gov/Support  ) or
1-800-518-4726. Grants.gov also provides a variety of support options
through online Help including Context-Sensitive Help, Online Tutorials,
FAQs, Training Demonstration, User Guide, and Quick Reference Guides.

Follow this checklist to complete your registration---

1\. Register Your Organization

\- Obtain your organization's Data Universal Number System (DUNS) number

\- Register your organization with Central Contractor Registry (CCR)

\- Identify your organization's E-Business POC (Point of Contact)

\- Confirm your organization's CCR "Marketing Partner ID Number (M-PIN)"
password

2\. Register Yourself as an Authorized Organization Representative (AOR)

\- Obtain your username and password

\- Register your username and password with Grants.gov

3\. Get Yourself Authorized as an AOR

\- Contact your E-Business POC to ensure your AOR status

\- Log in to Grants.gov to check your AOR status

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 is at
http://www.grants.gov/GetStarted. Applicants should read the Get Started
steps carefully. The site also contains registration checklists to help
you walk through the process. HRSA recommends that you download the
checklists and prepare the information requested before beginning the
registration process. Reviewing information required and assembling it
before beginning the registration process will save you time and make
the process faster and smoother.

**REGISTER YOUR ORGANIZATION**

Before you can apply for a grant via Grants.gov, your organization must
obtain a Data Universal Number System (DUNS) number and register early
with the Central Contractor Registry (CCR).

**Obtain your organization's DUNS number**

A 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.

\-**How do you do it**? If your organization does not have a DUNS
number, call the special Dun & Bradstreet hotline at 1-866-705-5711 to
receive one free of charge.

\- **How long will this take?** You will receive a DUNS number at the
conclusion of the phone call.

**Register your organization with CCR**

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 website. If your organization is not
already registered, identify the primary contact who should register
your organization.

When your organization registers with CCR, it will be required to
designate an E-Business Point of Contact (E-Business POC). The designee
authorizes individuals to submit grant applications on behalf of the
organization and creates a special password called a Marketing Partner
ID Number (M-PIN) to verify individuals authorized to submit grant
applications for the organization.

\-**How do you do it?** Visit the CCR website at http://www.ccr.gov.
Check whether your organization is already registered or register your
organization right online. Be certain to enter an MPIN number during
this process as this is an optional field for the CCR registration but
mandatory for Grants.gov.

\- **How long will this take?** It may take a few days for you to
collect the information needed for your organization's registration, but
once you finish the registration process, you can move on to Step 2 the
very next business day. Note it will take up to a month for the total
registration- therefore this should be done as soon as possible.

**GET AUTHORIZED as an AOR by Your Organization**

The registration process is almost complete. All that remains is the
final step ---getting authorized. Even though you have registered, your
E-Business POC must authorize you so Grants.gov will know that you are
verified to submit applications.

\- **Obtain your E-Business POC authorization**

After your Authorized Organizational Representative (AOR) profile is
completed, your organization's E-Business POC will receive an email
regarding your requested AOR registration, with links and instructions
to authorize you as an AOR.

\- **How do you do it?** Instruct your E-Business POC to login to
Grants.gov at http://www.grants.gov/ForEbiz and enter your
organization's DUNS number and M-PIN. They will select you as an AOR
they wish to authorize and you will be verified to submit grant
applications.

\- **How long will this take?** It depends on how long it takes your
E-Business POC to log in and authorize your AOR status. You can check
your AOR status by logging in to Grants.gov at
http://www.grants.gov/ForApplicants.

**REGISTER YOURSELF as an Authorized Organization Representative (AOR)**

Once the CCR Registration is complete, your organization is finished
registering. You must now register yourself with Grants.gov and
establish yourself as an AOR, an individual authorized to submit grant
applications on behalf of your organization. There are two elements
required to complete this step --- both must be completed to move onto
Step 3.

1\. **Obtain your username and password**

In order to safeguard the security of your electronic information, and
to submit a Federal grant application via Grants.gov, you must first
obtain a username and password from the Grants.gov Credential Provider.

\- **How do you do it**? Just register with Grants.gov's Credential
Provider at http://www.grants.gov/Register1. You will need to enter your
organization's DUNS number to access the registration form. Once you
complete the registration form you will be given your username and you
will create your own password.

\- **How long will this take?** Same day. When you submit your
information you will receive your username and be able to create your
password.

**2. Register with Grants.gov**

Now that you have your username and password, allow about 30 minutes for
your data to transfer from the Credential Provider, then you must
register with Grants.gov to set up a short profile.

\> **How do you do it?** Simply visit http://www.grants.gov/Register2 to
register your username and password and set up your profile. Remember,
you will only be authorized for the DUNS number which you register in
your Grants.gov profile.

\> **How long will this take?** Same day. Your AOR profile will be
complete after you finish filling in the profile information and save
the information at Grants.gov.

You have now completed the registration process for Grants.gov. If you
are applying for a [new or competing continuation]{.underline} you may
find the application package through Grants.gov FIND. If you are filling
out a [non-competing continuation]{.underline} application you must
obtain the announcement number through your program office, and enter
this announcement number in the search field to pull up the application
form and related program guidance. Download the required forms and enter
your current grant number in the

appropriate field to begin the non-competing continuation application
which you will then upload for electronic submittal through Grants.gov.
For continuation applications which require submittal of performance
measures electronically, instructions are provided in the program
guidance on how to enter the HRSA electronic handbooks to provide this
information.

**How to submit an electronic application to HRSA via Grants.gov/Apply**

a\. [Applying using Grants.gov.]{.underline} Grants.gov has a full set
of instructions on how to apply for funds on its website at
<http://www.grants.gov/CompleteApplication>. The following provides
simple guidance on what you will find on the Grants.gov/Apply site.
Applicants are encouraged to read through the page entitled, "Complete
Application Package" before getting started. See Appendix A for specific
information.

b\. [Customer Support]{.underline}. The grants.gov website provides
customer support via (800) 518-GRANTS (this is a toll-free number) or
through e-mail at support@grants.gov. The customer support center is
open from 7:00 a.m. to 9:00 p.m. Eastern time, Monday through Friday,
except federal holidays, to address grants.gov technology issues. For
technical assistance to program related questions, contact the number
listed in the Program Section of the program you are applying for.

**Timely Receipt Requirements and Proof of Timely Submission**

a\. Electronic Submission. All applications must be received by
www.grants.gov/Apply by 8:00 P.M. Eastern Time on the due date
established for each program.

Proof of timely submission is automatically recorded by Grants.gov. An
electronic time stamp is generated within the system when the
application is successfully received by Grants.gov. The applicant will
receive an acknowledgement of receipt and a tracking number from
Grants.gov with the successful transmission of their application.
Applicants should print this receipt and save it, along with facsimile
receipts for information provided by facsimile, as proof of timely
submission. When HRSA successfully retrieves the application from
Grants.gov, Grants.gov will provide an electronic acknowledgment of
receipt to the e-mail address of the AOR. Proof of timely submission
shall be the date and time that Grants.gov receives your application.

Applications received by grants.gov, after the established due date and
time for the program, will be considered late and will not be considered
for funding by HRSA. HRSA suggests that applicants submit their
applications during the operating hours of the Grants.gov Support Desk,
so that if there are questions concerning transmission, operators will
be available to walk you through the process. Submitting your
application during the Support Desk hours will also ensure that you have
sufficient time for the application to complete its transmission prior
to the application deadline. Applicants using dial-up connections should
be aware that transmission should take some time before Grants.gov
receives it. Grants.gov will provide either an error or a successfully
received transmission message. The Grants.gov Support desk reports that
some applicants abort the transmission because they think that nothing
is occurring during the transmission process. Please be patient and give
the system time to process the application. Uploading and transmitting
many files, particularly electronic forms with associated XML schemas,
will take some time to be processed.

Note the following additional information regarding submission of all
HRSA applications through Grants.gov:

• You must submit all documents electronically, including all
information typically included on the SF424 and all necessary assurances
and certifications.

• Your application must comply with any page limitation requirements
described in this program announcement.

• After you electronically submit your application, you will receive an
automatic acknowledgement from Grants.gov that contains a Grants.gov
tracking number. HRSA will retrieve your application from Grants.gov.

**Formal Submission of the Electronic Application**

Applications completed online are considered formally submitted when the
Authorizing Official electronically submits the application to HRSA
through Grants.gov.

Competitive applications will be considered as having met the deadline
if the application has been successfully transmitted electronically by
your organization's Authorizing Official through Grants.gov on or before
the deadline date and time.

**Performance Measures for 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.

**Performance Measures for Non-Competing Continuation Applications**

For applications which 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 e-mail, notifying grantees of their responsibility to provide this
information, and providing instructions on how to do so.

ATTACHMENTS FORM

Use this form to add files/attachments required in the program guidance
whose location has not been specified elsewhere in the application
package. Use the first line item to attach the file with information on
your organization's Business Official. Name this file BUSINESS OFFICIAL
INFORMATION. Attach other files as required in the program guidance.

# APPENDIX C\--Service Areas

These service areas are up for competition for August 1, 2008. New
proposals to replace existing grantees are expected to cover the same
service area of the existing grantee. Each grantee's service area is
listed separately.

  ---------------- -------------- -------------- ---------------------------------
  **Organization   **City**       **State**      **Geographic Service Area**
  Name**                                         

  UNIVERSITY OF    Birmingham     Alabama        Autauga County. Cleburne, Etowah,
  ALABAMA AT                                     Lee, Pike, Barbour, Coffee,
  BIRMINGHAM                                     Fayette, Limestone, Randolph,
                                                 Bibb, Colbert, Franklin, Lowndes,
                                                 Russell, Blount, Conecuh, Geneva,
                                                 Macon, St. Clair, Bullock Coosa,
                                                 Greene, Madison, Shelby, Butler,
                                                 Covington, Hale, Marengo, Sumter,
                                                 Calhoun, Crenshaw, Henry, Marion,
                                                 Talladega, Chambers, Cullman,
                                                 Houston, Marshall, Tallapoosa,
                                                 Cherokee, Dale, Jackson, Monroe,
                                                 Tuscaloosa, Chilton, Dallas,
                                                 Jefferson, Montgomery, Walker,
                                                 Choctaw, Dekalb, Lamar, Morgan,
                                                 Washington, Clarke, Elmore,
                                                 Lauderdale, Perry Wilcox, Clay,
                                                 Escambia, Lawrence, Pickens,
                                                 Winston

  MARICOPA         Phoenix        Arizona        Maricopa, Pima
  INTEGRATED                                     
  HEALTH SYSTEMS                                 

  JEFFERSON        Pine Bluff     Arkansas       Chicot, Drew, Lincoln, Prairie,
  COMPREHENSIVE                                  Ashley, Desha, Jefferson, Lonoke,
  CARE SYSTEM                                    Pulaski

  REGENTS OF       La Jolla       California     San Diego
  UNIVERSITY OF                                  
  CALIFORNIA                                     

  FRESNO COMMUNITY Fresno         California     Fresno, Kern, Kings, Tulare
  HOSPITAL &                                     
  MEDICAL CENTER                                 

  CONNECTICUT      Hartford       Connecticut    Fairfield, Hartford, New Haven
  PRIMARY CARE                                   
  ASSOCIATION,                                   
  INC.                                           

  CHILDREN\'S      Washington DC  District of    Washington DC Metro Area
  NATIONAL MEDICAL                Columbia       
  CENTER                                         

  Orlando Regional Orlando        Florida        Brevard, Orange, Osceola, St.
  Healthcare                                     Lucie, Seminole
  System, Inc.                                   

  WARE COUNTY      Waycross       Georgia        Appling, Bulloch, Clinch, Jeff
  HEALTH                                         Davis, Toombs, Atkinson, Candler,
  DEPARTMENT                                     Coffee, Pierce, Ware, bacon,
                                                 Charlton, Evans, Tattnall, Wayne,
                                                 Brantley

  University of    Louisvillle    Kentucky       Jefferson, Bullitt, Henry,
  Louisville                                     Oldham, Shelby, Spencer and
  Research                                       Trimble Counties 
  Foundation                                     

  MARYLAND STATE   Baltimore      Maryland       State of Maryland
  DEPARTMENT                                     
  ---------------- -------------- -------------- ---------------------------------

#  

  ----------------- --------------- --------------- ------------------------------
  MICHIGAN          Lansing         Michigan        Macomb, Monroe, Oakland, St.
  DEPARTMENT OF                                     Clair, Wayne
  COMMUNITY HEALTH                                  

  TRUSTEES OF       Hanover         New Hampshire   State of New Hampshire, State
  DARTMOUTH                                         of Vermont
  COLLEGE                                           

  The Research      Stony Brook     New York        Suffolk
  Foundation of                                     
  SUNY                                              

  Elmhurst Hospital Elmhurst        New York        Borough of Queens
  Center/NYC Health                                 
  & Hospital Corp.                                  

  Dominican Sisters Ossining        New York        Borough of The Bronx, Borough
  Family Health                                     of Manhattan/New York
  Service                                           

  New York          New York        New York        Borough of Manhattan/New York,
  University School                                 Borough of Staten
  of Medicine                                       Island/Richmond

  Western NC Comm.  Asheville       North Carolina  Avery, Haywood, McDowell,
  Health Services,                                  Mitchell, Rutherford,
  Inc.                                              Buncombe, Henderson, Madison,
                                                    Polk, Yancey, Transylvania
                                                    County

  Metrolina AIDS    Charlotte       North Carolina  Anson, Forsyth, Iredell,
  Project, Inc.                                     Mecklenburg, Stanly, Cabarrus,
                                                    Gaston, Lincoln, Rowan, Union,
                                                    Cleveland

  FAMILY PLANNING   Philadelphia    Pennsylvania    Philadelphia
  COUNCIL                                           
  SOUTHEASTERN PA                                   

  COMPREHENSIVE     Nashville       Tennessee       Davidson county
  CARE CENTER                                       

  UNIVERSITY OF     San Antonio     Texas           Antascosa, Frio, Jim Wells,
  TEXAS HEALTH SCI                                  Matagorda, Uvalde, Bandera,
  CTR                                               Gillespie, Kendall, Maverick,
                                                    Val Verde, Bexar, Goliad,
                                                    Kenedy, Medina, Victoria,
                                                    Brooks, Gonzales, Kerr,
                                                    Nueces, Webb, Calhoun,
                                                    Guadalupe, Kinney, Real,
                                                    Willacy, Cameron, Hidalgo, La
                                                    Salle, Refugio, Zapata,
                                                    Dimmit, Jim Hogg, Live Oak,
                                                    Travis, Zavala, Edwards,
                                                    Laredo

  VIRGIN ISLANDS    St. Thomas      Virgin Islands   Virgin Islands
  DEPARTMENT OF                                     
  HEALTH                                            
  ----------------- --------------- --------------- ------------------------------

# APPENDIX D \--Coordinator Position Description 

[Position Overview]{.underline}

Manage, 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 Functions]{.underline}

Serve 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.

[Requirements]{.underline}

A 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.

# Appendix E- Part D Agreement

**Ryan White HIV/AIDS Program of 2006 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 which 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 Modernization Act
of 2006, P.L. 109-415, 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**)]{.underline} to gain full knowledge of
its contents.

Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_