Fiscal Year (FY) 2016Part a Funding Opportunity Announcement (FOA)

Fiscal Year (FY) 2016Part A Funding Opportunity Announcement (FOA)

Questions Answers

Below is a list of questions received prior to and during the FY 2016 FOA Webinar. The list is arranged alphabetically by topic (except Misc. which is at the end).

Data/RSR

1. Is HRSA/HAB releasing the 2014 summary client-level data and the 2014 State Profiles for grantees before the application due data?

A: The 2014 summary client level dataand the 2014State Profiles will not be released in time for you to use for your application. The calendar year 2014 client level data is still in the process of being cleaned and aggregatedfor analysis and distribution.

1. How do we get unduplicated TGA-wide clientoutcome measure datafrom the RSR?

A: Outcome data is required as part of the client level report under the RSR for certain types of service providers.If this data is available to you, use it to develop TGA-wide client outcomes for your jurisdiction. If not, then use the data that you have, explain what it represents, and state why you may not be able to get total unduplicated data for your jurisdiction.

1. What specific reports can the RSR pull its data to generate reports which align with HAB Core Measures/Care Continuum?

A: For this question, any jurisdiction that wants to explore this would be best to explore this through their Project Officer in the Division of Metropolitan HIV/AIDS Services who can work with the HIV/AIDS Bureau’s Division of Data and Policy.

1. Throughout the guidance it states that applicants must provide data and reference citations. If we include a Reference List as an attachment will this count toward the page limit?

A: Yes, a reference list will count toward your page limit.

Early Identification of Individuals with HIV/AIDS (EIIHA)

1. Section 2b of EIIHA: which version of NHAS should be referenced? The new or old?

A: You can use either one. Use the version that corresponds to your planning activities at the time that they took place.

1. Do we need 3 target populations for the FY16 EIIHA plan? Can we have fewer target populations?

A: The FOA states that you are required to have three target populations.

1. On page 14, (2) EIIHA Plan, a) 2nd bullet, could you please provide more detail on what you mean by "all populations"? Do you mean that we should list them and describe why they are included in the EIIHA plan?

A: The populations to be addressed in your EIIHA plan should be listed and described.

1. In the EIIHA section (pg. 11), the instructions state to "select three (3) target populations in the previously submitted FY 2015 EIIHA Plan. For the selected three target populations, provide the following data for January 1, 2015 – June 30, 2015." Does the data have to be only for the specified six-month period or can it cover an entire year (July 1, 2014- June 30, 2015)?

A: The data should be, at a minimum, for the specified six months. Please label and define all data submissions for clarity.

Emerging Populations

1. Q. If we have no new/emerging populations (that have not already been mentioned) to be discussed, can we skip that question?

A:Since you don’t have new or emerging populations that your jurisdiction will focus on,provide a brief narrative to explain why. Explain your last year’semerging populations, that they are not new, and that there are no additional challenges with the same population.The FOA does say if applicable. We will be giving instructions to the reviewers around that issue, and we willmake it clear with reviewers that this is “if applicable”.

HIV Care Continuum

1. Is the Care Continuum to be for the entire HIV+ population in our jurisdiction OR for ONLY the RYAN WHITE population in our jurisdiction?

A: Either is fine, and we understand that jurisdictions are in different places in regards to availability and utilization of data and ability to analyze existing data. As long as you present the picture that describes your population and tell us what that population is, that is fine. So it can be either.

1. The definitions in HAB core indicators don't always line up with the definitions in the HIV Continuum of Care. Example-HAB maintained is different than COC retained. Which should we use? Also, do you want us to use surveillance data to calculate unmet need? Thank you.

A: Whatever works best for your jurisdiction is what we’d like you to use. Just be sure to provide the reviewerswith an explanation of why used that particular performance measure, that indicator, that data set.Be consistent, and provide a thorough explanation.

1. The retained in care bar is going to be smaller than the number of people on ARVS because lots of physicians are only seeing VLS once a year.

A: We understand where individuals are doing well, they are self-managing their disease, and therefore, are seen less frequently, even though they continue to be in great health and are virally suppressed. So we agree that the retained in care bar according to the definition may be smaller than the number of people on ARVs.

1. The project abstract requires more information, is it still one page length?

A: In the project abstract, the FOA did ask for two additional bullets. If you need to go past a page to a page and a half, that would be fine.But again remember, an abstract should give a quick snapshot about your jurisdiction.

Review Criteria

1. Three points are cited for Recipient & Sub-recipient Accountability – do the 3 points include the Fiscal Oversight section?

A: Yes, they include the fiscal oversight section.

1. Many questions were received on the review criteria, regarding inconsistencies between the guidance and the review criteria. In cases where there is incongruence between the two sections, should we defer to the guidance document?

A: Yes, please follow what is discussed in the FOA, as that’s what the reviewers will be basing their reviews on. Remember, if you respond with differing dates or data sets than is requested in the guidance, provide a thorough explanation for why you used that set.

Service Category

1. If a service category has more than one service unit definition, for example OutpatientAmbulatory Medical Care (OAMC ), do we have to list all of them separately?

A: Collapse the definition of the service units (ex. Under labs, you may have genotype and phenotype, and that would be one lab visit under OAMC)

1. Is this FY2016 or FY2015? Are being expended or will be expended?

A: We are all currently in FY2015 in terms of our funding, these are the funds that are being expended. The funds you are applying for are FY 2016 federal year funds, and those will be expended or are being planned.

1. Do we need to have a total for each year on the Service Category Plan table?

A: No.

1. Just to clarify; in the past 2 or 3 years, Implementation Plan has only to cover top 6 services funded. For this year, should it cover all services?

A: Cover all funded services.

1. The Implementation Plan has been removed from the grant guidance and is now replaced with the Service Category Plan Table, correct?

A: Yes.

1. On the MAI part of the Service Category Plan, do you just want all the MAI populations listed OR do you want all the data listed for each MAI population by service category?

A: Just list the targeted MAI populations. No data is required.

1. In the Service Category Plan table pg. 23-24, #3 2016 service categories it says to include total dollar amounts and percentages of expenditures for core and support services. This is the funding we are asking for under this application so it has not been awarded yet so how can we include amounts and percentages for expenditures? It cannot be expenditures for 2015 either.

A: Give actual amounts for FY 2014, allocated amounts forFY 2015, and anticipated/planned amounts for FY 2016.

1. Please clarify if a CMS waiver request needs to be included in the application, if it has already been submitted, but not yet approved.

A: If you have submitted waiver request for FY 2016, provide only the allocation table for this request; you do not need to resubmit your whole request.

1. FOA reference p. 23-24: a. i. Service Category Plan Table. Will DMHAP be providing a template for this new table or should each jurisdiction design their own? Please clarify that this Service Category Plan Table does not require goals, objectives, outcomes, or stages of HIV Care Continuum.

A: A Service Category template will be provided. Correct, the table does not require goals, objectives, outcomes, or stages of HIV Care Continuum.

Uninsured

1. What time period should be covered in the Uninsured and poverty table under the Impact of ACA?

A: Use the most recent data available, either calendar year or fiscal year. Use what you have and explain what it is.

Unmet need

1. Do you want us to use surveillance data to calculate unmet need?

A: Yes.

1. Does retained in care mean 2 med visits or can it be med visit and a lab?

A: Yes. In the FOA, we describe the third phase of the HIV care continuum as retained in care. This is the number of diagnosed individuals who have two or more documented medical visits, viral load or CD4 counts performed at least three months apart in the calendar year.

1. Jurisdictional Profile (and throughout): Much of the data requested will need to be pulled from HIV surveillance data. However, CDC does not consider HIV surveillance data to be final until at least one calendar year after the year in question – this is to account for reporting delays. As a result, 2014 data will be incomplete and will likely show higher levels of unmet need. How will HRSA take that in to account in the scoring of applications?

A: The unmet need is scored based on the clarity and completeness of the estimates, which should be supported by data sources and calculations, not the estimate itself.

1. For 2015 and 2016 should projections be based on RW eligible clients?

A: No, they should be based on Ryan White funded clients.

1. Please define the elements of attachment 4. Description of trends in the unmet need estimate should be in narrative or attachment 4?

A: There will be two tables for the original unmet need framework and then one table for the new framework, so there will be three tables altogether.They will all be submitted together in Attachment 4. The narrative should not be included in the attachment.

Planning Council

1. In the guidance the year for PC concurrence is listed as FY2015? Is it 2015 or 2016?

A: FY2015

Miscellaneous

1. When the salary cap changes with the new Consolidated Appropriations Act, updated in January, should we be applying the new cap/limit or will the 2015cap of $183,300, as indicated in today's slides still apply?

A: For the purpose of the application, use the 2015 amount.

1. Marketplace options “Explain any challenges, etc.” Is anecdotal information okay to use? And in relations to the bottom of page 20 not real sure what you mean or how to obtain the information requested on page 21 (1 and 2) at the top?

A: Yes, anecdotal or qualitative information is acceptable.

1. Maintenance of Effort (MOE) “…applicant’s two most recently completed fiscal years prior to the application deadline.” Please confirm the two (2) years required in the FY16 Application – are they FY13 and FY14?

A: Use the two most recent fiscal years that you have information for.

1. For Attachment 5: Co-morbidities, Cost and Complexity Table, in previous years, we included co-morbidity profiles for PLWH in the jurisdiction as well as those for the general population. The FY2016 Guidance does not request co-morbidity profiles for the general population. Please confirm that we do not need to include co-morbidity profiles for the general population.

A: The FOA does not require co-morbidity profiles for the general population.

1. In the CQM section, it states “list the performance measures for each service category which the applicant funds.” (p. 26). Can you clarify what is being asked for a performance measure? Are performance measures the 5 outcomes of the continuum of care? Or, is this asking for all process measures that are linked to the HCC outcomes?

A: Applicants may use the HHS core indicators or the HAB performance measures. We are not asking for the process measures.

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