Funding for Comprehensive High-Impact HIV Prevention Programs for Community-Based Organizations

Eligible applicants must provide services in one of the states, districts, and territories listed below. Additionally, applicants may provide services in a maximum of three (3) service areas throughout the eligible locations within the applicant’s jurisdiction. Applicants can provide HIV prevention services in areas that overlap eligible bordering jurisdictions (e.g., District of Columbia, Maryland, and Virginia).

• Alabama, Arkansas, Arizona
• California, Colorado, Connecticut
• District of Columbia, Florida, Georgia
• Illinois, Indiana, Kentucky, Louisiana
• Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri
• Nevada, New Jersey, New York, North Carolina
• Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico
• South Carolina, Tennessee, Texas
• U.S. Virgin Islands, Virginia, Washington, Wisconsin

The eligible states, District of Columbia, and Puerto Rico were selected based on diagnosed HIV infections at the end of 2018. The eligible locations have greater than 200 reported cases within the jurisdiction. These eligible states/jurisdictions comprise approximately 95% of the total number of HIV infection diagnoses as of 2018.

The applicant must have a history of providing HIV prevention services in these eligible areas. They also must have discussed provision of services with their state or local health department in which they report. Finally, applicants must have received written consent. (See Attachment C: Health Department Targeted HIV Testing and Partner Services Letter of Agreement).

If an applicant proposes to subcontract with organization(s) to provide direct services as described in this NOFO, please note the following:

• The 501(c)(3) IRS tax exemption letter for the subcontractor organization(s) must be included with the application at the time of submission.
• Applicant organizations may subcontract with a maximum of two organizations to provide direct services.
• Applicant organization must perform a substantial role in the delivery of services.
• The amount of funding allocated for subcontractors must be in alignment with the subcontractor's proposed services.
• Subcontractors must be located in and provide services in the same state as the applicant organization for at least the last 24 months.

Funding restrictions

Applicants must take the following funding restrictions into account when planning the program and writing the budget:

• Recipients may not use funds for research.
• Recipients may not use funds for clinical care except as allowed by law.
• Recipients may use funds only for reasonable program purposes, including personnel, travel, supplies, and services.
• Generally, recipients may not use funds to purchase furniture or equipment.
• Reimbursement of pre-award costs generally is not allowed.
• Other than for normal and recognized executive-legislative relationships, no funds may be used for:
  • Publicity or propaganda purposes designed to support or defeat the enactment of legislation before any legislative body.
  • The salary or expenses of any grant or contract recipient related to influencing the enactment of legislation before any legislative body.
• See Additional Requirement (AR) 12 for detailed guidance on this prohibition and additional guidance on lobbying for CDC recipients.
• The direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project outcomes.
• Recipients may not use funds for construction.
• Recipients may not use funds to support direct implementation of school-based HIV prevention programs.
• Awardees may not use funds to purchase or supply medications.
• Awardees may not use funds for clinical services, such as:
  • The provision of PrEP and nPEP.
  • Treatment of HIV, sexually transmitted diseases (STDs), viral hepatitis, and/or tuberculosis (TB).
  • Vaccination against hepatitis A or hepatitis B.
  • Vaccination against human papillomavirus (HPV).

Applicant organizations are required to provide HIV prevention services for persons with HIV and persons at high risk for acquiring HIV. The applicant organization's program must consist of all required Comprehensive Prevention Core and Operational Program activities and strategies.

Comprehensive HIV Prevention Core Program consists of the four pillars:

• Diagnose.
• Treat.
• Prevent.
• Respond.

Reporting provides continuous program monitoring and identifies successes and challenges that recipients encounter throughout the project period. Also, reporting is a requirement for recipients who want to apply for yearly continuation of funding.

Recipients must submit an annual performance report, ongoing performance measures data, administrative reports, and a final performance and financial report. A detailed explanation of any additional reporting requirements will be provided in the Notice of Award to successful applicants.

Recipients must report all required program performance data. This includes National HIV Prevention Program Monitoring & Evaluation (NHM&E) data, at the end of each budget period to CDC's Division of HIV/AIDS Prevention via CDC-approved data systems. These reporting requirements are inclusive of the data required for fulfillment of the annual performance report described in the following text.

Specific reporting requirements:

• Evaluation and Performance Measurement Plan.
  • Recipients must provide a more detailed evaluation and performance measurement plan within the first six months of the project.
• Annual Progress Report.
  • Recipients must submit the Annual Progress Report via Grants.gov 120 days before the end of the budget period.
• Performance Measure Reporting.
  • CDC programs must require recipients to submit performance measures annually, at a minimum, and may require reporting more frequently.
• End of Year Performance Report.
  • Recipients must submit the End of Year Performance Report at the end of the performance year.

• Federal Financial Reporting (FFR).
  • The annual FFR form (SF-425) is required and must be submitted within 90 days after each budget period ends.

• Final Performance (Closeout Report) and Financial Report.
  • Within 90 days of the project period's end, recipients must submit a final report including a final financial and performance report.

Measures of effectiveness

Applicants must provide measures of effectiveness that demonstrate the accomplishment of the various identified objectives of the cooperative agreement. Funded organizations are required to meet the minimum requirements established in the NOFO program objectives. Performance goals are stated in the "CDC Evaluation and Performance Measurement" section of the NOFO.

Q: Can we submit an application and also be listed as a subcontractor on another application?
A: It is allowable to submit an application and be listed as a subcontractor on another application

Q: Can we use funds to allocate for COVID testing?
A: Please visit the CDC website regarding awards and allowance for allocation of funds for COVID-19.

Q: Can you clarify the target population; do we have to select a racial/ethnic minority group – can we just target men who have sex with men (MSM) and women?
A: The eligible target population consists of high-risk groups identified as a priority population within the jurisdiction. Applicants are required to select one target population from the identified high-risk population disproportionately affected by HIV within the jurisdiction. This could be, for example, MSM, people who inject drugs (PWID), heterosexual, or transgender populations.

The high-risk population you select, must include an identified racial/ethnic minority group. Of selected program target populations, 75% of the clients served by the organization must be from the approved identified target population. Up to 25% of the clients served can be outside of the selected target population. Therefore, of all the clients served, 75% must be of racial/ethnic minority.

Q: Does the 20-page limit pertain to narrative only or does it include attachments as well?
A: Yes, the narrative only.

Q: Is the workplan part of the 20 pages?
A: Yes, the workplan is part of the 20 pages.

Q: Must we use 12-point font for footnotes and tables, or can we use 10-point font for footnotes and tables?
A: According to the NOFO, the project narrative is written in Calibri 12-point, 1-inch margins, number all pages. A font less than 12-point may be used for footnotes and tables.

Q: Can a previous CDC Notice of Award (NOA) be submitted as evidence of previous of work with a target population?
A: A progress report from a previous CDC award may be used as evidence of previous work with a target population.

Q: Does the table of contents or abstract count towards the 20-page limit?
A: The table of content or project abstract does not count towards the 20-page limit for the narrative.

Q: Is the average award amount per year of $470,000 more likely to be around that amount or can applicants apply for more than this amount?
A: There is no ceiling for the funding amount an organization may request. The anticipated average award is $470,000. If funded, your budget and program deliverables and allocations may need to be revised. If they are revised, they are subject to approval by CDC based on the award amount. Please ensure that you develop a budget that adequately supports the proposed PS21-2102 program.

Q: When will we know if we are awarded?
A: The anticipated award date is July 1, 2021.

Q: Are lab costs, copays, and deductibles fundable by this grant?
A: Some lab costs are allowable, it may include the processing of HIV test and integrated screening tests. PS21-2012 funds may not be used to cover copays and deductibles for clients.

Q: May grant funds be used to lease a "safe space" for prevention services?
A: Recipients may designate a dedicated physical space located either within the organization or off-site within close-proximity. This safe space should be culturally and age-appropriate. The safe space may function as a primary point of recruitment and location for project activities for the target population. Funds may be used for leasing a space, if deemed appropriate and based on program needs.

Q: Can grant funds be used to purchase a mobile unit for testing or to perform updates to a currently owned mobile testing unit?
A: The purchase or leasing of a mobile van/unit may be an allowable cost. It must be listed in the application and initial budget. Approval may be dependent on several factors and associated documentation will be required.

Q: May funds be used to lease a safe space facility for prevention services?
A: Yes, it must be outlined within the program narrative application and budget.

Q: Can we use funds for rapid HIV testing kits?
A: Yes, funds may be used to conduct rapid testing.

Q: Can funds be used to pay for PrEP and nPEP doctor's visits and or exam related to that?
A: No, funds cannot be used to pay for PrEP and nPEP doctor's visits or associated exams.

Q: Should the budget narrative be only for one year? Or should we include a brief summary for the subsequent four years?
A: The budget narrative should only address one year. It should align with the SF-424A.

Q: Would you like us to submit a detailed budget spreadsheet in addition to the budget narrative and the SF424A?
A: No, the budget narrative should include all the cost details and supporting information. Please refer to the CDC Budget Preparation Guidance.

Q: Are universities eligible?
A: Institutions of higher education are not eligible for funding.

Q: Our agency is non-profit under the auspices of a university. Are we eligible to apply?
A: The applicant organization 501(c)(3) letter must have the official organization name of the applicant organization and EIN. Organizations may not have a government affiliation and not be under the administrative and management authority of a college or university.

Q: Can we serve more than one target population?
A: Under this NOFO, applicants are asked to select only one target population. Applicants may serve other clients, but 75% of the total number of clients you serve must be from the target population.

Q: Can you provide clarification on the evaluation and performance measurement plan (EPMP)? Does a draft need to be submitted with the proposal?
A: The EPMP is not required with the application. CDC will work with recipients in the first six months to develop an EPMP. However, you must include performance targets in the work plan submitted with the application.

Q: How can I find out if my organization needs to submit Attachment D: Letter of Intent from a Physician for State Regulations and HIV Testing Activities? Can any licensed medical professional, including a Physician Assistant or Nurse Practitioner where they are working within the scope of their state licensure, oversee the applicant's HIV testing program?
A: The requirement to complete Attachment D is dependent on your state laws and guidelines. Your state/local health department can provide guidance on this requirement. State health department representatives can provide guidance on the required service provider allowable based on the state guidelines and regulations.

Q: For a Federal Qualified Health Center (FQHC) considering applying, how do you define "majority" when it comes to testing conducted in an outreach setting?
A: The majority of the HIV testing must be conducted in an outreach setting (75% or greater). Up to 25% of HIV testing efforts can be conducted as routine, opt-out HIV testing.

Q: If the applicant is a clinical/medical provider, do we instead write a letter stating that we provide HIV specialty medical care?
A: Since you have an internal medical care provider, you may utilize that provider. You will generate an internal memorandum of understanding or memorandum of agreement (MOU/MOA) documenting the agreement.

Q: How is service area defined and what are the service area requirements?
A: A service area may be a small as a city or as large as a multi-county neighboring region. The service area should be within a reasonable area that would allow clients access to services offered by your organization. For example, if your organization is located in Pittsburgh, you may service areas in the metro Pittsburgh area. However, it would not be feasible to provide services in Philadelphia because of the geographic distance between the cities.

Additionally, applicants can propose to provide services in up to three service areas throughout the eligible locations within the applicant's jurisdiction. Applicants may provide services in up to three areas within that jurisdictions or neighboring states (e.g., Washington, DC, Virginia, and Maryland). The three service areas must be near the applicant organization's address and have a history of providing service in the area.

Q: Must you fund a navigator under this NOFO, or could you refer to an existing program, if you have a navigation program funded by another project? If the agency has a HIV navigator employed with other funding, is it necessary to use PS21-2102 funds to do so?
A: Funded organizations must employ at least one trained HIV navigator (a minimum of 0.5 FTE) within the agency. They will help facilitate the coordination of the organization's linkage to HIV medical care plan activities. The navigator may work to service clients across the PS21-2102 program and the existing program in your organization.

Q: If a large-scale event in our service area is considered 500-1000 people, do we need to clarify that in the application? Or does the CDC require large scale events to be at least (predetermined number) of people?
A: There is no predetermined number for the large-scale event. However, please clarify the proposed type of event and expected number of individuals at the event in your application/proposal.

Q: Are incentives allowable?
A: Incentives are allowable. The incentive must be appropriate for the target population and are subject to approval by CDC based on the award amount. Please ensure that any incentive used adequately supports the proposed PS21-2102 program.

Q: Can the target population be MSM, of any race or does it have to be MSM of a specific race/ethnicity?
A: In this example, the target population can be MS. At a minimum, 75% of clients served must be a racial or ethnic minority.

Q: We have an in-house data specialist. Do we need to put in funding for hiring an outside evaluator?
A: It is not necessary to hire an outside evaluator. CDC can assist with in-house evaluation. You need to have someone for data entry at least half-time. If you feel you need specific evaluation that is not related to program specifically, you can hire an outside evaluator.

Q: Does the data management plan need to be included with this application? If it does, is it part of the narrative?
A: It can be included in the narrative. CDC will work with recipients in the first six months to develop an evaluation performance and measurement plan (EPMP). This includes a data management plan. However, include performance targets in the work plan submitted with the application. Specify how to collect performance measures, possible data sources, feasibility of collecting, and plans to update the data management plan.

Q: If we do not have key personnel positions filled yet (e.g., program manager), should we include a job description as a resume/CV attachment or just leave that position out of that section?
A: Please provide a job description in the budget narrative and mark it as "to be determined "(TBD).

Q: Is it possible to submit more than one MOU for a medical provider and prevention and essential support services?
A: Only one service agreement is needed with the application for an HIV medical provider and one for prevention and support services. Once awarded, your PO will help you with MOUs/MOAs for the essential support services needed by your target population.

Q: Can we fund staff to do integrated screenings?
A: Agencies with the capacity or already implementing integrated screening may use up to 5% of requested funds to support these activities. If agencies are without these services, they may establish a service agreement with a clinical care provider to offer those services.

Q: Can we use PS21-2102 funds to hire a social worker to deliver mental health counseling services?
A: Clinical services are not an allowable cost under this NOFO. Funds cannot be used for social work or mental health or substance use counselors.

Q: Can you give us advice on how to budget for interventions?
A: On the CDC Effective Interventions website there are links to all of the public health strategies and interventions. Some sections will have information about budgets and cost analysis, as well as incentives that may be allocated. Costs need to be reasonable and related to what you say you are going to do.

Q: Can we propose to implement the other CDC-approved evidence-based interventions or can we only use those listed in the NOFO?
A: The only allowed risk reduction behavioral interventions for implementation under PS21-2102 are the interventions listed in the PS21-2102 NOFO.

Q: Are behavioral health interventions required or optional?
A: All HIV high-impact behavioral interventions are optional.

Q: Are CDC intervention trainings free?
A: Yes, the intervention trainings are free.

Q: Does Safe in the City have to be implemented in a waiting room?
A: No, it can be offered in other parts of the agency. The free videos can be downloaded from the Effective Interventions website.

Q: Are we allowed to use interventions that we found effective with our target population but are not listed in the NOFO? There are several interventions on the CDC website, so do we have to offer only the ones listed in PS21-2102?
A: The interventions listed in the NOFO under Risk Reduction Behavioral Interventions are the only behavioral interventions supported with PS21-2102 funds. Applicants are not required to offer a behavioral intervention under this program. If a behavioral intervention is offered by the applicant's organization, please choose one that fits the target population.

Q: Do we also need to submit the other CDC assurances (e.g. non-construction programs)?
A: Yes, CDC Assurances and Certifications are required with your submission.

Q: For the Assurance of Compliance form and the panel members that we need to designate, can they be members of the board or staff members from different departments? Should we ask the health department for a representative as well, as it appears that there is a place on the form for one?
A: Members may be board members, program staff members, community members, community advisory board members, etc. Ensure that the members represent your community or target population. Additionally, one health department representative (city, local, county, or state) should be included.

Q: Is there a template for the duplication of efforts report?
A: There is no template for the duplication of effort report. Submit a written statement if this application will overlap with another application or award submitted to another funding source. Applicants need to submit this as part of their application, even if they do not have duplication of effort.

Q: Can we attach more information at the end of the Linkage to Care form?
A: You may include any current linkage to care protocol or policy instead of the form, or you can create your own form. Include any tables, diagrams, etc., that will not fit on the form. However, the information must be included in the document you are submitting.

Q: How do we name and upload Attachment C?
A: List it as appendix_HIV testing document or appendix_ HD testing document.

Q: Our agency does not participate in lobbying activities, do we still need to submit the form?
A: The lobbying activities form is still required. Please complete it with all related information and include N/A for the applicable to do not apply to your agency.