General Asked Questions

Notice of Funding Opportunity (NOFO)

PS18-1802: Integrated HIV Surveillance and Prevention Programs for Health Departments

General Asked Questions (GAQs) for Web Posting

Date as of: September 7, 2017 (updated)

This GAQ document is developed based on the questions received via the mailbox or voicemail from potential applicants and stakeholders related to the notice of funding opportunity. Please view the question and answers (Q&As) under each respective heading/section for responses to submitted questions.

Sections:

• Eligibility
• Submission Requirements
• Budget and Funding Requirements
• Required Strategies and Activities
• Evaluation and Performance Management Plan (EPMP)
• Demonstration Projects
• Additional Questions

Eligibility

Q: Which agencies/types of organizations are eligible for this notice of funding opportunity?

A: Eligible applicants include state, local and territorial health departments or their Bona Fide Agents currently funded under PS12-1201 (HIV prevention) or PS13-1302 (HIV surveillance). This includes the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. Also eligible are the local (county or city) health departments serving the following metropolitan areas: Baltimore City, Chicago, Fulton County (Atlanta), Houston, Los Angeles County, Philadelphia, New York City, and San Francisco.

Submission Requirements

Q: What is the page limit for the project narrative and any other text requirements?

A: The project narrative (description) is limited to 15 pages for the base program (Component A) and up to 4 additional pages per component (Component B). This would be a total of 19 pages if the eligible health department is applying for both Component A and Component B. The work plan can be uploaded in “Other Attachments” and will not count towards the page limit described above. The project narrative (description) must include the following headings: Background, Approach, Applicant Evaluation and Performance Measurement Plan, Organizational Capacity of Applicants to Implement the Approach, and Work Plan. The applicant can include Refer to Attachment X or Other Attachments under the Applicant Evaluation and Performance Measurement Plan section. The applicant can include Refer to Attachment X or Other Attachments under the Work Plan section.

Budget and Funding Requirements

Q: How many budgets and 424A forms do we need to submit?

A: Please submit one line item budget for the core program that clearly delineates funding for HIV surveillance and HIV prevention within the budget narrative. Please provide one 424A that includes HIV surveillance on one column and HIV prevention on another column, and the total amount in the total column (one 424A with separate grant program functions).  If applying for a demonstration project, please include a separate budget narrative and 424A form. There will be one notice of award. A second option is to include all components on one 424A: Place Component A- Prevention in one column, Component A-Surveillance in another column, Component B in the third column, and the total (cumulative) in the column to the far right.

Q: Can we request more that the award ceiling? How much should we request?

A: The award ceiling for Component A is included in the individual funding ranges included in Attachment B. The award ceiling for Component B is included within the ranges (3 tiers) provided in the NOFO (page 37-38). CDC will not consider any application requesting an award higher than the specified amount.

Q: How many years of budgets and budget narratives should we include in the application? Just year 1?  Is this the same for the core and demonstration project?

A: The budgets and budget narrative should be developed for Year 1 (January 1 – December 31, 2018). This is the same for both components A and B.

Q: Are there any budget templates you could share with us, to include the categories to use for the budget development?

A: Please refer to page 47 of 77 of the PS18-1802 NOFO: see Budget Preparation Guidelines at: https://www.cdc.gov/grants/applying/application-resources.html

Q: How many trips and for how many people, under which program, Surveillance or Prevention, should be budgeted?

A: Please plan to budget for both HIV surveillance and prevention staff to attend a grantee meeting in year 1 of the award. Furthermore, based on an applicant’s training needs and available resources, please include any possible training/TA needs within the budget.

Q: Is Direct Assistance (DA) available through this notice of funding opportunity (NOFO)?

A: DA is available through this NOFO. Applicants may request federal personnel, equipment, or supplies, including SAS licenses, as Direct Assistance (DA) to support HIV surveillance and prevention activities, in lieu of a portion of financial assistance (FA). To address staffing and/or program expertise deficits, applicant may convert FA to DA to recruit staff with the requisite training, experience, expertise (e.g., Public Health Associate Program [PHAP]). For information on Direct Assistance for Assigning CDC Staff to State, Tribal, Local, and Territorial Health Agencies, refer to: https://www.cdc.gov/stltpublichealth/GrantsFunding/direct_assistance.html.

Q: How much should we budget for SAS licenses?

A: Applicants may request SAS licenses as Direct Assistance (DA) to support HIV surveillance and prevention activities as a portion of financial assistance (FA).  The cost for any additional SAS licenses that are above the applicant’s 2017 users list is projected to be $1,172.44 per license in FY 2018  (rate is subject to adjustment by the Working Capital Fund based on usage).

Q: How do we request the same number of SAS licenses as were on our 2017 users list? Do we need to submit a SAS Licensing Request and MOA for 2018, with the grant application?

A: Jurisdictions shall include the requested number of SAS licenses in the grant application.  Please review your jurisdiction’s 2017 SAS license users list.  If you do not have a change in the 2017 SAS license user list, please clearly indicate no change to your 2017 SAS license user list in the budget narrative. If you have a decrease in the 2017 SAS license user list, please clearly indicate the number of SAS licenses to decrease from your 2017 SAS license user list in the budget narrative.   The SAS Grantee Memorandum of Agreement (MOA) is not required at the time the NOFO application is submitted.  Applicant’s FY 2018 SAS license renewal process, MOA, and instructions are forthcoming.

Q: Who should the budget letter be addressed to?

A: A budget letter is not required.

Q: Is the statement signed by an Overall Responsible Party (ORP) required to be submitted with the NOFO application due September 13, 2017?

A: Yes, the statement signed by an Overall Responsible Party (ORP) certifying program compliance with the NCHHSTP guidelines is required to be submitted with the NOFO application due September 13, 2017. Attachment H: Official Responsible Party (ORP) Certification Sample Template is available in the attachments section of the PS18-1802 website https://www.cdc.gov/hiv/funding/announcements/ps18-1802/attachments.html

Required Strategies and Activities

Q: Do we have to implement all 11 strategies? Can we opt out of any of the requirements?

A: Implementation of all strategies and activities is required. Applicants can request to opt out of selected required activities by providing a strong justification, which must be based on program need, resources and/or policies. These select required activities are indicated within the NOFO (i.e., targeted perinatal activities, SSP). Approval will be made after review of the application.

Q: Could you define the term “interventional surveillance, with examples?

A:  Refers to using quality, timely and complete HIV surveillance data for public health intervention such as intensive data-to-care models to reduce transmission of HIV and cluster detection, investigation and response to rapidly detect and interrupt active HIV transmission.

Example activities related to the use of surveillance data for data-to-care models include: collecting complete CD4 and viral load reporting, enhancing data quality to improve the classification of persons “Not in Care” lists, conducting cohort reviews and prioritizing cases, and conducting intensive linkage, re-engagement and referrals to treatment, prevention and other essential services for prioritized cases. Activities related to cluster detection, investigation and response include: collecting complete CD4, viral load and HIV sequence data, detecting molecular and time/space clusters, investigating clusters of active transmission, and implementing intensive prevention interventions in networks with active transmission.

Q: If a jurisdiction has already applied and received CDC concurrence on their Determination of Need (DON) is that sufficient or will jurisdictions have to resubmit under this FOA?

A: If you have already applied for and received CDC concurrence with the submission of your jurisdiction’s Determination of Need (DON) to support SSP, then your current DON is sufficient.  It does not expire and can be used for PS18-1802 supported activities. However, if you would like to conduct SSP activities and have not yet submitted nor received concurrence on a DON, then please submit accordingly.

Q: What is the rational for requiring a Determination of Need (DON) to be submitted to perform syringe services?

A: As described in the HHS SSP Guidance, state, local, territorial, and tribal health departments interested in directing federal funds to support SSPs must first demonstrate need in consultation with CDC. As part of the consultation with CDC, state, local, territorial, and tribal health departments should submit to CDC evidence in a DON request that includes data indicating whether the jurisdiction is either (1) experiencing or (2) at risk for, significant increases in viral hepatitis infections or an HIV outbreak due to injection drug use. The scope of the evidence should address the geographic area that will be served by the SSPs and include county, city, and state level data, as appropriate. The CDC Program Guidance for Implementing Certain Components of Syringe Services Programs, 2016 (https://www.cdc.gov/hiv/pdf/risk/cdc-hiv-syringe-exchange-services.pdf) provides specific procedures for CDC-funded grantees.  The CDC guidance details which SSP activities can be supported with CDC funds, which relevant CDC cooperative agreements can be used to support SSPs, and the process by which CDC-funded programs may request to direct resources to implement new or expand existing SSPs for PWID.

Q: Do we need to submit a letter of concurrence from our HIV planning group (HPG) with the application?

A: The letter of concurrence was submitted with the Integrated HIV Prevention and Care Plan (concurrence to the Plan). A letter of concurrence is not needed with the submission of the application. Concurrence is for the Integrated Plan, not the application.

Q: Can you clarify if and when we need to submit updates to the “Integrated HIV Prevention and Care Plan,

Including the Statewide Coordinated Statement of Need” and do we need to submit a letter of concurrence with it?

A: Updates to the Integrated HIV Prevention and Care Plan can be developed at the jurisdictional level and submitted annually, if necessary, to reflect local need and changes in the healthcare delivery system. A letter of concurrence from the co-chairs of the planning body and the health department representatives is only required if there are changes to the Integrated HIV Prevention and Care Plan. For further guidance, please refer to the Integrated HIV Prevention and Care Plan Guidance https://www.cdc.gov/hiv/pdf/funding/announcements/ps12-1201/cdc-hiv-integrated-hiv-prevention-care-plan-guidance.pdf.

Q: Can we conduct effective behavioral interventions (EBIs) under this NOFO? Where do I find information on the effective behavioral interventions that can be conducted under this NOFO?

A: Risk reduction interventions for PLWH and for HIV-negative persons at risk for HIV infection may be conducted under this NOFO. For additional guidance on behavioral interventions supported by CDC to enhance biomedical interventions and reduce risk behaviors, refer to https://effectiveinterventions.cdc.gov/en/HighImpactPrevention/Interventions.aspx

Q: Where do I find additional information on perinatal HIV prevention and surveillance activities?

A: The perinatal program guidance has been posted to the website. This program guidance includes a summary of perinatal HIV prevention and surveillance activities covered under PS18-1802. Additional information can be found in Attachment I: HIV Perinatal Program Guidance on the PS18-1802 website. https://www.cdc.gov/hiv/pdf/funding/announcements/ps18-1802/CDC-HIV-PS18-1802-Attachment-I.pdf.

Q: What is the black box – concept?                                                                  

A: A data sharing tool that uses HIV surveillance data and a person-matching algorithm to determine the level of matching for a case-pair, comprised of a record from one jurisdiction paired with a record from another jurisdiction. The algorithm determines whether each case-pair was an ‘exact’, ‘high’, ‘medium’, or ‘low’ match. Currently CDC is conducting a pilot with a limited number of states to assess the use of a secure, automated data sharing tool for matching HIV surveillance records to support de-duplication of cases in the National HIV Surveillance System (NHSS).

Q: Could you clarify if grantees will have to conduct cumulative interstate duplicate review in addition to RIDR?

A: Jurisdictions need to complete RIDR in addition to the cumulative interstate duplicate review which will resolve the backlog of potential case-pairs. Routine interstate duplicate review (RIDR) must be carried out on a regular basis to prevent over counting and undercounting of cases, identifying potential intrastate and interstate duplicate case reports, merging case reports that have been deemed to be duplicates at all levels, and providing duplicate review resolution to CDC (i.e., Same as or Different than). CDC will continue to provide guidance and support on de-duplication activities including cumulative interstate duplicate review; cumulative interstate duplicate review activities can be conducted throughout the NOFO project period (2018-2022).

Q: Do we need to provide budgetary resources for the cumulative interstate duplicate review?

A: Plan for staff to conduct routine interstate duplicate review (RIDR) as well for cumulative interstate duplicate review.  Given the urgent need for high quality and timely HIV case surveillance data, CDC is seeking to implement more efficient electronic tools for data sharing to reduce the burden of the RIDR process. CDC is conducting a pilot with a limited number of states to assess the use of a secure, automated data sharing tool for matching HIV surveillance records to support de-duplication of cases in the National HIV Surveillance System (NHSS).

Q: Is it CDC’s expectation that state and local health departments are doing the “cluster identification” rather than receiving these clusters from CDC as in the past?

A: The expectation is that state and local health departments develop and improve program capacity for cluster detection, investigation and response. CDC will provide guidance, technical assistance and tools to support this activity.  CDC will continue to conduct cluster analysis at the national level and collaborate with jurisdictions. Additional information can be found in Attachment E: Detecting, Investigating, and Responding to HIV Transmission Clusters.

Q: Do we need to submit a Memorandum of Agreement (MOA) for geocoding with CDC for PS18-1802?

A: In accordance with the Technical Guidance for HIV Surveillance Programs, applicants are required to submit an MOA for geocoding with CDC for PS18-1802. The Technical Guidance for HIV Surveillance Programs also provides the process and outcome standards of Geocoding and Data Linkage. Applicants should refer to Appendix A of the Technical Guidance Chapter on Geocoding and Data Linkage for information on the requirement to submit a MOA.

Q: What is the initial process for Geocoding and Data Linkage?

A:  The Technical Guidance for HIV Surveillance Programs – Geocoding and Data Linkage (GDL) describes the overall process and is available on SharePoint at: https://partner.cdc.gov/sites/NCHHSTP/HICSB/default.aspx. CDC has developed additional resources for GDL that are also available on SharePoint, including:

• PS18-1802 Geocoding and Data Linkage (GDL) Pre-Award Generally Asked Questions document
• Geocoding and Mapping HIV Surveillance Data: Guidelines and Tools
• Case Surveillance: Geocoding and Data Linkage (GDL) Guidance Document

Q: Does a signed MOA for GDL need to be submitted with the NOFO application due September 13, 2017?

A: An MOA for GDL is due at the beginning of the 5-year funding cycle year and is not required to be submitted with the NOFO application due Sept 13, 2017. Applicants should refer to Appendix A of the Technical Guidance Chapter on Geocoding and Data Linkage for information on the requirement to submit a MOA and the MOA template available on SharePoint.

Q: Will the CDC provide training on ArcGIS and purchase the ArcGIS application for all sites?

A: Applicants should plan to include costs related to ArcGIS application and staff training in their budget. The Technical Guidance for HIV Surveillance Programs includes the process and outcome standards for GDL. CDC will provide guidance, technical assistance and tools to support this activity; however, CDC will not purchase ArcGIS application licenses. Please refer to the Technical Guidance for HIV Surveillance Programs Chapter on Geocoding and Data Linkage for more information.

Q: Can we purchase Hepatitis A and B vaccines or PrEP with PS18-1802 funds?

A: Funds from this NOFO may not be used for clinical services (the provision of medication, vaccinations, and/or treatment), such as the provision of PrEP and nPEP; treatment of HIV, STDs, viral hepatitis, and/or TB infection; vaccination against hepatitis A or hepatitis B; and vaccination against human papillomavirus (HPV). Arrangements for these clinical services should be made through collaboration with health department STD, viral hepatitis, and TB programs or other clinical care providers.

Q: Will third-party billing be a required activity under PS18-1802?

A: Programs are expected to adopt sustainable, routine HIV testing programs in healthcare facilities. Use all available mechanisms to obtain reimbursement for HIV testing from third-party payers (e.g., Medicare, Medicaid, private insurance, health maintenance organization (HMO) programs) and develop the infrastructure to seek reimbursement for testing for HIV and related co-infections.

Evaluation and Performance Management Plan (EPMP)

Q: Is there is a fillable copy or a word document available for the “PS18-1802 Monitoring and Evaluation Questions, Indicators, and Data Source” template referred to in the “PS18-1802 CDC Evaluation Plan Guide”?

A: A fillable copy of the “PS18-1802 Monitoring and Evaluation Questions, Indicators, and Data Source” template referred to in the “PS18-1802 CDC Evaluation Plan Guide” was forwarded to applicants on 9/5 via the HDFOA mailbox. In addition, they are now available in the attachments section of the PS18-1802 website https://www.cdc.gov/hiv/funding/announcements/ps18-1802/attachments.html.

Q: What are the PS-18-1802 Component A evaluation and performance measurement plan requirements?

A: As part of the notice of funding opportunity (NOFO) project narrative, applicants must provide a brief description of their jurisdictional evaluation and performance measurement plan (jurisdictional EPMP) that includes how the applicant will address the strategies, output, outcomes, and indicators described in the NOFO (page 26-32). Applicants can also include plans for the implementation and monitoring of additional local measures. Applicants will be evaluated based on criteria described on page 53-54 of the NOFO.

Q: How should I include my PS-18-1802 Component A evaluation and performance measurement plan with my application submission?

A: In the “Applicant Evaluation and Performance Measurement Plan” section of the project narrative, applicants can describe their jurisdictional EPMP or indicate that their jurisdictional EPMP is described in an uploaded attachment. Although it is not listed on pages 64-65 of the NOFO, the jurisdictional EPMP is an acceptable attachment and will be reviewed by CDC.

The jurisdictional EPMP is required as part of the application process, however, applicants can use their own format or the format provided in the jurisdictional EPMP template (posted as an attachment on CDC website) to complete their EPMP.  Applicants who choose to use the jurisdictional EPMP template provided by CDC to complete their application should upload the completed template as an attachment to their application and note that in the “Evaluation and Performance Measurement Plan” section of the project narrative.  Jurisdictional EPMPs formatted by the applicant (i.e., EPMPs that do not use the CDC template) can also be uploaded as an attachment (see 2A) and noted as such in the project narrative.

Q: When am I required to use the Jurisdiction EPMP template to complete my PS-18-1802 Component A evaluation and performance measurement plan?

A: Applicants are required to use the PS18-1802 Jurisdiction EPMP template provided by CDC to complete their post-award jurisdiction-specific EPMP that is due 6-months after the award.  During the 6-month post-award period, CDC will work closely with grantees to help finalize their jurisdiction EPMP.

Q: What are the PS-18-1802 Component B evaluation and performance measurement plan requirements?

A: As part of the NOFO project narrative for applicants who choose to participate in demonstration projects, applicants must provide a description of their demonstration project evaluation and performance measurement plan (demonstration EPMP) that includes how the applicant will fulfill the requirements described in the NOFO (page 32).

Q: How should I include my PS-18-1802 Component B evaluation and performance measurement plan with my application submission?

A: In the “Demonstration Project” section of the project narrative, applicants can either describe their demonstration EPMP or note that their demonstration EPMP is describe in an uploaded attachment. Although it is not listed on pages page 55 of the NOFO, the demonstration EPMP is an acceptable attachment for review.

For applicants who elect to propose a demonstration project, a demonstration EPMP is required as part of the application process, however, applicants can use their own format or the format provided in the demonstration EPMP template to complete the EPMP.  Applicants who choose to use the demonstration EPMP template provided by CDC to complete their application should upload the completed template as an attachment to their application and note it in the “Demonstration Project” section of the project narrative. Demonstration EPMPs formatted by the applicant can also be uploaded as attachments (see 5A) and noted as such in the project narrative.

Q: When am I required to use the Demonstration EPMP template to complete my PS-18-1802 Component B evaluation and performance measurement plan?

A: Applicants are required to use the Demonstration EPMP template provided by CDC to complete their post-award demonstration EPMP that is due 6-months after the award.  During the 6-month post-award period, CDC will work closely with grantees to help finalize their demonstration EPMP.

Q: What is the difference between CDC National Evaluation and Performance Measurement Plan and Jurisdiction Evaluation and Performance Measurement Plan?

A: CDC’s national EPMP describes how the FOA will be monitored and evaluated at the national level.  The national plan lists all required program activities, outputs, and outcomes; specifies measure calculations, sources, and reporting frequency; and describes when and how data will be collected, analyzed, and reported.  The national EPMP will be finalized after the review and finalization of grantees’ jurisdiction-specific EPMP templates. This is a reference document of how the FOA will be monitored.

Jurisdictional EPMP template is provided to assist grantees with the development of their final jurisdiction-specific EPMP templates. The template provides a structured format that includes all required EPMP elements, prepopulates and clearly delineates CDC required evaluation elements, and permits grantees to add additional questions, outputs, outcomes, and measures.

Q: Is the information required for the work plan and jurisdiction EPMP the same?

A: Although there are some overlaps in the information provided in the jurisdiction EPMPs and the work plans (i.e., strategies, outcomes, outputs, activities, measures), the work plans provide additional information that is not captured in the EPMPs.  Specifically, the work plans includes a 5-year project overview of the implementation timelines and a detailed overview of your proposed program for Year 1.

Q: Where can I find a copy of the National HIV Prevention Program Monitoring and Evaluation Guidance?

A: The National HIV Prevention Program Monitoring and Evaluation Guidance is in development and will be posted as soon as it is available. In the interim, the national EPMP provides the most current PS-18-1802 monitoring and evaluation guidance.

Demonstration Projects

Q: For the 18-1802 Demonstration Project – do we need to do a separate evaluation plan and data management plan – or are we addressing these aspects in the project narrative piece as described in the NOFO?

A: For the application process, applicants can develop one evaluation and data management plan that clearly delineates what data will be collected and managed when and how for each component.  Once awarded, applicants will work will CDC to develop separate evaluation and data management plans for each component.  Applicants can attach their evaluation plans as long as they note in the narrative section of the application that the evaluation plan has been included as an attachment.  Attachments do not count towards the application page limit.

Additional Questions

Q: What needs to be included in the work plan?

A: Applicants are required to provide a work plan that: provides a high-level overview of the entire five-year project period; provides detailed description of the first year of the award; incorporates all FOA-related program strategies and activities; includes training, capacity building, and TA needs to support the implementation of the proposed program; includes a concise description on how the grantee plans to implement and monitor each program activity; and includes specific, measurable, achievable, realistic, and time-based (SMART) process and/or outcome objectives for each activity aligned with the related FOA performance objectives, including FOA performance targets. Note: Work plans may be uploaded as “other attachments” with your application submission.

Q: How many Principle Investigator(s) may we include on the integrated NOFO application?

A: With the submission of your application, please include 1 Principle Investigator (PI) and 1 Business Official.  After the NOFO has been awarded, grantees may complete a “new user form” to add an additional PI, if needed.

Q: I cannot find the CDC Assurance of Compliance from Grants.Gov, where is the form available?

A: For the CDC Assurance of Compliance form, please refer to https://wwwn.cdc.gov/grantassurances/(S(igk24zc0ql3yyle1dcg3gkzt))/Homepage.aspx

Q: Is a cover letter required and if so, who should the letter be addressed to?

A: A cover letter is required for submission and should be addressed to the GMS Specialists Constance Jarvis.