Ryan White Services

3. Status Neutral Approach 15 pts

4. Clinical Quality Improvement 15 pts

6. Budget Narrative and Forms 10 pts

D. PROPOSAL NARRATIVE OUTLINE (MAXIMUM OF 40 PAGES)

1. ORGANIZATIONAL HISTORY and CAPACITY 25 POINTS

1. Provide a brief history of the organization including mission and vision and how it addresses racial and ethnic disparities, social determinants of health, medical biases, and historic structural barriers to optimal medical care. Include a map or other means to identify its satellite locations including school-based health centers and urgent care/walk-in clinics for the areas covered in this proposal.

1. Describe your organization’s history in providing services to people living with HIV and how it is uniquely poised to provide the full array of services to people with HIV in this proposal.

1. Document specific examples of the organization’s ability to deliver services in a multi-cultural (including LGBTQ) and multi-lingual manner. Describe its current programs for the three groups that require special focus; Young Men of Color Who Have Sex with Men, Black Women and Transwomen in addition to prevalent HIV populations.

1. Describe the organization’s history to manage and/or deliver the proposed HIV services to identify, refer, link, retain, prescribe anti-retrovirals and increase rates of viral suppression for populations of focus in this RFP and prevalent populations.

1. Describe how the applicant will deploy professional expertise to improve the health outcomes of individuals living with HIV based on each of the service categories for which you are applying.

1. Describe coordination efforts with non-Ryan White-funded community partners, e.g. social service organizations, Faith communities, LGBTQI groups/organizations whose programs support the needs of the focus populations.

1. All subrecipients will be required to attend a monthly meeting convened by the Ryan White project Director to review YTD expenditures by category, service utilization, viral suppression rates by population and clinical quality management activities and Whole Person/status neutral coordination. Describe the organization’s capacity to conduct programmatic and fiscal monitoring and reporting monthly.

1. Describe the process that will be utilized to ensure that client data is entered in a timely (within 7 days) and accurate manner.

1. The Ryan White CARE Act requires that Part A funds serve as a payer of last resort for services to clients with alternative means of payment (e.g. Medicare/Medicaid, medical insurance obtained through the Affordable Care Act, employer-based health insurance plans, etc.). Describe the organization’s efforts to maximize available sources of medical coverage and other community resources before using Ryan White Part A funding vigorously pursues enrollment of Part A clients into insurance coverage for which they might be eligible (Part B CT Insurance Premium Assistance, 340 B income, food pantries, etc.)

2. SERVICE DELIVERY 35 POINTS (IMPLEMENTATION PLANS NOT INCLUDED PAGE LIMIT)

1. How will the applicant provide all core and support services prioritized by the New Haven/Fairfield Counties’ Eligible Metropolitan Area Planning Council in a coordinated manner located where most PLH reside (New Haven, Waterbury, Bridgeport, Lower Fairfield County (Norwalk, Stamford and Danbury). The Planning Council had previously allocated funding per service region which is no longer in effect for FY 2025. However, applicants should use these figures in the funding table above (see Figure 1 under Funding Initiatives/Availability of Funds as a guide for this application).

1. Describe how it would design a service delivery system that provides an array of high-quality medical and support services (RW funded and non RW funded) embedded in communities, and that are culturally and linguistically appropriate for PLH.

1. Describe the organization’s history to manage and/or deliver the proposed HIV services to identify, refer, link, retain, prescribe anti-retroviral medications and increase rates of viral suppression for populations of focus in this RFP and prevalent populations.

1. Include a description of mechanisms within the organization that enable newly infected, those with late-stage HIV diagnosis, populations of focus and out of care individuals to access and remain in primary care and achieve viral suppression. Describe the regional strategy for identifying and engaging at-risk individuals who are unaware of their status and re-engaging individuals who have fallen out of care.

1. All applicants must submit a completed Implementation Plan template for each of the services provided. The applicant must apply for each of the services listed in the funding allocation table at the amount indicated.

3. WHOLE PERSON/ STATUS NEUTRAL APPROACH TO CARE and TREATMENT (15 POINTS)

Whole Person/Status Neutral is an approach to HIV education, testing and treatment that emphasizes a continuum of care no matter if someone is found to be HIV negative or positive. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016418/

All applicants must participate in a Whole Person approach to testing and treatment. Although Ryan White-funded programs may not engage in HIV prevention activities, they must have a mechanism for HIV prevention and testing internally and locally for referral and rapid start of HIV antiretroviral medication or Pre-exposure prophylaxis (PrEP).

1. Provide a flowchart for the Whole Person/status neutral approach that is designed to test and treat newly diagnosed persons and prescribe antiretroviral therapy or PrEP within 72 hours of test result.

1. If your organization provides HIV testing, describe the successes and challenges to link individuals to HIV providers within 72 hours. How have you addressed these challenges for a better outcome?

1. For those who work with other/outside local HIV testing and prevention programs, please outline the process from off-site testing to HIV care and PrEP within 72 hours. Describe the challenges and successes. How have you addressed these challenges for a better outcome?

1. How does the organization use or will use a braided funding model (e.g. CDC prevention and testing funds with Ryan White treatment funds) to accomplish a Whole Person approach?

4. CLINICAL QUALITY IMPROVEMENT (15 POINTS)

Using HRSA’s PCN 15-02 as a guide, please address the following sections.

1. Describe the current quality management plan or activities including the staff who participate in quality improvement/management activities, the Quality Management (QM) Committee, how often it meets, etc. How does the organization envision the role of Persons with HIV in the quality management program.

1. Discuss how your organization’s current quality management program has worked to improve the care or services your program provides, including how an item or measure was identified as needing improvement, the process used in analyzing and designing a QM intervention (Plan-Do-Study-Act) and how the intervention was tested. Describe one specific Quality Improvement project that best illustrates a CQM approach.

1. CQM efforts will focus primarily on the focused populations in this RFP but not to the exclusion of others as data may show. Discuss plans to conduct distinct quality management activities for the focus populations set forth in this RFP.

5. BUDGET NARRATIVE 10 POINTS (BUDGET NOT INCLUDED PAGE LIMIT)

Using HRSA’s PCN 16-02 regarding client eligibility and allowable costs, ( https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-category-pcn-16-02-final.pdf_) please prepare you budgets accordingly.

a. Using the budget template, prepare a separate budget for each service category. Please see NHFF Ryan White Part A Planning Council Homepage ( www.nhffryanwhitehivaidscare.org ) for staff qualifications by service category.

Please note: The budget should cover 12 months, and administrative expenses cannot exceed 10%

D. PROPOSAL OUTLINE

The outline below provides a checklist to ensure that all required information is included with the proposal. Applicants should follow the outline to organize and present the information required.

1. RFP Coversheet

1. Proposal Narrative (not more than 40 pages)

1. Implementation Plan (see sample implementation plan)

1. Budget Forms and Budget Narrative (see sample budget)

1. Medicare/Medicaid Certification Letter

1. 501(c) (3) Letter of Determination

1. Required City of New Haven Documents