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Ryan White Part A Services in the Tri-County Region

Grants to New York Nonprofits for
Services to Individuals Living with HIV/AIDS

Agency Type:

Local

Funding Source:

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Public Health Solutions (PHS) - New York City Department of Health and MentalHygiene (NYC DOHMH), Bureau of HIV/AIDS Prevention and Control (BHIV)

Conf. Date:

06/08/18

LOI Date:

07/31/18

Deadline Date:

08/07/18 2:00 PM EDT Receipt

Description:

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Grants to New York nonprofit organizations to provide services to individuals living with HIV/AIDS in New York City and Westchester, Putman, and Rockland Counties. Funding is available in the following categories: HIV testing, housing services, legal services, harm reduction services, health education and risk reduction services, medical care, medical case management, mental health services, non-medical case management, supportive counseling, and Medicaid, Medicare, and NYS Health Insurance Exchange Systems services.

Introduction:

Since 1991, the federal government has provided emergency relief to cities and counties hardest hit by HIV and AIDS through the Ryan White HIV/AIDS Program, formerly known as the Ryan White CARE Act. Ryan White Part A funding is directed to eligible metropolitan areas (EMAs) and transitional grant areas (TGAs), including the New York EMA.

The Ryan White HIV/AIDS Program funding is administered by the federal Health Resources and Services Administration (HRSA), a division of the U.S. Department of Health and Human Services (HHS). The New York EMA includes the five boroughs of New York City (NYC) and the counties of Westchester, Rockland, and Putnam (Tri-County). In the New York EMA, the grantee for Part A funds is the New York City Department of Health and Mental Hygiene (NYC DOHMH). The HIV Health and Human Services Planning Council of New York (Planning Council), whose members are appointed by the Mayor, prioritizes service categories and allocates funds. The Planning Council also designs service directives that drive the development of programs. Public Health Solutions (PHS), under contract with NYC DOHMH, procures and administers contracts in the New York EMA.

General Client Eligibility Requirements:

The general client eligibility requirements for all RWPA services include HIV status, residency, and income. Eligibility documentation requirements will be provided during the contracting process/post-award.

1. HIV Status Requirements

The principal intent of the RWPA Program is the provision of services that improve the health of low-income, uninsured and under-insured PLWH. Organizations will be required to obtain and maintain written documentation of HIV-positive status once an individual is enrolled in RWPA services.

2. Residency Eligibility Requirements

All new and continuing clients enrolled in RWPA programs must provide documentation of residency in the NY EMA (i.e., one of the five boroughs of New York City or Putnam, Rockland or Westchester counties).

3. Income Eligibility Requirements

All new and continuing clients enrolled in RWPA programs must meet income eligibility requirements to receive services. The Planning Council has currently set the maximum household income at 435% of the Federal Poverty Level (FPL).

General Background:

The New York Eligible Metropolitan Area (NY EMA), which includes the five boroughs of NYC and the adjacent Tri-County region of Westchester, Rockland, and Putnam counties, is home to more than 9.9 million people. The NY EMA continues to have the largest HIV epidemic in the U.S., with approximately 12% of the nation’s PLWH in 2014 and 7% of all HIV diagnoses in 2015. As of December 31, 2016, there were 131,933 reported PLWH in the NY EMA. Of those, 4,023 cases were reported in the Tri-County Region. Of the 57 counties outside of New York City, Westchester County has the highest number of HIV diagnoses and reported PLWH, with Rockland and Putnam Counties following closely behind. 1 Despite annual declines in new HIV diagnoses and significant advances in medical care for PLWH, disparities in health outcomes and access to health care persist. Factors associated with high service need and low service utilization in the Tri-County region include being unstably housed and having low mental health functioning.

As of December 31, 2016, 4,023 HIV cases have been reported in the Tri-County region.2 Of the total number of PLWH in the Tri-County region 80.9% reside in Westchester, 15.4% in Rockland, and 3.7% in Putnam County. It is estimated that an additional 9% of PLWH in the Tri-County region (i.e. another 324 individuals) are unaware of their positive sero-status. As is the case throughout the United States, the Tri-County epidemic continues to disproportionately affect communities of color. While non-Hispanic blacks comprise only 12.9% of the region’s population,3 36.4% of reported HIV cases are black. Hispanics, who comprise 19.5% of the area’s residents, represent 28.8% of those reported living with HIV.

HIV Care Continuum:

The HIV Continuum of Care (also known as the Cascade of HIV Care) displays the various stages of engagement in HIV care after infection. It can be used to highlight the unmet need of PLWH with the length of the bars representing progress towards complete (100%) identification of PLWH, diagnosis of infected persons, retention in HIV care, utilization of ART, and ultimately viral suppression.

According to the New York State (NYS) Cascade of HIV Care in the Tri-County Region, 77% of the 3,790 persons living with a diagnosed HIV infection received HIV care. However, this rate drops to 63% when looking at those who received continuous care during follow up. Of those who received a positive HIV diagnosis, only 68% were virally suppressed, highlighting the approximately 1,200 individuals who are not in care and who are not virally suppressed. Removing barriers and supporting individuals to enter into and maintain consistent HIV medical care requires both a variety of support services and concerted collaborative efforts aimed at retaining patients in HIV care and treatment to achieve viral load suppression. The services sought through this RFP aim to increase the numbers of PLWH who are engaged in primary care and are, ultimately, virally suppressed.

General Service Delivery Framework:

Services should be client-centered, non-judgmental, trauma informed,4 culturally appropriate, sensitive to physical and sensory impairments, and tailored to the population served. A variety of engagement strategies should be employed to ensure that client-specific needs are met. Clients should be included in the decision making whenever possible. The utilization of peers in all applicable service areas is strongly encouraged. Organizations funded to provide services in the Tri-County Region are encouraged to coordinate services in such a way that referrals between organizations and across services categories ensure smooth and continuous care and treatment for all RWPA clients.

General Service Delivery Model:

All RWPA service providers must refer clients, as appropriate, to entitlement and benefits specialists with experience within the health care system. As clients with unmet medical and social service needs are identified, referrals and linkages must be provided.

Concerted outreach efforts should be made to schedule, re-confirm, and follow-up on missed appointments for individuals whose circumstances present added barriers to remaining in care. Providers must discuss viral load, CD4 cell count, antiretroviral therapy adherence, and retention in primary care, as appropriate, with clients.

Ryan White as a Payer of Last Resort:

Ryan White dollars must be used as funds of last resort and are expected to be utilized for allowable services only when other funding sources are not available.

Organizations that are awarded contracts through this RFP will be required to document, in client files, how each client was screened for and enrolled in eligible third-party programs to pay for those services that are billable.

Services Availability:

Organizations must ensure that the following services are available to clients either through co-location/affiliation* or a formal linkage agreement:

-Food and Nutrition Services
-Harm Reduction Services and Other Appropriate Substance Use Services
-Health Education and Risk Reduction Services, as appropriate
-HIV Testing
-Housing Services
-Legal Services
-Medicaid, Medicare, and NYS Health Insurance Exchange Systems
-Medical Care
-Medical Case Management
-Mental Health Services
-Non-Medical Case Management
-Supportive Counseling, as appropriate

*Affiliation is defined as being geographically close and aligned to provide available patient care.

GrantWatch ID#:

GrantWatch ID#: 183739

Estimated Total Program Funding:

$3,952,992

Number of Grants:

There will be 10-18 awards total, including: 1-3 Food and Nutrition Services awards; 1-2 Housing/Short Term Assistance Services awards; 3-7 Medical Case Management Services; 1 Mental Health Service award; 1 Oral Health Care Service award; 1-2 Psychosocial Support Services awards; 1 Medical Transportation Service award; and 1 Emergency Financial Service award.

Estimated Size of Grant:

Annual Funding Ranges:
-Food and Nutrition Services: $322,936 - $968,807
-Housing/Short Term Assistance Services: $292,504 - $585,008
-Medical Case Management Services: $198,299 - $462,698
-Mental Health Services: $99,697
-Oral Health Care Services: $186,986
-Psychosocial Support Services: $64,578 - $129,155
-Medical Transportation Services: $345,246
-Emergency Financial Services: $250,000

Proposed amounts must fall within the minimum and maximum range. However, final awards may be less than requested in order to meet the needs of target populations and to ensure adequate geographic distribution of services. The first funded year might start during the fiscal year and will be prorated accordingly.

Term of Contract:

The contract start date is March 1, 2019.

Contracts will be awarded for a term of up to three years with two 2-year renewal options.

Additional Eligibility Criteria:

General Organizational Eligibility Requirements:

This RFP is intended to solicit proposals from nonprofit organizations with experience serving people living with HIV/AIDS (PLWH), as well as experience providing relevant services. General organizational eligibility criteria are as follow:

1. Legal incorporation by the State of New York as a not-for-profit corporation;
2. Federal tax-exempt status under Section 501(c)(3) of the Internal Revenue Code; and
3. Currently operating with a brick-and-mortar site in Westchester, Rockland or Putnam counties.

Facilities must comply with the Americans with Disability Act (ADA) and be accessible by public transportation. Although any individual applicant agency does not have to serve clients from all eight counties in the New York EMA (the five boroughs in NYC and three counties in Tri-County), funded agencies should have the capacity to serve clients from throughout the New York EMA.

Applicants must have demonstrated experience providing related services to PLWH. Applicants should meet the following experience requirements to be eligible for funding under RFP.

Organizations must:
-Have demonstrated experience providing the designated service to people living with HIV equivalent to: at least 2 years of experience serving PLWH; and at least 1 year of experience providing the designated service
-Be co-located with service programs to refer patients for needed medical and/or social support services OR;
-Have established Linkage Agreement (LA) or Memorandum of Understanding (MOU) or Memorandum of Agreement (MOA) with service programs to refer patients for needed medical and/or social support services.
-Be able to address, either directly or through referral, the needs of clients with physical, behavioral, psychosocial, or sensory impairments.
-Be able to bill Medicaid for services that are billable to Medicaid.

Agencies must ensure that staff members have HIV knowledge, training, and cultural sensitivity appropriate to the populations that they serve. Agencies must have the capacity to provide services in the languages spoken by the populations served.

For-profit organizations are not eligible for funding through this RFP. HRSA guidance prohibits not-for-profit organizations from serving as conduits that pass awards to for-profit entities.

All applicants must meet the General Organizational Eligibility Requirements outlined in this section AND any Program Specific Eligibility Requirements outlined in the specific service category in this RFP.

Pre-proposal Conference:

There will be a Pre-Proposal Conference held for this RFP. Attendance at the Pre-Proposal Conference is not mandatory; however, those organizations interested in submitting a proposal are strongly urged to attend.

Please RSVP if you plan to attend via the RFP email address listed below. RSVP is not required, but it is encouraged.

The conference is scheduled for June 8, 2018, 10:00am - 1:00pm EDT.

The Pre-Proposal Conference location is:

Westchester County Department of Social Services
10 County Center Road, Floor 2, DSS Training Room
White Plains, NY 10607

Parking is available and the Metro-North Railroad is nearby.

Pre-Application Information:

The Planning Council has allocated funding for RWPA services in the Tri-County Region. Funding pools are as follows:

-Food and Nutrition Services: $968,807
-Housing/Short Term Assistance Services: $585,008
-Medical Case Management Services: $1,388,093
-Mental Health Services: $99,697
-Oral Health Care Services: $186,986
-Psychosocial Support Services: $129,155
-Medical Transportation Services: $345,246
-Emergency Financial Services: $250,000

Questions about eligibility, proposal requirements or other requests for clarification about information in the RFP must be submitted via email no later than 5:00pm on June 14, 2018.

Responses to questions from the Pre-Proposal Conference, as well as questions submitted via email, may be addressed in a supplement to the RFP. The Supplement will also include the presentation slides from the Pre-Proposal Conference, and both will be posted on Public Health Solutions’ website:
https://www.healthsolutions.org/get-funding/request-for-proposals/

An email notification will be sent to all individuals that have registered on Public Health Solutions’ RFP website and download the RFP, submitted questions via the RFP email and/or attended the Pre-Proposal Conference. Please note that not all written inquiries will receive written responses. NYC DOHMH and Public Health Solutions reserve the right not to respond to questions received after June 14, 2018.

The Notice of Intent to Respond form is not mandatory; however, proposers interested in responding to this RFP are strongly urged to submit the form by the due date so that Public Health Solutions may be better able to plan for the proposal evaluation process. Any information related to this RFP will be emailed to the individual(s) designated as the Proposal Contact Person. The form should be submitted by email no later than July 31, 2018 via email.

NOTE: Please see Proposal Submission Instructions on page 93 of the RFP. To ensure that you have a working portal login, and to familiarize yourself with the CAMS Contracting Portal’s Proposal Upload area, you should create and test the portal login at least one week before the proposal submission deadline.

Proposals received after 2:00 PM on August 7, 2018 are late and shall not be accepted, except as provided under the New York City’s Procurement Policy Board Rules.

Timeline:
-RFP Issue Date May 25, 2018
-Pre-Proposal Conference: June 8, 2018
-Deadline for Written Inquiries: June 14, 2018, 5:00 PM EDT
-Notice of Intent to Respond July 31, 2018, 5:00 PM EDT
-Proposals Due Date August 7, 2018, 2:00 PM EDT
-Projected Award Notification Date October 2018
-Contract Start Date March 1, 2019

Contact Information:

Before starting your grant application, please review the funding source's website listed below for updates/changes/addendums/conferences/LOIs.

Mayna Gipson, Public Health Solutions
RWTriCountyRFP@healthsolutions.org

Funding or Pin Number:

Solicitation #: 2018.05.HIV.03.01

URL for Full Text (RFP):

Geographic Focus:

USA: New York City;   New York: Westchester, Rockland, or Putnam Counties