To provide direct financial assistance to eligible metropolitan areas (EMAs) and Transitional Grant Areas (TGAs) that have been the most severely affected by the Human Immunodeficiency Virus (HIV) epidemic to develop, organize and operate programs that provide an effective, appropriate and cost efficient

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continuum of health care and support services for the individuals and families with HIV disease.

In FY 06, 51 non-competing continuation awards were made and in FY 07 and FY 08, 56 non-competing applications were made.

Uses and Use Restrictions

Funds received under a grant are to be used to fund 75 percent core medical services and 25 percent support services.

Core medical services include: outpatient and ambulatory health services, AIDS Drug Assistance Program, AIDS, pharmaceutical assistance, oral health care, early intervention services, medical nutritional therapy, substance abuse treatment and mental health treatment, medical case management, including treatment and adherence services.

Support services for individuals with HIV/AIDS to achieve medical outcomes (such as respite care for persons caring for individuals with HIV/AIDS, outreach services, medical transportation, linguistic services and referral for health care and support services).

A percentage of the grant, determined by the percentage of women, infants, and children in the area with Acquired Immune Deficiency Syndrome, will be used to provide health and support services to infants, children, and women with HIV disease, including treatment measures to prevent the perinatal transmission of HIV.

No more than 10 percent of amounts received under a grant may be used to fund grant administration and monitoring activities, program support activities and all activities associated with grantee contract award procedures.

Funds may not be used to supplant or replace the resources of such institutional providers that are already devoted to the support of personnel providing HIV-related services.

Funds may not be used to purchase or improve land, or to purchase, construct or make permanent improvement to any building except for minor remodeling.

Funds may not be used to make payments to recipients of services.

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Eligibility Requirements

Applicant Eligibility

Eligible metropolitan areas (EMA) with a population of 50,000 or more individuals for which the Centers for Disease Control and Prevention has reported a cumulative total of more than 2,000 HIV/AIDS cased for the most recent period of 5 calendar years period.

EMAs include: Atlanta, Georgia; Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Detroit, Michigan, Ft.

Lauderdale, Florida; Houston, Texas; Los Angeles, California; Miami, Florida; New Orleans, Louisiana; New York, New York; Newark, New Jersey; Orlando, Florida; Philadelphia, Pennsylvania; Phoenix, Arizona; San Diego, California; San Francisco, California; San Juan, Puerto Rico; Tampa-St.

Petersburg, Florida; Washington, DC; and West Palm Beach, Florida.

Transitional Grant areas (TGA) with a population of 50,000 or more individuals for which the Centers for Disease Control and Prevention has reported a cumulative total of at least 1,000, but not more than 1,999 HIV/AIDS cases for the more most recent five year period.

TGAs include: Austin, Texas; Bergen-Passaic, Caguas, Puerto Rico; Cleveland, Ohio; Denver, Colorado; Dutchess County, New York; Fort Worth, Texas; Hartford, Connecticut; Jacksonville, Florida; Jersey City, New Jersey; Kansas City, Missouri; Las Vegas, Nevada; Middlesex, New Jersey; Minneapolis, Minnesota; Nassau/Suffolk Counties, New York; New Haven, Connecticut; Norfolk, Virginia; Oakland, California; Orange County, California; Ponce, Puerto Rico; Portland, Oregon; Riverside-San Bernardino, California; Sacramento, California; St.

Louis, Missouri; San Antonio, Texas; San Jose, California; Santa Rosa, California; Seattle, Washington; and Vineland, New Jersey.

Beneficiary Eligibility

Individuals and families with HIV disease will benefit.

Credentials/Documentation

Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.

Aplication and Award Process

Preapplication Coordination

This program is eligible for coverage under E.O.

12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office of official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.

Application Procedures

Grant applications and required forms for this program can be obtained from Grants.gov. Please visit the Grants.gov Web site at www.grants.gov to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator for the Bureau of HIV/AIDS. The Associate Administrator has the authority to make final selections for awards.

Award Procedures

Applications will undergo an internal review process for funds awarded under Section 2603(a)(3). For funds awarded under Section 2603(b), applications will be reviewed by an Objective Grant Review Committee composed of representatives from various Department of Health and Human Services agencies, as well as outside reviewers that are experts in the field of HIV services planning and service delivery. Grants will be awarded to eligible metropolitan areas.

Deadlines

http://www.hrsa.gov.

Authorization

Public Health Service Act, Title XXVI, Part A, as amended, Public Law 109-415; Ryan White HIV/AIDS Treatment Modernization Act of 2006.

Range of Approval/Disapproval Time

About 60 days.

Appeals

None.

Renewals

None.

Assistance Considerations

Formula and Matching Requirements

None.

Length and Time Phasing of Assistance

Grants are awarded for a 12-month budget period.

Post Assistance Requirements

Reports

Annual progress and annual financial reports are required.

Annual reports are to be submitted within 90 days after the end of each budget period.

The final performance report and final financial status reports are due 90 days from the end of the project period.

Reports documenting services and costs will also be required.

Audits

In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records

All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-year period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.

Financial Information

Account Identification

75-0350-0-1-550.

Obigations

FY 07 $587,425,500; FY 08 est $549,905,180; and FY 09 est not available.

Range and Average of Financial Assistance

$875,000 to $102,000,000.

Regulations, Guidelines, and Literature

This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

Information Contacts

Regional or Local Office

Douglas Morgan, Director, Division of Service Systems, HIV/AIDS Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Room 7A-55, Rockville, MD 20857. Telephone: (301) 443-6745.

Headquarters Office

Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: (301) 443-2385; Research and Training Branch: (301) 443-3099; Government and Special Focus Branch: (301) 443-3288.

Criteria for Selecting Proposals

Applications must meet seven criteria set forth in the enacting legislation: (1) Contain a report concerning the dissemination of emergency relief funds and the plan for utilization of such funds; (2) document demonstrate need in such area for supplemental financial assistance to combat the HIV epidemic; (3) demonstrate the existing commitment of local resources of the area, both financial and in-kind, to combat the HIV epidemic; (4) demonstrate the ability of the area to utilize such supplemental financial resources in a manner that is immediately responsive and cost-effective; (5) demonstrate that resources will be allocated in accordance with the local demographic incidence of AIDS including appropriate allocations for services for infants, children, women, and families with HIV disease; (6) demonstrate the inclusiveness of the planning council membership, with particular emphasis on affected communities and individuals with HIV disease; and (7) demonstrate the manner in which proposed services are consistent with the local needs assessment and the statewide coordinated statement of need.