Health Resources and Services Administration HIV/AIDS Bureau Division of Training and Capacity Development Demonstration & Evaluation Branch Pre-review Webinar Health Information Technology Capacity Building for Monitoring and Improving Health Outcomes along the HIV Care Continuum – Capacity Building Sites Competitive Grant Application HRSA April 23, a.m. EDT

SPNS Program Information for HRSA SPNS Background Information Purpose of the Funding Opportunity Announcement Program Expectations and Data Requirements Overview of Major Application Sections Review Criteria and Selection Process 2

Background Special Projects of National Significance (SPNS) SPNS is a component of the Ryan White HIV/AIDS Program, funded under Part F of the Ryan White HIV/AIDS Treatment Extension Act SPNS Program supports the development of innovative models of HIV care to quickly respond to the emerging needs of clients served by the Ryan White HIV/AIDS Program SPNS evaluates the effectiveness of these models’ design, implementation, utilization, cost, and health-related outcomes, while promoting dissemination and replication of successful models SPNS’ mission is to improve HIV service delivery through demonstration projects and evaluation focused on primarily underserved, underinsured, and uninsured populations 3

Background National HIV/AIDS Strategy and HIV Care Continuum Initiative Aligns with Goals 2 & 3 of the NHAS : to increase access to care and improve health outcomes of people living with HIV/AIDS; and to reduce HIV-related health disparities. Aligns with the HIV Care Continuum Initiative, which directs Federal agencies to prioritize the continuum of HIV care by accelerating efforts and directing existing Federal resources to increase HIV testing, services, and treatment, while improving patient access. 4

Purpose for HIT Capacity Building Funding Opportunity Support four (4) Ryan White Part A or B grantees to enhance the health information technology (HIT) systems in their State or Eligible Metropolitan Area (EMA) or Transitional Grant Area (TGA) jurisdictions. Enhanced HIT systems will fully integrate and utilize HIV treatment, surveillance and laboratory data to allow for more efficient collection, monitoring and tracking of health outcomes of people living with HIV along the HIV Care Continuum. 5

Overall Goal of this HIT Capacity Building Initiative To enhance the ability of States, EMAs or TGAs to produce HIV Care Continuum models for HIV-infected subpopulations in their jurisdictions. Once implemented, the enhanced HIT system must be able to collect and report standardized HIV Care Continuum measures for the purpose of improved monitoring of HIV-infected subpopulations in their States or EMA/TGAs Program Expectations 6

Proposed HIT Capacity Building Methods may include: Interconnectivity improvements for an existing WAN, RHIO or HIE (adding new nodes to an existing network, or connecting two or more systems to facilitate data exchanges) Development of a new or enhancement of an existing central data repository (a host location for access and sharing of data to effectively monitor and track health outcomes of PLWH) Applicants will be expected to leverage existing HIT systems and resources in their capacity building proposals Program Expectations 7

Data Requirements HHS Common HIV Core Indicators Program Expectations 8

Data Requirements Required: Patient demographics including sex, race/ethnicity, age, HIV transmission risk group, income level, and health insurance type Optional: Sexual orientation, transgender status, primary language and country of origin Additional data elements may include: Ryan White Services Report (RSR), HAB performance measures, and National Quality Forum (NQF) indicators Inclusion of any additional data elements subject to review and approval by HAB Program Expectations 9

Application Summary of Funding Opportunity Funding provided during Federal fiscal years Approximately $2,000,000 expected to be available annually to fund four (4) grantees, with each award not to exceed $500,000 per year. Start Date: September 1, 2014 Project Period: September 1, 2014 – August 31, 2017 Funding beyond the first year is dependent on: o Availability of appropriated funds in subsequent fiscal years; o Satisfactory performance; and o Decision that continued funding is in the best interest of the Federal government 10

Application Format Project NarrativeReview Criterion IntroductionNeed Needs AssessmentNeed MethodologyResponse, Evaluative Measures and Impact Work PlanResponse Resolution of ChallengesResponse Evaluation and Technical Support Capacity Resource/Capabilities Organizational Information Budget / Budget Narrative Resource/Capabilities Support Requested 11

Application Project Narrative –Introduction & Needs Assessment INTRODUCTION: Clear and succinct description and purpose of the proposed project. Brief description of the applicant organization and any collaborators. NEEDS ASSESSMENT: Description of existing HIT infrastructure in the Ryan White jurisdiction, including HIV treatment, surveillance, laboratory, and other relevant data systems, such as a WAN, RHIO, HIE, central data repository and/or Medicaid databases, if they are included in the proposed plan. Description of how these systems currently integrate with one another, and include a flowchart that identifies these systems as Attachment 4. Full assessment of existing technology gaps that prevent production or utilization of the HIV Care Continuum model within the jurisdiction. Statement of how the proposed project is consistent with State’s SCSN as Attachment 5. 12

Application Project Narrative –Methodology Detailed plan for the HIT capacity building project that addresses the existing technology gaps described earlier Description of how existing HIT systems and resources will be leveraged to enhance capacity Description of all other HIT funding sources of the health department, and how additional SPNS funds will complement existing HIT development infrastructure Discussion of how the enhanced HIT system may be affected by technological issues such as different HIT standards and system interconnectivity differences. Description of interconnectivity configurations that ensure efficient integration /utilization of proposed system components. 13

Application Project Narrative –Methodology Data flowchart identifying all data systems involved in the project; any interconnectivity enhancements; all relevant data collection and reporting streams and processes, as Attachment 6. If feasible, description of how the implementation of the project will facilitate tracking of individual clients as they move through the different stages of the HIV Care Continuum Description of all other HIT funding sources of the health department, and how additional SPNS funds will complement existing HIT development infrastructure If the project includes the development of a new or the enhancement of central data repository, description of how it will collect data from all relevant data sources in its jurisdiction; how it will interact with the different stakeholders participating in the network; and how exchange of health information will facilitate access and sharing of data to improve health outcomes 14

Application Project Narrative –Methodology Description of how the proposed project will address issues of confidentiality and privacy surrounding use of client-level data. Description of any applicable State and local regulations regarding the sharing of clinical and laboratory data, and whether they exceed HIPAA requirements for the protection of disclosure of information regarding people living with HIV. If applicable, description of any current data sharing agreements in place at the time of application. Inclusion of single page Letter of Support or Memorandum of Agreement/ Understanding as evidence of these agreements in Attachment 7. 15

Application Project Narrative – Work Plan The work plan should describe the steps used to achieve each of the activities proposed during the project period in the methodology section: The work plan should be time-framed with specific dates to actively manage the project by measuring progress and quantifying accomplishments.; Major elements/tasks/activities to be performed during the project period listed in chronological order; and Identification of the staff members (in-kind and grant-supported) who will manage, oversee, configure and install new hardware and software, or modify existing systems in order to meet the objectives of project. The work plan should be included as Attachment 8. 16

Application Project Narrative – Evaluative Measures Description of how the proposed HIT system will be used: to evaluate State/EMA/TGA’s HIV testing, treatment & support services; to assess client unmet needs; and to monitor program performance and quality improvements Data Sources Table: Include specifics for all types of data to be collected from all of sources Identify any data not covered by the HIPAA exemptions for surveillance and quality improvement Description of how the HHS Common HIV Core Indicators will be collected and calculated from these sources Explain how health outcomes will be stratified by demographic data to address HIV-related health disparities across the HIV Care Continuum. Provide rationale for collection & use of any additional data elements. 17

Application Project Narrative – Organizational Information Description of applicant organization’s current structure and scope of current activities, and how these contribute to its ability to conduct the project One-page organizational chart depicting the structure of the project, including collaborating organizations, subcontractors and other significant collaborators as Attachment 9. If applicable, describe roles and responsibilities of any consultants and/or subcontractors to be used to carry out the proposed project. Include any MOAs, MOUs Letters of Support and descriptions of any existing or proposed contracts from current and/or proposed collaborating organizations, consultants and/or subcontractors demonstrating their commitment to fulfill goals and objectives of the project, as Attachment 7. 18

Application Attachments Attachment 1Line Item Budgets Spreadsheet for Years 1 through 3 Attachment 2Position Descriptions Attachment 3Biographical Sketches of Key Personnel Attachment 4Existing HIT Infrastructure Flowchart Attachment 5 Statement of Consistency with Statewide Coordinated Statement of Need Attachment 6Project Data Flowchart Attachment 7Letters of Agreement and/or Description(s) of Proposed/ Existing Contracts Attachment 8Work Plan Attachment 9Project Organizational Chart Attachments 10-Other Relevant Documents 15 19

Review and Selection Process Review Criteria Before submitting your application, it is important to review the following review criteria in this section of the funding opportunity announcement: Scoring: 100 points total Six Elements: o Need – 20 points (corresponds to Introduction and Needs Assessment) o Response – 30 points (corresponds to Methodology, Work Plan and Resolution of Challenges) o Evaluative Measures – 20 points (corresponds to Evaluative Measures) o Impact – 10 points (Corresponds to Methodology) o Resources/Capabilities – 10 points (Corresponds to Organization Information) o Support Requested – 10 points (corresponds to Budget sections and related attachments) 20

Thank you !