1. The CDC Prevention Grant Funding Opportunity Announcement (FOA) and OA’s Response Overview and Discussion September 21, 2011 California Department of Public Health, Office of AIDS

2.  Introduction & Background  Structure for OA-funded activities:  Tier I and Tier II  Changes to HIV Prevention Programs  Allocations  Next Steps  Discussion and Q&A Agenda

3. New Direction in HIV Prevention  Identify people with HIV infection  Link to care, retain and reengage  Reduce viral load for individuals and the community

4. The CDC FOA A more prescriptive approach which emphasizes:  HIV testing  Prevention with positives and their partners  Services in medical settings  Structural and policy interventions  Increasing collaboration between prevention and care

5. Overview of OA’s Response

8. OA’s Design for Prevention Activities: Tier I and Tier II OA’s Tier I and Tier II activities reflect the priorities described in the FOA OA will take on some of these activities LHJs will be able to choose among Tier I activities (or implement all) LHJs may choose to implement Tier II activities when Tier I activities have all been met

9. Tier I Activities Testing Linkage to care Partner services Risk assessment, linkages to services and behavioral interventions for HIV+ people HIV treatment adherence Syringe services programs Policy initiatives – Surveillance data use – Leveraging SAMHSA HIV set- aside funds – Healthcare reform planning Condom distribution & syringe supply bank State community planning

10. Tier II - Activities Hepatitis C testing (can test in non-healthcare settings prior to fulfilling all Tier I activities) Integrated HIV, hepatitis, TB and STD screening Behavioral interventions for high-risk negative people Social marketing, media and mobilization Pre-exposure prophylaxis (PrEP) planning and/or delivery

11. All Tier I activities must be implemented before funding can be used for Tier II activities. Tier I activities may be funded with either OA funding or other funding. The Expanded Testing in Healthcare Settings funding, which had been a separate grant from the CDC, has been integrated into this CDC prevention grant as Category B. Details of the Tier Design

12.  HIV Test kits to funded CPA jurisdictions  CA AIDS Clearinghouse supplies to all CPG LHJs:  Condoms  Harm reduction materials and syringe supply bank  Educational materials  LEO is available for use by all LHJs OA Resources

13. Settings - more emphasis on healthcare settings for HIV positive people, and linkages Targets - more emphasis on HIV positive individuals and their partners Activities – even more emphasis on evidence- based interventions CDC Changes for Prevention Programs

14. Process for Program Implementation Fiscal implementation: January 1, 2012 Programmatic implementation: July 1, 2012 This provides a 6-month period to adjust prevention programs to new directions

15. Fiscal Implementation Application of allocation formula cannot be done until official award amount is provided. – CDC did not include a date awards will be announced. There will be more funds available for allocation to the funded LHJs. Models of possible award amounts have been developed. A draft was provided to CCLAD members. A supplemental grant award will be provided for January 1, 2012 through June 30, 2012. New award amounts will be used for FY 12-13.

16. Allocation Funding Formula Previous formula New HIV infections identified through C&T (3 years) (20%) % Newly reported HIV cases (20%) % Living AIDS cases (20%) % Male syphilis (1 year) (7.5%) % Male gonorrhea (1 year) (7.5%) % Non-Hispanic AA (15%) % Hispanics (5%) % Below poverty level (5%) Current formula % People living with HIV and AIDS, excluding state prison cases (75%) % Non-Hispanic AA (15%) % Hispanics (5%) % Below poverty level (5%)

17. Activities between January 1 st and July 1 st may include: Maintaining some activities Concluding some activities Planning for some new activities OA has been granted transitional funding Transitional funding will assist programs requiring significant alteration as a result of the new grant direction. Transition Period

18. Timeline: Program-Specific Webinars October 13 th – Transitional Period October 20 th – Testing Activities October 27 th – PWP Activities November 3 rd – Policy Initiatives November 10 th – Syringe Service Programs & California AIDS Clearinghouse November 17 th – Tier II Activities (Social Marketing, HE/RR for High Risk Negatives, Hep C Testing, PrEP) December 8 th – Putting it All Together

19. To provide feedback on OA’s response to the FOA, please send comments to: OAFeedback@cdph.ca.gov