What is Ryan White Part A funding & how is the money available?
The Health Resources Services Administration (HRSA) has awarded funding to a six-county Transitional Grant Area (TGA) to augment the health care systems currently bearing the burden of HIV-related care. Mecklenburg County Health Department is the administrator for these funds because Mecklenburg County has the highest number of HIV cases in the six-county area.  The amount of the grant is $3.82 million and includes a HRSA Supplemental Award of $ 974,327.  Approximate allocations of the funds are as follows:

What is meant by continuation funding?
In order to maintain needed services for clients during the period between funding of Title II and new Part A funding, the North Carolina Health Department AIDS Care Branch agreed to fund those agencies currently receiving Title II monies through September 30, 2007.  They will be funded at current levels by using Part A money to continue these services through February 29, 2008. Agencies in the six-county region currently receiving Title II funding are eligible to apply for expanded services under Part A.
 

How is this money different from HIV funding that the county has gotten before and how is it different from the money the County awarded for HIV prevention and outreach in 2005-06?
This money is intended for primary medical care of HIV patients and their families and will only pay when all other means of payment have been exhausted. Money that has come to the county before and money awarded by the county to the health department last year were directed at HIV prevention and education.
 

Why do applicants have to apply for money if they are already receiving money under Title II funding?
Part A funding is new funding from the Health Resources Services Administration (HRSA) and is provided to our Transisitional Grant Area (TGA) due to the rising need for primary medical care funding for HIV Disease. Funding from past budget years have been under a different funding cycle called Title II and were provided to the region through the State. We have negotiated an agreement with HRSA & the State to provide part of the Part A money to current Title II providers until February 2008 so that they will not see a funding gap for clients.
 

It seems like much of the money for HIV in the region is controlled by a few agencies, hospitals, health departments, etc; is there an opportunity for small agencies to apply?
We strongly encourage all of the agencies in the region who are eligible and meet the requirements of the RFP to apply. The selection process is fair and balanced and does not favor one agency over the other. We are currently working on establishing evaluation teams that will be comprised of individuals from around the region and who reflect the clients that will be served by these funds.
 

The HIV epidemic has hit the African American community especially hard. Will some of this money be automatically directed to this group and how is this money addressing this issue?
Although funding from Part A is not specifically targeted at one group, we do anticipate agencies that serve the most vulnerable populations to apply and, if awarded funds, they will have to determine under HRSA guidelines who receives Part A funds for their needed health care.
 

How long will this grant last?
We have been awarded funds through February 2008 and will apply for funding in October 2007 for the grant period of March 2008 through February 2009. Mecklenburg County is also applying for the HRSA Minority Aids Initiative grant on May 25, 2007. If awarded, HRSA Minority Aids Initiative funding would start in September 2007 and continue for one year. It is aimed at primary medical care for minority populations in the same six county region. If received, these funds would be awarded to agencies through a separate RFP.
 

Will private practice therapists be considered under the mental health services area?
Only Organizations/Agencies meeting the following criteria are eligible to apply for funding under this RFP. For-profit agencies are eligible only in the absence of qualified nonprofit agencies able and willing to provide quality services.

• Private entities must be incorporated, or be authorized to do business in North or South Carolina, and have local offices, representatives and phone numbers. 
• Organization/Agency must deliver services to residents of one or more of the following North Carolina and South Carolina counties: Mecklenburg, Gaston, Cabarrus, Union, Anson, and York County, SC.
• Organization/Agency must perform one or more of the eligible services listed in this RFP.
• Organization/Agency proposing Medicaid reimbursable services must show proof of being a Medicaid provider at the time of application.
   

Are the Emerging Community funds received by York County included in the Title II allocation that the Health Department will fund from October, 2007 through February 29, 2008? 
Yes.  These funds will come through the Consortium as usual ending February 29, 2008.
 

Will the Supplemental Funds, that will soon be received, be part of the base allocation for future years? 
No, only the initial Award is the base amount.
 

York County is currently using the software Provider which is required by South Carolina.  Can they continue to use this? 
York is currently receiving Title II through the Consortium.  Reporting through 2/29/2008 for these funds will remain the same. If York applies for any new Part A funds, the MCHD will investigate the data transmission setup. For Gaston Family Health Services, HIV Consortium, and MAP receiving Title II funds from the State, they will report through CAREWare to the State through 9/30/2007 for the 6 county TGA area.  MAP and the HIV Consortium will continue to report through CAREWare to the State for the Non-TGA counties through the end of the FY 07-08 contract.   

Effective 10/1/2007, these agencies reporting through CAREWare will be submitted to the Mecklenburg County Health Department (MCHD).  The MCHD IT staff will assist with this process.  Other Title II recipients (those receiving funds through the Consortium) will continue reporting as usual through 2/29/2008.  
 

Since the contracts may not be finalized until mid August and the fiscal year ends 2/29/2008, should providers only apply for six months of funding? 
Yes, please apply only for funds that can be expended by 2/29/2008.  
 

Will providers have to reapply for funds effective 3/1/2008? 
Yes, a new RFP will be advertised in the fall 2007 for this application process.
 

Do Title II providers receiving funds through 2/29/2008 have a deadline of 6/29/2007 for responding to this RFP? 
This deadline is only for those applying for new Part A funding. If current Title II providers propose extending their services or funding level beyond their current rate, an application must be filed by the deadline to be considered.
 

How many times per year will providers be required to look at the HIV seropositive loads?  
We will confer with HRSA on this requirement; to be finalized in the contract.
 

For medical case management, on the pricing schedule, are we to record our cost per unit or what the state goes by? 
Your cost.
 

Is there an eligibility requirement of below 200% of poverty?  A current Title II provider said they had no income limitations. 
Yes, HRSA requires that all clients must meet the low-income qualification.  The level was set at 200% of poverty.
 

What happens with Union County residents who do not have any Infectious Disease doctors?  Are they to be referred to Carolinas HealthCare System or CW Williams? 
Yes, at this point. 

How does my agency apply for several services?
Agency must submit Exhibit II for each service. There will be different evaluation teams evaluating the different service areas who will rate applications on a point scale. The health department will make allocations to selected agencies.

Is there a template for rules on case management?
No formal definition is currently available since this is evolving. The current understanding is that patient must be under care, understood to mean that within the last year, patient has: been seen by a physician, had lab work, and has taken medication (if required). You can bill for case management if agency can document patient has had care based on these requirements. Further clarification will be provided as it is defined by HRSA.

Will CAREWare training be available locally or in Raleigh?
Training will be provided by the Mecklenburg County Health Department and will take place in Charlotte. Schedule will be determined at a later date.

How will fee for service work since the application asks for 1 line item per service?
Mecklenburg County understands that there are multiple levels of services that can be rendered under each service area and ask that agencies provide an average costs in Exhibit III. If selected, agencies will be required to submit further cost detail which will be included in the agency contract.

My agency is a current Title II provider, how should we apply?
No, for MOST of the Title II Providers, these Title II funds will be received and reported the same as the past however the funds will expire 2/29/08.  (For MAP, Gaston Family Health Services, and the HIV Consortium, the Health Department will contract with you for these funds effective 10/1/2007).  If these providers want to apply for additional funding under Part A (Title I), please complete the current application due 6/29/2007.

When can agencies begin rendering Part A services?
Services can be rendered after contract is awarded, expected August 2007.

How will CAREWare be available, is it an Internet-based application?
CAREWare is free software available from and supported by HRSA. It is desktop-based software that must be installed at your agency. Mecklenburg County will provide oversight during setup of this application.

Are agencies expected to spend one-half of the fees since the performance period will be approximately six months?
We expect to spend 100% of funding, despite the shorted performance period. Future funding can be dependant on our ability to exhaust our allocated funding.

Is the supplemental funding a renewable amount?
The supplemental funding is not a guaranteed allocation.

If the client receives Ryan White funds for ambulatory care, do they have to have case management? 
No.  Some clients may not need case managers.

Are patients currently under Title II or III eligible for Title I funding?  What is the priority for reimbursement?
All Titles (now Part A, B, C, D) want to become the payer of last resort.  Those patients currently receiving Title II or III services can also receive Title I (Part A) funded services if those services are not available under current arrangement.  But you should first try to serve those currently without any resources including Part B and C.

Will the Health Insurance coverage cover medical and pharmacy?  Is the coverage for premiums or will this cover co-pays too?
Yes

Can a pharmacist provide Adherence Counseling with a patient?
Yes, as long as this arrangement is cost and outcome effective.  The important point is to make sure that the provider can monitor and track such activities.

Can a Provider subcontract services?  For example, can a Provider apply for case management and ambulatory services (to be subcontracted out)?
Yes.   The grantee can contract with a provider who sub-contracts part of the proposed services.

I can not enter information into the Ryan White Application form. It tells me that the document cannot be altered. Is there another form I can download that I can enter data into?
The document is protected, but the fields where we are requesting input can be edited. These editable fields have gold colored symbols. If you are using Microsoft Word version 2002 or older, please download the version .RTF version of the application.

I refer patients to a local doctor. When they can not pay for these visits I usually request payment for the assistance of Ryan White funding to assist client with the payment of the medical bill and once the check is cut for the Finance Office, I pay the bill.  I need to know if this doctor has to fill out Ryan White Grant information for you also to receive payment for services that are rendered to our clients for payment through the Ryan White Funding for emergency cases.
Your agency can apply for case management and ambulatory/outpatient services (doctor visit) under this Ryan White Part A RFP.  If awarded, you can then subcontract with the doctor for his services. The Ryan White funds for the case management and the doctor visits would be paid to your agency. Your agency would then pay the doctor. 

Request a clarification of the answer to question 29:  Our title 3 (Part C) program has a relatively small grant budget for clinical charges compared to the number of enrolled clients.  We anticipate funds to pay for laboratory tests, professional fees and other charges will be depleted before the end of the fiscal year.  Can patients also be enrolled in Part A (title 1) as a secondary insurance and bill title 1 if title 3 can no longer cover costs of care?  Will this create accounting problems for the tracking of number of clients in care for each program?
Yes, clients eligible for Part A can use these funds AFTER the Part C has been exhausted.  Please track the number of clients separately for each Part as they are reported separately.

For Ryan White Part A funding - What specific activities/costs will be funded under Psychosocial Support(i.e., food, speakers, cost of group activities, transportation, supplies, etc)? Please clarify.
Activities/costs for HIV clients must be directly related to receiving HIV care to be considered allowable. Non-standard costs will need to be considered on a case-by-case basis.

How many agencies will be awarded the Ryan White Title 1 grant?
The number of contracts has not been limited.

What is the breakdown of funds available per category now that the supplemental money has been added to the available funding?
The supplemental funding of an additional $974,327 was approved by the BOCC on 6/5/2007. These funds will be allocated to services in the same percentages as the initial formulary funding, see the RFP. Amounts are pending confirmation of Title II services to be funded.

Would you please clarify question #30.  When referring to Health Insurance Coverage premiums and copays for ambulatory medical care services and copays for prescription medications, do you mean private Health Insurance?  For instance, I have a number of patients who have health insurance through their employers but are unable to fully pay for their prescription copays.  Would the grant help these people even though they have some other kind of insurance.
Yes, Part A may be used to pay for public or private health insurance co-pays and deductibles for low-income individuals only.  Low-income has been defined at or below 200% of poverty.

I have been unable to enter information into the grant application because it said the document was locked.
We are making available an unprotected version of the application. Do not alter forms. Only text entered in the space provided will be evaluated. Click here to download.

How should adherence counseling be billed, on a per unit or salary basis? 
For Title II recipients, you can continue billing in the same format you have previously billed.  Please make sure you track the number of clients served and number of services provided for the reporting. For Title I applicants, please bill on a per unit basis (15 minute increments like case management). 

On Exhibit III pricing Schedule under 8. Food Bank/Meals Nutrition why is the unit of service $5. If we want less than the
$5  or more than the $5 for our service how do you want us to show this? Let's say we plan to provide 1000 meals and the cost for each meal is $4.90, it would seem the unit should be meals not $5.
Please propose the number of units and cost for your agency. If your costs for nutrition services are more or less than $5 per unit, please indicate that rate on Exhibit III.

The eligibility criteria require persons to have an income below 200% of FPL.  Who is responsible for determining this?  Will the client have some sort of "card" indicating their eligibility or will they have to be screened by every provider over and over?  Will there be standard criteria, examples: who is counted in the "household" when determining the FPL?  how often are patients rescreened?  etc.
Providers will be responsible for determining client eligibility for Ryan White funds and documenting it in the client file. There will be no standard "card" proving eligibility. Clients should be re-screened annually or as any income/family structure changes occur. Criteria standards will be specified in the provider contract.

Are all agencies required to carry the insurance requirements outlined in the RFP? As a new company and tring to find the insurance listed, I am having some issues. Where/what company carries this type of insurance (Worker's Comp and Fidelity Bond)?
All providers must have all insurance requirements listed in the RFP.  All insurance agents either provide these coverages or have another agency they work with that would provide them. Discuss this with your insurance agent. It is an agent's job to meet a his/her client's insurance needs.

On the "Agency Questionnaire" under "Services Included in the Proposal/Service Location(s) proposed", do you want the county or the agency where the service will be provided?
Please provide the address where the services will be performed.

Do we need to submit both the 501c3 form (item 18 on checklist) and additional seperate documentation as proof of non profit status (item 13 or checklist).
The 501c3 form will serve as the proof.

Regarding the proof of insurances coverage, do you require a COI, Certificate of Insurance or a copy of the facepage of the policy?
A copy of the face page of the contract is sufficient documentation for the application submittal. However, a certificate listing Mecklenburg County as additional insured will be required prior to issuing a contract.

Is it ok to hand deliver the application to the front desk at Billingsley (before 5 on Friday) or do you prefer that it be mailed? 
Hand delivered applications will be accepted at the front desk. Please mark the envelope "Sealed Response for Ryan White Grant". 

We are applying as a government entity.  Do we need to submit by-laws and articles of incorporation or is this just for non-profits?
Please note governmental entity. The by-laws and articles of incorporation are not needed for government entities.

On Exhibit III, the directions under column 7 has a typo. 
Column 7 should say "Column 5 plus column 6 times column 4".

Should personal care services be listed  under number 1:  Ambulatory/Outpatient Medical Care?
Personal care services are not funded in this RFP.