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NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION OF PUBLIC AND BEHAVIORAL HEALTH

Bureau of Behavioral Health, Wellness, and PreventionOffice of HIV/AIDS

SAPTA HIV Testing Program

Announcement Type: Request for Proposal 2017-2018

Funding Opportunity AnnouncementOctober 1, 2017 – September 30, 2018

Release Date: Monday, June 12, 2017Application Due Date: Friday, July 28, 2017 at 5:00 PM (PDT)

Preston Nguyen Tang, BSWHealth Program Specialist I

Nevada Department of Health and Human ServicesDivision of Public and Behavioral Health | Office of HIV/AIDS1840 East Sahara Avenue, Suite 111 Las Vegas, NV 89104Email: [email protected]: (702) 486-6488Fax: (702) 486-8101

Authority: 45 CFR, PART 96 - BLOCK GRANTS

To our Current and Potential Subgrantees:

The Division of Public and Behavioral Health, Bureau of Behavioral Health, Wellness, and Prevention, Office of HIV/AIDS and Substance Abuse Prevention & Treatment Agency (SAPTA) HIV Testing Program is accepting applications for grant year (GY) 2017-2018 (October 1, 2017 to September 30, 2018) for the SAPTA HIV Testing Program. The purpose of this Request for Proposal (RFP) is to assist SAPTA state-certified residential and/or transitional treatment facilities in offering rapid HIV testing at treatment locations. This RFP supports the goals of the National HIV/AIDS Strategy (NHAS) by reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities. It also supports the requirement of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) initiative to expand early intervention services for HIV by funding certified residential and/or transitional treatment facilities to offer and encourage rapid HIV testing (including confirmatory and diagnostic testing), HIV risk reduction education, linkages to care, and other ancillary services. Federally Qualified Health Centers (FQHC) and Health Districts are not eligible to apply for this funding, unless they are a SAPTA state-certified residential and/or transitional treatment facility.

Multiple SAPTA certified residential and/or transitional treatment programs will be selected statewide. The State will pay personnel, administrative fees, office supplies, the cost of lab/CLIA licenses, set-up costs related to lab/CLIA inspections, and the Alere Determine™ HIV-1/2 Ag/Ab Combo.

The budget period for this proposal is October 1, 2017 through September 30, 2018.

Completed applications must be received no later than Friday, July 28, 2017 at 5:00 PM (PDT).

Thank you,

Lyell S. Collins, MBAHIV Prevention Program Manager

Nevada Department of Health and Human ServicesDivision of Public and Behavioral Health | Office of HIV/AIDS1840 East Sahara Avenue, Suite 111 Las Vegas, NV 89104T: (702) 486-8105

SAPTA HIV Testing Program – Request for Proposal 2017-2018 | Page 2 of 39

Executive Summary

The Division of Public and Behavioral Health, Bureau of Behavioral Health, Wellness, and Prevention; Office of HIV/AIDS is accepting applications for grant years (FY) 2017-2018 (One [1] Years) for the SAPTA HIV Testing Program. The purpose of this program is to assist SAPTA residential and/or transitional treatment facilities to offer and encourage rapid HIV testing (including confirmatory and diagnostic testing), HIV risk reduction education, linkages-to-care, and other ancillary services. It supports the National HIV/AIDS Strategy (NHAS) by reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities. It also supports the requirement of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) initiative to expand early intervention services for HIV.

Funding Opportunity Title: SAPTA HIV Testing Program 2017 RFP

Funding Opportunity Number: SAPTA-HTP 17-18

Due Date for Applications: July 28, 2017 at 5:00 PM (PDT)

Anticipated Total Funding Available: $455,796

Estimated Number of Award(s): 15 Subgrants

Estimated Award Amount: Dependent upon Federal Notice of Grant Award

Cost Sharing/Match Required: None

Project Period: October 1, 2017 through September 30, 2018(1 Year)

Eligible Applicants: This opportunity is limited to SAPTA residential and/or transitional treatment facilities to offer and encourage rapid HIV testing (including confirmatory and diagnostic testing), HIV risk reduction education, linkages-to-care, and other ancillary services.


Table of ContentsTechnical Requirement 5

Grant Objectives/Achievables 6

Subcontracting Services to another Agency 8

Request for Proposal (RFP) Timeline 9

Submittal Instructions 10

Application Evaluation Criteria 11

Subgrant Award Process 13

Terms, Conditions, and Exceptions 14

ATTACHMENT A: APPLICATION SUBMITTAL PACKAGE 16

Cover Page 17

Agency Profile 18

Contact Information 19

Agency Summary and Experience 20

Project Narrative 21

Scope of Work 22

Budget Template 27

Application Checklist 28

ATTACHMENT B: DETAILED INSTRUCTIONS 29

Instructions for Agency Profile 30

Instructions for Proposed Budget Plan(s) 31

Instructions for Subcontracting Budget Plan 33

ATTACHMENT C: The Nevada Integrated HIV Prevention and Care Plan 2017-2021 35

ATTACHMENT D: Assurances 36

ATTACHMENT E: Conflict of Interest Policy Acknowledgement 38

ATTACHMENT F: Definitions & Acronyms 39



Technical Requirements

1. Who may apply?a. To apply for a subgrant from the SAPTA HIV Testing Program, an organization must be

SAPTA state-certified residential and/or transitional treatment facility.b. Federally Qualified Health Center (FQHC) and Health Districts are not eligible to apply for

this funding, unless they are a SAPTA state-certified residential and/or transitional treatment facility.

c. Excluded Parties – The DPBH requires that no contractors or sub-recipients of federal funding are to be found on the Lists of Parties Excluded from Federal Procurement or Non-procurement Programs accessible at https://www.sam.gov.

2. How does an agency submit an application?a. Applications must be completed on the forms included in the application packet provided by

the Office of HIV/AIDS. The application packet must be emailed to Preston Tang in original files (Word, Excel) and two required hard copies must be received on or before the deadline July 28, 2017 at 5:00 PM (PDT). See Submittal Instructions for more information.

3. Will there be a conference call about the Request for Proposal?a. Yes, there will be a Bidder’s Conference Call on June 23, 2017 at 10:00 AM (PDT). Interested

agencies/bidders should call into the conference call at 1-888-363-4735, Access Code: 5147703.

4. What is the required format?a. Each proposal submitted must contain the following sections:

i. Cover Pageii. Agency Profile

iii. Contact Informationiv. Agency Summary & Experiencev. Project Narrative

vi. Scope of Workvii. Budget Plan

viii. Required Supplements – Staff(s) updated resumes, 501(c) 3 tax exempt, latest audit letter, and signed Conflict of Interest Policy Acknowledgement.

ix. Optional Supplements1. You can include relevant support materials, including samples of newspaper

articles, letters of support, etc. In addition, any charts, graphs, statistical information or substantiating documentation of statements listed in the text of the proposal should be included in the list of attachments.

x. Application Checklist


https://www.sam.gov/

Grant Objectives/Achievables

The primary grant objectives are to fund certified SAPTA residential and/or transitional treatment facilities to offer and encourage rapid HIV testing (including confirmatory and diagnostic testing), HIV risk reduction education, linkages-to-care, and other ancillary services. The applicant agency must be able to meet the following objectives/achievables listed below. In the Scope of Work section of the application packet, the applicant will list activities to describe how the applicant plans to meet each objective and how the activities will be measured and evaluated.

Training

The applicant must be able to complete the State approved Rapid HIV Testing, Counseling, Safety, and Certification Program. The required training is a 1-week training (5 days) in Las Vegas, NV.

Complete blood borne pathogen training. Complete additional training if required by the State of Nevada.

SAPTA HIV Testing Site(s) Set-Up

All applicants must have the infrastructure to apply for a State Lab License and The Clinical Laboratory Improvement Amendments (CLIA) waiver to offer rapid HIV testing.

o SAPTA certified residential and/or transitional treatment programs must apply for State Lab License and The Clinical Laboratory Improvement Amendments (CLIA) waiver to offer rapid HIV testing.

Applicants must be able to successfully pass a Bureau of Health Care Quality and Compliance (HCQC) site inspection for rapid HIV testing and maintain compliance throughout the grant cycle.

HIV Testing / Linkages to Care

The applicant will administer ## rapid HIV opt-out test for clients accessing services through their facility or facilities.

o Applicant will address the number of clients expected to be served during the grant year (GY) 2017-2018 (October 1, 2017 to September 30, 2018). The number of proposed rapid HIV tests should be based on historical HIV testing data or the number of clients served at residential and/or transitional treatment facilities

The applicant must ensure 100% of clients receiving a rapid HIV test will be informed of their test results at the time of rapid HIV test administration.

The applicant must ensure 100% of clients who receive a rapid HIV test will be provided client-centered counseling to address high-risk behavior(s) and provide strategies to mitigate the identified risks.

o Certified rapid HIV test counselors must conduct pre- and post-test counseling and HIV education for all clients’ accessing services at residential and/or transitional treatment programs.

o Proving client education alone, such as community educational presentations, is not a supported activity.

The applicant must ensure that all clients with a reactive rapid HIV test will receive a confirmatory HIV test within 48 hours, following CDC HIV testing guidelines.

o Confirmatory testing is to be referred to the Nevada State Health Division and will not be completed by the applicant. Applicants must ensure an appropriate referral occurs.


The applicant must work with the local health authority to ensure all clients with a confirmed HIV positive test result are provided Partner Services and are linked into HIV care services.

The applicant must provide linkages-to-care for all newly identified HIV-positive clients. The applicant must follow the CDC Rapid HIV Testing Guidelines, federal, and state

requirements, including, but not limited to the Nevada Revised Statutes 441a and the Nevada Administrative Codes.

Quality Management / Reporting

The applicant will be responsible for the accurate collection of all rapid HIV testing data using the approved CDC recommended HIV Counseling and Testing Form.

The applicant will submit all HIV Counseling and Testing Forms to the SAPTA HIV Testing Program, via mail or FedEx by the 3rd of each month.

The applicant will submit to the Nevada Division of Public and Behavioral Health a monthly report of all activities, including any successes, challenges, and/or struggles, using the approved monthly reporting form.

Fiscal Management

The applicant must submit a “Request for Reimbursement” monthly, not later than the 15th of the following month via mail or FedEx. Requests for Reimbursement must be on the approved form and include all back-up documentation.

o Failure to do so may result in the withholding of grant payments.


Subcontracting Services to Another Agency

If the applicant does not have the means and/or is unable to provide all of the services outlined in Grant Objectives/Achievables or Scope of Work sections, the applicant is encouraged to select a subcontractor. The applicant must list the name of the potential subcontracting agency in the Project Narrative, Scope of Work, and Proposed Budget Plan.

The applicant must include the subcontractor’s staff name(s) on the Contractual/Consultant line in Proposed Budget Plan, and address the number of clients expected to be served during the grant year (GY) 2017-2018 (October 1, 2017 to September 30, 2018). The number of proposed rapid HIV tests should be based on historical HIV testing data or the number of clients served at residential and/or transitional treatment facilities.

The SAPTA HIV Testing Program will reimburse a subcontracted agency at $20 per rapid HIV test; this includes the staff time for rapid HIV test administration, individual risk reduction education, and HIV data documentation. The reimbursement rate is in alignment with the 2017 Clinical Laboratory Fee Schedule for rapid testing as outlined by the Centers for Medicare and Medicaid Services. The reimbursement rate the State is offering is slightly higher than the CMS Fee Schedule to account for the administration of the rapid HIV test, individual risk reduction education, and data requirements of this contract.

The SAPTA HIV Testing Program will not cover time spent conducting group HIV presentations or any additional activities outside of the designated, rapid HIV test administration, individual risk reduction education, and documentation.

If applicant intends to subcontract its services to another agency, then the applicant is not required to attend the State approved Rapid HIV Testing, Counseling, Safety, and Certification Program. However, the subcontracted agency must complete the Certification Program. The required training is a 1-week training (5 days) in Las Vegas, NV.

If the applicant intends to subcontract, the applicant assumes a number of responsibilities, including:

The applicant will manage and provide oversight of the subcontracted agency. The subcontractor must complete the State approved Rapid HIV Testing, Counseling, Safety, and

Certification Program and complete all additional training required by the State of Nevada. The applicant will work with the subcontracted agency to implement rapid HIV testing through

applicant’s facility or facilities. The applicant will ensure all counseling and testing forms filled-out by the subcontractor are

complete and accurate. The applicant will submit a monthly report to the SAPTA HIV Testing program of all activities,

using the approved reporting template. The applicant will ensure the subcontractor adheres to the applicant’s Scope of Work, as

outlined in this RFP and final subgrant award agreements and terms. The applicant and the SAPTA HIV Testing Program will monitor program funds in accordance

with program requirements. The applicant and the subcontractor will respond to State of Nevada requests in a timely

manner.


Request for Proposal (RFP) Timeline

TASK DUE DATE & TIME

SAPTA HIV Testing Program announces the Request for Proposal guide and budget template

June 12, 2017

Bidder’s Conference Call* June 23, 2017, 10:00 AM (PDT)

Letter of Intent Email to [email protected]

June 30, 2017, 5:00 PM (PDT)

Deadline for Questions Email to [email protected]

July 7, 2017, 5:00 PM (PDT)

Answers to Questions http://dpbh.nv.gov/Programs/HIV/dta/Testing/SAPTA_HIV_Testing_Program/

July 12, 2017

Deadline for submission of applications July 28, 2017, 5:00 PM (PDT)

Evaluation Period: review of applications July 31, 2017 – August 4, 2017

Selection notice to applicants August 14, 2017

Completion of subgrant awards and contracts October 1, 2017

Grant Contract Commencement of Project – Pending approved SAMHSA grant award and receipt of Notice of Award

October 1, 2017

NOTE: These dates represent a tentative schedule of events. The State reserves the right to modify these dates at any time, with appropriate notice to prospective applicants.

Bidder’s Conference Call Information: Date: June 23, 2017

Time: 10:00 AM (PDT)

Phone Number: 1-888-363-4735

Access Code: 5147703


http://dpbh.nv.gov/Programs/HIV/dta/Testing/SAPTA_HIV_Testing_Program/

mailto:[email protected]

mailto:[email protected]

Submittal InstructionsFIRST: The proposal shall be prepared and submitted in original Word and Excel format on the forms provided in this guide and should be presented in the same order as the checklist. Applicants shall prepare their proposal responses written in Times New Roman 12-point font with one-inch margins immediately following the applicable question/section.

SECOND: Applicants shall submit their entire application package electronically to SAPTA HIV Testing Program to Preston Tang at [email protected] on or before the proposal submission deadline. An emailed reply will verify your submission has been received. Applicants may submit their proposal any time prior to the stated deadline.

THIRD: In addition to the electronic submission, one (1) hard copy original proposal marked “MASTER” and one (1) identical copy, must be received on or before the deadline to the following location:

To: Nevada Division of Public and Behavioral HealthATTN: Preston Tang1840 East Sahara Ave, Suite 111Las Vegas, NV 89117

Proposals submitted shall be clearly labeled on the outside of a sealed envelope as follows: SAPTA HIV Testing Program - Request for Proposal 2017

PROPOSAL DEADLINE DATE: July 28, 2017 at 5:00 PM (PDT)

Please be advised: Proposals that do not arrive as instructed by deadline will not be reviewed.

1. The State will not be held responsible for proposal envelopes mishandled as a result of the envelope not being properly prepared. Proposals may be modified by e-mail or written notice provided such notice is received prior to the opening of the proposals.

2. For ease of evaluation, the proposal shall be submitted on the forms provided in this guide and should be submitted using the same order. Responses to each section and subsection should be complete, marking any section or sub-section as “N/A” for not applicable, so as to indicate that no item was missed or addressed. Exceptions to this will be considered during the evaluation process.

3. If complete responses cannot be provided without referencing supporting documentation, such documentation must be provided with the proposal and specific references made to the tab, page, section, and/or paragraph where the supplemental information can be found.

4. Proposals are to be prepared in such a way as to provide a straightforward, concise delineation of capabilities to satisfy the requirements of this RFQ. Expensive bindings, colored displays, promotional materials, etc., are not necessary or desired. Emphasis should be concentrated on conformance to the RFQ instructions, responsiveness to the RFQ requirements, and completeness and clarity of content.

5. The proposal application must be signed by the individual(s) legally authorized to bind the applicant.


Application Evaluation Criteria

Applicants shall be evaluated and scored based on material presented in the RFP application. Each application will be evaluated and scored using the following criteria:

a) Agency Summary and Experience (25 Points)Applicant described the agency’s history and experience in the community and how it applies to the proposed project(s). Applicant described the mission and purpose of the agency including staff members, their expertise, and the structure of the agency including the Board of Directors, hours of operation, and number of locations.

Applicant provided a statement as to the agency’s knowledge and familiarity with the local community's needs and goals. Applicant described the client population currently served and the level of service provided. If the project is to be accomplished through a subcontract, applicant listed the names and address the subcontractor; a signed Memorandum of Understanding or agreement was furnished for each as an addendum.

b) Project Narrative and Scope of Work (25 points) Applicant described the target population of the applicant’s facility and how the applicant will provide client-centered risk reduction education with the funds requested. The Project Narrative provided a detailed narrative of intended activities to meet the objectives listed in the Scope of Work.

If the applicant does not have the means and/or is unable to provide services outlined in the Scope of Work, the applicant is encouraged to select a subcontractor. The applicant clearly described their plan for subcontracting in the Project Narrative and how the subcontractor will provide rapid HIV testing and client-centered risk reduction education with the funds provided, and provided a detailed narrative of intended activities to meet the objectives listed in the Scope of Work. The applicant mentioned how they intend to ensure adherence to the provisions of the final subgrant award agreements and terms.

Activities listed in the Scope of Work were reasonable and achievable and meet the objectives as outlined in this RFP.

c) Budget Plan (25 points) Applicant completed the budget form in the excel form provided, followed the directions listed in the Budget Plan Instructions in Attachment B, and provide detailed a narrative for each line-item budget expense.

d) Supplements (15 points)Staff Most Updated Resumes: Applicant provided the most updated resumes that included current position(s), qualifications credentials, educational background, and experience of persons that are included in the budget.

Fiscal / Administrative Declarations: Applicant provided a Internal Revenue Service 501(c) 3 tax-exempt determination letter and copy of latest audit letter, if applicable.

Disclosure of Ownership / Conflict of Interest: Applicant provided a list of the Board of Directors


and Programmatic, Fiscal, and Administrative Officers, and signed the Conflict of Interest Form; see Attachment E.

Memorandum of Understanding or Agreement (MOU): Applicants listed all agencies that it has developed a MOU with and a list of agencies it is currently working with to develop a MOU. Full MOU should be made available upon request.

e) The application packet is not to exceed 25 pages, including attachments; with exceptions for resumes. (5 Points)

f) Accurate and full completion of the Cover Page, Agency Profile, and Technical Proposal. (5 points)


Subgrant Award Process1. SAPTA HIV Testing Program staff may contact any applicant to clarify any response; solicit

information from any available source concerning any aspect of a proposal; and seek and review any other information deemed pertinent to the evaluation process. The evaluation committee shall not be obligated to accept the lowest priced proposal, but shall make an award in the best interests of the State of Nevada NRS § 333.335(5)

2. Discussions may, at the State’s sole option, be conducted with applicants who submit proposals determined to be acceptable and competitive NAC §333.165. Applicants shall be accorded fair and equal treatment with respect to any opportunity for discussion and/or written revisions of proposals. Such revisions may be permitted after submissions and prior to award for the purpose of obtaining best and final offers. In conducting discussions, there shall be no disclosure of any information derived from proposals submitted by competing applicants.

3. Any award is contingent upon the successful negotiation of final subgrant terms. Negotiations shall be confidential until an agreement is reached.

4. Any subgrant resulting from this RFQ shall not be effective unless and until approved by the Nevada Division of Public and Behavioral Health; any subgrant resulting from this RFQ shall not be effective unless and until approved by all parties.


Terms, Conditions, and Exceptions1. The State reserves the right to alter, amend, or modify any provisions of this RFQ, or to withdraw

this RFQ, at any time prior to the award of a contract pursuant hereto, if it is in the best interest of the State to do so.

2. The State reserves the right to waive informalities and minor irregularities in applications received.3. The State reserves the right to reject any or all applications received prior to contract award (NRS

§333.350).4. The State shall not be obligated to accept the lowest priced application, but will make an award in

the best interests of the State of Nevada after all factors have been evaluated (NRS §333.335).5. Any irregularities or lack of clarity in the RFQ should be brought to the Division designee’s attention

as soon as possible so that corrective addenda may be furnished to prospective applicants.6. Alterations, modifications, or variations to an application may not be considered unless authorized

by the RFQ or by addendum or amendment.7. Applications which appear unrealistic in the terms of technical commitments, lack of technical

competence, or are indicative of failure to comprehend the complexity and risk of this RFQ may be rejected.

8. Applications from employees of the State of Nevada will be considered in as much as they do not conflict with the State Administrative Manual, NRS Chapter §281 and NRS Chapter §284.

9. Applications may be withdrawn by written or email notice received prior to the submission time.10. Prices offered by applicants in their applications are an irrevocable offer for the term of the contract

and any contract extensions. The awarded applicant agrees to provide the project at the costs, rates, and fees set forth in their application in response to this RFQ. No other costs, rates, or fees shall be payable to the awarded applicant for implementation of their application.

11. The State is not liable for any costs incurred by applicants prior to entering into a formal contract. Costs of developing the applications or any other such expenses incurred by the applicant in responding to the RFP are entirely the responsibility of the applicant and shall not be reimbursed in any manner by the State.

12. The awarded applicant will be the sole point of contract responsibility. The State will look solely to the awarded applicant for the performance of all subgrant obligations that may result from an award based on this RFQ, and the awarded applicant shall not be relieved for the non-performance of any or all subgrantees.

13. Each applicant must disclose any existing or potential conflict of interest relative to the performance of the contractual services resulting from this RFQ. Any such relationship that might be perceived or represented as a conflict should be disclosed. By submitting an application in response to this RFQ, applicants affirm that they have not given, nor intend to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant or any employee or representative of it in connection with this grant award. Any attempt to intentionally or unintentionally conceal or obfuscate a conflict of interest will automatically result in disqualification of the application. An award will not be made where a conflict of interest exists. The State will determine whether a conflict of interest exists and whether it may reflect negatively on the State’s selection of an applicant. The State reserves the right to disqualify any applicant on the grounds of actual or apparent conflict of interest.

14. The State reserves the right to negotiate final subgrant terms with any applicant selected. The subgrant between the parties will consist of the RFQ together with any modifications thereto, and the awarded application, together with any modifications and clarifications thereto that are submitted at the request of the State during the evaluation and negotiation process. In the event of any conflict or contradiction between or among these documents, the documents shall control in


the following order of precedence: the final executed contract, the RFP, any modifications and clarifications to the awarded application. Specific exceptions to this general rule may be noted in the final, executed subgrant.

15. Applicant understands and acknowledges that the representations above are material and important and will be relied on by the State in evaluation of the application. Any applicant misrepresentation shall be treated as fraudulent concealment from the State of the true facts relating to the application.

16. Pursuant to NRS Chapter 613 in connection with the performance of work under this contract, the applicant agrees not to unlawfully discriminate against any employee or applicant for employment because of race, creed, color, national origin, sex, sexual orientation or age, including, without limitation, with regard to employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including, without limitation apprenticeship.

17. The applicant further agrees to insert this provision in all subcontracts, hereunder, except subcontracts for standard commercial supplies or raw materials.

18. It is expressly understood and agreed all work done by the contractor shall be subject to inspection and acceptance by the State.

19. If travel is required, the following processes must be followed:a. Requests for Reimbursement of travel expenses must be submitted on the State Claim for

Travel Expense Form with original receipts for all expenses.b. Providers will be reimbursed travel expenses and per diem at the rates allowed for State

employees at the time travel occurs.20. No announcement concerning the award of a contract as a result of this RFQ can be made without

the prior written approval of the HIV Prevention Program Manager of the Office of HIV/AIDS.21. The awarded applicant must agree, whether expressly prohibited by federal, state, or local law, or

otherwise, that no funding associated with this subgrant will be used for any purpose associated with or related to lobbying or influencing or attempting to lobby or influence for any purpose including the following:

a. Any federal, state, county or local agency, legislature, commission, counsel, or board;b. Any federal, state, county or local legislator, commission member, council member, board

member, or other elected official; orc. Any officer or employee of any federal, state, county or local agency, legislature,

commission, counsel, or board


ATTACHMENT A:

APPLICIATION SUBMITTAL PACKAGE

COVER PAGE

AGENCY PROFILE

AGENCY SUMMARY AND EXPEREINCE

PROJECT NARRATIVE

SCOPE OF WORK

BUDGET PLAN

SUPPLEMENTS

APPLICATION CHECKLIST

(Instructions for completing the application begins after the checklist)

COVER PAGENevada Division of Public and Behavioral Health

Bureau of Behavioral Health Prevention and WellnessOffice of HIV/AIDS

Request for Proposal 2017 to Provide SAPTA HIV Testing Program GY 17-18

Release Date: June 12, 2017Deadline for Submission and Time: July 28, 2017 @ 5:00 PM (PDT)

For additional information, please contact:Preston Nguyen Tang, BSW | Health Program Specialist I1840 East Sahara Avenue, Suite 111 Las Vegas, NV 89104

Telephone: (702) 486-6488 | Fax: (702) 486-8101Email: [email protected]

Website for Additional References: http://dpbh.nv.gov/Programs/HIV/HIV_and_AIDS_Prevention_-_Home/

Company Name:

Address:

City: State: Zip:

Tel: Fax:

Executive Director/CEO:

Executive Director Email:

Grant Writer:

Grant Writer Email:

I have read, understand, and agree to all terms and conditions herein.

Signed: Date:

Print Name: Print Title:

Agency ProfileProject HD Number: (Assigned by DPBH)

Application Number: (Assigned by DPBH)

Agency Name:

Agency Website:

Agency Telephone Number:

Agency Fax Number:

Agency Address:

Agency City, State:

Agency Zip Code:

Employer ID Number (EIN):

DUNS Number:

SAPTA Certified Residential and/or Transitional Treatment Facility:

Yes No Date certified?

Project Period: (Month/Day/Year)Start Date10/01/17

End Date09/30/18

Amount Requested:

Additional Facility Locations1. Service Location:

Address:Phone Number:Site Contact Person/Email:

2. Service Location:Address:Phone Number:Site Contact Person/Email:



1. Contact Information

Name of Project Director:Title:Telephone:Fax:Email:

□ Check, If same as Project Director

Name of Financial Officer:Title:Telephone:Fax:Email:

2. Signature Authority□ Check, If same as Project Director

Name of Agency Director:Title:Telephone:Fax:Email:

3. Additional Point Of Contacts

Name // Title: Title:Telephone:Email:



Agency Summary and Experience

In no more than 500 words, please describe the agency’s history and experience in the community and how it applies to the proposed project(s). Describe the mission and purpose of the agency including staff members, their expertise, and the structure of the agency including the Board of Directors, hours of operation, and number of locations.

Provide a statement as to the agency’s knowledge and familiarity with the local community's needs and goals. Describe the client population the agency currently serves and the level of service provided. If the project is to be accomplished through a subcontractor, please list the names and address the subcontractor; a signed Memorandum of Understanding or agreement shall be furnished for each as an addendum.

Project Narrative

In no more than 650 words, please describe the target population of the applicant’s facility and how the applicant will provide client-centered risk reduction education with the funds requested. The Project Narrative should provide a detailed narrative of intended activities to meet the objectives listed in the Scope of Work. *Please reference the Nevada Integrated HIV Prevention and Care Plan 2017-2021 (Attachment C).

Subcontracting Project NarrativeIf the applicant does not have the means and/or is unable to provide services outlined in the Grant Objectives/Achievables or Scope of Work sections, the applicant is encouraged to select a subcontractor. The applicant should clearly describe their plan for subcontracting in the Project Narrative and how the subcontractor will provide rapid HIV testing and client-centered risk reduction education with the funds provided, and provide a detailed narrative of intended activities to meet the objectives listed in the Scope of Work. The applicant must mention how they intend monitor the subcontractor to ensure adherence to the provisions of the final subgrant award agreements and terms.

SCOPE OF WORKPlease provide the following information for the Scope of Work using the provided template below.

Objectives – Predesignated objectives outlined for the SAPTA HIV testing program following the requirements of the National HIV/AIDS Strategy (NHAS), Substance Abuse and Mental Health Services Administration’s (SAMHSA), State of Nevada Division of Public and Behavioral Health, Substance Abuse Prevention & Treatment Agency (SAPTA), and Office of HIV/AIDS.

Activities – Describe the steps or activities that the program will use to accomplish the objective.

Due Dates: The date by which activities can be completed.

Documentation:

Performance Measures – What are the measures by which you will evaluate the progress of achieving your goals and objectives through the activities? These are the items that should correlate with the National Monitoring Standards and the Nevada Integrated HIV Prevention and Care Plan 2017-2021 of what will be evaluated as a successful realization of the project.

Evaluation and Outcome for this Objective – This is how your agency will qualify and quantify the selected performance measures. The measuring or evaluating of the work being done to ensure that the agency is on track to achieve the goals and objectives. What tools will the agency use to evaluate performance?

[Insert Agency Name Here]Scope of Work

Operation of a SAPTA HIV Testing Program in [County], Nevada Health Division

Please utilize the template below for the Scope of Work

Goal: The applicant must complete training(s) to conduct HIV testing for the SAPTA HIV Testing Program. Objective Activities Date

Due ByDocumentation

The applicant must be able to complete the State approved Rapid HIV Testing, Counseling, Safety, and Certification Program.

Complete blood borne pathogen training.

Complete additional training if required by the State of Nevada.

N/A

Goal: Facility(s) set-up to be in compliance for Lab Licensure and CLIA Waiver to offer rapid HIV testing.Objective Activities Date

Due ByDocumentation

SAPTA certified residential and/or transitional treatment programs must apply and obtain, or currently possess, a State Lab License and the Clinical Laboratory Improvement Amendments (CLIA) waiver to offer rapid HIV testing.

SAPTA certified residential and/or transitional treatment programs need to obtain supplies for site inspection by the Bureau of Health Care Quality and Compliance (HCQC).

Applicants must be able to successfully pass a Bureau of Health Care Quality and Compliance (HCQC) site inspection for rapid HIV testing and maintain compliance throughout the grant cycle.

Goal: The applicant will conduct opt-out rapid HIV testing and provide linkage-to-care for reactive/positive test.Objective Activities Date

Due ByDocumentation

The applicant will administer___ rapid HIV opt-out tests for clients accessing services through their facility or facilities. **Fill-in the number of tests**

The applicant must ensure 100% of clients receiving a rapid HIV test will be informed of their test results at the time of rapid HIV test administration.

The applicant must ensure 100% of clients who receive a rapid HIV test will be provided client-centered counseling to address high- risk behavior(s) and provide strategies to mitigate the identified risks.


Certified rapid HIV test counselors must conduct pre- and post-test counseling and HIV education for all clients’ accessing services at residential and/or transitional treatment programs.

The applicant must ensure that all clients with a reactive rapid HIV test will receive a confirmatory HIV test within 48 hours, following CDC HIV testing guidelines.

The applicant must work with the local health authority to ensure all clients with a confirmed HIV positive test result are provided Partner Services and are linked into HIV care services.

The applicant must provide linkages to care for all newly identified HIV-positive clients.

The applicant must follow the CDC Rapid HIV Testing Guidelines, federal, and state requirements, including, but not limited to the Nevada Revised Statutes 441a and the Nevada Administrative Codes.

Goal: The applicant will conduct quality management and monthly reporting.Objective Activities Date

Due ByDocumentation

The applicant will be responsible for the accurate collection of all rapid HIV testing data using the approved CDC recommended HIV Counseling and Testing Form.

The applicant will submit all HIV Counseling and Testing Forms to the SAPTA HIV Testing Program, via mail or FedEx by the 3rd of each month.

The applicant will submit to the Nevada Division of Public and Behavioral Health a monthly report of all activities, including any successes, challenges and/or struggles, using the approved monthly reporting form.

Proposed Budget Template Please use Excel template provided with the announcement package to complete and submit.

Review and complete the attached Excel budget form (may be provided separately from this RFP document). Please refer to the Instructions for Proposed Budget Plan(s) and/or Subcontracting Budget Plan provided in Attachment B.

Develop a line item budget for the project. For each itemized category, specify the total project costs (including subcontracting cost), description of expense, and the amount requested from Nevada Division of Public and Behavioral Health (DPBH) funding. **A line item expense under a category must include a description of the line item expense in the detail description.**

SAPTA HIV TESTING PROGRAMGY 2017-2018

SUB-GRANT BUDGET DETAIL Name of Subgrantee:

CATEGORY DETAIL DESCRIPTION QTYPERSONNEL

0 $ - $ - 0 $ - $ - 0 $ - $ - 0 $ - $ -

Fringe 0 $ - $ - Total: $ -

TRAVEL0 $ - $ - 0 $ - $ - 0 $ - $ -

Total: $ - OPERATING

0 $ - $ - 0 $ - $ - 0 $ - $ -

Total: $ - EQUIPMENT

0 $ - $ - 0 $ - $ -

Total: $ - Contractual/Consultant

0 $ - $ -

0 $ - $ - 0 $ - $ - 0 $ - $ - 0 $ - $ -

Total: $ - TRAINING

0 $ - $ - 0 $ - $ - 0 $ - $ -

Total: $ - DIRECT COSTS TOTAL: $ -

OTHERAdmin Costs 10% of Direct Costs 0.10 $ - $ -

Totals $ - BUDGET TOTAL: $ -

COST PER UNIT

TOTAL GRANT

CYCLE

APPLICATION CHECKLISTSAPTA HIV Testing Program, 2017 - 2018

1. RFQ Cover Page Completed and Signed ________

2. Agency Profile Completed ________

3. Contact Information Completed ________

4. Agency Summary & Experiences Completed ________

5. Project Narrative Completed ________

6. Scope of Work Completed ________

7. Proposed Budget Plan(s) Completed ________

8. Required Supplements – Staff(s) updated resumes, 501(c) 3 tax exempt, latest audit letter, and signed Conflict of Interest Policy Acknowledgement. ________

9. Application package submitted via email to Preston Tang – [email protected](Microsoft Word or Excel only for items 2-7; PDFs Allowable for items 1 and 8) ________

10. Original plus one (1) copy of RFQ mailed via US Postal ServiceTwo Hard Cover Copies Total ________

All applications must use the following format:

Single Spaced. 12- point Times New Roman font. Not to exceed 25 pages, including attachments.

o With exceptions for resumes. All pages must be numbered. Resumes must be current and up-to-date, not counted in the page limit.

ATTACHMENT B:

DETAILED INSTRUCTIONS

INSTRUCTIONS FOR AGENCY PROFILE

INSTRUCTIONS FOR PROPOSED BUDGET PLAN

INSTRUCTIONS FOR SUBCONTRACTING BUDGET PLAN

NEVADA INTEGRATED HIV PREVENTION AND CARE PLAN 2017-2021


Instructions for Agency Profile

Project Number – Leave blank (Assigned by SAPTA HIV Testing Program)

Application Number – Leave blank (Assigned by SAPTA HIV Testing Program)

Project Name – Provide a short descriptive name for the proposed project

Agency Name – Applicant’s legal agency name

Agency Website – If applicable, provide the applicant’s website address

Agency Address – Street and floor or suite number

Agency City/State – City and State

Agency Zip Code – Five or nine digit zip code

Employer ID Number – Provide employer identification number (EIN)

DUNS Number – Provide Data Universal Numbering System (DUNS) number

Locations – Service location (i.e. Fallon, Clark, Elko, or Carson City), provide full address, phone number, fax, site contact person and their email (if applicable)

Project Director – This will be the main programmatic contact person for this project

Financial Officer – This will be the main fiscal contact person for this project

Agency Director – This will be the main administrative contact person for this project


Instructions for Proposed Budget PlanBudget Itemization Sections

Itemize costs for the project under the following categories:

1. Personnel: a. Salaries and Wages

i. Personnel costs include listing each staff member who is providing direct client services. Include the staff name (if possible), position title, percent of full time equivalency (FTE), and annual salary/hourly rate.

1. Example of the Detail Description: Coordinator (.5 FTE)- Annual Salary $50,000 x .5 FTE = $25,000 (also provide a position description)

ii. In the description section, write a detailed position narrative and the job duties as it relates to the SAPTA HIV testing Program. Do this for each position to be funded.

1. If a portion of a direct program supervisor’s time is devoted to providing professional oversight and direction then include the staff in Personnel.

2. An administrator’s time or a fiscal officer’s time would be included in the capped 10% Admin/Indirect Costs.

b. Fringe Benefitsi. List components that comprise the fringe benefit rate; for example: health

insurance, taxes, unemployment insurance, life insurance, retirement plan. The fringe benefits should be directly proportional to the amounts listed in personnel.

ii. Indicate the applicant’s fringe benefit rate. After completing the list of positions, multiply the subtotal of personnel costs by the agency’s standard percentage for fringe benefits, and enter the amounts in the appropriate lines on the “Fringe Benefits” row.

2. Travel a. Line-item budget travel costs according to “In-State Travel.” Please include the following:

mileage, rate (current GSA rate), reason for travel, staff member names, and number of trips. Travel is allowed only for staff listed in the Personnel costs section and/or Contractors.

i. No Per Diem (hotel & meals) for travel less than 50 miles.ii. Registrations are included in the Training category.

iii. Example: 3 employees X 50 miles/month X 12 months X $0.535/mile = $963b. Cost resources include Nevada’s State Administrative Manual (SAM) and US General

Services Administration (GSA).

3. Operating a. Line-item includes:

i. Testing supplies include Alere Determine™ HIV-1/2 Ag/Ab Combo ($10/per test), Alere Determine™ External Controls ($35/each- 1 needed per grant year), Finger stick Sample Collection Kit ($29.95/each- 1 needed per 100 Alere Determine HIV tests).

ii. General Office supplies could include paper, pencils, binders, ink, copier paper, etc. iii. Medical supplies are plastic gloves, gauze, alcohol swabs, Band-Aids, biohazard

containers, biohazard disposal, etc. iv. Educational supplies may be pamphlets related to Rapid HIV Testing, HIV/AIDS

medical care, etc.


v. Costs associated to Lab Licensure.b. The applicant must address the number of clients expected to be served during the grant

year (GY) 2017-2018 (October 1, 2017 to September 30, 2018). This number of proposed rapid HIV tests should be based on historical HIV testing data or client served at residential and/or transitional treatment facilities.

c. Allocate all your costs exactly the same.

4. Other a. This category includes all administrative or indirect costs that do not apply to any of the

above categories. All indirect costs charged by the applicant are considered an administrative cost subject to the capped 10% aggregate limit.

b. As stated in the SAMHSA, the 10% administrative cap includes:i. Routine grant administration and monitoring activities, including the development

of applications and the receipt and disbursal of program funds;ii. Development and establishment of reimbursement and accounting systems;

iii. Preparation of routine programmatic and financial reports;iv. Compliance with grant conditions and audit requirements;v. All activities associated with the recipient’s (grantee's) contract award procedures,

including the development of requests for proposals, subgrantee and contract proposal review activities, negotiation and awarding of contracts;

vi. Reporting on contracts, and funding reallocation activities;vii. Related payroll, audit and general legal services;

viii. Generating monthly progress reports.


Instructions for Subcontracting Budget PlanAs mentioned, SAPTA state-certified residential and/or transitional treatment facilities are required to offer rapid HIV testing at treatment locations. To supports the goals of the National HIV/AIDS Strategy (NHAS) by reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities. It also supports the requirement of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) initiative to expand early intervention services for HIV by funding certified residential and/or transitional treatment facilities to offer and encourage rapid HIV testing (including confirmatory and diagnostic testing), HIV risk reduction education, linkages to care, and other ancillary services. Federally Qualified Health Centers (FQHC) and Health Districts are not eligible to apply for this funding, unless they are a SAPTA state-certified residential and/or transitional treatment facility.

If applicant doesn’t have the means and/or is unable to provide services outlined in Scope of Work, the applicant must select a subcontractor who has completed, or can complete, the State approved Rapid HIV Testing, Counseling, Safety, and Certification Program. The subcontractor needs to be named at the time the application is submitted.

Subcontracting Budget Itemization SectionsWhen preparing the budget, the applicant must ensure that all costs cover the administration of the subgrant, as well as, the subcontractor reimbursement rate. Please create ONE proposed budget plan that encompasses both the applicant and the subcontractor selected. The budget should use the logic identified in the Instructions for Proposed Budget Plan, with the new addition of a Contractual/ Contractor section included. Please include/address the following:

1. Operating - Note to Applicanta) The applicant is responsible for purchasing all supplies necessary for the success and

implementation of the SAPTA HIV Testing Program, including the rapid HIV tests and supplies. Please review Operating under Budget Itemization Sections for more information.

b) **The expense for the rapid HIV test kits will be listed under Operating, while the subcontractor’s $20 test administration fee, to include individual risk reduction education and data documentation, will be listed under Contractual/Consultant.**

2. Contractual/Consultant - To be included in the budget only if the applicant uses a contractor. a) Under the Contractual/Consultant Line section - The applicant must list the name of the

subcontracting agency potentially awarded, include the subcontractor staff name(s) and the number of clients expected to be served during the grant year (GY) 2017-2018 (October 1, 2017 to September 30, 2018). This number of proposed rapid HIV tests should be based on historical HIV testing data or client served at residential and/or transitional treatment facilities and match the number of rapid HIV tests listed under Operating.

b) SAPTA HIV Testing program will reimburse a sub-contracted agency at $20 per rapid HIV test; this includes the staff time for rapid HIV test administration, individual risk reduction education, and data documentation.

i. The reimbursement rate is in alignment with the 2017 Clinical Laboratory Fee Schedule for rapid testing as outlined by the Centers for Medicare and Medicaid Services. The reimbursement rate the State is offering is slightly higher than the CMS Fee Schedule to account for the administration of the rapid HIV test, individual risk reduction education, and data requirements of this contract.


c) The SAPTA HIV Testing program will not cover time spent conducting a HIV presentation or any additional activities outside of the designated, rapid HIV test administration, individual risk reduction education, and data documentation.

Additional questions regarding implementation of subcontracting budget can be directed to Preston Tang with the Office of HIV/AIDS - SAPTA HIV testing program. You can contact Preston at (702) 486-6488 or [email protected].


ATTACHMENT C:Nevada Integrated HIV Prevention and Care Plan 2017-2021

In preparing your proposal, please reference The Nevada Integrated HIV Prevention and Care Plan 2017-2021. The Integrated Plan, including the Statewide Coordinated Statement of Need, was developed in response to the guidance provided by the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) in June 2015.

The HIV Prevention and Care Integrated Plan includes strategies for ongoing monitoring and improvement. The HIV Prevention and Care Integrated Plan Internal Workgroup will meet every six months to review progress on plan implementation. The Ryan White Part A, Ryan White Part B, and HIV Prevention programs have contracted the School of Community Health Sciences (SCHS) at the University of Nevada, Reno to oversee the evaluation and monitoring of the plan. SCHS will collaborate with the workgroup and planning bodies throughout the evaluation and monitoring process. An evaluation report will be produced annually to document the implementation process as well as progress towards the plan goals and objectives. The workgroup, community planning groups, and Part A Planning Council will review current epidemiological data on an annual basis and use it to make adjustments to the plan as needed.

Website links: Nevada HIV Prevention Program Homepage http://dpbh.nv.gov/programs/hiv/hiv_and_aids_prevention_-_home/


http://DPBH.NV.GOV/PROGRAMS/HIV/HIV_AND_AIDS_PREVENTION_-_HOME/

ATTACHMENT D:

Assurances

As a condition of receiving subgranted funds from the Nevada State Division of Public and Behavioral Health, the Subgrantee agrees to the following conditions:

1. Grant funds may not be used for other than the awarded purpose. In the event Subgrantee expenditures do not comply with this condition, that portion not in compliance must be refunded to the Division.

2. To submit reimbursement requests only for expenditures approved in the spending plan. Any additional expenditure beyond what is allowable based on approved categorical budget amounts, without prior written approval by the Division, may result in denial of reimbursement.

3. Approval of subgrant budget by the Division constitutes prior approval for the expenditure of funds for specified purposes included in this budget. Unless otherwise stated in the Scope of Work the transfer of funds between budgeted categories without written prior approval from the Division is not allowed under the terms of this subgrant. Requests to revise approved budgeted amounts must be made in writing and provide sufficient narrative detail to determine justification.

4. Recipients of subgrants are required to maintain subgrant accounting records, identifiable by subgrant number. Such records shall be maintained in accordance with the following:

a. Records may be destroyed not less than three years (unless otherwise stipulated) after the final report has been submitted if written approval has been requested and received from the Administrative Services Officer (ASO) of the Division.

b. Records may be destroyed by the Subgrantee five (5) calendar years after the final financial and narrative reports have been submitted to the Division. In all cases an overriding requirement exists to retain records until resolution of any audit questions relating to individual subgrants.

c. Subgrant accounting records are considered to be all records relating to the expenditure and reimbursement of funds awarded under this subgrant award. Records required for retention include all accounting records and related original and supporting documents that substantiate costs charged to the subgrant activity.

5. To disclose any existing or potential conflicts of interest relative to the performance of services resulting from this subgrant award. The Division reserves the right to disqualify any subgrantee on the grounds of actual or apparent conflict of interest. Any attempt to intentionally or unintentionally conceal or obfuscate a conflict of interest will automatically result in the disqualification of funding.

6. To comply with the requirements of the Civil Rights Act of 1964, as amended, and the Rehabilitation Act of 1973, P.L. 93-112, as amended, and any relevant program-specific regulations, and shall not discriminate against any employee or offeror for employment because of race, national origin, creed, color, sex, religion, age, disability or handicap condition (including AIDS and AIDS-related conditions).

7. To comply with the Americans with Disability Act of 1990, P.L. 101-136, 42 U.S.C. 12101, as amended, and regulations adopted thereunder contained in 28 C.F.R. 26.101-36.999 inclusive and any relevant program-specific regulations

8. To comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, 45 C.F.R. 160, 162 and 164, as amended. If the subgrant award includes functions or activities that involve the use or disclosure of protected health information (PHI) then the


subgrantee agrees to enter into a Business Associate Agreement with the Division as required by 45 C.F.R. 164.504(e). If PHI will not be disclosed then a Confidentiality Agreement will be entered into.

9. Subgrantee certifies, by signing this notice of subgrant award, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. This certification is made pursuant to regulations implementing Executive Order 12549, Debarment and Suspension, 28 C.F.R. pr. 67 § 67.510, as published as pt. VII of May 26, 1988, Federal Register (pp. 19150-19211). This provision shall be required of every subgrantee receiving any payment in whole or in part from federal funds.

10. Sub-grantee agrees to comply with the requirements of the Title XII Public Law 103-227, the “PRO-KIDS Act of 1994,” smoking may not be permitted in any portion of any indoor facility owned or regularly used for the provision of health, day care, education, or library services to children under the age of 18, if the services are funded by federal programs either directly or through state or local governments. Federal programs include grants, cooperative agreements, loans and loan guarantees, and contracts. The law does not apply to children’s services provided in private residences, facilities funded solely by Medicare or Medicaid funds, and portions of facilities used for inpatient drug and alcohol treatment.

11. Whether expressly prohibited by federal, state, or local law, or otherwise, that no funding associated with this subgrant will be used for any purpose associated with or related to lobbying or influencing or attempting to lobby or influence for any purpose the following:

a. Any federal, state, county or local agency, legislature, commission, council, or board;b. Any federal, state, county or local legislator, commission member, council member, board

member, or other elected official; orc. Any officer or employee of any federal, state, county or local agency, legislature,

commission, council or board.12. Division subgrants are subject to inspection and audit by representative of the Division, Nevada

Department of Health and Human Services, the State Department of Administration, the Audit Division of the Legislative Counsel Bureau or other appropriate state or federal agencies to:

a. Verify financial transactions and determine whether funds were used in accordance with applicable laws, regulations and procedures;

b. Ascertain whether policies, plans and procedures are being followed; c. Provide management with objective and systematic appraisals of financial and

administrative controls, including information as to whether operations are carried out effectively, efficiently and economically; and

d. Determine reliability of financial aspects of the conduct of the project.13. Any audit of Subgrantee’s expenditures will be performed in accordance with generally accepted

government auditing standards to determine there is proper accounting for and use of subgrant funds. It is the policy of the Division, as well as federal requirement as specified in the Office of Management and Budget (2 CFR § 200.501(a)), revised December 26, 2013, that each grantee annually expending $750,000 or more in federal funds have an annual audit prepared by an independent auditor in accordance with the terms and requirements of the appropriate circular. A COPY OF THE FINAL AUDIT REPORT MUST BE SENT TO:

Nevada State Division of Public and Behavioral HealthAttn: Contract Unit4150 Technology Way, Suite 300Carson City, NV 89706-2009


ATTACHMENT E:

CONFLICT OF INTEREST POLICY ACKNOWLEDGMENT

Vendor must have a conflict of interest policy designed to foster public confidence in our integrity and to protect our interest when we are contemplating entering a transaction or arrangement that might benefit the private interest of a director, a corporate officer, our top management official, and top financial official, any of our key employees, or other interested persons.

I hereby acknowledge that [INSERT NAME OF AGENCY], has a conflict of interest policy on file and that all employees, contractors, and volunteers have read and understood it, and agree to comply with its terms.

_________________________________________ ____________________________

Authorized Agency Signature Date

ATTACHMENT F:

Definitions & Acronyms

Acronym Definition

AIDS Acquired Immunodeficiency Syndrome

ApplicantSubstance Abuse Prevention & Treatment Agency (SAPTA) certified residential and/or transitional treatment facilities applying for SAPTA HIV Testing funding.

CDC Centers for Disease Control and Prevention

CLIA The Clinical Laboratory Improvement Amendments

FQHC Federally Qualified Health Center

HCQC Bureau of Health Care Quality and Compliance

HD Health Districts

HIV Human Immunodeficiency Virus

IDU Injection Drug Use / Intravenous Drug User

NAC Nevada Administrative Codes

NHAS National HIV/AIDS Strategy

NRS Nevada Revised Statutes

SAMHSA Substance Abuse and Mental Health Services Administration

SAPTA Substance Abuse Prevention & Treatment Agency

SubcontractorA contract between the applicant of the grant and an outside agency to perform tasks identified in the RFP, such as rapid HIV test administration and counseling.


Documents

sapta hiv testing program - Request for qualification 2017 ...dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Programs… · Web viewSAPTA HIV Testing Program – Request ... office