CDC Expectations — CDC is committed to the concept of HIV prevention community planning as outlined in this Guidance. CDC will monitor the progress health departments and CPGs are making in meeting these expectations through a select number of required indicators. In summary, CDC expects that:

• Health departments will support a collaborative community planning process, including providing sufficient financial resources, in compliance with the eight objectives and guiding principles;
• Priority target populations and a recommended set of interventions/activities identified in the comprehensive HIV prevention plan are based on: (a) having the greatest impact on reducing HIV transmission, and (b) reducing HIV transmission in populations with highest incidence. Priority target populations and prevention interventions/activities should be consistent with the epidemiologic profile, community services assessment, and behavioral/social science data presented in the plan;
• CPGs will review the entire health department application for federal HIV prevention funds, including the budget, prior to writing letters of concurrence, concurrence with reservations or nonconcurrence; and
• The allocation of CDC-awarded resources should be consistent with the prioritized target populations and set of appropriate prevention interventions/activities as described in the comprehensive HIV prevention plan.

A. Program Performance Indicators

Program Performance Indicators — The following required indicators provide a gauge for HIV prevention community planning implementation specifically in processes, activities, and/or products that must be developed or implemented to achieve the goals and objectives of HIV prevention community planning. The data sources detail what data will be reported to CDC. Furthermore, CDC will provide specific guidance on how performance indicators will be operationalized and reported and also how to set baselines and targets for each indicator.

• Indicator E.1: Proportion of populations most at risk, as documented in the epidemiologic profile, that have at least one CPG member that reflects the perspective of each population
• National Data Source: PEMS: Community Planning Membership Survey, The Epidemiologic Profile
• Measure: Numerator: The number of populations most at risk (as documented in the epidemiologic profile that have at least one CPG member that reflects the perspective of each population. Denominator: Number of populations most at risk (up to 10) as documented in the epidemiologic profile.
• Measure(s) Used to Obtain the Data: Epidemiological Profile CPG Membership Survey
   
• Indicator E.2: Proportion of key attributes of an HIV prevention community planning process that CPG membership agreed have occurred.
• National Data Source: PEMS: Community Planning Membership Survey
• Measure: Numerator: The total number of key attributes of which CPG members agreed occurred. Denominator: The total number of valid responses (“agree” or “disagree”).
• Measure(s) Used to Obtain the Data: HIV Prevention Community Planning Membership Survey
• Indicator E.3: Percent of prevention interventions/supporting activities in the health department CDC funding application specified as a priority in the comprehensive HIV prevention plan.
• National Data Source: PEMS: Community Planning Linkage Table Worksheet
• Measure: Numerator: The number of prevention/ other supporting activities in the health department CDC funding application specified as a priority in the comprehensive HIV prevention plan. Denominator: The number of all prevention/ other supporting activities identified in the health department CDC funding application.
• Measure(s) Used to Obtain the Data: Community Planning Linkage Table Worksheet
• Indicator E.4: Percent of health department-funded prevention interventions/supporting activities that correspond to priorities specified in the comprehensive HIV prevention plan.
• National Data Source: PEMS: Community Planning Linkage Table Worksheet & Process Monitoring System
• Measure: Numerator: The number of funded prevention/ other supporting activities that correspond to priorities specified in the most current comprehensive HIV prevention plan. Denominator: The number of all funded prevention/ other supporting activities.
• Measure(s) Used to Obtain the Data: Community Planning Linkage Table Worksheet, Program Monitoring and Evaluation System

Note: For more guidance or information on these HIV Prevention Community Planning indicators, please reference CDC’s Technical Assistance Guidelines for Health Department HIV Prevention Program Performance Indicators.

B. Concurrence, Concurrence with Reservations or Nonconcurrence

Letter of Concurrence, Concurrence with Reservations, or Nonconcurrence — As part of its application to the CDC for federal HIV prevention funds, every health department must include a letter of concurrence or nonconcurrence from each CPG officially convened and recognized in the jurisdiction.

CPG members should carefully review the comprehensive HIV prevention plan and the health department’s entire application (including the proposed budget) to CDC for federal funds.

• It is the responsibility of the health department to provide the CPG with ample time to review the health department’s application.
• Health departments should provide the CPG with the jurisdiction’s “Community Planning Linkage Table Worksheet” showing how the priorities identified in the plan are being addressed in the jurisdiction and which priorities specifically are being addressed in the application for CDC funding.
• It is the responsibility of the CPG to determine whether the health department’s application reflects the priorities of the CPG’s comprehensive HIV prevention plan.

   It is critical that the CPG review the proposed allocation of resources in the health department’s application using the “Community Planning Linkage Table Worksheet.” In reviewing the application, CPGs are reminded that:

• CPGs are not asked to review and comment on internal health department issues such as salaries of individual health department staff or funding to specific HIV prevention services agencies,
• The letter of concurrence or nonconcurrence directly relates to the jurisdiction’s proposed allocation of CDC funds for HIV prevention, and
• The community planning process requires setting priorities for target populations and a recommended mix of prevention interventions for each population.

Letters of concurrence, concurrence with reservations, nonconcurrence should indicate:

The Letter of concurrence may include reservations or a statement of concern/issues. The health department will be required to address these reservations or concerns in an addendum to the HIV prevention application.

Letter(s) of nonconcurrence indicate that the HIV prevention community planning group disagrees with the program priorities identified in the health department’s application. The letter should cite specific reasons for nonconcurrence. In instances when a health department does not concur with the recommendations of the HIV prevention community planning group(s) and believes that public health would be better served by funding HIV prevention activities/services that are substantially different, the health department must submit a letter of explanation in its application. CDC will assess and evaluate these explanations on a case-by-case basis and determine what action may be appropriate.

When CDC receives a letter of nonconcurrence or if the health department does not meet the requirements specified by this Guidance, actions may include any of the following:

• Obtaining more input/information regarding the situation;
• Meeting with the health department and co-chairs;
• Negotiating with the health department regarding the issues raised;
• Recommending local mediation;
• Requesting that the health department provide a detailed corrective action plan to address areas of concern and specify a timeframe for completion;
• Conducting an on-site comprehensive program assessment to identify and propose action steps to resolve areas of concern;
• Conducting an on site program assessment focused on a specific area(s);
• Developing a detailed technical assistance plan for the project area to help systematically address the situation;
• Placing conditions or restrictions on the award of funds pending a future submission by the applicant; and
• Loss of funding in future applications, if nonconcurrence or poor performance is not satisfactorily addressed.

In the event of the availability of supplemental funds for HIV prevention, CDC will require a letter of concurrence for health department applications for such funds. A Letter of Concurrence for Supplemental Funds will be expected to address the criteria above.

Sample letters of concurrence, concurrence with reservations or nonconcurrence are included in Appendix B.