HOPWA FY2026 RFA Application

HOPWA FY2026 RFA Application
Organization's Legal Name
Organization's DBA Name (if applicable)
Organization UEI#
Organization Employer Identification Number (EIN)
Address of Organization

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Organization
Please enter a valid phone number.Format: (000) 000-0000.
Please list the name of each county within your service area that you will serve with IHCDA's HOPWA funding.
Please provide the name of your organization's CEO or Executive Director.

First NameLast Name
CEO/Executive Director Email Address
example@example.com
CEO/Executive Director Office Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Will the CEO or Executive Director specified above also be the individual that signs your contract?
Name of your organization's signatory

First NameLast Name
Title/Role of Organization's signatory
Email Address of Organization's signatory
example@example.com
Phone Number of Organization's signatory
Please enter a valid phone number.Format: (000) 000-0000.
In addition to the organization's CEO/Executive Director and contract signatory, is there a HOPWA Program Contact you would like us to use for your award?
Please provide the first and last name of one main HOPWA Program Contact at your organization:

First NameLast Name
Title/Role of HOPWA Program Contact
Email of HOPWA Program Contact
example@example.com
Phone Number of HOPWA Program Contact
Please enter a valid phone number.Format: (000) 000-0000.
Do you have another HOPWA Program Contact to add?
Please provide the name of an additional HOPWA Program Contact at your organization:

First NameLast Name
Title/Role of HOPWA Program Contact #2
Email of HOPWA Program Contact #2
example@example.com
Phone Number of HOPWA Program Contact #2
Please enter a valid phone number.Format: (000) 000-0000.
Do you have another HOPWA Program Contact to add?
Please provide the first and last name of an additional HOPWA Program Contact at your organization:

First NameLast Name
Title/Role of HOPWA Program Contact #3
Email of HOPWA Program Contact #3
example@example.com
Phone Number of HOPWA Program Contact #3
Please enter a valid phone number.Format: (000) 000-0000.

FY2026 Budget Request

On this page, you will enter the dollar amount your organization is requesting for each budget line item outlined in the RFA. If you do not seek funding in any of the line-items, please type "0" or "0.00" to indicate this. Afterwards, this will auto-calculate the "Total of HOPWA FY2026 Funding Requested (in U.S. Dollars)."
TBRA
Enter amount in decimals
Long-Term Program Delivery
Enter amount in decimals
STRMU
Enter amount in decimals
Short-Term Program Delivery
Enter amount in decimals
Facility Operations/Facility Assistance
Enter amount in decimals
Supportive Services
Enter amount in decimals
Housing Information Services
Enter amount in decimals
Permanent Housing Placement
Enter amount in decimals
Resource Identification
Enter amount in decimals
Administration
Enter amount in decimals
Total of HOPWA FY2026 Funding Requested (in U.S. Dollars):
This value is auto populated once you complete the requested amounts for the other line-items listed below.

Threshold Requirement Questions

Please read each question and option carefully before responding. Please note that organizations will be asked to provide documentation to support their responses.
Is your organization a private, nonprofit organization (defined as a tax exempt or secular or religious organization described in Section 501(c)(3) of the Internal Revenue Code?
Please provide documentation of your organization's 501c3 status.

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Does your organization have an up-to-date UEI Number from sam.gov?
Please provide documentation of your organization's UEI Number from sam.gov.

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Is your organization registered with the Indiana Secretary of State?
Please provide documentation demonstrating that your organization is registered with the Indiana Secretary of State.

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Does your organization have documentation showing that the organization either (1) is designated by the Indiana Department of Health as a Non-Medical Case Management Provider (NMCMP) or (2) has a formal agreement with a NMCMP?
Please provide documentation showing that your organization either (1) is designated as a Non-Medical Case Management Provider (NMCMP) or (2) has a signed, formal agreement with a NMCMP.

Examples of documentation that demonstrate the organization's status as a NMCMP may include: a letter from IDOH confirming receipt of Ryan White funding, an up-to-date NMCMP map indicating that your organization is an NMCMP, or another form of documentation from IDOH not previously named.
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Please elaborate on how your organization coordinates with your Regional Planning Council. Per the RFA narrative, please explain whether your organization attends monthly meetings and case conferencing sessions and provides or accepts referrals for assisting clients. Please explain the extent to which this coordination occurs.
If your organization attended RPC meetings, please provide documentation showing that an affiliated staff or board member attended Regional Planning Council on the Homeless meetings in the previous calendar year. A blank Certificate of Attendance is available on IHCDA’s HOPWA webpage.

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Financial Management Information
Please attach your most recent 990 here.

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Please attach your 2025 year-to-date Balance Sheet, Income Statements and Cash Flow statements. Please provide your most recent (2024 or 2025) Financial Statement.

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Please attach at least one (1) Current Certificate of Completion from HUD Exchange’s 2 CFR 200 Financial Management Module.

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Please attach at least one (1) Current Certificate of Completion from HUD Exchange’s HOPWA Financial Management Module

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Experience with Service Provision
Has your organization received any funding from IHCDA in the past?
In the past 5 years, has your organization received and administered a federal grant other than HOPWA?
Please list all non-HOPWA, federal grants your organization has received and administered within the last 5 years. Please also include the name of the funder your organization received each grant from.
How long has your organization served persons living with HIV/AIDS, with or without HOPWA funding?
Please provide answer in number of years.
Please provide a description of your organization's mission and services.
Please describe your experience with HMIS. Does your organization need HMIS technical assistance or training?
Please elaborate on how your organization implements low-barrier, person-centered approaches in administering HOPWA assistance.
Please describe your organization’s experience in serving youth, veterans, VAWA-eligible clients, or those who experienced or are experiencing chronic homelessness. Please explain any services or interventions that are directly offered to these clients. Describe instances to which you refer clients to other providers.
How do prospective clients become enrolled in your organization’s HOPWA TBRA program? Include a summary of how clients connect with the organization to address their housing needs and the process of initial intake to discharge (as applicable depending on client circumstances). Include a summary of the overall strategy and the role of each partner in the referral process (if your organization is working with other agencies or external stakeholders).
How do prospective clients become enrolled in your organization’s HOPWA STRMU program? Include a summary of how clients connect with the organization to address their housing needs and the process of initial intake to discharge once the time limit for STRMU assistance ends. Include a summary of the overall strategy and the role of each partner in the referral process (if your organization is working with other agencies or external stakeholders).
How does your organization identify and recruit landlords to house HOPWA clients? Include a summary of the overall strategy and steps that will be taken to recruit, engage, and retain landlords.
What partnerships or relationships does your organization have with Permanent Supportive Housing (PSH) programs in your HOPWA area(s)? If there is no MOU for each HOPWA region that your program covers, please explain below.
What partnerships or relationships does your organization have with other agencies serving people living with HIV/AIDS? How does your organization approach maintaining existing and creating new relationships with other agencies?
Is your organization an active member of any regional/local HOPWA planning or community planning committees OTHER than your regional continuum of care/regional planning council on the homeless? If yes, please list below:

Staff and Board of Directors
Please attach a list of your organization's current Board of Directors; including names, affiliating organization(s), email addresses, and phone numbers.

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Please attach the Bylaws that govern your Board of Directors.

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Please attach your organization's staffing/organizational chart of HOPWA staff, including FTE employees

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What training or continuing education opportunities have program staff attended in the last year that related to the administration of HOPWA or assisting persons living with HIV/AIDs? If none, please explain.
How often do HOPWA staff undergo training related to confidentiality protections?
If "Other" was selected for the previous question, please specify.

Attachments
Current Policy by which HOPWA clients are selected and approved (do not share documentation containing a client's personal identifying information)

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Organization's Confidentiality Policies and Procedures

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Tracking Sheet of 75% served at or below 50% AMI

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Blank Housing Plan or Outline

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One MOU with a Permanent Supportive Housing (“PSH”) provider in each region that your organization covers.

Only required if PSH is available in the area you will serve with IHCDA funding.
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Grievance/dispute policy

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Termination of Assistance Policy

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Supplementary Attachment #1

This OPTIONAL field allows you to upload any documentation that better contextualizes your application. This can be in the form of an addendum to contextualize your request or another form of documentation to showcase your ability to successfully administer HOPWA assistance. There is no penalty for providing or NOT providing documentation that you believe better contextualizes your application.
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Supplementary Attachment #2

This OPTIONAL field allows you to upload any documentation that better contextualizes your application. This can be in the form of an addendum to contextualize your request or another form of documentation to showcase your ability to successfully administer HOPWA assistance. There is no penalty for providing or NOT providing documentation that you believe better contextualizes your application.
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I hereby certify that all information in the program proposal forms are true, correct, and accurately reflect the organization's ability to run the HOPWA program. I have read the request for application materials and understand the intent, limitations, and requirements of services purchased through this application and the contractual requirements of IHCDA.

By signing this application, I also certify the following:

1.      My organization will cooperate and coordinate with relevant state and local governments in providing HOPWA assistance.

2.      My organization implements standards of financial accountability that conform to 2 CFR 200.302, ‘Financial Management’ and 2 CFR 200.303, ‘Internal Controls’, which includes systems and software that allow for effective control over, and accountability for, all funds, property, and other assets.

3.      My organization that does not have any unresolved findings from IHCDA or HUD.

4.      I understand and will comply with the programmatic contractual requirements placed upon this organization if we are awarded funding.
Signature

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Name

First NameLast Name
Title
Legal Name of Organization
Today's Date

MonthDayYear
Date
Preparer Information: Please complete this section for contact purposes in the event there are questions regarding your organization's response to this RFA.
Should be Empty:

HOPWA FY2026 RFA Application

FY2026 Budget Request

Threshold Requirement Questions

Financial Management Information

Experience with Service Provision

Staff and Board of Directors

Attachments