Grants to Provide Outpatient Early Intervention Services with Respect to HIV Disease

The purpose of the RWHAP Part C Early Intervention Services (EIS) Program funding is to provide comprehensive HIV primary care and support services in an outpatient setting for low-income people with HIV. This includes: 1) counseling for individuals

The purpose of the RWHAP Part C Early Intervention Services (EIS) Program funding is to provide comprehensive HIV primary care and support services in an outpatient setting for low-income people with HIV. This includes: 1) counseling for individuals with respect to HIV; 2) targeted HIV testing; 3) periodic medical evaluations of individuals with HIV and clinical and diagnostic services for HIV care and treatment; 4) therapeutic measures for preventing and treating the deterioration of the immune system, and for preventing and treating conditions arising from HIV; and 5) referrals for people with HIV to appropriate providers of health care and support services. These services are to be provided directly or through referrals, contracts, or memoranda of understanding. The purpose of the RWHAP Part C Capacity Development Program is to strengthen organizational capacity to respond to the changing health care landscape and to increase access to high-quality HIV primary health care services for low-income people with HIV.

Public and nonprofit private entities that are: a) Federally qualified health centers under section 1905(1)(2)(B) of the Social Security Act; b) Grant recipients under section 1001 (regarding family planning) other than States; c) Comprehensive hemophilia diagnostic and treatment centers; d) Rural health clinics; e) Health facilities operated by or pursuant to a contract with the Indian Health Service; f) Community-based organizations, clinics, hospitals, and other health facilities that provide early intervention services to people who contracted HIV through intravenous drug use; or g) Nonprofit private entities that provide comprehensive primary care services to populations at risk of HIV, including faith-based and community-based organizations.

Individual/Family Low income, people with HIV.

Part C recipients are expected to develop comprehensive and coordinated systems of HIV services which are available to people with HIV in the local service area, especially those populations who are the hardest to reach, have the greatest unmet need, and/or the greatest gaps in HIV primary care services. These HIV service systems should ensure the progress of the target populations along the HIV care continuum with the goal of optimizing health outcomes demonstrated by retention in medical care, viral load reduction, and decreases in new HIV infections in the community. For the Part C program, no more than 10 percent of total grant funds may be expended for administrative expenses, including planning and evaluation. At least 50 percent of total grant funds must be expended for Early Intervention Services (except counseling and referrals/linkage to care). At least 75 percent of total grant funds, after reserving funds for clinical quality management, planning/evaluation, and administration must be expended for core medical services. For the Capacity Development Program, no more than 10 percent of the total grant funds may be expended for administrative expenses, including planning and evaluation, and excluding costs of a clinical quality management program. Administrative costs are those direct and indirect costs associated with the administration of the RWHAP Part C Capacity Development grant. For Part C and Part C Capacity Development Programs, all funds must be expended solely for carrying out the approved project in accordance with the NOFO, the terms and conditions of the award, and the applicable cost principles. Funds may not be used for purchase, construction, or major alterations or renovations on any building or other facility; purchase or improvement of land; payments for clinical research; payments for nursing home care; cash payments to intended recipients of RWHAP services; research; foreign travel; or for any item or service to the extent that payment has been made, or reasonably can be expected to be made, with respect to that item or service under any State compensation program, insurance policy, Federal or State health benefits program or by an entity that provides health services on a prepaid basis (except for a program administered by or providing the services of the Indian Health Services). Funds may also not be used towards pre-exposure prophylaxis (PrEP) or non-occupational post-exposure prophylaxis (nPEP) medications or medical services. As outlined in the June 22, 2016 RWHAP and PrEP program letter the RWHAP legislation provides grant funds to be used for the care and treatment of people with HIV, thus prohibiting the use of RWHAP funds for PrEP medications or related medical services, such as physician visits and laboratory costs. However, RWHAP Parts C recipients and subrecipients may provide prevention counseling and information, which should be part of a comprehensive PrEP program. Additionally, the purchase of sterile needles or syringes for the purposes of hypodermic injection of any illegal drug is not allowable. Some aspects of Syringe Services Programs are allowable with HRSA's prior approval and in compliance with HHS and HRSA policy (see: https://www.hiv.gov/federal-response/policies-issues/syringe-services-programs).

Part C recipients are expected to develop comprehensive and coordinated systems of HIV services which are available to people with HIV in the local service area, especially those populations who are the hardest to reach, have the greatest unmet need, and/or the greatest gaps in HIV primary care services. These HIV service systems should ensure the progress of the target populations along the HIV care continuum with the goal of optimizing health outcomes demonstrated by retention in medical care, viral load reduction, and decreases in new HIV infections in the community. For the Part C program, no more than 10 percent of total grant funds may be expended for administrative expenses, including planning and evaluation. At least 50 percent of total grant funds must be expended for Early Intervention Services (except counseling and referrals/linkage to care). At least 75 percent of total grant funds, after reserving funds for clinical quality management, planning/evaluation, and administration must be expended for core medical services. For the Capacity Development Program, no more than 10 percent of the total grant funds may be expended for administrative expenses, including planning and evaluation, and excluding costs of a clinical quality management program. Administrative costs are those direct and indirect costs associated with the administration of the RWHAP Part C Capacity Development grant. For Part C and Part C Capacity Development Programs, all funds must be expended solely for carrying out the approved project in accordance with the NOFO, the terms and conditions of the award, and the applicable cost principles. Funds may not be used for purchase, construction, or major alterations or renovations on any building or other facility; purchase or improvement of land; payments for clinical research; payments for nursing home care; cash payments to intended recipients of RWHAP services; research; foreign travel; or for any item or service to the extent that payment has been made, or reasonably can be expected to be made, with respect to that item or service under any State compensation program, insurance policy, Federal or State health benefits program or by an entity that provides health services on a prepaid basis (except for a program administered by or providing the services of the Indian Health Services). Funds may also not be used towards pre-exposure prophylaxis (PrEP) or non-occupational post-exposure prophylaxis (nPEP) medications or medical services. As outlined in the June 22, 2016 RWHAP and PrEP program letter the RWHAP legislation provides grant funds to be used for the care and treatment of people with HIV, thus prohibiting the use of RWHAP funds for PrEP medications or related medical services, such as physician visits and laboratory costs. However, RWHAP Parts C recipients and subrecipients may provide prevention counseling and information, which should be part of a comprehensive PrEP program. Additionally, the purchase of sterile needles or syringes for the purposes of hypodermic injection of any illegal drug is not allowable. Some aspects of Syringe Services Programs are allowable with HRSA's prior approval and in compliance with HHS and HRSA policy (see: https://www.hiv.gov/federal-response/policies-issues/syringe-services-programs).

Early Intervention Services grants are typically awarded for up to a 3 year period of performance. Continued support, beyond the first year, is contingent upon satisfactory performance and the availability of Federal funds. Capacity development grants may be funded for up to 1 year.

An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review. An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.

Eligible applicants are reviewed by an objective review committee based on the criteria detailed in the NOFO.

Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions. Notification is made in writing by a Notice of Award (NOA).

Approximately 6 months.