Ending the HIV Epidemic: A Plan for America — Ryan White HIV/AIDS Program Parts A and B

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This notice announces the opportunity to apply for funding for the Ending the HIV Epidemic: A Plan for America — Ryan White HIV/AIDS Program (RWHAP) Parts A and B as administered by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) in conjunction with the existing RWHAP Parts A and B funding. The purpose of this initiative is to focus resources in 48 counties, Washington, D.C., San Juan, Puerto Rico (PR), and seven states (hereafter referred to as “jurisdictions” and listed in Appendix A) to implement effective and innovative strategies, interventions, approaches, and services to reduce new HIV infections in the United States. The overarching goal for this initiative is to reduce new HIV infections in the United States to less than 3,000 per year by 2030. The Ending the HIV Epidemic: A Plan for America (hereafter referred to as the “initiative”) has four pillars, or key strategies: • Pillar One: Diagnose all people with HIV as early as possible; • Pillar Two: Treat people with HIV rapidly and effectively to reach sustained viral suppression; • Pillar Three: Prevent new HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs); and • Pillar Four: Respond quickly to potential HIV outbreaks to get needed prevention and treatment services to people who need them. HRSA and the Centers for Disease Control and Prevention (CDC), along with the National Institutes of Health (NIH) Centers for AIDS Research (CFARs), the Indian Health Service (IHS), and the Substance Abuse and Mental Health Services Administration (SAMHSA) are collaborating on the implementation of each of these Pillars. At the most general level: • Pillar One is led by CDC and, among many activities, includes working with the HRSA Health Center Program to increase testing among Health Center Program patients; • Pillar Two is led by HRSA and focuses on providing access to HIV care and treatment through the RWHAP and the Health Center Program, including working with CDC funded organizations and/or CDC staff to link people with HIV, newly diagnosed or re-identified through testing programs, to care; • Pillar Three is co-led by CDC and HRSA with the HRSA Health Center Program focusing on providing PrEP related outreach, care coordination, medical services and medications supported by CDC efforts to promote PrEP among populations needing PrEP services as well as other prevention activities, such as syringe services programs (SSPs); and • Pillar Four is led by CDC to rapidly detect HIV clusters and networks with support from the HRSA RWHAP and Health Center Program to provide HIV care and treatment or PrEP services through the Health Center Program, as applicable. HRSA-20-078 2 This HRSA HAB initiative is authorized under Section 311(c) of the Public Health Service Act, (42 U.S.C. § 243(c)) and title XXVI, (42 U.S.C. § 300ff-11 et seq.), with the funding to be used in conjunction with the RWHAP. As such, there is the opportunity for RWHAP programs funded under this announcement to have a broader approach to addressing HIV in their communities than what exists in services authorized by the RWHAP legislation. For example, for this initiative, the only requirement for determining eligibility for service provision is that the individual has a documented HIV diagnosis; there is no requirement that individuals meet RWHAP eligibility requirements. In addition, funded recipients are not limited to using the RWHAP service categories for this initiative. Recipients are encouraged to be innovative and creative as they design ways to use these funds to end the HIV epidemic in their jurisdictions. (See Funding Restrictions section on page 21 for more information). Proposed activities may include, but are not limited to: increasing organizational capacity; information dissemination and public outreach; community engagement; implementation of emerging practices, evidence-informed and/or evidenced-based interventions, particularly around linkage to care, retention in care, reengagement in care, and adherence counseling; the provision of needed client services; and data infrastructure development and systems linkages. Applicants must describe how proposed activities will address Pillar Two (Treat), including: • Expanding access to HIV care and treatment in the focus jurisdictions for people with HIV, both those who are newly diagnosed and those who are not engaged in care, and/or not virally suppressed; and • Addressing unmet needs and improving client-level health outcomes. Applicants must also describe how proposed activities support Pillar Four (Respond), to respond quickly to HIV cluster detection efforts for those people with HIV needing HIV care and treatment. Funded recipients will use these initiative resources in conjunction with the RWHAP Parts A and B systems of HIV care and treatment to develop, implement, and/or enhance innovative approaches to engaging people with HIV who are newly diagnosed, not in care, and/or not virally suppressed. In addition, the recipients will provide rapid access to a comprehensive continuum of high quality care and treatment services. All funded recipients will be required to collaborate with the recipients of HRSA-20-079 Ending the HIV Epidemic: A Plan for America – Technical Assistance Provider (TAP) and HRSA-20-089 Ending the Epidemic: A Plan for America – Systems Coordination Provider (SCP). The purpose of the TAP is to provide technical assistance to you on implementation of work plan activities, innovative approaches, and interventions. The purpose of the SCP is to assist you in coordinating your initiative planning, funding sources, and programs with the existing HIV care delivery systems. In addition, the SCP will assist in the identification of existing and new stakeholders, as well as collate and disseminate best practices, innovative approaches, and interventions identified by the TAP that facilitate the success of the initiative.

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