Ryan White HIV/AIDS Program Part D - Women, Infants, Children and Youth Grant Supplemental Funding is sponsored by Health Resources and Services Administration (HRSA). This grant provides supplemental funding to improve access to and quality of HIV care and treatment services for women, infants, children, and youth. The program aims to improve health outcomes and reduce health disparities.

U.S. Department of Health and Human Services # NOTICE OF FUNDING OPPORTUNITY # Division of Community HIV/AIDS Programs # Ryan White HIV/AIDS Program Part C Early Intervention Services Program: # Limited Existing Geographic Service Areas # Funding Opportunity Numbers: HRSA-25-052 # Funding Opportunity Type(s): Competing Continuation, New # Assistance Listings Number: 93. 918 # Application Due Date: December 10 , 2024 Ensure your SAM.

gov and Grants. gov registrations and passwords are current immediately! We will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete. Issuance Date: October 8, 2024 Division of Community HIV/AIDS Programs (DCHAP) See Section VII for a complete list of agency contacts. Authority: 42 U.S.C.

§§ 300ff-51 to -67 and 300ff-121 (sections 2651-2667 and 2693 of the Public Health Service (PHS) Act). HRSA-25-052 RWHAP Part C EIS i # 508 COMPLIANCE DISCLAIMER Persons using assistive technology may not be able to fully access information in this file.

For assistance, email or call one of the HRSA staff listed in Section VII Agency Ryan White HIV/AIDS Program (RWHAP) Part C Early Intervention Services Program: Limited Existing Geographic Funding Opportunity Number: Assistance Listing Number: Due Date for Applications: Purpose: The purpose of this program is to provide comprehensive primary health care and support services in an outpatient setting for low-income people with HIV in existing geographic service areas, as defined in Appendix C .

Under this announcement, applicants must propose to provide all 5 RWHAP Part C Early Intervention Services (EIS) either directly or through referrals, contracts or memoranda of understanding (MOU).

These services are: (1) counseling for individuals with respect to HIV; (2) targeted HIV testing; (3) periodic medical evaluations of individuals with HIV and other clinical and diagnostic services regarding HIV; (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 and support services.

Eligible Applicants: This competition is open to current RWHAP Part C EIS recipients and new organizations proposing to provide RWHAP Part C EIS funded services in the geographic service areas listed in Appendix C.

Eligible applicants must be public or HRSA-25-052, RWHAP Part C EIS ii nonprofit private entities that are: a) Federally qualified health centers under section 1905(1)(2)(B) of the Social Security Act (SSA); b) Grant recipients under section 1001 of the Public Health Service Act (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.

See Section III. 1 of this notice of funding opportunity (NOFO) for complete eligibility information. Anticipated FY 2025 Total Available Funding: We are issuing this notice to ensure that, should funds become available for this purpose, we can process applications and award funds appropriately.

You should note that we may cancel this program notice before award if funds are not appropriated. Estimated Annual Award Amount: See Appendix C .

Ceiling amounts are subject to the availability Cost Sharing or Matching Required: Either April 1, 2025 through March 31, 2028 or May 1, 2025 through April 30, 2028, according to Appendix C Each period of performance will be for 3 years Agency Contacts: Business, administrative, or fiscal issues: Grants Management Specialist Division of Grants Management Operations, Office of Federal Assistance and Acquisition Management (OFAAM) Email: Bhaley@hrsa.

gov HRSA-25-052, RWHAP Part C EIS iii Program issues or technical assistance: Division of Community HIV/AIDS Programs (DCHAP) Email: PARTCEIS@hrsa. gov You (the applicant organization / agency) are responsible for reading and complying with the instructions included in this NOFO and in the HRSA Application Guide (Application Guide) .

Visit HRSA’s How to Prepare Your Application page for more We have scheduled the following webinar: Day and Date: Thursday, October 17, 2024 gov.zoomgov. com/j/1600314058? pwd=3vyxmALogE5OS2YUOUzArViVkK4NGo.

1 Attendees without computer access or computer audio can use the following dial-in information: Call-In Number: 1-833-568-8864 We will record the webinar. The link to the recording will be available on the TargetHIV site within five (5) business days. HRSA-25-052, RWHAP Part C EIS iv I.

PROGRAM FUNDING OPPORTUNITY DESCRIPTION ......................................................... 1 1. PURPOSE ..........................................................................................................................

1 2. BACKGROUND .................................................................................................................... 2 THE RYAN W HITE HIV/AIDS PROGRAM ...................................................................................

2 II. AWARD INFORMATION ........................................................................................................ 4 1.

TYPE OF APPLICATION AND AWARD ..................................................................................... 4 2. SUMMARY OF FUNDING ......................................................................................................

4 III. ELIGIBILITY INFORMATION ................................................................................................ 6 1.

ELIGIBLE APPLICANTS ........................................................................................................ 6 2. COST SHARING OR M ATCHING ............................................................................................

7 3. O THER .............................................................................................................................. 7 IV.

APPLICATION AND SUBMISSION INFORMATION............................................................. 8 1. ADDRESS TO REQUEST A PPLICATION PACKAGE ...................................................................

8 i. Project Abstract ...................................................................................................... 15 ii.

Project Narrative ..................................................................................................... 16 iii. Budget ....................................................................................................................

25 iv. Budget Narrative ..................................................................................................... 28 v.

Attachments............................................................................................................ 29 3. UNIQUE ENTITY I DENTIFIER (UEI) AND SYSTEM FOR AWARD M ANAGEMENT (SAM) ..............

33 4. SUBMISSION DATES AND TIMES ........................................................................................ 34 5.

I NTERGOVERNMENTAL REVIEW ......................................................................................... 34 6. FUNDING RESTRICTIONS ..................................................................................................

34 V. APPLICATION REVIEW INFORMATION ............................................................................ 35 1.

REVIEW CRITERIA ............................................................................................................ 35 2. REVIEW AND SELECTION PROCESS ...................................................................................

38 3. ASSESSMENT OF RISK ...................................................................................................... 41 VI.

AWARD ADMINISTRATION INFORMATION ..................................................................... 41 1. AWARD NOTICES .............................................................................................................

41 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS ................................................... 42 3.

REPORTING ..................................................................................................................... 44 VII. AGENCY CONTACTS .......................................................................................................

45 VIII. OTHER INFORMATION ................................................................................................... 46 APPENDIX A: PAGE LIMIT WORKSHEET ..............................................................................

47 APPENDIX B: RWHAP PART C EIS ADDITIONAL AGREEMENTS AND ASSURANCES ...... 50 APPENDIX C: EXISTING GEOGRAPHIC SERVICE AREAS .................................................. 52 HRSA-25-052, RWHAP Part C EIS 1 # I.

Program Funding Opportunity Description HRSA-25-052 announces the opportunity to apply for funding under Ryan White HIV/AIDS Program (RWHAP) Part C Early Intervention Services (EIS) Program: Limited Existing Geographic Service Areas. The purpose of this program is to provide comprehensive primary health care and support services in an outpatient setting for low-income people with HIV.

Under this announcement, successful applicants must provide: (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 (MOUs). This competition is open to current RWHAP Part C EIS recipients and new organizations proposing to provide RWHAP Part C EIS funded services in the geographic service areas listed in Appendix C . Please note that the period of performance varies by service area.

If you are applying for more than one service area, you must submit a separate application for each proposed service area. All allowable services must relate to HIV diagnosis, care, and support, and must adhere to established HIV clinical practice standards consistent with U.S. Department of Health and Human Services (HHS) Guidelines .

Please refer to the HIV/AIDS Bureau (HAB) Policy Clarification Notice (PCN) 16-02 Ryan White HIV/AIDS Program Services for a list of RWHAP allowable core medical and support services and their descriptions.

According to the RWHAP Part C statute: • At least 50 percent of the amount received under the award must be expended on EIS costs (except counseling and referrals/linkage to care); • At least 75 percent of the award (after reserving amounts for administrative costs, planning/evaluation, and clinical quality management (CQM)) must be expended on core medical services costs (Please note EIS is a subset of this 75 percent of the award) and; • Not more than 10 percent of the total RWHAP Part C award funds can be expended on administrative costs.

Applicants seeking a waiver to the core medical services requirement must submit a waiver request with this application as Attachment 15 . For more details, see Program Requirements and Expectations . HRSA-25-052, RWHAP Part C EIS 2 The RWHAP Part C Early Intervention Services Program is authorized by 42 U.S.C.

§§ 300ff-51 to -67 and 300ff-121 (sections 2651-2667 and 2693 of the Public Health Service (PHS) Act). The Ryan White HIV/AIDS Program The HRSA Ryan White HIV/AIDS Program (RWHAP) provides a comprehensive system of HIV primary medical care, essential support services, and medications for low-income people with HIV.

The program funds grants to states, cities, counties, and local community-based organizations to provide care and treatment services to people with HIV to improve health outcomes and reduce HIV transmission among priority populations.

The RWHAP has five statutorily defined Parts (Parts A, B, C, D, and F) that provide funding for core medical, support services, and medications; technical assistance (TA); clinical training; and the development of innovative interventions and strategies for HIV care and treatment to respond to emerging needs of RWHAP clients.

An important framework in the RWHAP is the HIV care continuum, which is comprised of the series of stages a person with HIV engages in from initial diagnosis through their successful treatment with HIV medication to achieve viral suppression. Supporting people with HIV to reach viral suppression not only increases their own quality of life and lifespan, it also prevents sexual transmission to an HIV-negative partner.

The HIV care continuum framework allows recipients and planning groups to measure progress and to direct HIV resources most effectively. RWHAP recipients are required to assess the outcomes of their programs and should work with their community and public health partners to improve outcomes across the HIV care continuum.

HRSA encourages recipients to use the performance measures developed for the RWHAP at their local level to assess the efficacy of their programs and to analyze and improve the gaps along the HIV care continuum.

Strategic Frameworks and National Objectives National objectives and strategic frameworks like Healthy People 2030 , the National HIV/AIDS Strategy (NHAS) (2022–2025) ; the Sexually Transmitted Infections National Plan for the United States: A Roadmap to Elimination (2021–2025) are crucial to addressing key public health challenges facing low-income people with HIV.

These strategies detail the principles, priorities, and actions to guide the national public health response and provide a blueprint for collective action across the Federal Government and other sectors. The RWHAP supports the implementation of these strategies and recipients should align their organization’s efforts, within the parameters of the RWHAP statute and program guidance, with these strategies to the extent possible.

HRSA-25-052, RWHAP Part C EIS 3 Expanding the Effort: Ending the HIV Epidemic in the United States As demonstrated by recent data from the 2022 Ryan White HIV/AIDS Program Services Report (RSR), the RWHAP has made tremendous progress toward ending the HIV epidemic in the United States.

From 2018 to 2022, HIV viral suppression among RWHAP patients who have had one or more medical visits during the calendar year and at least one viral load with a result of <200 copies/mL reported, has increased from 85. 9 percent to 89. 7 percent.

Additionally, racial and ethnic, age-based, and regional disparities reflected in viral suppression rates have significantly decreased. [1] The Ending the HIV Epidemic in the U.

S (EHE) initiative expands the RWHAP’s ability to meet the needs of clients, specifically focusing on linking people with HIV who are either newly diagnosed, diagnosed but currently not in care, or are diagnosed and in care but not yet virally suppressed, to the essential HIV care, treatment, and support services needed to help them reach viral suppression.

Using Data Effectively: Integrated Data Sharing and Use HRSA and the Centers for Disease Control and Prevention’s (CDC) Division of HIV Prevention support integrated data sharing, analysis, and utilization for the purposes of program planning, conducting needs assessments, determining unmet need estimates, reporting, quality improvement, enhancing the HIV care continuum, and public health action.

HRSA strongly encourages RWHAP recipients to: • Follow the principles and standards in the Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Programs: Standards to Facilitate Sharing and Use of Surveillance Data for Public • Establish data sharing agreements between surveillance and HIV programs to ensure clarity about the process and purpose of the data sharing and utilization.

Integrated data sharing, analysis, and utilization of HIV data by state and territorial health departments can help further progress toward reaching the NHAS goals and improve outcomes on the HIV care continuum.

HRSA strongly encourages complete CD4, viral load (VL), and HIV nucleotide sequence reporting to the state and territorial health departments’ HIV surveillance systems to benefit fully from secure integrated data sharing, analysis, and utilization. State health departments may use CD4, VL, and nucleotide sequence data to identify cases, stage of HIV disease at diagnosis, and monitor disease progression.

These data can also be used to evaluate HIV testing and prevention efforts, determine entry into and retention in HIV care, measure viral suppression, monitor prevalence of antiretroviral drug resistance, detect transmission clusters and understand transmission patterns, and assess unmet health care needs.

Analyses at the national level to monitor progress toward ending the HIV epidemic in the United States can only occur if all HIV-related CD4, VL, and HIV nucleotide sequence > [1] Health Resources and Services Administration. Ryan White HIV/AIDS Program Annual Client-Level Data Report 2022. https://ryanwhite.

hrsa. gov/data/reports . Published December 2023.

Accessed January 3, 2023. HRSA-25-052, RWHAP Part C EIS 4 test results are reported by all jurisdictions. CDC requires the reporting to the National HIV Surveillance System (NHSS) all HIV-related CD4 results (counts and percentages), all VL results (undetectable and specific values), and HIV nucleotide sequences.

HRSA’s RWHAP Compass Dashboard is an interactive data tool to allow users to visualize the reach, impact, and outcomes of the RWHAP and supports data utilization to understand outcomes and inform planning and decision making.

The dashboard provides a look at national-, state-, and metro area-level data and allows users to explore RWHAP client characteristics and outcomes, including age, housing status, transmission category, and viral suppression. The RWHAP Compass Dashboard also visualizes information about RWHAP services received and the characteristics of those clients accessing the AIDS Drug Assistance Program (ADAP).

In addition, RWHAP recipients and subrecipients are encouraged to develop data sharing strategies with other RWHAP recipients and relevant entities to reduce administrative burden across programs.

As outlined in Policy Clarification Notice 21-02, Determining Client Eligibility & Payor of Last Resort in the Ryan White HIV/AIDS Program , recipients and subrecipients should use electronic data sources (for example, Medicaid enrollment, state tax filings, enrollment and eligibility information collected from health care marketplaces) to collect and verify client eligibility information, such as income and health care coverage (that includes income limitations), when possible.

RWHAP recipients and subrecipients should first use available data sources to confirm client eligibility before requesting additional information from the client. Program Resources and Innovative Models HRSA has several projects and resources that may assist RWHAP recipients with program implementation.

These include a variety of HRSA HIV/AIDS Bureau (HAB) projects focused on specific TA, evaluation, demonstration, and intervention activities. A full list is available on TargetHIV . Recipients should be familiar with these resources and are encouraged to use them as needed to support their program implementation.

1. Type of Application and Award Application type(s): Competing Continuation, New We will fund you via a grant. We estimate approximately $3,102,000 to be available annually (total amount of all service areas listed in Appendix C ).

You may apply up to the published ceiling amount in Appendix C. The actual amount available will not be determined until enactment of the final FY 2025 federal budget. HRSA-25-052, RWHAP Part C EIS 5 The funding announcement has two (2) period of performance start dates depending on the existing service areas listed in Appendix C.

Funding for each period of performance will be for three (3) years. This program notice depends on the appropriation of funds. If funds are appropriated for this purpose, we will proceed with the application and award process.

Support beyond the first budget year will depend on: • Satisfactory progress in meeting the project’s objectives • A decision that continued funding is in the government’s best interest We encourage current RWHAP Part C recipients to assess your history of expending Part C funds and to examine all resources available, including program income generated as a result of the RWHAP Part C award, when considering the funding level for which to apply.

Appendix C describes the ceiling amount for each service area; you can request a funding level that is less than the listed amount in light of your history of expending Part C funds and availability of other resources. If there is an increase in appropriations during the period of performance, we propose to distribute these funds based on the number of new and/or re-engaged in care clients a recipient has served.

In addition, we reserve the right to reduce future funding, or to fund less than the amount requested, based on a recipient’s history of unobligated balances.

HRSA determines funding levels in the RWHAP Part C EIS program using a methodology to ensure funds are awarded across service areas based on the following objective RWHAP data: the number and current demographics of clients served, HIV-related health disparities, and the number of uninsured clients.

The RWHAP Part C funding methodology ensures baseline funding for the maintenance of program operations, minimizes disruptions by constraining the maximum allowable decrease in funding, and maintains the provision of quality HIV care in existing service areas. This competitive discretionary funding opportunity continues using this same funding methodology to determine the funding ceiling amount per service area.

HRSA may also apply additional funding considerations as noted in Section V. 2 Review and Selection Process . The RWHAP Part C funding methodology uses quantitative data primarily from the RSR to allocate funds to service areas in a more streamlined and consistent manner, achieving a reasonable and sustainable allocation of resources to improve health outcomes for people with HIV.

Similar to FY 2018 and FY 2022, the RWHAP Part C funding methodology includes the following proportions and objective factors: HRSA-25-052, RWHAP Part C EIS 6 1) 70 percent of funding is base funding (minimum award amount of $100,000 1 per service area augmented by an amount corresponding to the number of eligible Part C clients served in that area as reported through the 2021 RSR); and 2) 30 percent of funding is based on a) demographics as reported through the 2021 RSR (limited to the service area’s proportion of populations disproportionately impacted by the HIV epidemic with significant disparities in health outcomes, and b) RWHAP Part A resources (RWHAP Part C service areas outside of RHWAP Part A jurisdictions will receive additional funding).

Future iterations of the RWHAP Part C funding methodology may include new proportions in funding and factors, such as number of clients new to care and/or re-engaged individuals in care, and performance in HIV viral suppression. This approach ensures funding allocation across service areas will be responsive to HIV health disparities and the changing demographics of the HIV epidemic, as well as the evolving health care landscape.

To maintain continued access to high quality HIV primary care and support services, funds will continue to be awarded across existing service areas. Existing service areas will be kept intact, as described in this NOFO. Under this three-year award, HRSA has constrained the degree of change in funding.

45 CFR part 75 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards , or any superseding regulation applies to all HRSA awards. If you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate of 15 percent of modified total direct costs (MTDC). See 2 CFR 200.

1 for the definition of MTDC. You can use this rate indefinitely. If you choose this method, you must use it for all federal awards until you choose to negotiate a rate.

You may apply to do so at any time. See Section 3. 1.

4 Budget Narrative in the Application Guide . *Note : One exception is a governmental department or agency unit that receives more than $35 million in direct federal funding. # III.

Eligibility Information This competition is open to current recipients and new, eligible applicants proposing to provide comprehensive primary health care and support services in outpatient settings for > 1Due to efforts to constrain the degree of change in funding experienced by each service area, there is one service area whose base award amount is slightly lower than $100,000.

HRSA-25-052, RWHAP Part C EIS 7 low income, uninsured, and underserved people with HIV in the service areas as described in Appendix C .

You can apply if your organization provides services in the service areas described in Appendix C, is in the United States, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau, is a public or non-profit private entity, and, as identified in section 2652(a)(1) of the PHS Act, is one of the following types of eligible organizations: • Federally-qualified health center under section 1905(1)(2)(B) of the Social Security Act; • Grant recipient under section 1001 of the PHS Act (regarding family planning) other than States; • Comprehensive hemophilia diagnostic and treatment centers; • Health facilities operated by or pursuant to a contract with the Indian Health Service; • Community-based organizations, clinics, hospitals, and other health facilities that provide early intervention services to people who contracted HIV through intravenous drug use; or • Nonprofit private entities that provide comprehensive primary care services to populations at risk of HIV, including faith-based and community-based organizations.

• Native American tribal governments and organizations are eligible. 2. Cost Sharing or Matching Cost sharing or matching is not required for this program.

We may not consider an application for funding if it contains any of the following non-responsive criteria: • Exceeds the funding ceiling amount • Fails to satisfy the deadline requirements referenced in Section IV.

4 You must agree to maintain a level of non-federal funding for EIS services (i.e., counseling of individuals with respect to HIV, targeted HIV testing, referrals/linkage to care, therapeutic measures, and periodic medical evaluations of people with HIV and other clinical and diagnostic services related to HIV diagnosis).

This must be at least at the same spending level for the fiscal year prior to the fiscal year for which you receive the award, as required by section 2664(d) of the PHS Act. Federal funds should add to, not replace, existing non-federal spending for such activities. Complete the Maintenance of Effort (MOE) information and submit as Attachment 9 .

We will enforce statutory MOE requirements through all available mechanisms. Multiple Applications HRSA-25-052, RWHAP Part C EIS 8 You may submit multiple applications under the same Unique Entity Identifier (UEI), if each proposes a different service area. If you are applying for more than one service area listed in Appendix C , you must submit a separate application for each service area under the correct funding opportunity number.

Each application must address the entire service area, as defined in Appendix C . For each service area, we will only review your last validated application before the Grants. gov due date .

# IV. Application and Submission Information 1. Address to Request Application Package We require you to apply online through Grants.

gov . Use the SF-424 workspace application package associated with this notice of funding opportunity (NOFO). Follow these directions: How to Apply for Grants .

If you choose to submit using an alternative online method, see Applicant System-to-System . Note : Grants. gov calls the NOFO “Instructions.

” 2. Content and Form of Application Submission Application Format Requirements Submit your information as stated in section 3 of the Application Guide and this program-specific NOFO state. Do so in English and budget figures expressed in U.S. dollars.

The total number of pages that count toward the page limit shall be no more than 80 pages when printed. We will not review any pages that exceed the page limit. Using the pages within the page limit, HRSA will determine eligibility using Section III.

Eligibility Information These items do not count toward the page limit: • Standard Office of Management and Budget (OMB)-approved forms you find in the NOFO’s workspace application package • Abstract (standard form (SF) “Project_Abstract Summary”) • Indirect Cost Rate Agreement • Proof of non-profit status (if it applies) • Funding Preferences HRSA-25-052, RWHAP Part C EIS 9 If there are other items that do not count toward the page limit, we’ll make this clear in Section IV.

2. vi Attachment s. If you use an OMB-approved form that is not in the workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants. gov before the deadline . Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification • When you submit your application, you certify that you and your principals 2 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project.

That is, no federal department or agency has debarred, suspended, proposed debarment, claimed you ineligible, or you have voluntarily excluded yourself from participating. • If you fail to make mandatory disclosures, we may take an action such as those identified in 45 CFR § 75. 371 .

This includes suspending or debarring you. 3 • If you cannot make this certification, you must include an explanation in Attachment 15 : Other Relevant Documents . (See Section 3.

1. 10 “Certifications” of the Application Guide ) Program Requirements and Expectations If you are awarded and receive funding under this announcement, you will be required to follow the requirements and expectations of this program.

This section contains a list of requirements that your organization must follow, and they include requirements for how your organization provides clinical services, how your organization manages and administers the RWHAP Part C EIS Program, and how your organization manages the financial or fiscal responsibilities of this federal award.

• HIV Counseling, Testing, and Referral (CTR) – RWHAP Part C funds can be used to provide HIV Counseling, Testing, and Referral (CTR) services to high-risk targeted populations in your service area in order to identify people with HIV and link them into medical care. You must coordinate these services with other HIV prevention and testing programs in your service area to avoid duplication of effort.

You should establish linkages and formal referral agreements to ensure follow-up care and treatment for those persons you have identified as having HIV. Please note that RWHAP Part C funds cannot (1) replace CTR services paid for by other sources, (2) support routine CTR services in the general patient population (those who are not high risk for HIV in your service area), or (3) pay for testing activities in the general population.

If HIV CTR is provided, these services must > 2See definitions at eCFR :: 2 CFR 180. 995 -- Principal. and eCFR :: 2 CFR 376.

995 -- Principal (HHS > supplement to government-wide definition at 2 CFR 180. 995). > 3See also 2 CFR parts 180 and 376 ,31 U.S.C.

§ 3354 , and 45 CFR § 75. 113 . HRSA-25-052, RWHAP Part C EIS 10 comply with sections 2661 to 2663 of the PHS Act.

The revised HHS Guidelines for CTR are available at: https://clinicalinfo. hiv. gov/en/guidelines .

When conducting CTR, you must assure the confidentiality of patient information and follow applicable federal, state, and local laws. Pre-exposure prophylaxis (PrEP) or non-occupational post-exposure prophylaxis (nPEP) is intended for persons who do not have HIV; therefore, RWHAP Part C funds shall not be used to pay for PrEP or nPEP medication or associated medical services.

However, RWHAP recipients, including Part C providers, may provide services such as counseling and targeted testing, which should be part of a comprehensive PrEP program.

For further guidance, please see the HAB • Medical Care Evaluation and Clinical Care – As a RWHAP Part C recipient, you must provide comprehensive patient-centered primary health care services in an outpatient setting for low-income people with HIV throughout your entire service area.

In addition, you must ensure, directly or by referral agreement with other organizations, access for clients to core medical services as described in HAB PCN 16-02 . If your program is unable to provide any of these services directly, you must have formal arrangements, such as contracts or MOUs, with other organizations who will provide these services.

You must also be able to diagnose, provide prophylaxis, and treat or refer clients with tuberculosis, Hepatitis B or C, and sexually transmitted infections. Program-wide clinical protocols should be in place to address these infections that can also occur among the clients you plan to serve. In addition, your clinical staff should track and coordinate all inpatient care.

They should also develop plans for patients to be seen at your clinic after they are discharged from the hospital, or if there is any other disruption in the care that you provide.

Finally, your RWHAP Part C program must have a system in place for after-hours and weekend clinical coverage for medical and dental services; and patients must be involved in and fully educated about their medical needs and treatment options within the standards of medical care. • Clinical Guidelines – All clinical care must be provided in accordance with HHS Guidelines, which can be found on the HIV.

gov website at: https://clinicalinfo. hiv. gov/en/guidelines .

HRSA strongly encourages you to require, at least yearly, continuing education opportunities for RWHAP Part C program staff to ensure they remain knowledgeable of clinical advances in the treatment of HIV and are familiar with the most recent HHS Guidelines.

• Referral Systems – You must have a process in place for referring patients to needed health care and support services such as oral health, specialty care, medical case management, etc . The referral system should include tracking and monitoring those referrals, including