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

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).