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  4. Part F: Special Projects of National Significance (SPNS) Program

Part F: Special Projects of National Significance (SPNS) Program

The Ryan White HIV/AIDS Program (RWHAP) Part F Special Projects of National Significance (SPNS) Program supports the development of innovative models of HIV care and treatment to quickly respond to emerging needs of RWHAP clients. Through its demonstration, implementation, and IT projects, SPNS uses implementation science to evaluate the design, implementation, utilization, cost, and health-related outcomes of treatment strategies while promoting the dissemination and replication of successful interventions. This unique program advances knowledge and skills in the delivery of health care, support services and data integration to support underserved populations. Through these special projects, RWHAP SPNS recipients implement a variety of interventions, which contribute to the advancement of public health knowledge and the goal of ending the HIV epidemic in the United States.

Current SPNS Initiatives

Supporting Replication (SURE) of Housing Interventions in the Ryan White HIV/AIDS Program

Funded 2022-2026

This initiative has two separate, yet coordinated, recipients: the Implementation and Technical Assistance Provider (ITAP) and an Evaluation Provider (EP). The purpose of the ITAP initiative is to support a single organization that will provide technical assistance to up to 10 sites implementing and adapting housing-related, evidence-based interventions, evidence-informed interventions, and emerging strategies (collectively, “intervention strategies”) for three key populations of people with HIV experiencing unstable housing: 1) lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) people; 2) youth and young adults (aged 13-24 years); and 3) people who have been justice involved (i.e., people impacted by the justice system). The ITAP will select and fund implementation sites under individual subawards; provide implementation-related technical assistance to the sites; and develop a communication plan and replication tools for widespread adoption of these housing-related intervention strategies for the three key populations of people with HIV experiencing unstable housing. The EP will develop and implement a multi-site evaluation of these intervention strategies and provide evaluation-related technical assistance using an implementation science framework.

Emerging Strategies to Improve Health Outcomes for People Aging with HIV 

Funded 2022-2025

This initiative funds three components: one capacity-building provider, 10 demonstration sites, and one evaluation provider. All three components of the initiative will work together using HRSA’s HIV/AIDS Bureau’s (HAB) implementation science framework to conduct the following activities simultaneously: implement emerging interventions that comprehensively screen and manage comorbidities, geriatric conditions, behavioral health, and psychosocial needs of people aged 50 years and older with HIV; assess the uptake and integration of emerging strategies; understand implementation processes including assessing specific implementation strategies; understand and document broader contextual factors affecting implementation; evaluate the impact of the emerging strategies; and document and disseminate the emerging strategies. 

Telehealth Strategies to Maximize HIV Care 

Funded 2022-2025

The purpose of this initiative is to identify and maximize the use of telehealth strategies most effective in improving linkage to care, retention in care, and health outcomes, including viral suppression, for people with HIV who receive services through the RWHAP. This initiative builds upon existing programs, and HRSA HAB will coordinate the initiative activities in collaboration with the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention. The recipient will: 1) research and select telehealth strategies that can be used to maximize HIV care in the RWHAP; 2) fund, coordinate, provide technical and capacity building assistance, monitor, and evaluate implementation of telehealth strategies for a minimum of five RWHAP recipients and subrecipients; 3) create an inventory of project strategies and tools; 4) disseminate the project’s products through various outlets, ultimately for uptake and replication by RWHAP recipients and subrecipients; and 5) evaluate the project using an implementation science framework.

Using Innovative Intervention Strategies to Improve Health Outcomes Among People With HIV

Funded 2021–2025

This initiative’s purpose is to use an implementation science framework to identify, pilot test, and evaluate innovative intervention strategies in four focus areas to improve health outcomes among people with HIV. The Innovative Intervention Strategies Coordinating Center for Technical Assistance (2iS CCTA) will solicit and subaward up to 20 RWHAP-funded recipients and subrecipients (approximately five sites per focus area) to serve as implementation sites where one intervention strategy per site will be piloted. This initiative will focus on three priority populations and one area of opportunity to improve service delivery. Combined, these four focus areas are: 1) Improving HIV health outcomes for people with substance use disorder; 2) Improving HIV health outcomes for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth; 3) Improving HIV health outcomes for people who are or have been incarcerated; and 4) Improving HIV health outcomes by using telehealth services. The piloted intervention strategies will be evaluated by the Using Innovative Intervention Strategies to Improve Health Outcomes Among People with HIV – Evaluation Center (2iS EC).

Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set

Funded 2021–2025

This initiative seeks to develop strategies to build capacity among HIV surveillance and Medicaid programs for reporting high-quality HIV viral suppression data to comply with HIV Viral Load Suppression measure reporting on the Medicaid Adult Core Set. HRSA awarded one System Coordination Provider (SCP) to select, fund, and work with up to 10 RWHAP Part B recipients, as well as HIV surveillance and Medicaid programs to build capacity to report high-quality HIV viral suppression data to the CMS as part of the annual state Medicaid Adult Core Set reporting. The SCP will work with state RWHAP, HIV surveillance, and Medicaid programs to develop, implement, and evaluate strategies to improve the collection and reporting of HIV viral suppression data to the Medicaid Adult Core Set. In addition, the SCP will promote the dissemination and replication of effective strategies and lessons learned for adoption across other states.

Leveraging a Data to Care Approach to Cure Hepatitis C within the Ryan White HIV/AIDS Program (RWHAP)

Funded 2020-2022

Learn more about Leveraging a Data to Care Approach to Cure Hepatitis C within the Ryan White HIV/AIDS Program (RWHAP)

This demonstration project will link people with Hepatitis C Virus (HCV) and HIV within the Ryan White HIV/AIDS Program (RWHAP) to care, by leveraging existing public health surveillance with clinical data systems. A Technical Assistance Provider (TAP) organization will be funded to select and provide targeted technical assistance to up to ten (10) RWHAP Part A and/or Part B jurisdictions (i.e., state, city, and/or local health departments) to focus jurisdictional efforts on improving existing collaboration between their HCV surveillance systems and RWHAP care providers. The goal of improving collaboration between HCV and HIV surveillance systems and RWHAP providers is to facilitate the sharing of data and identification of people with HIV and HCV who are not currently receiving care. The TAP will work collaboratively with a contractor who will evaluate the overall effectiveness and impact of this project.

Building Capacity to Implement Rapid ART Start for Improved Care Engagement in Ryan White HIV/AIDS Program (RWHAP)

Funded 2020–2023

Learn more about Building Capacity to Implement Rapid ART Start for Improved Care Engagement in Ryan White HIV/AIDS Program (RWHAP)

This initiative supports the implementation and evaluation of “rapid start,” or the accelerated entry into HIV medical care and rapid initiation of ART for people with HIV who are newly diagnosed, new to care, or out of care. The program will fund 15 implementation sites that have the capacity and infrastructure to support rapid start implementation, but have not yet been able to, with the goal of replicating and expanding successful rapid start models. This initiative is supported through funding from the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health Minority HIV/AIDS Fund (MHAF).

Rapid Antiretroviral Therapy (ART) Start in the Ryan White HIV/AIDS Program – Dissemination Assistance Provider

Funded 2020-2023

Learn more about Rapid Antiretroviral Therapy (ART) Start in the Ryan White HIV/AIDS Program - Dissemination Assistance Provider

This initiative will fund a single organization that will develop a compendium of promising rapid antiretroviral therapy (ART) interventions. The recipient will systematically identify and document innovative practices and procedures of rapid ART interventions and promote the dissemination of these models for replication among RWHAP and other providers serving people with HIV.

Improving Care and Treatment Coordination: Focusing on Black Women with HIV

Funded 2020-2023

Learn more about Improving Care and Treatment Coordination: Focusing on Black Women with HIV

This initiative will support up to twelve cooperative agreements for up to three years to design, implement, and evaluate the use of bundled interventions for Black women with HIV. Bundled interventions will address socio-cultural health determinants, expand the delivery and utilization of comprehensive HIV care and treatment services, support continuous engagement in care, and improve health outcomes for Black women with HIV in a culturally-sensitive and responsive manner. All demonstration sites funded under this initiative will be required to collaborate with the evaluation and technical assistance provider (ETAP), This initiative is supported through funding from the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health Minority HIV/AIDS Fund (MHAF).

Capacity Building in the Ryan White HIV/AIDS Program to Support Innovative Program Model Replication

Funded 2019–2022

Learn more about Capacity Building in the Ryan White HIV/AIDS Program to Support Innovative Program Model Replication

This initiative will build and enhance the capacity of RWHAP recipients and subrecipients to replicate evidence-informed models of care/interventions among RWHAP jurisdictions using previously developed program implementation tools, manuals, and other resources. In addition, this initiative will increase system-level capacity for adopting these models of care/interventions that offer comprehensive, high-quality, culturally competent HIV screening, care, and treatment for people with HIV who are not fully engaged in primary care. By building capacity and encouraging the implementation or replication of effective models of care, the RWHAP will improve systems of care, reduce health disparities, and improve outcomes along the HIV care continuum. The Center for AIDS Prevention Studies (CAPS) of the University of California San Francisco will lead and support the dissemination and replication of evidence-informed innovative models of care/interventions in Atlanta, GA, Jackson, MS, Las Vegas, NV, and New Orleans, LA.

Enhancing Linkage of Sexually Transmitted Infection (STI) and HIV Surveillance Data in the Ryan White HIV/AIDS Program

Funded 2019–2022

Learn more about Enhancing Linkage of Sexually Transmitted Infection (STI) and HIV Surveillance Data in the Ryan White HIV/AIDS Program

This initiative will improve linkage, re-engagement in care, and health outcomes for people with HIV in the RWHAP. HRSA funded Georgetown University to serve as the Technical Assistance Provider (TAP) to identify and fund up to five jurisdictions (state, city, and/or local health departments) to provide programmatic technical assistance for each jurisdiction to create or improve data sharing across their STI and HIV surveillance systems, as well as an evaluation contractor to evaluate the overall effectiveness of the project. The TAP will assess jurisdictional barriers to data sharing across STI and HIV surveillance departments and develop tools to address these barriers. Improved data sharing will allow the matching of STI (chlamydia, gonorrhea, and/or syphilis cases) and HIV surveillance data, which will be used to improve the capacity of RWHAP clinics to prioritize resources for linking and re-engaging people with HIV into care. Improving the frequency of this data sharing will inform RWHAP clinics’ decision-making around allocation of resources and services to improve health outcomes of people with HIV.

Strengthening Systems of Care for People with HIV and Opioid Use Disorder

Funded 2019–2022

Learn more about Strengthening Systems of Care for People with HIV and Opioid Use Disorder

This initiative supports two entities, referred to as System Coordination Providers (SCPs), who will assist states in leveraging resources at the federal, state, and local levels for people with HIV and opioid use disorder (OUD). JSI Research and Training Institute and Yale University are serving as the SCPs for this initiative and will work across 14 state partners, which include Arizona, Connecticut, Iowa, Louisiana, Massachusetts, New Jersey, Rhode Island, Utah, Vermont, Virginia, Washington, and West Virginia. This initiative will strengthen system-level coordination and networks of care between RWHAP recipients and other federal, state and local entities funded to respond to the opioid epidemic to ensure people with HIV and OUD have access to behavioral health care, treatment, and recovery services. In addition, this initiative will build upon existing systems of care and treatment that will maximize cross-sector collaboration in order to achieve improvements in the system-level coordination and to leverage available resources for improving the health outcomes of people with HIV and OUD.

See previous SPNS Program initiatives

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