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

The Special Projects of National Significance (SPNS) Program supports the development of innovative models of HIV care and treatment in order to quickly respond to emerging needs of clients served by Ryan White HIV/AIDS Programs. SPNS advances knowledge and skills in the delivery of health care and support services to underserved populations living with HIV. Through its demonstration projects, SPNS evaluates the design, implementation, utilization, cost, and health related outcomes of treatment models while promoting the dissemination and replication of successful interventions. The SPNS Program also funds projects to build capacity in the health information technology (HIT) systems of Ryan White HIV/AIDS Program grant recipients and provider organizations to report client-level data and to improve health outcomes along the HIV care continuum.

Current SPNS Initiatives

Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services

Funded 2017-2020

This initiative will support the design, implementation, and evaluation of innovative interventions that coordinate HIV care and treatment, housing, and employment services to improve HIV health outcomes for low-income, uninsured, and underserved people living with HIV (PLWH) in racial and ethnic minority communities. The overall goal of this coordinated services intervention is to decrease the impact of the social determinants of health (such as unmet housing or employment needs) that affect long-term HIV health outcomes for PLWH impacted by employment and housing instability in racial and ethnic minority communities. To promote long-term health and stability for PLWH, this initiative supports 12 demonstration sites across the United States that will implement, evaluate and disseminate innovative strategies for integrating HIV care, housing and employment services into a coordinated intervention and one Evaluation and Technical Assistance Provider (ETAP). This Special Projects of National Significance Program initiative is supported through the Department of Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Fund.

Curing Hepatitis C among People of Color Living with HIV

Funded 2017-2020

This three-year initiative awarded to Yale University and the University of Texas Health Science Center San Antonio will support the expansion of Hepatitis C (HCV) prevention, testing, care, and treatment capacity; improve coordination of linkage to and retention in HCV care and treatment for people living with both HIV and HCV; and improve coordination with SAMHSA-funded substance use disorder (SUD) treatment providers to deliver behavioral health and SUD treatment support to achieve treatment completion and prevent HCV infection and re-infection. In addition, the initiative will enhance state, local and tribal health department surveillance systems to increase their capacity to monitor acute and chronic infections of HIV and HCV in areas of high populations or low-income, uninsured, and underserved racial and ethnic minorities. This Special Projects of National Significance Program initiative is supported through the Department of Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Fund.

Using Evidence-Informed Interventions to Improve Health Outcomes among People Living with HIV (E2i)

Funded 2016-2019

This initiative will identify and provide support for the implementation of evidence-informed interventions to reduce HIV-related health disparities and improve health outcomes, including increasing retention in care, improving treatment adherence, and improving viral suppression for people living with HIV. Fenway Community Health Center, Inc. will serve as the Evidence-Informed Interventions Coordinating Center for Technical Assistance (E2i CCTA), and up to 24 Ryan White HIV/AIDS Program funded recipients/subrecipients will support the implementation of evidence-informed interventions. The University of California San Francisco will serve as the Evidence-Informed Interventions Evaluation Center (E2i EC) for this initiative.

Jurisdictional Approach to Curing Hepatitis C among HIV/HCV Coinfected People of Color

Funded 2016 - 2019

This is a three-year initiative to develop and evaluate the implementation of comprehensive jurisdiction-level approaches for the screening, care, and treatment systems for people of color living with both HIV and Hepatitis C (HCV). The Rand Corporation serves as the Evaluation and Technical Assistance Center (ETAC), providing technical assistance and capacity building, and leading the evaluation activities across three Ryan White HIV/AIDS Program (RWHAP) Part A jurisdictions: City of Hartford, Hartford, CT; City of New York, Long Island, NY; and the City of Philadelphia, Philadelphia, PA. In addition, the National Alliance for State and Territory AIDS Directors (NASTAD) was funded to select and fund two RWHAP Part B recipients to participate in this initiative: North Carolina and Louisiana. The ETAC is collaborating with the RWHAP Part F AIDS Education and Training Center National Coordinating Resource Center (AETC/NCRC) to develop National HCV Provider Competencies and Curriculum for HCV screening, care, and treatment, with a focus on people living with HIV/HCV co-infection. The ETAC will also design and implement a multi-site evaluation to assess the implementation and impact of the jurisdiction projects and to lead and coordinate the efforts for publication and dissemination of best practices, lessons learned and other findings from the initiative. This Special Projects of National Significance (SPNS) Program initiative is supported through the Department of Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Fund (SMAIF).

Dissemination of Evidence-Informed Interventions to Improve Health Outcomes along the HIV Care Continuum Initiative

Funded 2015 - 2020

This initiative will disseminate four adapted linkage and retention interventions from prior SPNS and the Secretary's Minority AIDS Initiative Fund (SMAIF) initiatives to improve health outcomes along the HIV care continuum. The initiative is funding two cooperative agreements, a Dissemination and Evaluation Center (DEC) for five years, and an Implementation Technical Assistance Center (ITAC) for four years. The end goal of the initiative is to produce four evidence-informed Care And Treatment Interventions (CATIs) that are replicable, cost-effective, capable of producing optimal HIV care continuum outcomes, and easily adaptable to the changing health care environment. The multi-site evaluation of this initiative will take a rigorous Implementation Science (IS) approach, which places greater emphasis on evaluation of the implementation process and cost analyses of the interventions, while seeking to improve the HIV care continuum outcomes of linkage, retention, re-engagement and viral suppression among client participants.

Use of Social Media to Improve Engagement, Retention, and Health Outcomes along the HIV Care Continuum

Funded 2015 - 2019

This initiative is a multi-site demonstration and evaluation of innovative social media methods designed to identify, link, and retain HIV positive underserved, underinsured, hard-to-reach youth and young adults (ages 13-34) in HIV primary care and supportive services. These methods include system approaches utilizing a variety of social media, internet, and mobile-based technologies to improve engagement and retention in care and viral suppression. Demonstration projects are expected to implement these models, evaluate their effectiveness and to disseminate findings, best practices, and lessons learned. These social media interventions will focus on youth and young adults living with HIV who are aware of their HIV infection status but have never been engaged in care; are aware but have refused referral to care; have dropped out of care; are infected with HIV but are unaware of their HIV status; or have not achieved viral suppression.

Addressing HIV Care and Housing Coordination through Data Integration to Improve Health Outcomes along the HIV Care Continuum

Funded 2015-2018

This initiative supports the electronic integration of housing and HIV care data and implementation of  enhanced coordinated service delivery strategies between HRSA's Ryan White HIV/AIDS Program and the U.S. Department of Housing and Urban Development's (HUD) Housing Opportunities for Persons with AIDS (HOPWA) program.  The RAND Corporation serves as the Coordination and Technical Assistance Center (CTAC), which provides technical assistance and capacity building to performance sites and leads the multi-site evaluation on the effectiveness of the integrated data systems on provider utilization, coordination of housing and HIV care services, and the impact on health outcomes along the HIV care continuum. Five performance sites are funded under this initiative. This SPNS initiative is a collaboration between HRSA's HIV/AIDS Bureau and HUD's Office of HIV/AIDS Housing through support by HHS's Secretary's Minority AIDS Initiative Fund (SMAIF).

System-level Workforce Capacity Building for Integrating HIV Primary Care in Community Health Care Settings

Funded 2014 - 2018

This initiative is a multi-site demonstration and evaluation of system-level changes in staffing structures to improve health outcomes along the HIV care continuum. The initiative will fund 15 demonstration sites for up to four years to promote the design, implementation, and evaluation of innovative strategies to increase organizations' workforce capacities and to achieve efficient and sustainable service delivery practices that both optimize human resources and improve quality outcomes. The demonstration projects will implement and evaluate innovative Practice Transformative Models (PTMs) for the delivery of HIV treatment and comprehensive care services in order to better respond to the changing health care landscape marked by shortages of HIV primary care physicians and increasing demand for access to quality HIV services. Evaluation of these innovative PTMs will identify best practices and methods to support other organizations to adapt and re-align their workforces, as well as factors that increase the potential for successful integration of HIV care into primary care and community health care settings serving vulnerable populations. The University of California at San Francisco is serving as the Evaluation and Technical Assistance Center (ETAC) for this initiative. The ETAC will coordinate the multi-site evaluation, provide programmatic technical assistance to the demonstration sites, and lead publication and dissemination efforts of best practices and lessons learned.

Culturally-Appropriate Interventions of Outreach, Access, and Retention among Latino(a) Populations

Funded 2013 - 2018

This initiative is a multi-site demonstration and evaluation of culturally-specific service delivery models focused on improving health outcomes among Latinos/as living with HIV. The initiative's ten demonstration sites will design, implement, and evaluate innovative methods to identify Latinos/as who are at high risk or living with HIV, and improve their access, timely entry, and retention in quality HIV primary care. This initiative is one of the first public health adaptations of the transnational approach with interventions targeting HIV-infected Latino/a subpopulations living in the U.S. that are specific to their country or place of origin. The University of California at San Francisco's Center for AIDS Prevention Studies will serve as the Evaluation and Technical Assistance Center for this initiative, coordinating the multi-site evaluation and providing technical assistance to the demonstration sites.

See previous SPNS Program initiatives

Date Last Reviewed:  January 2018