Ryan White HIV/AIDS Program Part B States/Territories Supplemental Grant Program

This notice announces the opportunity to apply for funding under the Ryan White HIV/AIDS Program (RWHAP) States/Territories Part B Supplemental Grant Program, which includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, the Republic of Palau, the Federated States of Micronesia, and the Republic of the Marshall Islands. The purpose of this program is to supplement formula-based funding provided through the HIV Care Grant Program – RWHAP Part B States/Territories Formula and AIDS Drug Assistance Program (ADAP) Formula and ADAP Supplemental Awards Notice of Funding Opportunity (HRSA-22-033). States/territories use RWHAP Part B Supplemental Grant Program funding in conjunction with RWHAP Part B HIV Care Grant Program funding to develop and/or enhance access to a comprehensive continuum of high-quality care and treatment services for low-income people with HIV. To obtain funding, states/territories must demonstrate that RWHAP Part B supplemental funding is necessary to provide comprehensive HIV care and treatment services for people with HIV in the state/territory. Proposed activities should include the provision of core medical and/or support services, as defined in HRSA HAB Policy Clarification Notice (PCN) 16-02: RWHAP Services: Eligible Individuals and Allowable Uses of Funds, and other activities to ensure responsiveness to unmet needs. States/territories must describe how proposed activities will address unmet needs and improve client-level health outcomes across the HIV care continuum, including viral suppression. Eligible RWHAP Part B states/territories that are focus areas, or have counties that are focus areas, for the Ending the HIV Epidemic (EHE) initiative should consider if there is an increased need for RWHAP Part B supplemental funding due to the EHE initiative efforts using criteria below. As required in section 2620(b) of the Public Health Service (PHS) Act, states/territories must demonstrate the severity of the need for RWHAP Part B supplemental funding using quantifiable data in one or more of the following areas: 1. The unmet need for such services, as determined under section 2617(b) of the PHS Act. 2. An increasing need for HIV/AIDS-related services, including relative rates of increase in the number of cases of HIV/AIDS. 3. The relative rates of increase in the number of cases of HIV/AIDS within new or emerging subpopulations. 4. The current prevalence of HIV/AIDS. 5. Relevant factors related to the cost and complexity of delivering health care to individuals with HIV/AIDS in the eligible area. 6. The impact of co-morbid factors, including co-occurring conditions, determined relevant by the Secretary. 7. The prevalence of homelessness. 8. The prevalence of individuals who were released from federal, state, or local prisons during the preceding three (3) years, and had HIV/AIDS on the date of their release. 9. The relevant factors that limit access to health care, including geographic variation, adequacy of health insurance coverage, and language barriers. 10. The impact of a decline in the amount of RWHAP Part B funding received on services available to all individuals with HIV/AIDS identified and eligible under this title. Pursuant to section 2620(c) of the PHS Act, the Secretary prioritizes funds to states/territories to address the reduction or disruption of services related to a decline in the amount of formula funding. Such a decline in funding is determined by comparing the amount of formula funding received in the current fiscal year (FY) to the amount received in FY 2006. If you are a state/territory with current or potential shortfalls in ADAP resources, HRSA strongly encourages you to prioritize use of RWHAP Part B supplemental funds to augment ADAP resources when the following conditions exist: 1. Existing or anticipated ADAP waiting list, 2. Capped enrollment, 3. Reductions in ADAP formulary, 4. Reduction in the percentage of federal poverty level (FPL) eligibility requirement, and/or 5. Other ADAP restrictions within the state/territory.

Under Sections 2620 and 2689(11) of the PHS Act, all “States” – defined as all 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, the Republic of Palau, the Federated States of Micronesia, and the Republic of the Marshall Islands – are eligible for RWHAP Part B supplemental funding, unless any such state/territory had an unobligated balance of more than five percent of a prior year’s formula funds. However, the Coronavirus Disease 2019 (COVID-19) public health emergency has posed significant challenges for RWHAP recipients, providers, and clients to provide and access care. On February 23, 2021, HRSA HAB released a letter that waived certain statutory penalties and administrative requirements for funds awarded in FY 2020 and 2021 in accordance with the Consolidated Appropriations Act, 2021, Pub. L. 116- 260, Division M, § 307. Requirements regarding the timeframe for obligation and expenditure of formula and supplemental RWHAP funds within the designated timeframe, including the requirement to submit an estimated unobligated balance and carryover request prior to the end of the grant year, and associated penalties were waived. Therefore, no states/territories will be deemed ineligible for the FY 2022 RWHAP States/Territories Part B Supplemental Grant Program. Failure to expend at least 95 percent of RWHAP Part B/ADAP formula funds in FY 2022 or future years will result in penalties.

Susan Robilotto, D.O.

(301)443-6554