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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

Linking Eligibility Across the Ryan White HIV/AIDS Program Parts—Dissemination Assistance Provider

Funded FY24 – FY25

The purpose of this initiative is to (1) examine current eligibility determination and confirmation processes in place across all RWHAP Parts and identify administrative, technical, and legal barriers facing providers and clients; (2) identify best practices and facilitators that improve navigation for clients who seek services from multiple RWHAP recipients and subrecipients; (3) develop and disseminate materials about eligibility determination and confirmation processes, including cost analysis tools, examples, and lessons learned; and (4) facilitate peer-to-peer information exchange and dissemination of information. The initiative will promote efficiencies in the intake, navigation, and determination of RWHAP client eligibility across all RWHAP Parts. Additionally, it will improve the customer’s experience when applying for and continuing RWHAP services; reduce administrative burden for RWHAP clients and providers; and increase the availability of tools to help RWHAP providers streamline eligibility processes across all RWHAP Parts.

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

Funded FY22 – FY25

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 selects and funds 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 FY22 – FY24

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 FY22 – FY24

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 FY21 – FY24

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 FY21 – FY24

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.

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