HIV Early Intervention Services (EIS) Program Limited Competitive Service Areas (Brooklyn, NY, and Boston, MA) | Apply Online

Opportunity Summary:

The HIV Early Intervention Services (EIS) Program Limited Competitive Service Areas (Brooklyn, NY, and Boston, MA) grant opportunity (HRSA-13-274) is a fiscal year 2013 funding announcement from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB). It supports the Ryan White HIV/AIDS Program Part C EIS model, which is centered on delivering outpatient HIV early intervention and ongoing primary medical care for people living with HIV who are low income and medically underserved. This is a limited competition tied specifically to defined service areas in Brooklyn, New York, and Boston, Massachusetts, and applicants are required to clearly define the service area they propose to cover, including whether they intend to serve the entire designated area or only a portion of it. The program’s core idea is straightforward: get people into HIV care early, keep them engaged, and provide a full clinical continuum in an outpatient setting, while making sure services are organized in a way that measurably improves health outcomes and reduces disparities.

At the heart of the announcement is the expectation that applicants will operate a comprehensive outpatient HIV primary care program. Proposed projects must cover four broad components: targeted HIV counseling, testing, and referral; medical evaluation and clinical care; other primary care-related services; and referrals to other needed health services. While the program emphasizes starting HIV primary care as early as possible after infection, it also recognizes that patients may enter care at any stage of disease and at any point in life, so the model is designed to accommodate newly diagnosed individuals as well as people who have been living with HIV for years. A key compliance point is that, under the Public Health Service (PHS) Act provisions governing Part C, grantees must spend award funds on HIV primary medical care within the proposed service area, and that commitment must be clearly reflected in the project budget.

The clinical expectations are detailed and lean heavily toward a true medical model of care rather than a loosely connected set of supportive services. HRSA makes clear that staffing and budgeting should be built around credentialed HIV medical providers who can diagnose, treat, prescribe medications, and order and interpret clinically necessary tests in line with federal guidelines. Support staff such as nurses, medical assistants, and dental hygienists can absolutely be included, but they are expected to complement, in appropriate proportion, the primary clinical providers (for example physicians, dentists, physician assistants, and nurse practitioners). In practical terms, the program is looking for a clinic or clinical network that can evaluate patients, initiate and manage antiretroviral therapy, monitor labs, address complications, and coordinate referrals while maintaining continuity and accountability for outcomes.

The required medical evaluation and clinical care scope includes the standard pillars of HIV primary care: confirming HIV infection; assessing immune function and disease progression using tests such as CD4 and viral load; providing antiretroviral therapy and monitoring; preventing, diagnosing, and treating opportunistic infections and HIV-related malignancies; providing routine immunizations; offering perinatal interventions when applicable to prevent mother-to-child transmission; and delivering patient education that connects people to prevention services. Programs are also expected to have after-hours and weekend clinical coverage systems for medical and dental needs, reflecting an emphasis on real-world access rather than only weekday office-hour care. The announcement also emphasizes that co-morbidity management is not optional: tuberculosis, hepatitis B and C, and sexually transmitted infections are described as indispensable components of HIV primary care, meaning programs should be able to diagnose and treat these conditions directly or have well-defined referral pathways supported by clinical protocols.

Beyond direct clinical services, the opportunity places a strong operational emphasis on coordination, tracking, and follow-through. Applicants are expected to track and coordinate inpatient care so that when a patient is hospitalized, the program remains responsible for continuity and has a plan for re-engagement and resumption of outpatient care after discharge. Similarly, programs must have a systematic mechanism to track referrals, document outcomes in the medical record, and actively follow up, rather than simply handing a patient a referral slip. Another expectation is that programs have a plan to refer patients to biomedical research sites or community organizations conducting HIV-related clinical trials, signaling a preference for programs that know how to connect patients to cutting-edge treatment opportunities when appropriate. Because HIV clinical standards evolve quickly, the grant also requires ongoing continuing education for staff and regular updates to clinical protocols consistent with current HHS guidelines (for adults and adolescents, pediatric patients, opportunistic infections, and pregnancy/perinatal transmission prevention).

The announcement also describes an expected set of “other primary care services” that should be available either on-site or through formal agreements such as contracts or memoranda of understanding. These include oral health care, treatment adherence counseling, outpatient mental health services, outpatient substance use treatment, nutritional services, and access to specialty and subspecialty care (for example hematology/oncology, dermatology, ophthalmology, gynecology, gastroenterology, and pulmonary care). The underlying message is that successful HIV outcomes require more than prescribing antiretrovirals; programs need a practical way to address behavioral health, substance use, nutrition, and specialty needs that commonly affect retention in care and viral suppression.

Prevention is woven into the care model, but in a targeted and clinically integrated way. Part C funds are meant to support targeted counseling, testing, and referral for high-risk populations, but the announcement warns against duplicating other locally available testing resources and explicitly discourages using Part C funds for routine testing of general patient populations or broad, generic outreach like health fairs. If the applicant does provide HIV testing services directly, they must follow federal requirements under the Ryan White statute and adhere to confidentiality rules under applicable federal, state, and local laws. Separately, the program strongly encourages providers to incorporate CDC/HRSA/NIH/HIVMA recommendations on integrating HIV prevention into medical care for people already living with HIV. That means routinely screening for risk behaviors, screening for STIs and pregnancy as appropriate, offering brief behavioral interventions and prevention messaging during clinical encounters, making condoms and educational materials accessible, and providing partner counseling and referral services, including partner notification approaches. Importantly, prevention-related services and interventions are expected to be documented properly in the medical record, reinforcing that prevention is part of clinical care, not an add-on.

Two major policy frameworks shape how HRSA expects these projects to operate: the Minority AIDS Initiative (MAI) and the National HIV/AIDS Strategy (NHAS). MAI is intended to address the disproportionate impact of HIV on racial and ethnic minority communities and disparities in access and outcomes. Under this opportunity, MAI funding is not a separate application in the usual sense; instead, MAI dollars are designated as part of the base award for programs that qualify, and HRSA assigns MAI amounts based on the proportion of the population served (or proposed to be served) from racial and ethnic minority communities. The MAI goals are explicitly about increasing the number of minority patients who receive HIV care and increasing the number who remain in care, with an emphasis on culturally and linguistically appropriate services.

NHAS alignment is also a clear expectation. The announcement ties program activities to NHAS’s three headline goals: reducing new infections, increasing access to care and improving health outcomes, and reducing HIV-related disparities. It highlights early linkage to care as both a health protection strategy and a prevention strategy (because viral suppression reduces transmission risk). It also encourages community-level approaches to identify people who are HIV-positive but unaware of their status, and to reduce stigma and discrimination. On the performance and reporting side, HRSA points to a set of common federal indicators being implemented across seven domains: HIV testing, late diagnosis, initial linkage to care, retention/engagement, antiretroviral therapy, viral load suppression, and housing status. These indicators align with reporting through the Ryan White HIV/AIDS Program Services Report (RSR), positioning HRSA to calculate and monitor outcomes across programs and support more standardized measurement.

From an administrative standpoint, HRSA emphasizes that applicants must be able to handle the fiduciary and financial management responsibilities that come with federal awards. Applicants are expected to demonstrate fiscal capability to carry out the proposed scope of work and manage grant funds appropriately. The opportunity is a discretionary grant in the health category (CFDA 93.918), with an expected total of four awards. The announcement was posted April 3, 2013, and closed May 3, 2013 (later archived June 29, 2013). No cost sharing or matching requirement is listed, and award floor and ceiling amounts are shown as zero in the summary fields, meaning applicants would need the full announcement for any detailed funding ranges or award calculations.

In short, this HRSA Part C EIS limited competition was designed to fund outpatient HIV primary care programs in two specific geographic areas, with a clear expectation of comprehensive, guideline-driven medical care, strong care coordination and referral tracking, integrated prevention for people living with HIV, and a measurable focus on improving outcomes and reducing disparities, particularly for racial and ethnic minority communities through MAI and in alignment with NHAS priorities.

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