Part B - States/Territories

Part B of HRSA's Ryan White HIV/AIDS Program (RWHAP) funds States and Territories to deliver HIV/AIDS care, including HIV/AIDS medications under the AIDS Drug Assistance Program (ADAP). Part B addresses care needs across many cities and rural regions. Recommendations about service priorities are typically made by statewide planning groups or regional and local consortia. States then advertise and award contracts to agencies to deliver services. HRSA project officers and technical assistance/training services help Part B programs conduct planning; deliver care (with attention to quality, clinician training, and data reporting); and manage their grant funds. Learn more about Part B—formula and supplementary grants, ADAP, eligible services, and more. 

Questions? Email the HRSA HAB Division of State HIV/AIDS Programs (DSHAP).

Resources 41

Best Practices

  • NASTAD

    Ideas for RWHAP Part B/ADAPs to support access to medications and tailor related services for Black/African American men living with HIV.

  • Best Practices Compilation
    Ten organizations across the U.S. integrated Community Health Workers (CHWs) into their multidisciplinary care teams. Enrolled clients had statistically significant improvements in viral suppression, antiretroviral therapy prescription, and appointment attendance after six months in the program.
  • Best Practices Compilation
    The Oregon Health Authority awarded contracts to local public health authorities across the state to work with community partners to integrate early intervention services and outreach services, link people to HIV care, and provide support to help clients reach viral suppression. Quick linkage to care resulted in a median of 57 days to viral suppression for Early Intervention Services and Outreach clients in 2019.
  • Best Practices Compilation
    The Enhanced Patient Navigation for Women of Color with HIV intervention uses patient navigators, who are non-medical staff in clinical settings, to reduce barriers to health care and optimize care. The intervention was effective in improving linkage to and retention in care, as well as viral suppression.
  • Best Practices Compilation
    Extramural dental clinics implemented the medical home model, with integrated trauma-informed care, to expand oral health care services for people with HIV, and saw increases in referrals from partner organizations and the number of new clients.
  • Best Practices Compilation
    The HIV Clinical Pharmacist Services intervention shortens the time between referral to and engagement in care by allowing newly referred clients to see pharmacists in addition to other clinical providers for their initial appointment. This intervention is supported by findings from a retrospective cohort study that took place from 2013 to 2017 at a RWHAP-funded clinic. In addition to significantly decreasing the time between referral and initial visit, clients who saw a pharmacist also experienced shortened time to antiretroviral therapy initiation and viral suppression compared to those who only saw non-pharmacist providers.
  • Best Practices Compilation

    Caracole, an AIDS Service Organization, uses three interconnected approaches to improve retention in HIV care: housing first, harm reduction, and motivational interviewing. Clients in permanent supportive housing had high rates of viral suppression, exceeding Caracole's goal of 75%.

  • Best Practices Compilation
    The AIDS Institute is committed to promoting, monitoring, and supporting the quality of clinical services for people with HIV in New York State. The Adolescent Quality Learning Network (AQLN) is a collaborative of 16 HIV Adolescent/Young Adult Specialized Care Center (SCC) programs. In collaboration with the AIDS Institute, SCC providers selected a quality improvement project aimed to raise viral suppression rates by improving access to mental health services.
  • Best Practices Compilation
    LA Links is a combined data-to-care and client navigation approach that cross-references routinely collected HIV surveillance data with other secondary data sources to identify and locate people with HIV who are not in care, as well as those who are in care, but with high viral loads. Originally implemented in 2013 as part of the Care and Prevention in the United States Demonstration Project, LA Links improved linkage to care, reengagement in care, and viral suppression. Louisiana expanded the program statewide in 2016.
  • Best Practices Compilation
    Link-Up Rx is a pharmacy-data-based Data to Care program implemented by the Detroit Health Department in partnership with the Michigan Department of Health and Human Services and a specialty pharmacy. Using pharmacy data to identify clients in need of follow-up greatly reduced the amount of time for clients to appear on “not in care” lists compared to traditional D2C approaches. Protocols for a three-tiered outreach and reengagement approach were developed to connect clients back to antiretroviral therapy and HIV care following a missed pharmacy pick-up. Nearly half of identified clients were linked back to their pharmacy or other HIV medical services.
  • Best Practices Compilation
    This data-to-care (D2C) initiative, implemented by the San Francisco Department of Public Health and its affiliated clinics from 2015–2017, used three sources of data to identify people not in care: HIV surveillance data, healthcare provider referrals, and electronic health record (EHR) data. LINCS navigators then used disease intervention searching tools and EHR data to locate clients and connect them to an HIV care provider. LINCS navigators followed up with clients for 90 days to support engagement in care. LINCS participants were more likely to be retained in care and virally suppressed after the intervention than before.
  • Best Practices Compilation
    The Louisiana Public Health Information Exchange is a bidirectional exchange that connects hospital system electronic health records with state surveillance data. Providers use the exchange to identify and relink people with HIV who are out of care to clinical and supportive services. Since LaPHIE was implemented in 2009, thousands of people with HIV who were out of care have been identified, with a significant number being successfully linked to care.
  • Best Practices Compilation
    The Utah Department of Health and Human Services collaborated with RWHAP Part B-funded medical case managers to improve care and outcomes for clients following Franklin Covey’s 4 Disciplines of Execution: 1) focus on the wildly important goal; 2) act on the lead measures; 3) keep a compelling scoreboard; and 4) create a cadence of accountability. Through intensive case management, regular monitoring, and feedback sessions, the state's RWHAP Part B program's overall viral suppression rate increased from 88.9% in 2020 to 90.4% by December 2021.
  • Best Practices Compilation
    MORE focuses on people who are not virally suppressed and/or who have not attended an HIV medical appointment in six months. Participants can choose from one of three MORE programs, depending on the intensity of services they want. Based on initial evaluation findings, participants who received more intensive MORE services were more likely to be virally suppressed and less likely to be lost to follow-up than those who received less intensive services.
  • Best Practices Compilation
    The Navigator Case Management intervention helps people with HIV who are incarcerated and are leaving to return to the community. The intervention uses harm reduction, case management, and motivational interviewing techniques to promote healthy behaviors. Enhanced case management including peer support and connection to other needed services both immediately before and after release supports increased linkage to and retention in HIV care for people transitioning to the community from jail.
  • Best Practices Compilation
    The University of Pittsburgh Medical Center, Center for Care of Infectious Diseases, Pittsburgh Area Center for Treatment (PACT) began implementing the Food Assistance Program in August 2017 to serve as a supplemental resource for people with HIV receiving care who experience food insecurity. The program helps bridge gaps in Supplemental Nutrition Assistance Program (SNAP) benefits and monthly food costs while promoting access to healthy foods and retention in HIV care.
  • Best Practices Compilation
    PositiveLinks is a mobile platform deployed by clinics or community-based organizations to connect people with HIV to a digital support community. The client-facing app helps people with a new diagnosis of HIV become engaged in care and helps people at risk of being lost to care overcome barriers related to geographic or social isolation. From the app, people can access Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant patient dashboards, secure messaging, and patient lab records. People who used PositiveLinks had increased rates of retention in care and viral suppression.
  • Best Practices Compilation
    Project ACCEPT is designed to improve engagement and retention in medical care for youth ages 16 to 24 years with newly diagnosed HIV. The educational and skill-building intervention was deployed at four demonstration sites and increased rates of medication use and appointment adherence in comparison to a control group. Although originally developed for cisgender youth, Project ACCEPT may be adapted for gender-diverse people.

Resources

Webinars

Conference Presentations

HRSA HIV/AIDS Bureau, Division of State HIV/AIDS Programs
Presenters:
2022 National Ryan White Conference on HIV Care & Treatment
NASTAD
Presenters:
Chloe' Bernard, MSCP
2022 National Ryan White Conference on HIV Care & Treatment
HRSA HAB DSHAP
Presenters:
Kenya Young, MPH
2022 National Ryan White Conference on HIV Care & Treatment
HRSA DSHAP
Presenters:
Susan Robilotto, D.O., and others
2022 National Ryan White Conference on HIV Care & Treatment
Massachusetts Department of Public Health
Presenters:
Dennis Canty, Randie Kutzen, Alyssa Harrington
2020 National Ryan White Conference on HIV Care & Treatment

Technical Assistance

  • HRSA recipients first point-of-contact for managing federal grants and accessing training and technical assistance.

  • TAP-in supports the 47 EHE jurisdictions funded by HRSA to strengthen their EHE work plans, promote cross-jurisdictional learning, and ensure jurisdictions have access to the resources they need. Project period: 2020-2025.

  • TA and training on administration of Ryan White ADAPs and Part B planning and management. Project period: 2022-2027.

  • Help with the RSR, ADR, CDR, EHE, HIVQM, and AETC data systems. Project period: 2020-2025.

  • The SCP delivers TA aimed at strengthening healthcare system engagement in local EHE efforts by supporting the coordination of planning activities, alignment of funding sources, and program implementation. Project period: 2020-2025.
  • Help with HRSA Electronic Handbooks (EHB) - 877-464-4772 - 8am-8pm ET, M-F - Contact HRSA About the EHB

  • Support for Part A and B recipients and their planning bodies around integrated HIV/AIDS planning efforts. Project period: 2016-2023.

  • Interactive data tool to visualize the reach, impact, and outcomes of the RWHAP. HRSA offers office hours and webinars to help use the tool.
  • RSR, ADR, HIVQM, PTR, AETC, DSR, GCMS, EHE - 888-640-9356 - 10am-6:30pm ET, M-F [email protected] Project period: 2018-2022.

  • Initiative documenting best practice strategies and interventions that have been shown to improve HIV outcomes in a "real world" setting and can be replicated by other programs. Project period: 2021-2024.