HRSA HIV/AIDS Bureau Update: Special Bulletin
The Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) shares the following update with our Ryan White HIV/AIDS Program (RWHAP) and HAB Ending the HIV Epidemic in the U.S. (EHE) recipients, subrecipients, stakeholders, national partners, and federal colleagues.
Dear Colleague Letter from HRSA Administrator Thomas J. Engels
HRSA Administrator Thomas J. Engels has issued a Dear Colleague Letter. It will be posted on HRSA’s HIV/AIDS Bureau’s website.
Dear Ryan White HIV/AIDS Program Awardees and Stakeholders,
Since its inception over three decades ago, the Ryan White HIV/AIDS Program (RWHAP) has been a cornerstone of hope and a lifeline for Americans living with HIV and AIDS. The largest federal initiative of its kind, RWHAP has provided critical care and support to low-income, uninsured, and under-insured Americans with HIV and AIDS. During his first term, President Donald J. Trump championed the ambitious Ending the HIV Epidemic initiative, a transformative plan to reduce new HIV infections by 75 percent by 2025 and 90 percent by 2030. Now in President Trump’s second term, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) stands recommitted and ready to achieve this bold agenda. With your support and collaboration, HAB will leverage the RWHAP to fulfill this Administration’s pledge to all Americans, particularly those living with HIV/AIDS—to Make America Healthy Again.
Program integrity and responsible fiscal stewardship are critical elements of the indispensable services RWHAP provides. But under the previous administration, certain interpretations of RWHAP’s allowable uses, as outlined in prior communications, co-opted the program’s patient-centered mission in favor of radical ideological agendas and policies.1 Congress envisioned RWHAP as a lifeline for those battling HIV and AIDS, not as a vehicle for broader social or medical experimentation. More to the point, this politicized commandeering risks diverting resources away from HIV/AIDS patients, whose lives depend on RWHAP’s core medical services.
Accordingly, HAB reaffirms that RWHAP funds shall be marshaled exclusively toward evidence-based interventions proven to combat HIV, sustain viral suppression, and improve the quality of life for those living with the disease. This includes outpatient medical care, antiretroviral therapies, and essential support services such as case management, housing assistance, and substance use disorder treatment—each a vital thread in the fabric of HIV/AIDS care, each demonstrably aligned with the program’s statutory intent.2
We clarify and remind RWHAP awardees that funds are not authorized for procedures or interventions beyond the scope of outpatient care, as expressly delineated in Policy Clarification Notice #16-02.3 The prohibition on surgeries and inpatient care, irrespective of setting or anesthesia, remains absolute, ensuring that resources remain laser-focused on the HIV-specific needs of eligible individuals. Where disparities persist, particularly among underserved populations, our response shall be targeted, evidence-driven enhancements to HIV care delivery, not a broadening of scope that risks undermining this progress.
The Trump Administration, in its renewed commitment to Make America Healthy Again, calls upon RWHAP recipients and subrecipients to join us in this realignment. We will provide training and technical assistance through the AIDS Education and Training Centers to ensure culturally competent, patient-centered care that maximizes antiretroviral adherence and viral suppression—goals that unite us in the fight to end the HIV epidemic. Together, we can honor the congressional vision that birthed RWHAP, delivering on its promise to those it was designed to serve, without deviation or distraction.
Sincerely,
Thomas J. Engels
Administrator
1 Health Resources and Services Administration, Gender Affirming Care and the Ryan White HIV/AIDS Program (2021), https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/gender-affirming-care-rwhap.pdf
2 See generally 42 U.S.C. §§ 300ff-11-140.
3 Eligible Individuals & Allowable Uses of Funds Clarification Notice. Available at: https://hab.hrsa.gov/sites/default/files/hab/program-grants-management/ServiceCategoryPCN_16-02Final.pdf