HIV Emergency Relief Project Grants

To provide direct financial assistance to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs) that have been the most severely affected by the Human Immunodeficiency Virus (HIV) epidemic to enhance access to a comprehensive, effective and cost efficient continuum of high quality, community-based

credit: aei-ideas
care for low-income individuals and families with HIV and to strengthen strategies to reach minority populations.

A comprehensive continuum of care includes the 13 core medical services specified in legislation and appropriate support services that assist people living with HIV (PLWH) in accessing treatment for HIV/AIDS that is consistent with the Department of Health and Human Service (HHS) Treatment Guidelines.

Comprehensive HIV/AIDS care beyond these core medical services may include supportive services that meet the criteria of enabling individuals and families living with HIV to access and remain in primary medical care to improve their medical outcomes.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - See Regional Agency Offices.
Website Address

Relevant Nonprofit Program Categories

Selected Recipients for this Program

RecipientAmount Start DateEnd Date
University Of Washington $ 2,140,906   2018-09-012027-08-31
National Alliance Of State $ 2,000,000   2014-07-012027-06-30
Cicatelli Associates, Inc. $ 2,400,000   2020-07-012025-06-30
Regents Of The University Of California, San Francisco, The $ 2,100,000   2020-07-012025-06-30
Regents Of The University Of California, San Francisco, The $ 11,009,030   2016-07-012025-06-30
Public Health, Alabama Department Of $ 4,667,400   2020-03-012025-02-28
Detroit, City Of $ 4,550,813   2020-03-012025-02-28
Philadelphia, City Of $ 5,763,968   2020-03-012025-02-28
Bexar County Hospital District $ 3,197,642   2020-03-012025-02-28
Health & Family Services, Kentucky Cabinet For $ 3,308,265   2020-03-012025-02-28

Program Accomplishments

Fiscal Year 2016: Nearly 68 percent of all clients served by the RWHAP in 2014 were served in one of the 52 metropolitan areas funded under the RWHAP Part A. Approximately 73 percent of all people living with diagnosed HIV reside in a RWHAP Part A EMA or TGA. Part A funded sites provided 3.7 million core medical service visits for health-related care utilizing a combination of Parts A, B, C, and D funding. The number of visits for health-related services demonstrates the scope of Part A in delivering primary care and related services for PLWH by increasing the availability and accessibility of care. From 2010 to 2015, HIV viral suppression among RWHAP patients has increased from 70 percent to 83 percent, and racial/ethnic, age-based, and regional disparities have decreased. These improved outcomes mean more PLWH in the U.S. will live near normal lifespans and have a reduced risk of transmitting HIV to others. RWHAP Part A jurisdictions are experienced in data-driven, community-based needs assessment, responsive procurement of a variety of direct medical and supportive services, working with a set of providers to weave together a constellation of services, serving diverse populations and continuing to make improvements that positively affect the HIV care continuum. Thus, the RWHAP Part A has a significant public health impact on HIV incidence. Fiscal Year 2017: No Current Data Available Fiscal Year 2018: No Current Data Available

Uses and Use Restrictions

Not less than 75 percent of grant funds remaining after reserving funds for administration and clinical quality management must be used to provide core medical services, unless a waiver request related to this requirement is submitted and approved.

Core medical services include: outpatient and ambulatory health services, AIDS Drug Assistance Program, AIDS pharmaceutical assistance, oral health care, early intervention services, health insurance premium and cost-sharing for low-income individuals, home health care, medical nutritional therapy, hospice services, home and community-based health services as defined under Section 2614 (c), mental health services, substance abuse outpatient care, and medical case management, including treatment adherence services.

Support services are for individuals with HIV to achieve medical outcomes and may include respite care for persons caring for individuals living with HIV, outreach services, medical transportation, linguistic services and referral for health care and support services, and others.

A percentage of the grant, determined by the percentage of women, infants, children and youth in the area with HIV, will be used to provide health and support services to women, infants, children, and youth with HIV disease, including treatment measures to prevent the perinatal transmission of HIV.

No more than 10 percent of amounts received under a grant may be used to fund the recipient?s grant administration and monitoring activities, program support activities and all activities associated with recipient contract award procedures.

In addition, the aggregate total of administrative expenditures for subrecipients, including all indirect costs, may not exceed ten (10) percent of the aggregate amount of all subawards.

Recipients may use up to five percent of funds or $3 million, whichever is less, for clinical quality management activities to assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent Department of Health and Human Services guidelines for the treatment of HIV/AIDS.

Funds may not be used to make payments for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to that item or service under any State compensation program, insurance policy, Federal or State health benefits program or by any entity that provides health services on a prepaid basis (except for a program administered by or providing the services to the Indian Health Service).

Funds may not be used for cash payments to intended recipients of Ryan White HIV/AIDS Program (RWHAP) services, purchasing or construction of real property, or pre-exposure prophylaxis (PrEP) or non-occupational post-exposure prophylaxis (nPEP) medications or the related medical services.

Additionally, the purchase of sterile needles or syringes for the purposes of hypodermic injection of any illegal drug is not allowable.

Some aspects of Syringe Services Programs are allowable with HRSA's prior approval and in compliance with HHS and HRSA policy (see

Eligibility Requirements

Applicant Eligibility

RWHAP Part A recipients that were classified as an EMA or as a TGA in fiscal year (FY) 2007 and continue to meet the statutory requirements are eligible to apply for these funds.

For an EMA, this is more than 2,000 cases of AIDS reported and confirmed during the most recent five calendar years, and for a TGA, this is at least 1,000, but fewer than 2,000 cases of AIDS reported and confirmed during the most recent period of five calendar years for which such data are available.

Additionally, they must not have fallen below, for three consecutive years, the required incidence levels already specified AND required prevalence levels (cumulative total of living cases of AIDS reported to and confirmed by the Director of the Centers for Disease Control and Prevention (CDC) as of December 31 of the most recent calendar year for which such data are available).

For an EMA, this is 3,000 living cases of AIDS, and for a TGA, this is 1,500 living cases of AIDS, except certain areas which have a cumulative total of at least 1,400 living cases of AIDS and which have no more than 5 percent of the total from formula grants awarded unobligated as of the end of the most recent fiscal year. Eligible metropolitan areas (EMA) with a population of 50,000 or more individuals for which the CDC has reported a cumulative total of more than 2,000 AIDS cases for the most recent period of 5 calendar years include: Atlanta, Georgia; Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Detroit, Michigan, Ft.

Lauderdale, Florida; Houston, Texas; Los Angeles, California; Miami, Florida; Nassau/Suffolk Counties, New York; New Haven, Connecticut; New Orleans, Louisiana; New York, New York; Newark, New Jersey; Orlando, Florida; Philadelphia, Pennsylvania; Phoenix, Arizona; San Diego, California; San Francisco, California; San Juan, Puerto Rico; Tampa-St.

Petersburg, Florida; Washington, DC; and West Palm Beach, Florida.

Transitional Grant areas (TGA) with a population of 50,000 or more individuals for which the CDC has reported a cumulative total of at least 1,000, but not more than 1,999 AIDS cases for the more most recent five year period include: Austin, Texas; Baton Rouge, Louisiana; Bergen-Passaic, NJ; Charlotte, North Carolina; Cleveland, Ohio; Columbus, Ohio; Denver, Colorado; Fort Worth, Texas; Hartford, Connecticut; Indianapolis, Indiana; Jacksonville, Florida; Jersey City, New Jersey; Kansas City, Missouri; Las Vegas, Nevada; Memphis, Tennessee; Middlesex, New Jersey; Minneapolis, Minnesota; Nashville, Tennessee; Norfolk, Virginia; Oakland, California; Orange County, California; Portland, Oregon; Riverside-San Bernardino, California; Sacramento, California; St.

Louis, Missouri; San Antonio, Texas; San Jose, California; and Seattle, Washington.

Beneficiary Eligibility

Individuals and families living with HIV disease.


Applicants should review the individual HRSA notice of funding opportunity issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. 2 CFR 200, Subpart E - Cost Principles applies to this program. 2 CFR 200, Subpart E - Cost Principles applies to this program.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is required.

Environmental impact information is not required for this program.

This program is eligible for coverage under E.O.

12372, 'Intergovernmental Review of Federal Programs.' An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.

Application Procedures

2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. HRSA requires all applicants to apply electronically through

Award Procedures

Two-thirds of the funds available are disbursed on a formula basis as required by the legislation, subject to a completeness review of required information specified in the HRSA notice of funding opportunity issued under this CFDA program. The remaining one-third of available funds are disbursed as a competitive, supplemental grant, based on criteria specified by the legislation. All qualified applications will be forwarded to an objective review committee. Based on the recommendations of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions. In addition, Minority AIDS Initiative (MAI) funds available under Section 2693 are disbursed on a formula basis together with the Formula and Supplemental awards as required by the legislation. Notification is made in writing by a Notice of Award.


Contact the headquarters or regional office, as appropriate, for application deadlines.


Sections 2601-2610 and 2693 of Title XXVI of the Public Health Service Act, (42 USC 300ff-11 ? 300ff-20, and 300ff-121), as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 11-87).

Range of Approval/Disapproval Time

Approximately 6 months.


Not Applicable.


Not Applicable.

Assistance Considerations

Formula and Matching Requirements

Statutory Formula: Statutory Formula: RWHAP Part A formula grants to EMAs and TGAs include Minority AIDS Initiative (MAI) funds, which supports access to services targeting minority populations. Statutory Formula: The formula portion of the grant is determined by the number of living cases of HIV/AIDS in each eligible area as reported to and confirmed by the Centers for Disease Control and Prevention by December 31 for the most recent calendar year for which data are available. Discretionary RWHAP Part A Supplemental grants are awarded competitively on the basis of demonstrated need and other criteria. [See Criteria for Selecting Proposals (180)]. MAI formula funds are based on the number of reported and confirmed living minority cases of HIV/AIDS for the most recent calendar year. Matching requirements are not applicable to this program. This program has MOE requirements, see funding agency for further details. This program has MOE requirements, see funding agency for further details. The RWHAP legislation requires Part A recipients to maintain, as a Condition of Award, political subdivision expenditures within the eligible area for HIV-related core medical services and support services at a level equal to the 1-year period preceding the fiscal year for which the recipient is applying to receive a Part A grant.

Length and Time Phasing of Assistance

Grants are awarded for a 12-month project/budget period. See the following for information on how assistance is awarded/released: Recipients draw down funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.

Post Assistance Requirements


Annual progress and annual financial reports are required.

Quarterly financial cash transaction reports are required within 30 days of the end of each calendar quarter.

Annual reports are to be submitted within 90 days after the end of each budget period.

The final performance report and final financial status reports are due 90 days from the end of the project period.

Reports documenting services and expenditures are required.

Recipients must report expenditures for WICY for the previous budget year within 90 days of the end of the grant year as mandated by the RWHAP.

Recipients must submit a Federal Financial Report (FFR) or SF 425 within 150 days after the end of the budget period.


In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.


Recipients are required to maintain financial records 3 years after the date they submit the final Federal Financial Report (FFR). If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.

Financial Information

Account Identification



(Project Grants) FY 16 $627,786,733; FY 17 est $618,322,901; and FY 18 est $618,322,901

Range and Average of Financial Assistance

$2,747,766 to $100,750,936; Average = $12,072,821.

Regulations, Guidelines, and Literature

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75. HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at

Information Contacts

Regional or Local Office

See Regional Agency Offices.

Headquarters Office

Steven Young, Director, 5600 Fishers Lane, Room 9W12, Rockville, Maryland 20857 Phone: (301) 443-7136

Criteria for Selecting Proposals

Applications for supplemental funds must meet nine criteria set forth in the enacting legislation: (1) contain a report concerning the dissemination of emergency relief funds and the plan for utilization of such funds; (2) demonstrate need in such area for supplemental financial assistance to combat the HIV epidemic; (3) demonstrate the existing commitment of local resources of the area, both financial and in-kind, to combat the HIV epidemic; (4) demonstrate the ability of the area to utilize such supplemental financial resources in a manner that is immediately responsive and cost-effective; (5) demonstrate that resources will be allocated in accordance with the local demographic incidence of AIDS including appropriate allocations for services for infants, children, women, and families with HIV disease; (6) demonstrate the inclusiveness of affected communities and individuals with HIV disease; (7) demonstrate the manner in which proposed services are consistent with the local needs assessment and the statewide coordinated statement of need; (8) demonstrate the ability of the applicant to expend funds efficiently by not having had, for the most recent Part A formula grant year for which data is available, more than 5 percent of grant funds unobligated at the end of the year, even if a request for carryover was granted; and (9) demonstrate success in identifying individuals with HIV and AIDS, who are unaware of their HIV/AIDS status, and provides a description of the strategy, plan, and data associated with the early identification of these individuals.

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