Curing Hepatitis C among People of Color Living with HIV | HRSA 17 047

Opportunity Information: Apply for HRSA 17 047

The HRSA funding opportunity "Curing Hepatitis C among People of Color Living with HIV" (HRSA-17-047) is a FY 2017 Secretarys Minority AIDS Initiative Fund (SMAIF) cooperative agreement designed to reduce hepatitis C (HCV) illness and ongoing transmission among people of color living with HIV, especially in communities where HIV/HCV coinfection is concentrated among low-income, underinsured, or uninsured groups. HRSA planned to support up to two recipients to build stronger local systems that move people smoothly from prevention and testing to care, treatment, and ultimately cure, while also addressing the behavioral health and substance use needs that often make HCV treatment harder to start and finish. The overall aim is not just individual patient outcomes, but a sustainable, area-wide approach that improves how clinics, community providers, and health departments work together to find people with coinfection, get them into care, and keep them engaged.

The initiative is intentionally multi-pronged. It focuses on expanding HCV prevention education, testing, and clinical capacity within settings that commonly serve people of color with HIV, including Ryan White HIV/AIDS Program (RWHAP)-funded clinics, HRSA- and Medicare-certified Federally Qualified Health Centers (FQHCs), and SAMHSA-funded community-based substance use disorder (SUD) and behavioral health treatment providers. A central expectation is improved coordination of linkage to and retention in HIV/HCV care, along with closer coordination with SUD providers so that people can get the behavioral health and substance use supports that help them complete HCV treatment and reduce the risk of reinfection. Another major pillar is public health surveillance: recipients are expected to work with state, local, or tribal health departments to strengthen HCV surveillance for people living with HIV and to establish an "HCV Data to Care" capability, similar to HIV Data to Care, where surveillance data are used to identify diagnosed individuals who are out of care and actively link them back to treatment services.

Applicants have to show clear need and access. They must provide evidence that HIV/HCV coinfection affects low-income, underinsured, or uninsured racial and ethnic minority populations in their target area, and they must demonstrate the ability to reach people living with HIV who are living with HCV or are at risk of acquiring it. The opportunity highlights priority populations with high HCV prevalence among people with HIV, including people who use drugs (PWUD), especially people who inject drugs (PWID), men who have sex with men (MSM), high-risk heterosexual populations, and transgender people. The emphasis on these groups reflects a practical public health strategy: targeting outreach, testing, and treatment support where both clinical burden and transmission risk are highest.

The project is structured as a three-year effort with a heavy planning front end. During year one, recipients are expected to conduct a planning and development phase and produce a detailed implementation plan tailored to local conditions. That plan should coordinate multiple strategies to increase the number of people in the service area who are screened, diagnosed, linked to care, treated, and cured of HCV. Years two and three are primarily implementation years, where the recipient puts the plan into action, expands capacity across partner sites, and demonstrates measurable improvements in HCV-related outcomes among people living with HIV, with a strong equity focus on people of color.

A key operating model is that the main recipient serves as a hub that builds capacity through partnerships and annual subawards. Recipients are expected to partner with clinical sites and provide subawards to help those clinics improve their ability to manage HIV/HCV coinfection. Capacity-building areas include delivering HIV/HCV care and treatment consistent with HHS guidelines, providing adherence support, ensuring access to the lab testing and clinical staging needed for HCV management (including referrals for liver biopsy or other staging procedures when appropriate), and delivering patient-facing prevention education about HCV infection and reinfection. Subrecipient clinics are also expected to do targeted outreach to people who are out of care, conduct contact tracing as appropriate, and form multidisciplinary HIV/HCV teams. The notice points to practical collaboration methods such as shared trainings, case conferences, and coordinated use of out-of-care lists to systematically re-engage patients.

The program also draws a clear boundary around what federal grant funds can and cannot pay for: funds may not be used to purchase HCV medications. Because direct-acting antivirals (DAAs) are central to curing HCV, the opportunity requires that participating providers already have viable pathways to obtain DAAs through other payors or funding mechanisms. In other words, the grant is meant to strengthen infrastructure, coordination, workforce capacity, and supportive services, rather than replace insurance coverage or medication financing.

Because substance use and mental health conditions can be major barriers to starting and completing HCV treatment, recipients must also build strong connections to SUD and mental health providers in the communities served by each clinical site, including through subawards when helpful. The required activities include creating partnerships that support integrated care and bidirectional referrals, linking clinic patients who screen positive for SUD into treatment services, and linking people in SUD or mental health programs who have HIV/HCV and are out of care back into HIV/HCV clinical care. The program also expects practical harm reduction and safety interventions to prevent overdose and reinfection, including referrals to syringe services programs (SSPs) where available, and referrals to community education efforts that explain the benefits of medication-assisted treatment (MAT) and SSPs. The design reflects a full continuum approach: curing HCV is the immediate clinical goal, but preventing reinfection and stabilizing behavioral health needs are necessary to make cure durable at the community level.

Workforce development and provider training are built into the award. Recipients are expected to deliver training to HCV care providers at participating clinical sites using curricula and competency frameworks developed by the AIDS Education Training Center (AETC) National Coordinating Resource Center. They are also expected to collaborate with their Regional AETC and, if applicable, their Local Performance Site (LPS). The intent is practice transformation, not one-off trainings, meaning clinics should strengthen workflows, clinical confidence, and team-based care models that make HIV/HCV coinfection treatment routine and scalable.

Surveillance and data use are treated as core infrastructure, not an add-on. Recipients must partner with health departments to improve monitoring of acute and chronic HIV/HCV coinfections in areas with large racial and ethnic minority populations. Enhanced systems should support using surveillance data to identify HCV-diagnosed people living with HIV who are not in care and link them directly to services, mirroring established HIV Data to Care strategies. Health departments are also expected to facilitate collection of HCV-related data required by the initiative, reinforcing that evaluation and accountability are central to the cooperative agreement model.

Finally, the opportunity is built around measurement, evaluation, and dissemination. Recipients must work closely with a HRSA-funded technical assistance and evaluation team and are required to collect and report data on knowledge levels among (1) HIV/HCV coinfected patients regarding HCV treatment and (2) health care providers regarding HCV screening and treatment. If these data were previously collected, applicants should report results; otherwise, they must conduct rapid assessments using existing instruments from the evaluation team. Those instruments must be submitted to an Institutional Review Board (IRB) within two months of award, and both assessments must be completed within the first nine months of year one so gaps can inform patient education and provider training strategies. By year three, recipients collaborate on a project monograph and other dissemination products that capture outcomes, best practices, and lessons learned.

By the end of the three-year period, recipients are expected to have built comprehensive, area-wide systems that improve HCV screening, linkage, treatment uptake, cure rates, and prevention of reinfection among people living with HIV and HCV, particularly people of color. Just as important, the program expects sustainability: recipients and partners should integrate these screening, care, and treatment approaches into ongoing clinical operations, program planning, and administrative and fiscal structures so the improvements continue after the grant ends.

• The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Curing Hepatitis C among People of Color Living with HIV" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.928.
• This funding opportunity was created on Jun 14, 2017.
• Applicants must submit their applications by Jul 28, 2017. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• The number of recipients for this funding is limited to 2 candidate(s).
• Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).

Apply for HRSA 17 047

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