Street Medicine Interventions for People with HIV who are Unsheltered – Capacity Builder Provider (HRSA-25-055) and Street Medicine Interventions for People with HIV who are Unsheltered – Evaluation Provider (HRSA-25-057) | HRSA 25 055

Opportunity Information: Apply for HRSA 25 055

The Health Resources and Services Administration (HRSA) is funding a coordinated, three-part initiative under the Ryan White HIV/AIDS Program (RWHAP) to strengthen and spread "street medicine" approaches for people with HIV who are unsheltered. The two opportunities you named focus on the system-building functions that support on-the-ground work at separate demonstration sites (HRSA-25-056): one award will fund a Capacity Building Provider (HRSA-25-055) and one award will fund an Evaluation Provider (HRSA-25-057). Together, the Capacity Builder, the Demonstration Sites, and the Evaluation Provider are expected to work as a single, aligned collaborative aimed at improving access, retention in care, and outcomes for people with HIV who are living outside and not well reached by conventional clinic settings.

The overall goal of the initiative is to adapt, document, implement, evaluate, and disseminate street medicine interventions that effectively respond to the needs of people with HIV who are unsheltered. HRSA frames street medicine as a client-centered model that brings services typically offered in clinics directly into the unsheltered places where people live and spend time, such as streets, encampments, and wooded areas. This is not described as a brand-new concept; HRSA emphasizes that street medicine programs have existed for decades and can produce improved outcomes, but they often require different operating assumptions than clinic-based care, especially around team and client safety, what services can be delivered in the field, and how local and state regulations shape permissible settings and workflows.

A key reason HRSA is investing in this approach is that traditional health care delivery does not consistently meet the needs of people who are rough sleeping or unsheltered. Practical access barriers like clinic hours and entry policies (for example, restrictions related to pets, carts, or dress requirements) can block care. In addition, stigma and discrimination, including prior negative experiences in clinic environments, can make people reluctant to seek services in traditional settings. HRSA also highlights that street medicine teams routinely encounter complex needs linked to social determinants of health, including chronic comorbidities, mental health conditions, substance use disorders, and other structural challenges, which often require more flexible and innovative service delivery strategies than a standard clinic visit can provide.

The initiative is organized around five objectives. Objective 1 is capacity building: strengthening the ability of demonstration sites to respond effectively to the health care needs of people with HIV who are unsheltered. Objective 2 focuses on implementation success over time, aiming for real uptake of the adapted interventions by RWHAP staff and clients and building sustainability so that the work continues beyond the demonstration period. Objective 3 is a rigorous multisite evaluation grounded in implementation science, designed to look not only at whether the interventions "work," but how and why they work (or do not) in real-world settings. This includes studying barriers and facilitators, implementation strategies, and cost, along with other implementation measures and client/service outcomes. Objective 4 requires the development and dissemination of practical, user-friendly, multimedia implementation materials so other RWHAP providers can replicate or adapt the interventions in their own contexts. Objective 5 calls for the use of Centers for Medicare and Medicaid Services (CMS) Place of Service Codes that reflect the setting where services are actually delivered, reinforcing accurate documentation and potentially supporting appropriate billing/claims consistency where applicable.

Within that structure, the Capacity Builder Provider (HRSA-25-055) is essentially the technical assistance and field support "backbone" for the demonstration sites. Its role is to help sites adapt street medicine interventions to local realities, build staff skills and operational readiness, and troubleshoot the real constraints that emerge in unsheltered environments (safety planning, staffing models, workflow redesign, navigation/engagement approaches, and ensuring services align with local and state rules). Because Objective 2 emphasizes uptake and sustainability, the capacity builder is also expected to support change management: helping RWHAP teams integrate street medicine practices into routine operations and ensuring the interventions remain feasible when initial project momentum or special supports taper off.

The Evaluation Provider (HRSA-25-057) is responsible for the cross-site evaluation, using implementation science methods across demonstration locations. The evaluation is expected to be "multisite" and "rigorous," which in practical terms means the evaluator should be positioned to harmonize data collection across sites, assess variation in context, and compare how different implementation strategies perform under different conditions. HRSA explicitly points to examining barriers and facilitators, strategies used to implement the interventions, and cost, along with broader implementation outcomes and client/service outcomes. The evaluation is not meant to sit on a shelf at the end; HRSA expects findings to be documented and shared throughout the initiative so the project can continuously improve implementation while it is underway.

A major deliverable that ties both awards together is dissemination. HRSA wants the initiative to produce replication-ready materials that other RWHAP settings can use, not just academic reports. The emphasis on "user-friendly, multimedia implementation materials" signals that products should be practical for frontline adoption (for example, playbooks, workflow templates, training modules, safety protocols, sample documentation tools, and field-ready engagement guidance), and that they should reflect lessons learned from the evaluation and the on-the-ground capacity-building experience.

The opportunity is offered as a discretionary cooperative agreement, meaning HRSA anticipates substantial involvement with awardees during the project rather than a purely hands-off grant. Eligible applicants are domestic organizations and public entities, including public and private institutions of higher education, nonprofits with or without 501(c)(3) status, and government entities at the state, county, city/township, special district, and independent school district levels, as well as Native American tribal governments and tribal organizations. "Domestic" is defined broadly to include the 50 states, Washington, DC, Puerto Rico, other US territories, and freely associated states listed in the notice. Individuals are not eligible to apply.

HRSA also grounds the need for this work in RWHAP data showing housing instability is tied to poorer HIV outcomes. Citing the 2022 RWHAP Services Report, HRSA notes that 5.2% of clients served were unstably housed and another 6.9% were temporarily housed, and that viral suppression among unstably housed clients (72.4%) and temporarily housed clients (84.1%) lags behind suppression among stably housed clients. The underlying message is that ending the HIV epidemic requires approaches that meet people where they are, especially those not engaged in care or not virally suppressed, and street medicine is positioned as a practical delivery model to close that gap for people living unsheltered or who avoid traditional clinic environments.

Key administrative details included in the listing are that the funding opportunity numbers are HRSA-25-055 (Capacity Builder Provider) and HRSA-25-057 (Evaluation Provider), the agency is HRSA, the assistance listing/CFDA number is 93.928, the closing date shown is March 11, 2025, and the expected number of awards shown for the listing is 1 (reflecting that each of these provider roles is typically funded as a single national-level award that then supports multiple demonstration sites). The award ceiling is shown as 0 in the listing excerpt, which usually indicates the ceiling is either not specified in that field or is provided elsewhere in the full notice of funding opportunity.

• The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Street Medicine Interventions for People with HIV who are Unsheltered – Capacity Builder Provider (HRSA-25-055) and Street Medicine Interventions for People with HIV who are Unsheltered – Evaluation Provider (HRSA-25-057)" 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 2025-01-08.
• Applicants must submit their applications by 2025-03-11. (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 1 candidate(s).
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, Others.

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