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 25 057

Opportunity Information: Apply for HRSA 25 057

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 scale street medicine approaches for people with HIV who are unsheltered. The two opportunities you named cover two of the three core roles in the initiative: the Capacity Builder Provider (HRSA-25-055) and the Evaluation Provider (HRSA-25-057). A third award track, the Demonstration Sites (HRSA-25-056), will implement street medicine interventions in the field. Together, these three entities are expected to work as a single learning collaborative that adapts, documents, implements, evaluates, and shares practical street medicine models that improve engagement in HIV care and related outcomes for people living outside.

At the center of the initiative is the idea that traditional clinic-based care often does not work well for people who are unsheltered, even when services technically exist. People living outdoors face access barriers that can be as basic as clinic hours, transportation, and entry rules (for example, restrictions around pets, carts, or clothing requirements). Many also avoid clinics due to stigma, discrimination, or prior negative experiences. Street medicine is presented as a client-centered delivery model that brings clinic-like services directly into unsheltered settings where people live and spend time, including streets, encampments, and wooded areas. The program description emphasizes that street medicine is not new, has existed for decades, and has a track record of reaching people who are otherwise disconnected from care, but that it requires intentional adaptation in how health care teams work, what safety practices they use, and how they comply with local and state regulations governing what can be delivered where.

The initiative is framed as an HIV outcomes strategy tied to the national goal of ending the HIV epidemic, with specific attention to lower viral suppression rates among people without stable housing. The opportunity cites RWHAP data indicating that in 2022, 5.2 percent of clients served were unstably housed and another 6.9 percent were temporarily housed, and that viral suppression among unstably housed clients (72.4 percent) and temporarily housed clients (84.1 percent) lags behind outcomes for people with stable housing. HRSA is essentially making the case that if programs want to improve viral suppression and retention in care for this group, they need service models designed for the realities of rough sleeping, high rates of co-morbid chronic conditions, and frequent mental health and substance use needs, along with the broader structural barriers that come with homelessness.

The shared goal across HRSA-25-055, HRSA-25-056, and HRSA-25-057 is to adapt, document, implement, evaluate, and disseminate street medicine interventions that effectively respond to the needs of people with HIV who are unsheltered. That shared goal is operationalized through five objectives that shape what the Capacity Builder and Evaluation Provider are expected to deliver. Objective 1 focuses on building the capacity of the demonstration sites to respond effectively to the health care needs of people with HIV who are unsheltered, which points to hands-on training, technical assistance, and practical problem-solving support rather than one-time guidance. Objective 2 emphasizes uptake and sustainability, meaning the interventions should actually be adopted by RWHAP recipient staff and used by clients in a way that can be maintained after the project period, rather than remaining a temporary pilot. Objective 3 calls for a rigorous multisite evaluation grounded in implementation science, looking not only at whether outcomes improve, but why and under what conditions, including barriers and facilitators, implementation strategies, and costs, along with service and client outcomes. Objective 4 requires the development and dissemination of user-friendly, multimedia implementation materials so other RWHAP settings can replicate the interventions. Objective 5 requires use of Centers for Medicare and Medicaid Services (CMS) Place of Service Codes that reflect where services are actually rendered, reinforcing that this initiative is also about accurate documentation, billing/claims alignment where relevant, and consistent data capture across non-traditional care locations.

Within that structure, the Capacity Builder Provider (HRSA-25-055) is best understood as the operational backbone for helping demonstration sites successfully design and deliver street medicine for unsheltered people with HIV. The capacity-building role implies supporting teams as they adapt existing clinic workflows to outdoor and highly variable environments, including outreach planning, service selection, safety procedures, staffing patterns, and compliance with local and state rules. Because the initiative also stresses sustainability and adoption by RWHAP staff and clients, the Capacity Builder is implicitly responsible for helping sites move from ad hoc outreach to a repeatable service model that can be maintained, integrated with HIV care systems, and carried forward beyond the demonstration period. This role also naturally links to Objective 4 because practical capacity building tends to generate field-tested tools (training modules, protocols, checklists, documentation templates, engagement scripts, and examples of workflow redesign) that can later be packaged for dissemination.

The Evaluation Provider (HRSA-25-057) is responsible for designing and conducting the multisite evaluation across demonstration sites using an implementation science approach. The description makes clear that the evaluation is not limited to clinical endpoints; it must also capture how implementation happens in real conditions, what gets in the way, what helps, which strategies are chosen to overcome challenges, and what those strategies cost. The evaluation is expected to produce actionable findings that are documented and shared throughout the initiative, not just at the end, so that programs can adjust while implementation is underway. This implies an evaluator that can manage cross-site measures, support consistent data collection, and translate findings into practical guidance that feeds into continuous quality improvement. The evaluation role also connects to the CMS Place of Service coding objective, since consistent coding and documentation are part of generating usable service delivery data across different street-based settings.

The opportunity is offered as a discretionary cooperative agreement, which typically means HRSA expects substantial involvement during the project period through collaboration, guidance, and shared learning across awardees. The funding announcement lists an expected number of awards as 1 for the opportunity record provided (HRSA 25 057), indicating HRSA anticipates selecting a single organization to serve in that provider role for the initiative (and similarly, the capacity builder track is intended to be a central provider supporting multiple sites). The closing date shown is March 11, 2025. The award ceiling is listed as 0 in the provided extract, which generally signals that the specific ceiling may be defined elsewhere in the full notice of funding opportunity or that the extracted field is not populated, so applicants typically need to confirm budget limits and expectations in the complete HRSA NOFO package.

Eligibility is broad and focused on domestic organizations rather than individuals. Eligible applicants include public and private institutions of higher education, nonprofits with or without 501(c)(3) status, state and local governments (including counties, cities/townships, and special districts), independent school districts, Native American tribal governments, and Native American tribal organizations. Domestic eligibility includes the 50 states, DC, Puerto Rico, Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and the freely associated states listed (Federated States of Micronesia, Republic of the Marshall Islands, Republic of Palau). Individuals are explicitly not eligible to apply.

Overall, HRSA-25-055 and HRSA-25-057 are designed to professionalize and scale street medicine within RWHAP by pairing real-world implementation (the demonstration sites) with structured capacity building and a strong, implementation-focused evaluation. The intended end product is not just improved services in a few locations, but a documented and shareable set of interventions, workflows, and multimedia tools that other HIV service settings can replicate, along with evidence about what works, what it costs, and what it takes to sustain street medicine services for people with HIV who are unsheltered.

• 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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