National Training and Technical Assistance - Cicatelli Associates, Inc. (CAI) submits this proposal to the Health Resources and Services Administration in response to HRSA-26-014, Fostering Collaboration Across Ryan White HIV/AIDS Programs to Engage People with HIV in Care, to strengthen the capacity of Ryan White HIV/AIDS Program (RHWAP) Part A, B, C, D and F (the “Parts”) to use collaborative and coordinated approaches, and sound planning processes, to identify, implement, and continuously improve policies, partnerships, systems, and practices to address the unmet needs of people disproportionately impacted by HIV who are out of care. Throughout, we will focus on maximizing existing resources and identifying concrete actions Parts can take at 3, 6, 12 and 24 months, that deliver immediate benefits for PWH and result in a strengthened overall system of care for lasting improvement. People living with HIV (PWH) who are reached by the RWHAP-funded system of care achieve exceptionally good health outcomes - but America’s fight to end HIV remains unfinished and progress uneven. Approximately 87% of new HIV transmissions are estimated to result from people who do not know their HIV status or are not engaged in care, one in three PWH are not currently receiving medical care, and more than one-third are not virally suppressed. Therefore, while sustaining high-quality care and treatment for people currently receiving services through RWHAP Parts, we must continue to strengthen our efforts to identify and engage PWH who are out-of-care. Ending the Epidemic in the U.S. (EHE) has been highly successful, but nearly half of all new infections are in areas that are not funded by EHE. Through this initiative, CAI will collaborate with HRSA to identify and engage eight non-EHE states with unmet need among populations disproportionately impacted by HIV who are out of care to plan and execute state-wide meetings in each state. To prepare for meetings we will work with Part A–F grantees, key partners, collaborators, and PWH to map each state’s current HIV landscape through a set of comprehensive assessment activities. Findings from assessments will inform the development of agendas and materials for statewide convenings, identify convening participants ensuring representation from all Parts, key partners and collaborators (e.g., Ryan White Community Councils), and PWH. During state convenings, participants will co-develop a plan with concrete goals, objectives, and actionable steps that outline responsibilities. Plans will focus on actions each Part, and identified collaborators, will take to support shared goals to link and retain out-of-care PWH, improving viral suppression rates and strengthening conditions associated with collaborative action, including monitoring activities. Following the conclusion of state meetings, CAI will provide TA to states to finalize action and monitoring plans and support the successful implementation of plans and support collaborative action. Throughout, CAI will employ a strengths-based, adaptable and relational approach to TA – ensuring that TA is done with Ryan White programs, not to them; and that it is grounded in implementation science and health systems strengthening frameworks, as well as adult learning principles. We will form and engage a cross-Part workgroup that includes PWH and other key partners and collaborators to support the planning and implementation of all project activities in each state. In addition, each state will be assigned a dedicated implementation coaching team, consisting of two experienced coaches with deep RWHAP experience. These coaches, working with our expert faculty, will provide ongoing and on-demand TA, guiding planning and collaboration before, during, and after convenings, as detailed in the sections that follow.
