Street Medicine Interventions for People with HIV who are Unsheltered - Demonstration Sites | HRSA 25 056

Opportunity Information: Apply for HRSA 25 056

The Street Medicine Interventions for People with HIV who are Unsheltered - Demonstration Sites opportunity (HRSA-25-056) is a discretionary grant from the Health Resources and Services Administration (HRSA) designed to expand and strengthen "street medicine" approaches for people with HIV who are living without shelter. The central idea is to bring HIV-related care and supportive services out of traditional clinic environments and into the places where unsheltered people actually live and spend time, such as sidewalks, encampments, wooded areas, and other outdoor locations. HRSA frames this as a client-centered model that requires a real shift in how care is delivered, because conventional clinic routines and rules often do not fit the realities of people experiencing unsheltered homelessness.

The initiative is structured as a coordinated, three-part effort in which Demonstration Sites (this funding opportunity), a separate Capacity Building Provider (HRSA-25-055), and a separate Evaluation Provider (HRSA-25-057) work together. Collectively, they are meant to adapt, document, implement, evaluate, and then broadly share street medicine interventions that better meet the needs of unsheltered people with HIV. In other words, HRSA is not only funding direct implementation in selected communities, but also investing in learning what works across multiple sites, what it costs, and what practical tools other Ryan White HIV/AIDS Program (RWHAP) settings can use to replicate successful models.

HRSA lays out five objectives that guide what demonstration sites are expected to do. First, sites are expected to build their capacity to respond effectively to the health care needs of unsheltered people with HIV, which often means developing new workflows, staff roles, partnerships, and safety practices for field-based care. Second, the program emphasizes uptake and sustainability, meaning the interventions should be realistically adoptable by RWHAP recipient staff and acceptable to clients, with an eye toward continuing beyond the grant period rather than remaining a short-term pilot. Third, the initiative calls for a high-quality, mixed-methods, multi-site evaluation using implementation science and including cost analysis, so the field can understand both outcomes and the practical conditions needed for success. Fourth, HRSA expects the development and dissemination of user-friendly, multimedia implementation materials, essentially toolkits and practical guides that other RWHAP programs can use to replicate the intervention and improve care for similar populations. Fifth, demonstration sites are directed to use Centers for Medicare and Medicaid Services (CMS) Place of Service Codes that accurately reflect where services are delivered, which signals a focus on correct documentation and billing/claims alignment as care moves outside clinic walls.

A key part of the rationale is that clinic-based care, even when high-quality, can be structurally inaccessible for people who are unsheltered. HRSA highlights common barriers like limited clinic hours, restrictive entry policies (for example, prohibitions on pets or carts, or requirements for certain clothing), and the impact of stigma or discrimination, especially for people who have had negative experiences in health systems before. Street medicine is presented as a way to reduce these barriers by meeting people where they are, building trust over time, and adapting services to environments that have fewer resources and different risks than a clinic. HRSA also notes that street medicine is not a new invention; programs have existed for decades and have shown they can deliver effective care and improve outcomes, though the operational details can look different from traditional settings.

The opportunity also underscores the complexity of needs among people who are unsheltered. Street medicine teams commonly encounter chronic co-morbidities alongside mental health conditions, substance use disorders, and difficult social determinants of health that can disrupt treatment continuity. This context helps explain why HRSA is pushing for "innovative approaches" and for demonstration sites to pay attention to practical considerations like staff and client safety in the field, local and state regulations that govern what services can be delivered outside traditional facilities, and thoughtful selection of services that can be realistically and safely provided in outdoor or nontraditional locations.

HRSA ties the need for this work to RWHAP client outcome data. The notice cites the 2022 RWHAP Services Report showing that 5.2 percent of clients served were unstably housed and another 6.9 percent were temporarily housed, and it highlights that viral suppression is lower for those without stable housing (72.4 percent for unstably housed and 84.1 percent for temporarily housed) compared to people who are stably housed. The grant is positioned as part of the broader effort to end the HIV epidemic in the United States by reaching people who are not engaged in care, have difficulty staying in care, or are not virally suppressed, especially when traditional service delivery models are not effectively reaching them. While the focus is on unsheltered populations, HRSA also notes that street medicine approaches can benefit people who avoid clinic buildings for other reasons, making the model relevant beyond homelessness alone.

Eligibility is tied to the Ryan White HIV/AIDS Program Parts A through D under Title XXVI of the Public Health Service Act, meaning applicants must be entities that qualify under RWHAP frameworks. Eligible applicant types listed include state, county, city/township, and special district governments (including DC and U.S. territories and freely associated states), independent school districts, Native American tribal governments and tribal organizations, nonprofits (with or without 501(c)(3) status), and public or private institutions of higher education. The opportunity is limited to domestic entities as defined in the notice (including U.S. states and specified territories and associated states), and individuals are explicitly not eligible to apply. The funding announcement lists an expected 10 awards and an application closing date of March 11, 2025.

• 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 - Demonstration Sites" 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 10 candidate(s).
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, 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.

Apply for HRSA 25 056

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