Emerging Strategies to Improve Health Outcomes for People Aging with HIV: Demonstration Sites | HRSA 22 028

Opportunity Information: Apply for HRSA 22 028

The Emerging Strategies to Improve Health Outcomes for People Aging with HIV: Demonstration Sites grant opportunity (HRSA 22-028) is a discretionary grant program from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), under CFDA 93.928. It is designed to strengthen how HIV care systems respond to the realities of an aging HIV population, especially people ages 50 and older who often face a more complicated mix of health issues than younger patients. The core idea is to fund real-world demonstration sites that can put promising, practical approaches into place, study how well those approaches fit into routine care, and produce lessons that other providers can replicate.

This funding opportunity is one part of a three-part initiative that HRSA structured to work as a coordinated package. Alongside the demonstration sites (HRSA 22-028), HRSA also planned to fund a capacity-building provider (HRSA 22-027) and an evaluation provider (HRSA 22-029). The intention is that these three components operate in parallel and in partnership: demonstration sites implement and test emerging strategies in clinical and service settings; the capacity-building provider supports sites with training, tools, and technical assistance to help implementation succeed; and the evaluation provider helps generate consistent evidence across sites about what was implemented, how it was implemented, and what outcomes changed. All three components are expected to align their work using the HRSA HIV/AIDS Bureau (HAB) implementation science framework, which emphasizes not only whether an intervention works, but also how it gets adopted, integrated, sustained, and scaled in real practice conditions.

At the demonstration-site level, the program focuses on implementing "emerging strategies" that improve the way organizations identify and manage the complex needs of older people with HIV. That includes comprehensive screening and management of comorbidities (such as cardiovascular disease, diabetes, kidney disease, and other chronic conditions that become more common with age), geriatric conditions (for example, functional limitations, fall risk, frailty, cognitive concerns, and medication-related issues), behavioral health needs (including mental health and substance use), and broader psychosocial needs (such as housing stability, social isolation, stigma, access to supportive services, and challenges navigating multiple systems of care). The emphasis on comprehensive screening and management signals that HRSA is looking for integrated models that go beyond viral suppression alone and address whole-person aging.

A central requirement is that sites do more than simply provide services; they are also expected to learn from implementation in a structured way. Demonstration sites are meant to assess the uptake and integration of the strategies they introduce, meaning they should pay attention to whether new practices are actually being used by staff, embedded in workflows, and accepted by patients. The opportunity also calls for understanding implementation processes, including identifying and assessing specific implementation strategies. In practical terms, that can mean documenting what steps sites take to roll out changes (staff training, workflow redesign, clinical decision support, referral partnerships, patient engagement approaches, and so on), and then examining which of those steps appear to drive adoption and fidelity.

In addition, the initiative explicitly highlights the importance of context. Sites are expected to understand and document broader contextual factors that affect implementation, such as organizational capacity, staffing constraints, patient population characteristics, local service networks, reimbursement environment, and the impact of structural barriers. This kind of contextual documentation is a key feature of implementation science because it helps other jurisdictions and providers judge whether a model is likely to translate to their own setting, and what adaptations might be necessary.

Evaluation is another core element of the work. Demonstration sites, in coordination with the initiative-wide evaluation provider, are expected to evaluate the impact of the emerging strategies. While the specific measures are not listed in the short description, the program framing suggests a mix of outcomes related to health (management of comorbidities, functional or geriatric outcomes, behavioral health indicators), care processes (screening rates, referral completion, retention in care, care coordination), and patient-centered outcomes (quality of life, reduced isolation, improved access to supportive services). The goal is to move from promising ideas to evidence-backed practices that show measurable improvement for people aging with HIV.

Finally, the opportunity places strong emphasis on documentation and dissemination. Sites are expected to capture what they did in a way that can be shared, including practical tools, workflows, screening protocols, partnership models, and lessons learned. The dissemination component is meant to ensure the field benefits from the investment by giving other HIV service providers and systems concrete, transferable strategies for supporting older adults with HIV.

Administratively, the grant was posted on October 26, 2021, with an original closing date of January 25, 2022. HRSA anticipated making around 10 awards. The listing shows an award ceiling of 0, which typically indicates that a fixed maximum was not specified in that summary field rather than implying no funding; the detailed notice of funding opportunity would normally provide budget guidance and expectations. Eligibility is categorized broadly as "Others," with further clarification referenced in the full eligibility text, implying that applicants could include a range of organizations involved in HIV care and supportive services, depending on the specific criteria in the full announcement.

In short, HRSA 22-028 is about funding practice-based demonstration sites that can implement and refine integrated, aging-focused HIV care strategies, study how those strategies are adopted in real settings using an implementation science approach, measure their impact, and produce practical guidance that can be spread across the HIV care system.

• The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Emerging Strategies to Improve Health Outcomes for People Aging with HIV: 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 Oct 26, 2021.
• Applicants must submit their applications by Jan 25, 2022. (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: Others (see text field entitled Additional Information on Eligibility for clarification).

Apply for HRSA 22 028

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