Become a Provider
Provider Application Process
Public or private non-profit organizations are eligible to apply for funding through the Ryan White HIV Services Program. Non-profit service providers must be able to document proof of non-profit status through appropriate documentation (i.e., a Letter of Determination issued by the Internal Revenue Service stating non-profit status). If a service provider does not wish to enter into a long-term contractual agreement for service provision, other options, such as a memorandum of understanding or business associates agreement may be discussed with the Ryan White HIV Services Program Director.
See the current Ryan White HIV Services Program providers here.
Application Materials for Service Provision (for all agencies and organizations seeking funds, regardless of current RWSP funding status)
- The following 4 documents are required to be completed for application for Part A/MAI funds for 2022-2023: Part A/MAI Request for Professional Services 2023-2024; Attachment A-Cost per unit template (this is an example); Attachment B-Requested Service Form; Attachment C-Budget Forms; Attachment D-Time and Effort Form for Subrecipients. The following 2 documents are for reference in completing the Request for Professional Services: PCN 16-02 HRSA Service Definitions; CAREWare Data Requirements (HRSA dot grid).
The following documents provide information on Program Income and are useful reference materials for preparation of applications:
- HRSA PCN 15-03, Program Income
- HRSA PCN 15-04, Pharmaceutical Rebates
- HRSA PCNs 15-03 and 15-04, Frequently Asked Questions
- Program Income Guidance and FAQs for Ryan White Part B and Parts A/C/MAI, Update
- Program Income Infographic
- Imposition of Charges Infographic
- Program Income Tracker Template IDOH-MCPHD
- Program Income Spending Plan Template for Part B and Parts A/C/MAI
There will be an online informational meeting for applicants on October 21, 2022 from 10am-11am. Instructions to join by Webex are included on page one of the Part A/MAI Request for Professional Services 2023-2024 posted above. Proposals for Part A/MAI funds for 2023-2024 must be emailed to firstname.lastname@example.org no later than 12:00P.M. (Noon), November 18, 2022. It is essential that all requested information is received by the deadline date and time. Proposals received after the deadline will not be considered for funding.
If you have questions regarding this Request for Professional Services, please contact:
Resources/Documents for Current Providers