The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced a new funding opportunity that will support up to three pilot sites to take a syndemic approach to services by integrating behavioral health, HIV, and other services that are delivered outside for unsheltered racial and ethnic minority individuals using a portable clinical care approach. The pilot sites will be required to deliver a core package of services that includes basic primary healthcare; infectious disease prevention, testing, and treatment; substance use disorder (SUD) treatment; mental healthcare; and harm reduction services.

The Integrated Behavioral Health and HIV Care for Unsheltered Populations Pilot Project (Short Title: Portable Clinical Care Pilot Project) is supported with resources from the Minority HIV/AIDS Fund, which is administered by the HHS Office of Infectious Disease and HIV/AIDS Policy. SAMHSA’s Center for Substance Abuse Treatment will manage the program. Funded projects may last up to three years. In FY2023, $2 million is available to support the pilot sites. Applications are due by July 24, 2023.

Program Purpose

Through the Portable Clinical Care Pilot Project, SAMHSA aims to improve healthcare for people experiencing unsheltered homelessness while learning, through the experience of funded grant recipients, best practices for HIV, HCV, SUD, and mental health service delivery using portable clinical care. These best practices and lessons learned will be disseminated to the public following the pilot project.

Portable clinical care brings providers out of the clinic and into the places where people in need of services are, meeting unsheltered people outside, without judgment, and providing individualized whole-person care. In this model, clinical care teams provide healthcare directly on the street or in encampments, to help remove access barriers, and prevent individuals’ medical conditions from deteriorating to the point of needing emergency care. Through this funding opportunity, recipients will provide behavioral healthcare, infectious disease services, and primary care services that address many of the reasons unsheltered individuals do not engage with the healthcare system. Successful applicants will be required to provide ample and timely services on-site, outside, at the point of contact, with minimal referrals, wait times, or consecutive appointments to reduce access to barriers and increase direct service delivery.

This program will advance efforts that support communities in taking action to achieve the goals of the National HIV/AIDS Strategy, Ending the HIV Epidemic in the U.S. initiative, STI National Strategic Plan, Viral Hepatitis National Strategic Plan, HHS Overdose Prevention Strategy, All In: The Federal Strategic Plan to Prevent and End Homelessness, and the ALL INside Initiative, a first-of-its kind initiative to address unsheltered homelessness across the country.

Required Core Services

Recipients will be expected to take a syndemic approach to healthcare delivery by providing the following care and services using a portable clinical care approach to people experiencing unsheltered homelessness:

• Low barrier services SUD treatment
• Mental health screening, treatment, and referral
• HIV testing, treatment, and prevention services, including condom and PrEP distribution
• Screening, testing, prevention, and/or treatment for other infectious diseases including sexually transmitted infections (STI), viral hepatitis, mpox, and tuberculosis, as appropriate
• Harm reduction services, including providing evidence-based harm reduction education, supplies, and services on-site and distributing FDA-approved overdose reversal medication, drug supply testing (e.g., fentanyl and xylazine test strips), and providing overdose prevention education
• Basic primary care, including wound care and health screenings (i.e., blood pressure, diabetes)
• Outreach and case management services to address social determinants of health, including housing through required collaborations with HUD’s local Continuum of Care and Housing Opportunities for People With AIDS (HOPWA) programs.

A variety of additional optional activities are allowable, but not required, so that funded pilot sites can tailor their services package to meet the needs of their population(s) of focus.

Application Information

Two awards will be made to applicants serving people experiencing unsheltered homelessness in urban areas, and one award will be to an applicant serving people experiencing unsheltered homelessness in rural areas, pending sufficient application volume. Priority (10 additional points) will be given to applicants that certify they will implement the required activities in the ALL INside Initiative jurisdictions: Chicago, Dallas, Los Angeles, Phoenix, Seattle, and the state of California.

Access the NOFO and application package.