Single Source Procurement: End of AIDS - Specialized Care Center PrEP Specialists

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

In June of 2014, Governor Cuomo announced a three-point plan to end the AIDS epidemic by reducing the number of new annual HIV infections below 750 by 2020. One of the cornerstones of this plan is the provision of pre-exposure prophylaxis (PrEP) to those at highest risk of contracting the virus in order to keep them HIV negative. Many community medical programs have expressed concerns about whether their medical staff will be able to provide adequate behavioral and adherence counseling needed for patients undergoing PrEP treatment, and have cited this concern in declining to initiate on-site PrEP programs.

Specialized Care Centers currently provide low-threshold clinical services to adolescents/young adults who are at high risk for HIV (aged 13-24 years). Services offered include HIV testing to adolescents/young adults whose status is unknown, along with STD testing and treatment, pregnancy testing, risk reduction counseling, family planning/reproductive health care and screening for Hepatitis and TB. An important focus of this model is prevention – connecting high risk youth who present to ongoing primary health care and needed psychosocial and supportive services. This enhancement will enable increased emphasis on prevention efforts with young adults. Grant enhancements would support a PrEP Specialist at each Specialized Care Center initiating the program. A PrEP Specialist would strengthen SCC services by:

  • Working with clinic staff to identify current patients appropriate for PrEP;
  • Educating potential patients about PrEP, and encouraging their participation in the program;
  • Providing behavioral and adherence counseling for clients receiving PrEP treatment;
  • Encouraging increased acceptance of PrEP by educating community residents and agencies about the clinic's program;
  • Conducting community outreach to increase the PrEP caseload;
  • Providing staff training for clinic personnel about PrEP; and
  • Ensuring patients are connected to and maintained in primary health care.

A review of newly diagnosed HIV cases by transmission risk from 2002-2012 (NYSDOH/AI/BHAE Dec. 2013) indicates the age group represents the majority of the newly diagnosed HIV cases. The effects of HIV chronic illness on quality of life for the infected and affected, the lifetime costs of treatment and care, combined with the potential increase reservoir for transmission of HIV, demands a public health response to address the health needs of this age group. The grant enhancements will allow for increased outreach to engage high risk adolescents/young adults in primary care and increase the number of adults (>18 years) on PrEP to avert new infections.

All state funded contractors that received awards through the AIDS Institute Specialized Care Centers Request for Applications OSC Code: 12000GLWB001 were offered an opportunity to initiate PrEP at the Specialized Care Centers through an enhancement to their contracts. These community medical providers are best situated to serve the target population. Responses were received from all twelve SCC contractors and eleven (11) of the twelve (12) providers agreed to initiate the program. The programs listed are established service providers in good standing with the AIDS Institute and able to easily implement the enhancement to existing services.

Procurement / Program Name End of AIDS - Specialized Care Center PrEP Specialists
Contractor Name(s) Multiple – Please see attached.
Contract Period 7/1/2014 – 6/30/2016
Contract Number(s) C027227 - C027238