Single Source Procurement: End of AIDS - Expansion of NYS HCV Screening

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.

On June 29, 2014, Governor Cuomo made an important announcement, in which he detailed a three-point plan to "Bend the Curve" and move us closer to the end of the AIDS epidemic in New York State. The goal is to reduce the number of new HIV infections to just 750 (from an estimated 3,000) by 2020.

The three-point plan includes:

  1. Identifying persons with HIV who remain undiagnosed and linking them to health care;
  2. Linking and retaining persons diagnosed with HIV in health care and maintaining them on antiretroviral therapy to maximize HIV viral load suppression so they remain healthy and to prevent further transmission; and
  3. Facilitating access to Pre-Exposure Prophylaxis (PrEP) for high-risk HIV negative persons.

The AIDS Institute is requesting to amend contract C029348 with The Foundation for AIDS Research (FAR) to allow for one-time additional HCV screening for local county jails outside of NYC. HIV and HCV are both transmitted through high risk behaviors, such as injection drug use (IDU). Up to one-third of people infected with HIV are co-infected with HCV. Making people aware of their HCV status will also assist in eliminating HIV.

The prevalence of hepatitis C virus (HCV) infection in incarcerated individuals is estimated to be 23.1% to 41.2%. (Chak E., et. al.) Individuals who are incarcerated are more likely to participate in high-risk behavior for HCV infection, including IDU, tattoos from non-licensed providers, and prostitution. In addition to their increased risk prior to incarceration, inmates are also at higher risk for becoming infected during incarceration, mostly from tattoos received in prison and continued use of injection drugs while incarcerated.

Recognizing the limited budgets of county jails and that the HCV prevalence among this population is higher than that of the general population, additional funding will support the expansion of the NYS HCV Screening Program to local county jails outside of NYC. On September 16, 2009, L. 2009, Ch.419 went into effect, adding a new subdivision 26 to New York State Public Health Law Section 206. Under this law, correctional facility policies and practices regarding HIV/AIDS and hepatitis C prevention and treatment must be consistent with current, generally accepted standards and procedures used to prevent transmission and provide treatment among the general public. The law went into effect with regard to local jails in September 2011. Since that time, the AIDS Institute has been providing guidance to county jails on HIV and HCV health care, including HCV screening.

According to the guidance, the expectation regarding hepatitis C relates primarily to screening (specifically HCV antibody testing), education, and linkage to diagnostic testing and care upon release for those that screen positive. During the initial health assessment, HCV testing is to be offered to every inmate in accordance with New York State HCV Testing Law. The HCV Testing Law requires the one-time offer of an HCV screening test to all persons born between 1945-1965. HCV screening should also be offered to those with an identified risk or symptoms and, as applicable, should take place during the mandated medical evaluation within 14 days of incarceration. Screening should also be done for those inmates requesting to be tested. All inmates who test positive must be provided an appointment for HCV medical care.

The goals of the county jail HCV screening initiative are to: 1) increase the number of people that know their HCV status; 2) increase the number of HCV positive persons that get linked to HCV care and treatment; and 3) better understand the HCV prevalence in NYS local county jails. The goals will be achieved by providing free HCV rapid antibody test kits and controls to county jails interested and have the infrastructure to conduct HCV rapid testing.

This contract was previously awarded as the result of an OSC-approved non-competitive procurement process. This one-time funding increase will utilize the same terms, conditions, and pricing authorized under the existing contract.

Procurement / Program Name End of AIDS - Expansion of NYS HCV Screening
Contractor Name(s) Foundation for AIDS Research
Contract Period 4/1/2014 - 3/31/2019
Contract Number(s) C029348