Rural Syringe Access Program Accelerator Fund #22567506

Overview

The overall purpose of this Colorado Department of Public Health and Environment (CDPHE) Request for Applications (RFA) is to solicit responses to support the delivery of services to prevent the acquisition of human immunodeficiency virus (HIV), viral hepatitis (VH), sexually transmitted infections (STIs) and preventable fatal overdose in rural and frontier Colorado. Additionally, this RFA will support the establishment of much needed harm reduction services in underserved regions of Colorado. 

The increasing number of people who inject drugs (PWID) due to the opioid crisis has led to a surge in fatal overdoses, rise in hepatitis C virus (HCV) infections, and threatens HIV/STI prevention efforts. PWID are highly vulnerable to acquiring viral hepatitis, human immunodeficiency virus (HIV), and bacterial or fungal infections, which can require costly and prolonged medical care. Also regardless of the route of administration (ROA), people who use drugs (PWUD) continue to die of preventable overdose. According to a prediction model identifying Colorado counties vulnerable to an HIV/HCV outbreak related to injection drug use (IDU), identified counties are rural and had a high burden of prescription opioid and heroin-related mortality. Due to the complexity of comorbidities often present in PWUD, linkage to care, especially in more rural communities, presents a huge challenge.

Syringe access programs (SAP) effectively reduce infectious disease, distribute overdose prevention tools and serve as excellent connections to care for PWUD. SAPs are highly effective, cost-saving community-based harm reduction programs that can fit the needs of any community- rural, frontier, or urban. SAPs are a trusted entrypoint to services like naloxone, syringes, vaccination, testing, and linkage to substance use disorder (SUD) treatment and infectious disease care. According to CDC, PWUD who access SAPs are five times more likely to enter SUD treatment and three times more likely to stop using drugs than those without access to SAPs. In Colorado, as of February 2024, there are 22 SAPs. Two-thirds of all Colorado SAPs are concentrated in urban counties near population centers and along the highway corridors. Rural and frontier areas lack access to healthcare, SUD treatment, testing, and SAPs. Implementing SAPs in rural areas especially can be challenging due to the regional variation in policies, politics, and resources. Colorado legislation limits SAP launch and expansion based on agency and experience. Agencies with none to little experience need capacity building, technical assistance, and start-up fiscal support to be successful. Partnerships with law enforcement, boards of health, county commissioners, and community organizations are critical to the success of SAP implementation.

To address this unique public health issue, CDPHE received funding from the Attorney General’s Innovation Grant Program utilizing Opioid Settlement Funds to specifically support up-and-coming SAPs in rural and frontier areas to assist with launch or expansion efforts. In line with the Colorado Opioid Abatement Council’s Memorandum of Understanding, this program will support prevention, harm reduction and care continuum efforts as it relates to opioid abatement.

Read the full RFA document. - updated 5/9/2024 

Reference documents

• Appendix A: Additional Tools and Guidance
• Appendix B: Definition of Terms

Application template documents

• Attachment A: CDPHE RFA Cover Sheet and Signature Page
• Attachment B: Application Checklist
• Attachment D: Work Plan
• Attachment E: Budget
• Attachment F: Financial Risk Assessment Questionnaire (if applicable)
• Attachment G: Sustainability Plan

Questions and recordings

• 5/1/2024 Pre-Application Informational Conference Call
  • Presentation
  • Meeting video recording
  • Meeting audio recording
• 5/9/2024 Responses to written questions and description of RFA updates

Timeline