In the past year, the implementation of the Affordable Care Act and redesign of New York State's Medicaid program have created a dramatic shift in the HIV/AIDS services field. Many small and mid-sized community-based organizations are unprepared to respond to the changes—and risk loss of funding and closure. Through this grant, the New York City AIDS Fund will offer an intensive learning collaborative for up to 20 HIV/AIDS service organizations to ensure that they understand the technical aspects of health reform and to help them build the skills and infrastructure needed to serve HIV/AIDS clients under new financial incentives and a changed payment structure.