The City and County of San Francisco, through the Department of Public Health (DPH), approved Amendment No. 4 to its agreement with Project Open Hand. This amendment increases the contract amount by $1,727,928, bringing the new total to $20,528,272. The agreement is for the provision of HIV/AIDS food and nutrition services to low-income HIV clients in San Francisco, with the contract term remaining from April 1, 2017, through March 31, 2027. Project Open Hand was selected via RFP 9-2017 to provide these vital services. The original agreement was valued at $6,258,690, with prior amendments increasing the total to $18,800,344. Services include medically tailored meals, groceries, nutrition assessments, and education aimed at improving the nutritional health of people living with HIV/AIDS. Project Open Hand annually serves over 350,000 meals and 70,000 grocery bags to approximately 2,800 individuals, offering free services with no waiting list. The program focuses on continuous quality improvement, adherence to food sanitation standards, and client satisfaction. Eligibility is based on HIV diagnosis, residency, and low-income status, now defined as 600% of the Federal Poverty Level.