The Ryan White The Ryan White HIV/AIDS Treatment HIV/AIDS Treatment Modernization Act of 2006Modernization Act of 2006

August 2008Council of Community ServicesVirginia HIV/AIDS Resources & Consultation Center

The LegislationThe Legislation

The Ryan White Comprehensive AIDS Resource Emergency Act of 1991Renewed in 1996 and 2000

The Ryan White HIV/AIDS Treatment Modernization Act of 2006Transitional legislation: expires 9/30/2010Focus on changing needsEmphasis on medical care over support services.

The Ryan White ProgramThe Ryan White Program Part A Localities (Formerly Title I) Part B States & Territories (Formerly Title II) Part C Early Intervention (Formerly Title III) Part D Pediatric/Family (Formerly Title IV) Part F Special Projects of National Significance

AIDS Education & Training CentersMinority AIDS InitiativeDental Program

75% of funds must go to core medical services

Part B Federal Grants to StatesPart B Federal Grants to States

AIDS Drug Assistance Program Funds for HIV-related medications

Virginia Department of Health

(800) 533-4148

Regional Consortia Provides funds for local Consortia (Medical & Support)

Southwest/Piedmont HIV Care Consortium, Roanoke

(540) 985-0131/(800) 354-3388

Part C Federal GrantsPart C Federal Grants

Primary Care GrantsComprehensive primary care for people living with HIV

Carilion Clinic, Roanoke (540) 981-7715

Centra Health Inc, Lynchburg (434) 947-3945

Part FPart F

AIDS Education & Training Centers (AETC)

Funds to conduct education & training for health care providers

Inova Juniper program (703) 321-2672

VCU HIV/AIDS Center (804) 828-2473

Southwest/PiedmontSouthwest/PiedmontHIV Care ConsortiumHIV Care Consortium Founded in 1991 to respond to a request

for proposals from the Virginia Department of Health

Operational year: April 1 - March 31 Current budget: $1,406,798

– Administration: $129,040 09.17%– Planning: $57,758 04.11%– Client Services: $1,220,000 86.72%

S/PHCC, ContinuedS/PHCC, Continued

Is made up of– Lead Agency ( VDH Contractor)– Subcontractors– Organizations interested in the care of

HIV disease– Individuals infected and/or affected by

HIV disease

S/PHCC CommitteesS/PHCC Committees

Client CommitteeCase Management CommitteePolicy CommitteeQuality Improvement CommitteeSOP Committee

S/PHCC Client EligibilityS/PHCC Client Eligibility

Eligibility Requirements of Part B– HIV infected or affected person– Low income (VA: 300% of Federal poverty)– Service not covered by health insurance or– Service has cost sharing component (co-pay).– Payee of last resort– ADAP Medications for co-pays only

S/PHCC Client Eligibility, ContS/PHCC Client Eligibility, Cont

Restrictions & Special Conditions– Part B services must be HIV-related– V.A. & Medicare Part D exempt from payee of last resort– Ambulatory/Outpatient services only– Incarcerated clients not eligible– Outreach services are case finding activities– Part B income levels vary by state (125% - 510% FPL)– Routine Doctor visits must include a prevention

message– Women, Infants, Children & Youth (WICY) are a priority– Billing must be completed by May 30 of each year

– Emergency Room visits not covered

S/PHCC Client ServicesS/PHCC Client Services

Provided by 7 local subcontractors– Appalachian Assistance Coalition– Carilion Clinic– Centra Health– New River Health District– Roanoke/Alleghany Health Districts– Piedmont Access To Health Services–West Piedmont AIDS Task Force

S/PHCC Services, ContinuedS/PHCC Services, Continued

Core Services– Outpatient /Ambulatory health services – AIDS pharmaceutical assistance – Oral health care –Mental health services –Medical case management – Substance abuse services, outpatient

S/PHCC Services, ContinuedS/PHCC Services, Continued

Support Services– Case management (non-medical) –Medical transportation services – Substance abuse services - residential

2007-2008 Year-End Data2007-2008 Year-End Data

YTD 0708 0607 Clients Served (606) 791 (708)

New Intakes: ( 20 ) 109 ( 94 ) Returned to Care: ( 6 ) 41 ( 24 ) Discharged: ( 21 ) 34 ( 43 ) Deceased: ( 3 ) 19 ( 24 ) Lost to Care?

2007-2008 Subcontractors2007-2008 Subcontractors

YTD 0708 0607 AAC ( 55 ) 61 ( 69 ) CCHS (185) 284 (245) CH (146) 216 (212) NRHD ( 24 ) 27 ( 29 ) PATHS ( 92 ) 118 ( 77 ) R/AHD (190) 305 (266) WPATF( 36 ) 45 ( 35 )

SPHCC(606) 791 (708)

2007-2008 WICY2007-2008 WICY

WICY = Women, Infants, Children & Youth YTD 0708 0607 YTD 0708 0607

Women: (195) 254 (222) (32) 32 (31) % ( Men ) (411) 537 (486) (68) 68 (69) % Infants: ( 0 ) 0 ( 0 ) (00) 0 (00) % Children: ( 0 ) 2 ( 1 ) (00) <1 (<1) % Youth: ( 12 ) 21 ( 19 ) (02) 3 (03) % Total: (200) 264 (233) (33) 33 (33) %Children = 13 & under Youth = 13-24