HIV / AIDS Programs

Legislation

 

The Ryan White HIV/AIDS Program is the largest Federal program focused exclusively on HIV/AIDS care. The program is for individuals living with HIV/AIDS who have no health insurance (public or private), have insufficient health care coverage, or lack financial resources to get the care they need for their HIV disease. As such, the Ryan White HIV/AIDS Program fills gaps in care not covered by other funding sources.

Overview of the Ryan White Legislation

The legislation authorizes programs, called Parts.  The purpose is to provide a flexible structure under which this national program can address HIV/AIDS care needs on the basis of:

• Different geographic areas (large metropolitan areas, States, and communities across the Nation)
• Varying populations hit hardest by the epidemic
• Types of HIV-AIDS-related services, and
• Service system needs (e.g., technical assistance for programs, training of clinicians, research on innovative models of care).

Legislative provisions (called Sections) address, for example, planning and decision-making, type of grants that are available, what funds may be used for, requirements for entities submitting applications for funding, and available technical assistance to help programs run more effectively.

The Ryan White HIV/AIDS Program is administered by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB).

Highlights of the 2009 Ryan White Legislation

Following is a summary of select provisions in the 2009 legislation, with references to key changes from the 2006 legislation.

• The 2009 Ryan White legislation continues the Ryan White HIV/AIDS Program through fiscal year 2013. Authorization levels increase 5 percent for each fiscal year but are dependent on annual appropriations.
• Minority AIDS Initiative (MAI) funds under Parts A and B will be distributed according to a formula (based on the distribution of populations disproportionately impacted by HIV/AIDS), a change from the former competitive process. Also, MAI awards now coincide with grant cycles under each Part.
• Under Part A, the law continues issuance of grant awards to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs). For TGAs that lose their eligibility status, the State in which the former TGA is located shall receive incremental transfers of funding for three years.
• In addition to existing Part A planning council responsibilities, the law adds a new requirement to determine not only the size and demographics of HIV/AIDS infected individuals but also those individuals who are unaware of their HIV status. One-third of Part A supplemental grants are to be based on the area’s ability to demonstrate its success in identifying individuals with HIV/AIDS who are unaware of their status and bringing attention to their status.
• Part A and Part B grantees must develop comprehensive plans that include a strategy for identifying individuals with HIV/AIDS who do not know their status and helping them seek medical services. The strategy must focus on reducing barriers to routine testing and disparities in access to services for minorities and underserved communities.
• The law continues hold harmless protections for Part A and Part B grantees for fiscal years 2009-2013.
• Part A and B grantees currently using code-based data reporting will have three more years to convert to names-based data reporting. Penalties will remain for Part A and Part B areas that report code-based data in fiscal years 2009 through 2012. In fiscal year 2013, only name-based data reporting will be accepted.
  The law makes adjustments in Part A and Part B unobligated balances (UOB) provisions. It retains the three penalties, but with some changes. The trigger for the penalty provisions changed from 2% to 5% of unobligated formula funds. If triggered, grantees are subject, in a future year, to: an offset of the amount of UOB less the amount of approved carryover, a reduction of the amount of UOB less the amount of approved carryover, and ineligibility for a supplemental award. Implementation of the UOB provisions was simplified by providing the Secretary with the option to offset unobligated funds rather than cancel those funds. 

In Southwest Florida, there is a state Part B program allocation, three (3) Part C programs, AETC opportunities, and access to Part D services. The Health Planning Council of Southwest Florida is the lead agency for the state of Florida in Area 8 for the Ryan White Part B program. The Florida Ryan White Part B program is administered through the Florida Department of Health, Bureau of HIV/AIDS. In the State of Florida’s Statewide Coordinated Statement of Need, there are seven (7) core services: Medical Care, Pharmaceuticals, Dental Care, Case Management, Health Insurance, Substance Abuse Treatment and Mental Health Treatment. In Area 8, the local planning body – Regional HIV/AIDS Council (RHAC) – recommended funding priorities in-line with these core services. The RHAC makes funding priority recommendations to the Health Planning Council of Southwest Florida who in turn develops and implements programs to allocate the funding and serve those most in need.

   Housing Opportunities for Persons with AIDS (HOPWA)
The Housing Opportunities for Persons With AIDS, known as HOPWA, is funded through a grant from the Department of Housing and Urban Development (HUD) to provide states ("HOPWA") and designated eligible metropolitan areas (“HUD HOPWA") with resources and incentives for meeting the housing needs of persons with HIV disease and AIDS. The Department of Health, which contracts with lead agency organizations at the local level, administers Florida's HOPWA program. The state HOPWA program provides temporary housing assistance to eligible individuals. The services include: Transitional Housing, Assistance with Rent, Mortgage, Utilities and Supportive Services (such as Case Management).

Services are provided to income eligible individuals with documented HIV disease and their families. By coordinating HOPWA services through the Ryan White Part B consortia, HOPWA participants have ready access to a variety of support services that contribute to a stable housing situation. Services not approved include: payments which exceed actual costs, payments made directly to clients, cash payments of any kind (including checks made out to cash), property taxes that are not included in mortgage payments, long distance telephone charges, fines and penalties, down payment or closing costs on a home.

Area 8 includes “State HOPWA" in Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota counties. The Health Planning Council of Southwest Florida is the lead agency for this program.

State HOPWA Jul 10 – Jun 11
Total Direct Services	$ 1,062,402
Case Management	$ 197,606
Short Term Rent, Mortgage, and Utility Assistance	$ 790,428

AIDS Insurance Continuation Program (AICP)
The AIDS Insurance Continuation Program (AICP) is a statewide program for persons who are diagnosed with AIDS or are HIV positive with symptoms and who, because of their illness, are unable to maintain their private health insurance coverage. The program makes direct payments (up to $750/month) to each client's employer or insurance company for the continuation of medical, dental, mental health and optical coverage. The AICP does not pay for disability or life insurance. The AICP will also pay any fees associated with conversion of a COBRA policy to an individual policy or policy upgrades. The program will also pay client co-payments and deductibles on an as-needed basis.

The AICP is funded by Florida's Department of Health through a combination of federal and state monies. The overall program is managed by the Health Council of South Florida (Miami). It is administered through local community-based organizations (CBOs), including the Health Planning Council of Southwest Florida.