1. Alisha Barrett Ryan White Part A Grantee Clark County Social Service

2. Ryan White
Ryan White was diagnosed with AIDS at age 13. He and his mother Jeanne White Ginder fought for his right to attend school, gaining international attention as a voice of reason about HIV/AIDS. In 1990, at the age of 18, Ryan White died, just months before Congress passed the AIDS bill that bears his name – the Ryan White CARE Act.

3. Basics of Ryan White hiv/aids Program
An Overview
The majority of Ryan White funds support medical care and essential support services. Ryan White funds are the payer of last resort, as required by Congress. Also, a smaller, but equally critical, portion funds technical assistance, clinical training and research on innovative models of care.

4. Basics of Ryan White HIV/AIDS Program
The Ryan White legislation created a number of programs, called Parts, to meet needs for different communities and populations affected by HIV/AIDS.
Part A: provides emergency assistance to Eligible Metropolitan Areas and Transitional Grant Areas that are most severely affected by the HIV/AIDS epidemic.
Part B: provides grants , including ADAP assistance, to all 50 States and U.S. Territories.
Part C: provides primary health care in an outpatient setting for people living with HIV disease.
Part D: provides outpatient health care for women, infants, children and youth with HIV/AIDS.
Minority AIDS Initiative (MAI): provides funding to evaluate and address the disproportionate impact of HIV/AIDS on minorities.

5. How does this relate to the Las Vegas area?

6. Part A Program Eligible Metropolitan Area (EMA):
2,000 new AIDS cases in the last 5 years
Population of at least 50,000 persons
Transitional Grant Area (TGA):
1,000 – 1,999 new AIDS cases in the last 5 years
Las Vegas Area

7. Las Vegas TGA

8. History of Las Vegas Part A TGA
Las Vegas Part A TGA includes:
Nye County, Nevada
Clark County, Nevada
Mohave County, Arizona
Las Vegas EMA was established in 1998
Reclassified from an EMA to a TGA in 2005
Chief Executive Officer (CEO) is Chair of the Clark County Commission
Clark County Social Service has been designated by CEO to manage Part A grant funds

9. Ryan White CARE Act and Affordable Care Act
The federal Ryan White CARE Act legislation was originally authorized by Congress in The authorization of the Affordable Care Act has altered the role of the Ryan White Program.

11. ASSESSMENT
Assess service needs and gaps in state and local systems for HIV care, including special populations.
Assess capacity and training needs of the workforce to provide comprehensive system of care for People Living with HIV.
Assess Models of Care and services required to care completion.
Assess and monitor the public health impact of the HIV disease.

12. POLICY
Provides Federal leadership on State and local initiatives that impact People Living with HIV.
Establish Federal HIV care and treatment policy guidelines that safeguards public health and ensures continued progress in the goal of a AIDS Free generation.
Engage State and locate entities in partnership to realize an AIDS Free generation.

13. CAPACITY DEVELOPMENT
Train the health care workforce to provide high quality HIV care and treatment.
Ensure capacity of state and local systems to meet the care and treatment needs of People Living with HIV.
Support the Health Information Technology to increase quality and capacity of care.
Provide technical assistance to support the provision of evidence-based Models of Care.

14. QUALITY ASSURANCE
Establish and monitor the HIV quality measures/indicators to assure high-quality care that adheres to DHHS standards of care.
Collect, analyze, evaluate and report on health outcomes of People Living with HIV to improve and advance the treatment of care.
Assure the availability of HIV care and treatment across the nation.

15. ACTION STEPS
Align client eligibility determination with Marketplace enrollment periods
Reduce burden by using AGI
Collect Marketplace/Medicaid notice of eligibility determination for annual RWHAP recertifications
Be able to document process for pursuing enrollment
Establish methodology for conducting Marketplace cost-effectiveness

16. Part A Federal Grant Funds
Ryan White Funding
Part A Federal Grant Funds
Part A federal grants include two parts, Formula and Supplemental.
Formula grants are based on reported living HIV/AIDS cases as of December 31 in the most recent calendar year for which data is available from the Center for Disease Control
Supplemental grants are awarded competitively on the basis of demonstrated need and other criteria determined by the federal government

17. Part A Federal Grant Funding Flow Chart
Congress passes Ryan White Legislation and awards funding
Health Resources and Services Administration (HRSA) manages Federal Grant
Federal Grants are awarded to areas that qualify as a Part A, and MAI

18. Las Vegas TGA Part A Funding Flow Chart
HRSA awards federal grant to Las Vegas TGA’s CEO
CEO (Chair of Clark County Commission) accepts federal grant funds
Clark County Social Service (CCSS) manages federal grant
CCSS contracts funds with local providers

19. Las Vegas TGA Part A Funding
Federal grant funds include
85% Direct Services
10% Administration
5% Clinical Quality Management
Las Vegas Grant Amount Part A
Grant Year $4,998,237.00
Las Vegas Grant Amount MAI
Grant Year $341,702.00
Funding contracted to Providers
90% Direct Service

20. Ryan white part A services
Core and Support Services
Part A funds may be used to provide a wide variety of medical and support services for people living with HIV disease. Services categories and definitions are mandated by Ryan White Legislation.

21. Ryan White Part A Core Services
The Las Vegas TGA is required to allocate at least 75% of the award amount on Core Medical Services per legislation.
Outpatient/Ambulatory Medical Care
AIDS Pharmaceutical Assistance
Oral Health Care
Early Intervention Services
Health Insurance Continuation
Medical Nutrition Therapy
Hospice Services
Home/Comm Based Health Services
Mental Health Services
Substance Abuse Outpatient Care
Home Health Care
Medical Case Management
Core Services Include:

22. Ryan White Part A Support Services
The Las Vegas TGA is required to allocate no more than 25% of the award amount on support services. All support services must be linked to medical outcomes per legislation.
Support Services Include:
Case Management (non-medical)
Child Care Services
Emergency Financial Assistance
Utilities
Housing
Food
Medication
Food Bank/Home Delivered Meals
Health Ed/Risk Reduction
Housing Services
Treatment Adherence
Legal Services
Linguistics Services
Medical Transportation Services
Outreach Services
Permanency Planning
Psychosocial Support Services
Referral: Healthcare/Supp Service
Substance Abuse (Residential)
Rehabilitation Services
Respite Care

23. Priority Setting & Resource Allocation GY 2013-2014

24. Las Vegas Part A TGA
Services Today
The Las Vegas TGA provides comprehensive medical and support services to people living with HIV disease that are eligible for the Ryan White Part A Program.

25. Las Vegas Part A TGA Service Providers
March 1, 2014 – February 28, 2015
Aid for AIDS of Nevada
1120 Almond Tree Lane
Las Vegas, NV 89104
(702)
AIDS Healthcare Foundation
1815 E. Lake Mead Blvd. STE113
North Las Vegas, NV 89030
(702)
3201 S. Maryland Parkway STE 218
Las Vegas, NV 89109
(702)
Community Counseling Center
714 E. Sahara Ave #101
Las Vegas, NV 89104
(702)
Community Outreach Medical Center
1140 Almond Tree Lane, Suite 306
(702)
Golden Rainbow
801 S. Rancho Dr. Suite B-1B
Las Vegas, NV 89106
(702)

26. Las Vegas Part A TGA Service Providers
March 1, 2014 – February 28, 2015
North Country Healthcare
1510 Stockton Hill Road
Kingman, AZ 86401
(928)
Nye County Health & Human Services
1981 E. Calvada Blvd. North STE#120
Pahrump, NV 89048
(775)
Southern Nevada Health District
Sexual Health Clinic
400 Shadow Lane STE 106
Las Vegas, NV 89107
(702)
UMC Wellness Center
701 Shadow Lane, Suite 200
Las Vegas, NV 89106
(702)
UNLV School of Dental Medicine
1700 W. Charleston Blvd. Bldg A
(702)

27. Ryan White Program 2013 and Beyond
Ryan White did not see legislative action in 2013
Appropriations/debt ceiling/sequestration taking up much of legislative discussion and debate
Committees have other priority areas that MUST be worked on
Need real information about how Affordable Care Act (ACA) will impact Ryan White clients
Ryan White’s authorization will lapse BUT program will continue to be funded and implemented
Ryan White recipient organizations continue to teach Members of Congress and their staff on importance of Ryan White post-ACA implementation

28. How you can get involved
Las Vegas TGA Planning Council
Planning Councils are a legislatively mandated group. They play a key role in providing a comprehensive system of care for people living with HIV.

29. Las Vegas Part A TGA Planning Council
Roles and Responsibilities
Develop Operating Policies & Procedures
Assess needs of TGA
Develop comprehensive plan
Set priorities and allocate resources to core and support service categories
Help ensure coordination of services with other HIV- related services
Assess the administrative mechanism
Develop standards of care

30. Las Vegas Part A TGA Planning Council
If you would like to learn more about our Planning Council please visit:

31. Las Vegas Part A TGA Planning Council Upcoming Meeting
Meeting Specifics:
Date: May 28, 2014
Time: 10:00 am – 12:00 pm
Location: Clark County Social Service
3rd Floor Training Room
1600 Pinto Lane
Las Vegas, NV 89106
Questions:

32. Questions?? Las Vegas Part A TGA Alisha Barrett Grant Administrator