The Ryan White HIV/AIDS Treatment Modernization Act of 2006 August 2008 Council of Community Services Virginia HIV/AIDS Resources & Consultation Center

The Legislation The Ryan White Comprehensive AIDS Resource Emergency Act of 1991 Renewed in 1996 and 2000 The Ryan White HIV/AIDS Treatment Modernization Act of 2006 Transitional legislation: expires 9/30/2010 Focus on changing needs Emphasis on medical care over support services.

The Ryan White Program Part ALocalities (Formerly Title I) Part B States & Territories(Formerly Title II) Part CEarly Intervention(Formerly Title III) Part DPediatric/Family(Formerly Title IV) Part FSpecial Projects of National Significance AIDS Education & Training Centers Minority AIDS Initiative Dental Program 75% of funds must go to core medical services

Part B Federal Grants to States AIDS Drug Assistance Program Funds for HIV-related medications Virginia Department of Health (800) Regional Consortia Provides funds for local Consortia (Medical & Support) Southwest/Piedmont HIV Care Consortium, Roanoke (540) /(800)

Part C Federal Grants Primary Care Grants Comprehensive primary care for people living with HIV Carilion Clinic, Roanoke (540) Centra Health Inc, Lynchburg (434)

Part F AIDS Education & Training Centers (AETC) Funds to conduct education & training for health care providers Inova Juniper program (703) VCU HIV/AIDS Center (804)

Southwest/Piedmont HIV 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, % –Planning: $57, % –Client Services:$1,220, %

S/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 Committees Client Committee Case Management Committee Policy Committee Quality Improvement Committee SOP Committee

S/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, 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 cover ed

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

Year-End Data YTD 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?

Subcontractors YTD 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)

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