1. Ryan White Part A Program Update Health & Family Services Department Presentation to the Board of County Commissioners June 12, 2007

2. Ryan White Part A Program Update Presentation Outline History Governance Disease Trends Clients Served Program Challenges

3. Ryan White Part A History

4.  Federal Program enacted 1990  Orange County has been funded since 1994  2006 reauthorization renamed the Ryan White HIV/AIDS Treatment Modernization Act (Part A):  Changed emphasis from acute care & support to longer term care  Funding formula changed to include HIV cases as well as AIDS

5. Ryan White Part A History Funding of last resort for people living with HIV/AIDS tied to medical outcomes Serves Orange, Osceola, Lake and Seminole Counties FY 06/07 funding: $8,579,297 Current year funding: $7,483,770 does not include Minority AIDS Initiative (MAI) grant which is pending ($925,000 MAI funding requested)

6. Ryan White Part A Services Include Outpatient Medical Care Drugs Medical case management Dental Early Intervention/testing Transportation to medical care Food & nutritional supplements Mental health/substance abuse counseling, psychosocial support Insurance assistance New act: 75% core services

7. Ryan White Part A Governance

8. HIV Health Services Planning Council  Appointed by Mayor  Represents specified parts of community  Orange County supports Council  Sets priorities for services and allocates funding  Ryan White office contracts for services

9. Ryan White Part A Disease Trends

10. New HIV drugs allow persons living with AIDS to remain relatively healthy, employed and self-sufficient Disease rate higher in Minority Communities  Emphasis on getting people into care and keeping them in care

11. Ryan White Part A Disease Trends  Incidence of new cases of HIV in the U.S. has not changed  Approximately 40,000 new cases per year  25% of persons infected do not know their status  Don’t seek care  May infect others

12. Ryan White Part A Clients Served

13. Ryan White Part A Disease Trends  This Eligible Metropolitan Area (EMA) Includes Orange, Osceola, Lake and Seminole Counties. A total of 11,572 people who are HIV positive and are aware of their status live in this EMA.  76% of this total live in Orange County (8,799)  61% are minorities

14. Ryan White Program Disease Trends

15. Incidence by Race/Ethnicity 0 10 20 30 40 50 Black WhiteHispanic Other % Incidence

16. Ryan White Part A Disease Trends % of minorities served is greater than or = to their % of persons infected with HIV 0 10 20 30 40 50 Black WhiteHispanic Other % Incidence % Clients

17. Ryan White Part A Trends Title I Funding Grant Funding 6,800,000 7,000,000 7,200,000 7,400,000 7,600,000 7,800,000 8,000,000 2003 2004 2005 2006

18. Ryan White Part A Program Challenges

19. Ryan White Part A Challenges  Provide medical care, drugs and support services to newly diagnosed patients  Provide services for patients with advanced stages of the disease who have greater disabilities  Address barriers to receiving care

20. Ryan White Part A Challenges  Ensure disproportionately impacted and underserved populations are equitably served  Increase capacity building  Maintain funding while serving more clients  Emphasis on medical treatment versus support services (75% medical/25%support required by Federal Grant)

21. Ryan White Part A Challenges  Develop quality management systems to insure and document program success  Develop services for a “chronic disease management system” designed to maintain health and self-sufficiency

22. Ryan White Part A Program Update Health & Family Services Department Presentation to the Board of County Commissioners June 12, 2007