Ryan White CARE Act

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Ryan White CARE Act Reauthorization

• What you can do!
• Sue Rowland -- VORA
• September 20, 2005

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(No Transcript)
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The Problem

• Whats the future for HIV/AIDS Treatment funding?
• Or
• The canary is awfully sick

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Or

• The Ryan White C.A.R.E. Act provides significant
  levels of public funding for HIV/AIDS treatment
  services
• It is authorized by Congress for 5 years at a
  time
• The current authority for Ryan White funds
  expires on Sept 30, 2005

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• History
• Of theRyan White C.A.R.E. Act

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• First passed as the Ryan White CARE Act of 1990
  Public law 101-381
• Amended as the Ryan White CARE Act of 1996
• Again amended as the Ryan White CARE Act of 2000

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• The primary purpose of the Act is established by
  Congress -- in the Law.
• The details (the rules) are established by the
  federal agency assigned
• Administered by the Health Resources and Services
  Administration (HRSA)

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The Act is complex

• Title I -- Eligible Metro Areas (EMAs)
• Title II -- the States
• ADAP
• Title III -- Community-based care
• Title IV -- Family-centered care

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theres more

• Part F -- AETCs
• Part F -- Dental Reimbursement Program
• SPNS -- Special Projects of National Significance
• Community-Based Dental Partnership Program

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Total RWCA Funds
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Title I Funds
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Title II Funds
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Title III Funds
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Title IV Funds
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AETC Dental Funds
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Virginias awards

• Title I
• Washington DC EMA - 29,431,967
• Norfolk EMA - 4,726,063
• Richmond EMA - 241,396
• Title II
• State - 5,543,229
• ADAP - 15,188,795
• Minority AIDS Initiative - 112,908
• Emerging Communities - 241,396

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Virginia Awards

• Title III
• University of Virginia - 430,537 (05)
• Carilion Medical Center - 107,634 (05)
• Centra Health, Inc. - 55,170 (04)
• Title IV
• VCU/MCV - 309,777 (04)
• AETC
• Based in Richmond
• Dental
• None

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RWCA Problems

• Structure of the titles results in double
  counting PLWH/A
• Hold harmless - 90 provided to San Francisco
• Southern states receiving less funding
• Disproportionate distribution of funds

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President Bushs Principles
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The Presidents Principles

• Eliminate hold harmless
• Eliminate double-counting
• Develop severity of need for core services
  index (SNCSI)
• National ADAP core meds

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Presidents Principles (cont)

• 75 of Titles I - IV directed to essential cores
  services
• Change role/make-up of Title I Councils
• Use HIV data in distribution formula
• New routine voluntary HIV testing

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Sen. Tom Coburn leading the Reauthorization review

• Held Hearing in June 2005
• GAO Report on RWCA Factors that Impact HIV and
  AIDS Funding and Client Coverage
• Testimony provided to respond to GAO Report
  implications supports President

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Current Status of Reauthorization

• No bill yet introduced to Amend
• One bill continues the Title IV portion

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The Problem

• Every day, 4 new cases of HIV are found in
  Virginia every day
• One third of Va. PLWH/A are women
• Two thirds are African American
• Treating HIV/AIDS costs about 20,000 per person
  per year

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The Problem

• Funding has not kept pace with the growing number
  of persons living with HIV/AIDS in Virginia
• Waiting lists have developed in Virginia
• Funding is not even distributed where PLWH/A live

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The Problem

• During AIDS Watch, we learned that Virginias
  delegation not well aware of needs
• In Richmond, Virginias State Legislators are
  unaware of whats happening with federal funding
  for HIV/AIDS prevention treatment

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I Cant Lobby . .
Can I?
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You, the Agency

• Your leadership decides
• Lobbying IS allowable -- and limited.

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You, the Individual

• Does the source of your livelihood explicitly
  prohibit you from lobbying?
• Very few do
• How about implicit prohibitions?
• Know your Rights as an American Citizen.

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What are the Rules?
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Yes, You can

• Two Senators
• One Congressperson
• One State Senator
• One State Delegate

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• What do I say?

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Sources of Help

• www.VORAonline.org
• www.NASTAD.org
• www.NMAC.org
• www.NAPWA.org
• www.C2EA.org
• And many more .

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Efforts in VirginiaJoint Commission on Health
Care Study of Federal Funding for HIV/AIDS
prevention and treatment
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