Alisha Barrett

Ryan White Part A Grantee

Clark County Social Service

RYAN WHITE 101

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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.

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An Overview

BASICS OF RYAN WHITE HIV/AIDS PROGRAM

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.

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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.

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How does this relate to the Las Vegas area?

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Part A ProgramEligible Metropolitan Area (EMA):

2,000 new AIDS cases in the last 5 yearsPopulation of at least 50,000 persons

Transitional Grant Area (TGA):1,000 – 1,999 new AIDS cases in the last 5

yearsPopulation of at least 50,000 persons

Las Vegas

Area

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Las Vegas TGA

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History of Las Vegas Part A TGALas Vegas Part A TGA includes:

Nye County, NevadaClark County, NevadaMohave County, Arizona

Las Vegas EMA was established in 1998Reclassified from an EMA to a TGA in 2005Chief Executive Officer (CEO) is Chair of the

Clark County CommissionClark County Social Service has been

designated by CEO to manage Part A grant funds

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RYAN WHITE CARE ACT AND AFFORDABLE CARE ACT

The federal Ryan White CARE Act legislation was originally authorized by Congress in 1990. The authorization of the Affordable Care Act has altered the role of the Ryan White Program.

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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.

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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.

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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.

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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.14

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

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Part A Federal Grant Funds

RYAN WHITE FUNDING

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

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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

MAI17

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

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Las Vegas TGA Part A FundingFederal grant funds include

85% Direct Services 10% Administration 5% Clinical Quality Management

Las Vegas Grant Amount Part A Grant Year 2013-2014 $4,998,237.00

Las Vegas Grant Amount MAI Grant Year 2013-2014 $341,702.00

Funding contracted to Providers 90% Direct Service 10% Administration

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Core and Support Services

RYAN WHITE PART A 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.20

Ryan White Part A Core ServicesThe 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:

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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

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Priority Setting & Resource Allocation

GY 2013-2014

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Services Today

LAS VEGAS PART A TGA

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.

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Las Vegas Part A TGA Service Providers

• Aid for AIDS of Nevada1120 Almond Tree Lane Las Vegas, NV 89104 (702) 382-2326

• AIDS Healthcare Foundation

1815 E. Lake Mead Blvd. STE113North Las Vegas, NV 89030(702) 639-81103201 S. Maryland Parkway STE 218Las Vegas, NV 89109(702) 862-8075

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• Community Counseling Center714 E. Sahara Ave #101Las Vegas, NV 89104(702) 369-8700

• Community Outreach Medical Center

1140 Almond Tree Lane, Suite 306Las Vegas, NV 89104(702) 657-3873

• Golden Rainbow801 S. Rancho Dr. Suite B-1BLas Vegas, NV 89106(702) 384-2899

March 1, 2014 – February 28, 2015

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Las Vegas Part A TGA Service Providers

• North Country Healthcare1510 Stockton Hill RoadKingman, AZ 86401(928) 718-4530

• Nye County Health & Human Services

1981 E. Calvada Blvd. North STE#120Pahrump, NV 89048(775)751-7090

• Southern Nevada Health District

Sexual Health Clinic400 Shadow Lane STE 106Las Vegas, NV 89107(702) 759-0702

• UMC Wellness Center701 Shadow Lane, Suite 200Las Vegas, NV 89106(702) 383-2691

• UNLV School of Dental Medicine

1700 W. Charleston Blvd. Bldg ALas Vegas, NV 89106(702) 774-2451

March 1, 2014 – February 28, 2015

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

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Las Vegas TGA Planning Council

HOW YOU CAN GET INVOLVED

Planning Councils are a legislatively mandated group. They play a key role in providing a comprehensive system of care for people living with HIV.

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Las Vegas Part A TGA Planning Council

Roles and ResponsibilitiesDevelop Operating Policies & ProceduresAssess needs of TGADevelop comprehensive planSet priorities and allocate resources to core

and support service categoriesHelp ensure coordination of services with

other HIV-related servicesAssess the administrative mechanismDevelop standards of care

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If you would like to learn more about our Planning Council please visit: www.lasvegasema.org

Las Vegas Part A TGA Planning Council

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Las Vegas Part A TGA Planning Council Upcoming Meeting

Meeting Specifics:Date: May 28, 2014Time: 10:00 am – 12:00 pmLocation: Clark County Social

Service 3rd Floor Training

Room 1600 Pinto Lane Las Vegas, NV 89106

Questions: 702-455-107131

Las Vegas Part A TGA

Questions??

Alisha BarrettGrant AdministratorLas Vegas Part A TGAp: 702-455-1071email: akc@clarkcountynv.gov

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