Ryan White CARE Act – Reauthorization – ‘What you can do!’ Sue Rowland -- VORA September 20,...
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Ryan White CARE Act – Reauthorization –
Ryan White CARE Act – Reauthorization –
‘What you can do!’
Sue Rowland -- VORASeptember 20, 2005
‘What you can do!’
Sue Rowland -- VORASeptember 20, 2005
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The Problem
What’s 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
QuickTime™ and aTIFF (Uncompressed) decompressor
are needed to see this picture.
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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 (EMA’s)
• Title II -- the States– ADAP
• Title III -- Community-based care
• Title IV -- Family-centered care
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… there’s more
• Part F -- AETC’s
• Part F -- Dental Reimbursement Program
• SPNS -- Special Projects of National Significance
• Community-Based Dental Partnership Program
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Total RWCA Funds
$0
$500,000,000
$1,000,000,000
$1,500,000,000
$2,000,000,000
$2,500,000,000
FY 1991FY 1992FY 1993FY 1994FY 1995FY 1996FY 1997FY 1998FY 1999FY 2000FY 2001FY 2002FY 2003*FY 2004*FY 2005*
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Title I Funds
$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,000
$700,000,000
FY1991
FY1993
FY1995
FY1997
FY1999
FY2001
FY2003*
FY2005*
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Title II Funds
0
100,000,000
200,000,000
300,000,000
400,000,000
500,000,000
600,000,000
700,000,000
800,000,000
FY1991
FY1994
FY1997
FY2000
FY2003*
(STATE)(ADAP)
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Title III Funds
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
FY1991
FY1993
FY1995
FY1997
FY1999
FY2001
FY2003*
FY2005*
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Title IV Funds
0
10000000
20000000
30000000
40000000
50000000
60000000
70000000
80000000
FY1991
FY1993
FY1995
FY1997
FY1999
FY2001
FY2003*
FY2005*
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AETC & Dental Funds
0
5000000
10000000
15000000
20000000
25000000
30000000
35000000
40000000
FY1991
FY1994
FY1997
FY2000
FY2003*
Part F: AETC
Part F: DentalReimbursements
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Virginia’s 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 Bush’s Principles
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The President’s Principles
• Eliminate “hold harmless”
• Eliminate double-counting
• Develop “severity of need for core services index” (SNCSI)
• National ADAP core meds
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President’s Principles (con’t)
• 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
Virginia’s delegation not well aware of needs
In Richmond, Virginia’s State Legislators are unaware of what’s happening with federal funding for HIV/AIDS prevention & treatment
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“I Can’t Lobby ….
…. Can I?”
“I Can’t 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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