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Health Resources & Services Administration - Appendix C: Care & Services

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Goal #1 To increase access to care and improve quality of life for persons living with HIV and AIDS.
Objectives
  1. Through the Ryan White Comprehensive AIDS Resources Emergency (Care) Act (RWCA), improve accessibility and quality of care for all persons living with HIV.
  2. Develop comprehensive and participatory planning processes at the state and local levels to guide funding allocation decisions. Increase patient access to clinical research.
  3. Establish quality guidelines and evaluate program effectiveness.
Action Steps
  1. Support comprehensive outpatient, ambulatory health and support services, case management, and inpatient case management services that prevent unnecessary hospitalization or expedite discharge (RWCA Title I);
  2. Support consortia to improve the quality and availability of health care, including home and community-based services, continuation of health insurance, purchase of AIDS drugs, direct provision of care for individuals and families living with HIV and AIDS (RWCA Title II);
  3. Develop a minimum drug formulary for federally-assisted AIDS Drug Assistance Programs (ADAP -RWCA Title II);
  4. Support outpatient early intervention services for low-income medically underserved people in existing primary health care systems (RWCA Title III);
  5. Support comprehensive care services for affected women, infants, children, and youth in a comprehensive community-based, family-centered system of care (RWCA Title IV);
  6. Support initial development of care systems linked to research for children, youth and women in seven new communities;
  7. Enhance linkages between care providers and sites where research is conducted;
  8. Provide leadership, training, and technical assistance;
  9. Convene youth and family leadership conferences and distribute findings;
  10. Develop, distribute, and train providers on quality indicators and quality assurance guidelines for the clinical management of HIV disease;
  11. Develop guidance for grantees in developing local strategies for changes in the standard-of-care; and
  12. Evaluate program effectiveness through development of common evaluation criteria of CARE Act grants that address program delivery and program outcomes and establishment of evaluation measures that are unique to each Title.
Description

Provide RWCA-supported services through individual grantees and service organizations. In addition to these broad-based efforts, support a variety of focused initiatives such as the adolescent research and clinical network and a cooperative agreement with Institute of Family-Centered Care to provide training and technical assistance to youth and families.

Resources
FY95
FY96
FY96
Title I
Title II
Title III
Title IV
$ 356.5 million
198.1 million
52.3 million
26 million
$ 391.7 million
260.8 million
56.9 million
29 million
$ 449.9 million
417.0 million
69.6 million
36.0 million
Populations
Served

HIV positive individuals and their family members, low income persons with HIV/AIDS, pregnant women living with HIV/AIDS, neonates and children born to HIV positive women. In addition, RWCA grantees and planning councils receive technical assistance in conducting and evaluating their programs.

Constituency
Involvement

The input and guidance of PLWAs and affected communities is gathered through a variety of avenues. Constituents are represented on the HRSA AIDS Advisory Committee, and RWCA planning councils, with the input of broad-based local representation, guide local prioritization of RWCA funds.

The development of evaluation measures is a participatory process whereby local groups assist in the development of self-assessment tools. Local participants have early and ongoing involvement in all phases of data collection design, planning, and implementation.

In addition, focus groups, workshops, and discussion groups of PLWAs, providers of HIV care, State and local officials, researchers, and national groups review proposed policies, program directives, and planning and evaluation activities to ensure constituency input.

 

Goal #2 To increase the number of competent primary care providers willing to care for HIV-positive persons.
Objective

Increase the number of health care providers who are effectively educated and motivated to counsel, diagnose, treat, and manage individuals with HIV infection.

Action Steps
  1. Support didactic and clinical training activities for primary health care providers in collaboration with Federal, state, and local HIV care programs.
  2. Disseminate state-of-the art HIV information to providers. Develop and coordinate distribution of HIV provider materials.
Description

AIDS Education and Training Centers (RWCA Title VI). In addition, as part of the overall operative budget, there are quarterly interactive conference calls with experts and providers, the National HIV Telephone Consultation Service (Warmline), phone consultation services, newsletters, bulletins, and provider guides for HIV priority areas (e.g., guidance for clinicians regarding the use of AZT for the prevention of perinatal transmission).

Resources
FY95
FY96
FY97
$ 16 million
$ 12 million
$ 16 million
Populations
Served

Health care providers and people living with HIV disease.

Constituency
Involvement

Faculty, staff, advisory committees, training panels, persons living with AIDS, and academic faculty.

 

Goal #3 To reduce barriers to obtaining dental care for HIV positive persons.
Objectives
  1. Increase the number of dental practitioners who provide care to HIV positive patients.
  2. Assist dental schools in meeting uncompensated costs associated with providing oral health care to HIV positive patients.
Action Steps

Provide reimbursement to dental schools of uncompensated costs incurred in treating patients with HIV.

Descriptions

The AIDS Dental Reimbursement Program (RWCA Title V) is designed to reimburse accredited dental schools and post doctoral dental programs for the documented uncompensated costs incurred from providing oral health treatments to HIV positive patients.

Resources
FY95
FY96
FY97
$ 7 million
$ 7 million
$ 7.5 million
Populations
Served

Children and adults living with HIV.

Constituency
Involvement

American Association of Dental Schools, American Association of Hospital Dentists, and the American Dental Association.

 

Goal #4 To develop and evaluate innovative models of comprehensive managed care for persons living with HIV.
Objectives

Develop and evaluate models of comprehensive managed care networks that enroll a broad spectrum of primary care and psychosocial providers within the HIV continuum of care, and that provide patients and their families access to services.

Action Steps

Develop innovative models, provide technical support for evaluation activities, and disseminate results of evaluation.

Descriptions

Special Projects of National Significance (SPNS).

Resources
FY95
FY96
FY97
$ 1.5 million
$ 1.5 million
$ 1.5 million
Populations
Served

Persons living with HIV and their families.

Constituency
Involvement

Primary care providers, community-based organizations, state and local health officials, Ryan White planning bodies, and persons living with HIV.

 


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