WASHINGTON, June 20 /PRNewswire/ -- AIDS Healthcare Foundation (AHF) the nation’s largest provider of HIV/AIDS medical care serving thousands of patients at 14 healthcare centers in California and Florida (in addition to operating free AIDS treatment clinics in Africa, Central America and Asia), will host a press conference Monday June 20th at 11am in Washington, DC, to unveil its call to redesign the Ryan White CARE Act, the nation’s AIDS program that is the principle source of funding for AIDS care and services for cities and states nationwide. The Ryan White CARE Act is due for Congressional reauthorization later this year. AHF’s plan calls for streamlining the Act to include only two ‘Titles’ or categories (as opposed to the six categories that currently comprise it) and requiring that cities receiving Ryan White funding earmark a minimum of 65% of such funds for primary HIV medical care, up from an average of less than 25% currently being spent. It is expected that administrative costs will be greatly reduced (current law allows for each RW Title or category to spend a certain percentage on administrative costs, so with only two categories, such spending will be reduced and redirected to client care and services).
“To better respond to the current state of HIV/AIDS, and in an effort to improve the delivery and effectiveness of care and services nationwide, AHF is calling for a far-reaching overhaul of the Ryan White CARE Act that will ensure appropriate funding for the most needed care and services today and in the future,” said Michael Weinstein, AHF’s President. “Fortunately, HIV is now a chronic, but treatable medical condition. Unfortunately, as it is currently written, the Ryan White CARE Act has not kept pace with changes in the disease and its demographics. Funding still largely reflects a time when HIV/AIDS was a terminal disease. Just last week, the CDC announced that over one million Americans are living with HIV. Almost half of these infections are among African Americans, and one quarter of these individuals are unaware they are infected. Yet in its current structure, the Ryan White CARE Act is unable to effectively reach these growing populations with appropriate funds for care and services. In addition, over the next five years, hundreds of thousands of additional people will need treatment, and we need to make sure the Act will adequately prepare and account for this. We put forth this timely proposal in an effort to both maximize the use of dwindling federal dollars and to improve delivery of HIV/AIDS care and services to those Americans most in need.”
Background:
The numbers on HIV/AIDS are stark: Over 1,000,000 Americans have HIV; there are 40,000-60,000 new infections in the U.S. every year; more than half of new HIV cases are African American; at least a quarter of Americans with HIV don’t receive treatment. In order for the Ryan White CARE Act to meet growing HIV needs, and reduce new infections, it needs to be retooled according to the following principles:
* HIV is first and foremost a medical issue. Medical care and treatment is the primary purpose of the Act; * Disparities of access to care, and disparities of CARE Act expenditures per person, especially in the South, rural areas and in communities of color, must be eliminated; * To make the best use of finite CARE Act dollars, the delivery of care must be as efficient as possible. Bureaucracy must be reduced to free up additional funds for drugs and for care. Specific CARE Act Provisions and Changes That Will Meet Today’s Needs
In order to meet these objectives, AHF calls for the following changes to the CARE Act:
1. Coordination Of The CARE Act Titles
The CARE Act should contain just two Titles (as opposed to the six parts that currently comprise it) -- one for services, and one for drugs. The Title for services would be set out in two parts -- grants to cities, and grants to States. These parts would continue to function much like the current Titles I and II, in terms of structure, determination of funding, etc.
Coordination Reduces Bureaucracy
By folding the non-drug parts into a single title, and by reducing the overhead currently granted to cities and states, up to $390 million could be freed up for distribution directly to States, cities, and the AIDS Drug Assistance Program (“ADAP”). This includes approximately $100 million in administrative overhead, enough to resolve any current shortfall in ADAP funding. Under this plan, States and cities have the responsibility to utilize these funds for essential services now provided under the eliminated Titles, such as clinics, dental care, and the Minority AIDS Initiative, if local needs are going unmet.
Coordination Addresses Disparities In Funding
Eliminating the other Titles also helps address the disparity of funding among States. Currently, certain areas can and do receive funding for services under Titles I through IV, while other areas have to rely solely on Title II funds. Now, all areas will have access to funds currently expended under Titles III and IV.
2. Require Cities To Spend At Least of 65% Of Funds On Medical Care
On average, cities spend less than 25% of CARE Act funds on primary medical care. As the Act has been reauthorized only twice in the past ten years, this low level of spending on medical care reflects a time when HIV was a terminal disease, life expectancy for people with AIDS was measured in months, and non-medical support services for people with HIV was more necessary due to poorer health. However, this simply does not reflect the current reality that HIV is first and foremost a chronic but treatable medical condition, nor does it adequately account for the fact that, over the next five years, hundreds of thousands of additional people will need treatment.
To address the current and emerging need, the CARE Act should require that cities spend a minimum of 65% of CARE Act funds on primary HIV medical care. This minimum will ensure adequate access to treatment, while simultaneously providing cities enough budgetary flexibility to meet other non-medical HIV needs.
3. Encourage Cities and States To Implement Disease Management Programs
One great disparity that exists in the CARE Act program is the quality of care provided in different regions of states and the country. For example, it is difficult for a general practitioner who may have two or three HIV patients to remain as current in the medicine and to provide the same level of care as an HIV specialist who works in an AIDS clinic. When it comes to HIV, geography must not be destiny.
AHF’s solution is the widespread implementation of disease management (“DM”) programs, programs that are specifically designed to provide HIV training, education, and monitoring to providers and patients to improve their knowledge and skill level regarding HIV. By raising the level of expertise, health outcomes improve, and costs actually go down (healthy people need less medical care). For example, AHF, under a contract with Florida Medicaid, provides DM services to over 10,000 patients and their providers in every county and location in Florida. Thus far, the program has improved health outcomes, while at the same time saving Florida Medicaid tens of millions of dollars in Medicaid costs.
AHF recommends that cities and States be allowed to use up to 5% of their grants to implement disease management programs.
AIDS Healthcare Foundation
CONTACT: Washington, DC, Tom Myers, AHF General Counsel, +1-202-543-1106,or mobile, +1-323-860-5259, or Los Angeles, Ged Kenslea, AHF CommunicationsDirector, +1-323-860-5225, or mobile, +1-323-791-5526