Ryan White HIVAIDS Treatment Modernization Act of 2006

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Ryan White HIV/AIDS Treatment Modernization Act
of 2006

• S2823

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Language that has passed

• Authorize additional 95 million
• Core Medical Services
• Title I III increase 3.7 each year
• Carryover funds to go back to Titles
• Minority AIDS Initiative
• Severity of Need Index (SONI) (FY2010)
• Native American clinics in Titles III IV
• Funds for Co-infection (Hep C)

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Core Medical Services (75)

• Outpatient and ambulatory health services
• AIDS Drug Assistance program treatments
• AIDS pharmaceutical assistance
• Oral health care
• Early intervention services
• Health insurance premium cost sharing
• Home health care
• Home community-based health services
• Mental health services
• Substance abuse outpatient care
• Medical case management (Tx adherence services)

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75 Core Service Requirement

• Can be waived by Secretary if
• Jurisdiction has no ADAP waiting list and
• Jurisdiction has services available

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Support Services (25)

• Respite care for individuals with HIV/AIDS
• Outreach services
• Medical Transportation
• Nutritional counseling
• Linguistic services
• Referral for health care and support services for
  individuals with HIV/AIDS
• (Rep from Sen. Enzis office stated that
  Emergency Housing is included in 25)

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General Eligibility

• Three tiers
• Tier I 2,000 Living AIDS cases (not ELCs
  Estimated Living Cases) in last 5 yrs Hold
  Harmless PCs Mandatory
• Tier 2 1,000-1,999 no Hold Harmless PCs
  voluntary
• Tier 3 500-999 5 million all formula PCs
  voluntary
• Determined on an annual basis for new
  metropolitan areas

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Distribution of Funding

• Switches to HIV and AIDS
• Four year proxy for HIV cases
• Proxy estimate 0.9 time AIDS cases (being debated
  0.7 also on the table Clinton/NY)

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Type and Distribution of Grants

• Changes from ½ supplemental ½ formula to 1/3
  supplemental and 2/3 formula.
• Un-obligated funds returned to HRSA, possibility
  of re-requesting
• Hold Harmless only for FY07 grantees
• 90 1st year
• 85 2nd year
• 80 3rd year

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Additional Changes

• Demonstrated Need instead of Severe Need
• 10 Administrative costs to include HIV Health
  Services Planning Council expenses. Members
  (must include Native Americans and Hep B/C
  co-infection)
• Indian Health Services exempt from payer of last
  resort provision.

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Time Tables

• Congress is in summer recess from July 31st
  September 4th of 2006 and the target adjournment
  for the year is October 6th. Since this is an
  election year, Congress is not likely to stay in
  session much past the target date, although they
  can come back for a lame duck session. The
  earlier a bill can be filed this year, the better
  the chance that reauthorization can be passed
  before this Congress adjourns.

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Best Guesses

• Bill to House subcommittee 6/5
• Committee will begin mark up 6/12
• House vote 6/19
• July recess
• Lame Duck Congress
• No Conference Bill needed because it is
  bi-cameral/bi-partisan product
• May reach Presidents desk by end of year or
  tomorrow

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References

• NASTAD
• Kaiser Family Foundation Newsletter
• Federal AIDS Policy Partnership (FAPP) Ryan White
  Reauthorization Workgroup
• CAEAR Coalition