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Ryan White CARE Act – Reauthorization –

Ryan White CARE Act – Reauthorization –. ‘What you can do !’ Sue Rowland -- VORA September 20, 2005. The Problem. What’s the future for HIV/AIDS Treatment funding? Or “The canary is awfully sick …”. Or ….

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Ryan White CARE Act – Reauthorization –

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  1. Ryan White CARE Act – Reauthorization – ‘What you can do!’ Sue Rowland -- VORA September 20, 2005

  2. The Problem What’s the future for HIV/AIDS Treatment funding? Or “The canary is awfully sick …”

  3. 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

  4. History Of theRyan White C.A.R.E. Act

  5. 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

  6. 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)

  7. 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

  8. … there’s more • Part F -- AETC’s • Part F -- Dental Reimbursement Program • SPNS -- Special Projects of National Significance • Community-Based Dental Partnership Program

  9. Total RWCA Funds

  10. Title I Funds

  11. Title II Funds

  12. Title III Funds

  13. Title IV Funds

  14. AETC & Dental Funds

  15. 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

  16. 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

  17. 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

  18. President Bush’s Principles

  19. The President’s Principles • Eliminate “hold harmless” • Eliminate double-counting • Develop “severity of need for core services index” (SNCSI) • National ADAP core meds

  20. 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

  21. 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

  22. Current Status of Reauthorization • No bill yet introduced to Amend • One bill continues the Title IV portion

  23. 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

  24. 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

  25. 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

  26. “I Can’t Lobby …. …. Can I?”

  27. You, the Agency … • Your leadership decides • “Lobbying” IS allowable -- and limited.

  28. 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.

  29. What are the Rules?

  30. “Yes, You can …” • Two Senators • One Congressperson • One State Senator • One State Delegate

  31. “What do I say?”

  32. Sources of Help • www.VORAonline.org • www.NASTAD.org • www.NMAC.org • www.NAPWA.org • www.C2EA.org And many more ….

  33. Efforts in VirginiaJoint Commission on Health Care Study of Federal Funding for HIV/AIDS prevention and treatment

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