North Dakota CARES/Ryan White Part B Program Krissie Guerard TB/HIV/RW Program Manager North Dakota Department of Health May 14, 2009
Federal Legislation: TheRyan White Comprehensive AIDS Resources Emergency (CARE) Act: addresses the unmet health needs of persons living with HIV disease (PLWH) by funding primary health care and support services that enhance access to and retention in care.
Federal Legislation: Intent: to reduce the use of more costly inpatient care, increase access to care for underserved populations, and improve quality of life for those affected by HIV disease.
CARE Act Programs • Part A: emergency assistance to EMAs (Emerging Metropolitan Areas) and TGAs (Transitional Grant Areas) that are most severely affected by the HIV/AIDS epidemic • Part B: grants to state and territories that focuses on improving access to primary care and support services • Part C: provides early intervention services by funding comprehensive primary health care in an outpatient setting for people living with HIV disease
CARE Act Programs • Part D: coordinates services and access to research for children, youth and women with HIV/AIDS • Part F: SPNS projects, AETCs, dental programs and minority AIDS initiative
ND CARES/Ryan White Part B Program • “Payer of last resort” • Eligibility criteria • Case management • State direct services
ND CARES/Ryan White Part B Program • Eligibility Criteria: • Proof of HIV status • Resident of North Dakota • Must produce a state issued ID within 60 days of enrollment • Verification of income: up to 400% FPL • Receipt of other services (Medicare, Medicaid, PI), or lack thereof
ND CARES/Ryan White Part B Program • Case Management Services • Client centered activities, including: • Initial comprehensive assessment of needs/personal support systems • Development of individualized service plan • Coordination of services required to implement plan • Client monitoring to assess efficacy • Periodic re-evaluation/revision • Client-specific advocacy/review of utilization of services
ND CARES/Ryan White Part B Program • State Direct Services • Outpatient services specific to preventive care for treatment of HIV/AIDS • Outpatient medical services: MD visits, lab/diagnostics • 80% paid • Oral health care • Up to $500 annually • Mental health services • 80% paid • Optometric/Ophthalmic services • Up to $200 biannually for glasses • Substance abuse treatment services • 80% paid
ND CARES/Ryan White Part B Program • State Direct Services • Supportive Services • Transportation to medical appointments or support groups (gas cards reimburse for cost of travel) • Nutritional supplements (ordered by MD) • Other assistance: • Continuation of Health Insurance (DHS)
ND CARES/Ryan White Part B Program • Emergency Assistance • Must be related to situations that may arise due to client’s HIV status and necessary to maintain access to care • Funds available for limited amounts, limited uses, and limited time period • Rent, rental deposit, utility bills • Case by case assessment
ND CARES/Ryan White Part B Program • AIDS Drug Assistance Program • Medications must be listed on ND CARES’ Reimbursable Medications List. • ND CARES pays 100 percent, or co-pay if privately insured.
ND CARES 2008 Clients • 77% Male • 68% Aged 25-45 years • 56% HIV • 80% White • 74% < 200% FPL ($ or less) • 93% Enrolled in ADAP • 40% Heterosexual
North Dakota CARES/Ryan White Part B Program Questions????