The Ryan White Program is a federal program that functions as a payer of last resort for HIV-positive individuals who face cost barriers in obtaining HIV care. It provides a comprehensive system of HIV primary medical care, essential support services, and medications for eligible individuals. Supported by funding from the Health Resources and Services Administration (HRSA) under the United States Department of Health and Human Services, the program funds grants to states, cities, counties, and local community-based organizations to provide care and treatment services, improve health outcomes, and reduce HIV transmission among HIV-positive individuals.
The majority of Ryan White funds support primary medical care and essential support services. A smaller but equally critical portion funds technical assistance, clinical training, and research on innovative models of care. Federal funds are awarded to a number of programs located throughout the country, which in turn deliver services to eligible individuals under funding categories, called
Parts, to meet the needs of communities and populations affected by HIV/AIDS.
Part B of the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87) provides grants to states and territories to improve the quality, availability, and organization of HIV health care and support services and allows for the operation of the Ryan White Part B Program in West Virginia (WV). The WV Ryan White Part B Program provides medical case management for eligible HIV infected WV residents and serves nearly 1,300 annually. The program collaborates closely with other Ryan White funded programs and private providers to coordinate client services and avoid duplication of efforts. Strong emphasis is placed on accessing and remaining in HIV primary care.
The Ryan White Part B Program contracts with the AIDS Task Force of the Upper Ohio Valley to administer state Direct Services. Medical Case Managers, located across the state, provide case management, referrals, education, advocacy, and act as the point of entry for accessing Ryan White Part B services. Supported services are divided into health related and support related areas. Medical case managers also assist clients who wish to obtain AIDS Drug Assistance Program (ADAP) services and provide referrals to the Housing Opportunities for Persons with AIDS (HOPWA) programs across the state. Specific allowable services funded by each state/territory are determined at the state/territory level based on needs assessment and available funding.
Ryan White Part B Core Medical Services include:
Medical Case Management
Health Insurance Premium and Cost Sharing Assistance
Mental Health Services
Oral Health Care
Substance Abuse Outpatient Care
Ryan White Part B Support Services include:
Food Bank/Home Delivered Meals
Emergency Financial Assistance
Ryan White Part B Support Services include:
Eligibility guidelines are applicable to all services available through the WV Ryan White Part B Program. To be eligible, applicants must:
ADAPs are state administered programs that provide HIV/AIDS medications to low-income individuals living with HIV disease who have little or no coverage from private or third-party insurance. ADAPs were originally authorized by the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which was enacted in 1990, and reauthorized in 1996, in 2000, and in the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87). The intent of state and federal legislation is to assure that ADAP funds are used only for the purchase of ADAP formulary drugs that cannot be paid for through other sources. ADAP must be the payer of last resort.
WV ADAP services are available to all eligible residents who meet the following criteria. Applicants must:
Ryan White Part B funds designated for the ADAP are also utilized to support reimbursement of health insurance premiums to help eligible persons with HIV infection maintain their existing health insurance when they might otherwise lose their coverage due to financial stress, a reduction of work hours, an unpaid medical leave, or a termination of their employment. In addition, the program assists eligible individuals with the purchase of health insurance through the marketplace during open enrollment or special enrollment periods. Participants with insurance and Medicare Part D are eligible for ADAP, which is utilized as the payer of last resort.
To be eligible for premium assistance, applicants must: