Ryan White CARE Act

How could the law could improve the

nursing practice

-Improving access to coverage

-Ensuring quality coverage

-Enhancing the capacity of the healthcare

delivery system

Different parts of CARE act

The Health Resources and Services Administration (HRSA) allocates funding to programs created by the CARE Act under various Parts.

http://aids.gov/federal-resources/policies/health-care-reform/

-Part A provides grants to eligible metropolitan areas disproportionately affected by HIV and AIDS.

-Part B provides grants to states and territories to improve the quality, organization, and access to their HIV/AIDS health care system. Part B also funds the AIDS Drug Assistance Program, or ADAP, to provide access to HIV/AIDS medications for people who cannot afford them.

-Part C funds outpatient early intervention and ambulatory care. It also support planning grants to help organizations more effectively deliver care.

-Part D provides grants for comprehensive, family-centered care for children,

youth, women, and families.

-Part F includes:

The Special Projects of National Significance (SPNS) Program

The AIDS Education and Training Centers (AETC) Program

The HIV/AIDS Dental Reimbursement Program

Kristin Wanta

Daniel Panopio

Isaac Brennan

Kim Truong

How the law could be improved

for the nursing practice?

Ryan White CARE Act

The law is very complex as it stands right now:

Parts A-D, then F has sub parts (dental, special projects, and education and training, minority initiative)

Nursing research and evidence based practice could help improve the data used to dedicate funds from the law.

(Aids Alliance for Children, Youth & Families, 2014)

http://www.gao.gov/assets/600/591496.pdf

United States Government Accountability Office

82 pages of improvements needed

CARE: Comprehensive AIDS Resources Emergency

What is the Ryan White CARE Act?

It is the centerpiece of the federal government’s efforts to improve the quality and availability of care for medically underserved individuals and families affected by HIV/AIDS.

When did the law originate?

August 18th 1990, a few months after Ryan White's death.

Death: Sunday April 8, 1990

Why Did The Law Come To Be?

To provide care and treatment for people living with HIV.

References Cont'd

References

Aids Alliance for Children, Youth & Families. (2014, 07 24). Ryan White CARE Act. Retrieved from www.aids-alliance.org: http://www.aids-alliance.org/policy/ryanwhite/

Gallant, J. E. (2011, 10 31). Clinical Infectious Disease. Retrieved from cod.oxfordjournals.org: http://cid.oxfordjournals.org/content/early/2011/10/20/cid.cir689.full

United States Department of Health & Human Services. (2014, 07 24). Aids.gov. Retrieved from www.aids.gov: http://aids.gov/federal-resources/policies/health-care-reform/

United States Government Accountability Office. (2012, June). assets/600/591496.pdf. Retrieved from www.gao.gov: http://www.gao.gov/assets/600/591496.pdf

Wakefield, M. K. (2014). Budget Justification 2014 PDF.

Retrieved from www.hrsa.gov: http://www.hrsa.gov/about/budget/budgetjustification2014.pdf

"A Timeline of Key Events in Ryan's Life". Ryanwhite.com. Archived from the original on 2007-10-12. Retrieved 07 15 2014.

The program is the third largest funder of HIV care in the United States, after Medicare and Medicaid, and provides grants to states, high-impact cities, and clinical programs (Gallant, 2011)

Williams, S. (2009, September 17). The Ryan White CARE Act - Health Care That Is Not Debatable. The Ryan White CARE Act – Health Care That Is Not Debatable. Retrieved July 15, 2014, from http://www.care2.com/causes/the-ryan-white-care-act-health-care-that-is-not-debatable.html

Waxman, H. (1990, February 22). Statement on Ryan White Care Act. Welcome to Congressman Henry Waxman. Retrieved July 15, 2014, from https://waxman.house.gov/statement-ryan-white-care-act

Supporters

Gallant, E., Adimora, A., Carmichael, J., Horberg, M., Kitahata, M.,

Quinlivan, E., Raper, J., Selwyn, P., & Williams, S. (2011). Essential Components of Effective HIV Care: A Policy Paper of the HIV Medicine Association of the Infectious Diseases Society of America and the Ryan White Medical Providers Coalition. Retrieved on 07 15 2014 http://cid.oxfordjournals.org/content/early/2011/10/20/cid.cir689.full.

The short story......

U.S. Department of Health & Human Services, 2014

Ryan White was diagnosed with AIDS at age 13. He and his mother Jeanne White Ginder fought for his right to attend school, gaining international attention as a voice of reason about HIV/AIDS. At the age of 18, Ryan White died.

Diagnosed with AIDS on December 17, 1984. He was one of the first children, one of the first hemophiliacs to come down with AIDS.

Doctors only gave him 3-6 months to live. He lived about 5 additional years.

-Ryan White and his family were supporters of promoting research

-Celebrities like Elton John and Michael Jackson

-Congress became one of the supporters after Ryan's Death

-The Ryan White CARE Act has continued to get support from the government by reauthorizing the act multiple times and continuing to have federal funding.

Critics

-The knowledge surrounding AIDS was minimal. It was thought only to be prominent throughout the gay male community.

-Due to the lack of knowledge there were rallies to protest Ryan attending school after his diagnosis.

-Students were mean to Ryan (defacing his locker with hateful terms).

-Some critics over the years feel that a portion of the RWCA called “hold harmless”, is a waste of resources and funding should be cut from funding.

**This could ultimately leave some individuals

choosing between their medications and

them eating for the day.

RW CARE Act

Enacted in 1990

Re-Authorized: 1996, 2000, 2006, 2009, and 2013.

Initial issues faced w/ getting the law heard or passed

How does this law/policy impact or influence nursing practice?

-The first, and most far reaching, of these proposals is to give States the option to expand the eligibility for Medicaid to provide access to early intervention prescription drugs to low-income HIV-infected people.

-There was an issue between what qualified someone for Medicaid and when a person should begin receiving assistance paying for medications, lab diagnostics and physician visits.

- Gives HIV clinics better access to needs (HIV testing within communities, access to HIV medication, medication adherence support, efforts to retain patients in care, etc.)

- Allows patients to get specialized care (HIV specialized clinicians, HIV specialized care = better outcome of managing HIV)

- Ryan White Care Act is the third largest funder

of HIV care in the U.S. behind Medicare

and Medicaid

-The obvious problem is that while prescription drugs are available to slow or prevent disabling immune deficiency and its accompanying illnesses, most of the people eligible for Medicaid assistance are those who already have such immune deficiency and illnesses. The parallel financial problem is that while early intervention drugs cost less than hospital care, most HIV-infected people become eligible for Medicaid only when early intervention is too late and hospitalization is needed.