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Ryan White CARE Act

Introduction
The federal Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was originally enacted on August 18, 1990. The CARE Act is named for Ryan White, an 18 year old Indiana teenager with hemophilia who died of AIDS in 1990. The primary goal of the CARE Act, which is made up of five program areas know as "titles", is to improve the quality and availability of care for individuals and families affected by HIV disease.

Part A
Provides funds to eligible metropolitan areas (EMA) and transitional grant areas (TGA). EMAs must exceed a total of 2,000 cumulative AIDS cases and TGAs must have between 1,000 and 1,999 cumulative AIDS cases in the most recent five years. Wisconsin is not eligible for this funding, however, two western counties, Pierce and St. Croix are included in the Minneapolis EMA.

Part B
Provides formula grants to all 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands. The funds include base dollars, ADAP earmark and supplemental dollars, emerging communities dollars, minority AIDS initiative dollars, and base supplemental dollars (if available). Funds are used to provide home and community-based care, assistance with the continuation of health insurance coverage, and treatment and drugs that prolong life and/or prevent hospitalization. The ADAP earmarked portion of the Part B award must be spent on HIV related medications. Emerging communities funds are for metropolitan areas that do not qualify as an EMA or TGA, but who over the most recent five years have reported between 500-999 cumulative AIDS cases.

Part C
Provides funding to community-based health care providers who provide early intervention and primary care services to affected individuals with HIV and AIDS. Services include early health care intervention, primary care, education, counseling, testing, and treatment. The UW Health HIV Care Program, Milwaukee Health Services, AIDS Resource Center of Wisconsin, and Sixteenth Street Community Health Center are Part C grantees currently funded in Wisconsin (see contact information below).

Part D
Provides support for maternal and pediatric HIV services and coordination with clinical research affecting women children, adolescents, and families. The Part D grantee is the Wisconsin HIV Primary Care Support Network, located at Children’s Hospital of Wisconsin (Milwaukee) and administered by the Medical College of Wisconsin.

Part F
Provides funds for the AIDS Education and Training Centers (AETC) and Special Projects of National Significance (SPNS). The Midwest AIDS Training and Education Center (MATEC) located at the University of Wisconsin Madison is the local AETC. MATEC is responsible for providing education and training opportunities for providers serving HIV positive individuals. The Wisconsin Department of Health Services is currently a recipient of two SPNS grants. One grant is to develop and electronic claims processing system for the ADAP. The second grant is a four year project to develop an innovative and replicable linkage to care model.

Under Part B, states may elect to use funds in four categories:

  • to establish and operate HIV CARE consortia within areas most affected by HIV disease, designed to provide a comprehensive continuum of care to individual and families;
  • to provide home-and community-based care services for individuals with HIV disease;
  • to provide assistance to assure the continuity of health insurance coverage for individuals with HIV disease; and
  • to provide treatment (drug therapies) that have been determined to prolong life or prevent serious deterioration of health for individuals with HIV disease.

The Wisconsin Division of Public Health (DPH) has three goals in the allocation of Ryan White Part B funds, including:

  • ensuring that combination antiretroviral therapy is available to HIV-infected persons eligible for the Wisconsin AIDS Drug Assistance Program (ADAP) without capping services or resorting to a waiting list.
  • providing funds to local agencies and communities to ensure that community-based care, treatment, and supportive services are available statewide; and
  • providing program and administrative support to the AIDS/HIV Program to adequately meet its obligations as the Part B grantee, contract administrator, and provider of drug and insurance service.

Wisconsin AIDS/HIV Drug Assistance Program
Ryan White ADAP and formula funds purchase Food and Drug Administration (FDA) approved, HIV-related treatment medications. Part B funds are used by the AIDS/HIV program to support staff within the AIDS/HIV Program responsible for the direct provision of drug reimbursement services statewide. This includes one professional staff responsible for the administration and oversight of the ADAP and one program assistant responsible for claims processing and program support.

AIDS/HIV Health Insurance Premium Subsidy Program
Ryan White formula funds are used to support program operations associated with the direct provision of insurance continuation services statewide.

Administration
Part B funds support the overall administration and coordination of the Part B grant, including the Ryan White CARE Grant Coordinator position and program support staff to assist with data collection and contract monitoring.

Planning & Evaluation
Part B funds support planning and evaluation activities related to care, treatment and supportive service programs. This includes activities to support the Statewide Coordinated Statement of Need (SCSN). As part of the Division of Public Health’s 1997 Ryan White Grant, the AIDS/HIV Program was required by the federal Health Resources and Service Administration to convene a meeting to develop a SCSN. The goal of the SCSN process is to collaboratively develop a statement that identifies the HIV care, treatment and supportive service issues of people living with HIV, and to encourage collaboration and information sharing among the other Ryan White CARE Act Parts in the state. The process is intended to enhance and support the planning and needs assessment activities currently being undertaken by local HIV service providers.

Quality Management Plan for Ryan White Part B and Life Care Services Funded Programs
Wisconsin HIV/AIDS Strategy (exit DHS)

 Wisconsin HIV/STD/Hepatitis C Information and Referral Center
The Wisconsin HIV/STD/Hepatitis C Information and Referral Center, supported by the Wisconsin Department of Health Services, promotes access and referral to HIV care, treatment and supportive services. The Information and Referral Center is operated by the AIDS Resource Center of Wisconsin in Milwaukee. 

Questions regarding Ryan White Part B should be directed to Mari Ruetten at 608-261-6397.

Questions regarding the other Ryan White Programs should be directed to the following:

Part C
Milwaukee Health Services
2555 N Martin Luther King Drive
Milwaukee, WI 53212
414-267-3700

University of Wisconsin Hospitals & Clinics
HIV Clinic
600 Highland Ave.
Madison, WI 53705
608-262-9414

AIDS Resource Center of Wisconsin
820 N. Plankinton Ave
Milwaukee, WI   53203
414-273-1991

Sixteenth Street Community Health Center
1032 S. 16th Street
Milwaukee, WI   53204
414-672-1353

Part D
Wisconsin HIV Primary Care Support Network
Department of Pediatrics
Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226
414/266-3158

AIDS Training and Education Centers
Midwest AIDS Training and Education Center (MATEC)
UW Dept. of Medicine
732 N. Midvale Blvd.
Madison, WI 53705
608-261-1152
MATEC web site: www.uic.edu/depts/matec (exit DHS)

Last Revised: September 02, 2014