Ryan White Part A GRANTEE SERVICE SUMMARY PC Meetings January - March Ryan White Part A Federal Outpatient and Ambulatory Medical Care, defined as the provision of professional diagnostic and therapeutic services rendered by a licensed physician, physician's assistant, clinical nurse specialist, or nurse practitioner in an outpatient setting (not a hospital, hospital emergency room, or any other type of inpatient treatment center), consistent with HHS guidelines and including access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies Allowable services include: Diagnostic testing Early intervention and risk assessment,
Preventive care and screening Practitioner examination, medical history taking, diagnosis and treatment of common physical and mental conditions Prescribing and managing of medication therapy Education and counseling on health issues Well-baby care Continuing care and management of chronic conditions Referral to and provision of HIV-related specialty care (includes all medical subspecialties even ophthalmic and optometric services) As part of Outpatient and Ambulatory Medical Care, provision of laboratory tests integral to the treatment of HIV infection and related complications Ryan White Part A Cleveland OAMC is the professional diagnosis and therapeutic services rendered by a physician, physicians
assistant, clinical nurse specialist or nurse practitioner in an outpatient setting. Settings include clinics, medical offices, and mobile vans where clients generally do not stay overnight. Emergency room services are not considered outpatient settings. Services include diagnostic testing (see separate definition), early intervention and risk assessment, preventative care and screening, practitioner examination, medical history taking, diagnosis and treatment of common physical and mental conditions, prescribing and managing medication therapy, care of minor injuries, education and counseling on health issues, well-baby care, continuing care and management of chronic conditions, and referral to and provision of sub-specialty care (includes all medical subspecialties). Primary medical care for the treatment of HIV infection includes the provision of care that is consistent with the Public Health Services guidelines. Such care must include access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies. Proposals should demonstrate interaction with mental health providers, dental providers, substance abuse treatment providers, dieticians and home health providers to ensure coordination of care. A referral of medical necessity is required for clients to
receive Ryan White funded nutritional counseling, home delivered meals, home health care, home and community based health services and hospice services. Such referrals should indicate the reasons why such care is necessary and the anticipated length of time service is expected. Referrals must be renewed at various intervals depending on the service. Ryan White Part A Cleveland OAMC continued This includes all indicated medical diagnostic testing including all tests considered integral to treatment of HIV and related complications (e.g. Viral Load, CD4 counts and genotype assays). Funded tests must meet the following conditions: Tests must be consistent with medical and laboratory standards as established by scientific evidence and supported by professionals, panels, associations or organization.
Tests must be: Approved by the FDA, when required under the FDA Medical Devices Act and/or Performed in an approved Clinical Laboratory Improvement Amendments of 1988 (CLIA) certified laboratory or State exempt laboratory; and Tests must be: Ordered by a registered, certified or licensed medical provider and Necessary and appropriate based on established clinical practice standards and professional clinical judgment. OAMC Summary Service Unit: Budgets may be developed on a unit rate model, fee schedule model, or cost reimbursement model. A corresponding fee schedule must be included with the proposal if using fee schedule model.
Includes FTEs ,visits, and labs Unit of Service: 1 unit = 15 minute client encounter Staffing FY15 8.59 FTEs at 5 agencies Spent FY14 $965,579.88 Clients Served FY14 1725 clients served 11,662 units provided Ryan White Part A Federal Local AIDS Pharmaceutical Assistance Program (LPAP) for the provision of HIV/AIDS medications using a drug distribution system that has: A client enrollment and eligibility determination process that includes screening for ADAP and LPAP
eligibility with rescreening every six months A LPAP advisory board Uniform benefits for all enrolled clients throughout the EMA or TGA A drug formulary approved by the local advisory committee/board A recordkeeping system for distributed medications A drug distribution system An LPAP that does not dispense medications as: A result or component of a primary medical visit A single occurrence of short duration (an emergency) Vouchers to clients on an emergency basis A Program that is: Consistent with the most current HIV/AIDS Treatment Guidelines Coordinated with the States Part B AIDS Drug Assistance Program
Ryan White Part A Cleveland The provision of Part A Formulary medications to treat HIV/AIDS or to prevent the serious deterioration of health arising from HIV/AIDS in eligible individuals, including measures for the prevention and treatment of opportunistic prevention. LPAP services must not be substituted for services available to eligible individuals under the Ohio ADAP program. LPAP programs are used to fill service gaps created by restrictions in the Ohio ADAP formulary and financial eligibility restrictions. Medication Assistance must be provided in accordance with the Cleveland TGA Local Pharmaceutical Assistance Program Policy. LPAP programs must be implemented in accordance with the requirements of the 340B Drug Pricing Program to ensure best price to maximize resources.
LPAP Summary Unit of Service: 1 unit = 1 Prescription Staffing FY15 0 FTEs 3 agencies Spent FY14 $1,203.39 Clients Served FY14 2 client 12 prescriptions Dispensing fees average $10 per prescription Ryan White Part A Federal Support for Oral Health Services including
diagnostic, preventive, and therapeutic dental care that is in compliance with state dental practice laws, includes evidencebased clinical decisions that are informed by the American Dental Association Dental Practice Parameters, is based on an oral health treatment plan, adheres to specified service caps, and is provided by licensed and certified dental professionals Ryan White Part A Cleveland Oral Health The provision of diagnostic, preventative and therapeutic services provided by a dental health professional licensed to render such services in
Ohio, including dental practitioners, dental specialists, and dental hygienists, as well as licensed and trained dental assistants. ORAL HEALTH SUMMARY Unit of Service: 1 unit = 1 visit/procedure Staffing FY15 .20 FTEs at 2 agencies Spent FY14 $561,809.34 Clients Served FY14 408 clients 1961 units
Ryan White Part A Federal Early Intervention Services (EIS) that include identification of individuals at points of entry and access to services and provision of: HIV Testing and Targeted counseling Referral services Linkage to care Health education and literacy training that enable clients to navigate the HIV system of care
Ryan White Part A Cleveland Early Intervention Services Programs must include the following components: HIV Testing (not funded through Ryan White Part A) and Targeted Counseling Referral Services Linkage to Care Health Education and literacy training that enables clients to navigate the HIV system of care. Services should be targeted to the following populations: Newly diagnosed Receiving other HIV/AIDS services but not in primary care Formerly in care dropped out Never in care Unaware of HIV status
EIS programs must have signed linkage agreements to work with key points of entry. Given that EIS leads EIIHA (Early Identification of Individuals with HIV/AIDS) EIS programs must coordinate with prevention services, counseling and testing centers, as well as other RW Part A providers. EIS Summary Unit of Service: 1 unit = 15 minute client encounter Staffing FY15 4.94 FTEs at 4 agencies Spent FY14 $265,344.09 Clients Served FY14 213 clients 1291 units
Ryan White Part A Federal Health Insurance Premium and Cost Sharing Assistance provides financial assistance for eligible clients living with HIV to maintain continuity of health insurance or to receive medical and pharmacy benefits under a health care coverage program. To use RWHAP funds for health insurance premium and costsharing assistance, a RWHAP Part recipient must implement a methodology that incorporates the following requirements: RWHAP Part recipients must ensure that clients are buying health coverage that, at a minimum, includes at least one drug in each class of core antiretroviral therapeutics from the Department of Health and Human Services (HHS) treatment guidelines along with appropriate HIV outpatient/ambulatory health services
Ryan White Part A Cleveland RWHAP Part recipients must assess and compare the aggregate cost of paying for the health coverage option versus paying for the aggregate full cost for medications and other appropriate HIV outpatient/ambulatory health services, and allocate funding to Health Insurance Premium and Cost Sharing Assistance only when determined to be cost effective The service provision consists of either or both of the following: Paying health insurance premiums to provide comprehensive HIV Outpatient/Ambulatory Health Services and pharmacy benefits that provide a full range of HIV medications for eligible clients Paying cost-sharing on behalf of the client Clients must have incomes 301% - 500% Federal Poverty Level (FPL)
HIPSCA Summary Unit of Service: 1 unit = 1 month premium or costsharing assistance Staffing FY15 1.05 at 2 agencies Spent FY14 New service in FY2015 Clients Served FY14 New service in FY2015 Ryan White Part A Federal Home Health Care is the provision of services in the home that are appropriate to a clients needs and are performed by licensed professionals. Services must relate to the clients HIV disease and may
include: Administration of prescribed therapeutics (e.g. intravenous and aerosolized treatment, and parenteral feeding) Preventive and specialty care Wound care Routine diagnostics testing administered in the home Other medical therapies The provision of Home Health Care is limited to clients that are homebound. Home settings do not include nursing facilities or inpatient mental health/substance abuse treatment facilities. Home Health Care Summary Unit of Service: 1 unit = 60 minute visit
units are FTE Staffing FY15 .15 FTE at 1 agency Spent FY14 $13,733.07 Clients Served FY14 31 clients 149 units Ryan White Part A Federal Home and Community-Based Health Services are provided to a client living with HIV in an integrated setting appropriate to a clients needs, based on a written plan of care established by a medical care team under the direction of a licensed clinical provider. Services
include: Appropriate mental health, developmental, and rehabilitation services Day treatment or other partial hospitalization services Durable medical equipment Home health aide services and personal care services in the home Program Guidance: Inpatient hospitals, nursing homes, and other long-term care facilities are not considered an integrated setting for the purposes of providing home and community-based health services. Home and Community Summary Unit of Service: 1 unit = 60 minute visit units are FTE
Staffing FY15 .85 FTE at 1 agency Spent FY14 $57,000.00 Clients Served FY14 24 clients 1449 units Ryan White Part A Federal Mental Health Services are the provision of outpatient psychological and psychiatric screening, assessment, diagnosis, treatment, and counseling services offered to clients living with HIV. Services are based on a treatment plan, conducted in an outpatient group or individual session, and provided by a mental health
professional licensed or authorized within the state to render such services. Such professionals typically include psychiatrists, psychologists, and licensed clinical social workers. Program Guidance: Mental Health Services are allowable only for HIV-infected clients. Mental Health Services Summary Unit of Service: 1 unit = 60 minute individual or group encounter Units are provided by either FTE or based on medicaid/medicare rates Staffing FY15 1.816 FTE at 6 agencies Spent FY14 $113,670.32
Clients Served FY14 112 clients 898 units Ryan White Part A Federal Medical Nutrition Therapy includes: Nutrition assessment and screening Dietary/nutritional evaluation Food and/or nutritional supplements per medical providers recommendation Nutrition education and/or counseling These services can be provided in individual and/or group settings and outside of HIV Outpatient/Ambulatory Health Services. Program Guidance:
All services performed under this service category must be pursuant to a medical providers referral and based on a nutritional plan developed by the registered dietitian or other licensed nutrition professional. Services not provided by a registered/licensed dietician should be considered Psychosocial Support Services under the RWHAP. Medical Nutrition Therapy Summary Unit of Service: 1 unit = 15 minute client encounter units are provided by either an FTE or medicaid/care rate Staffing FY15 .9 FTE at 3 agencies Spent FY14 $32,620.61
Clients Served FY14 246 clients 739 units Ryan White Part A Federal Medical Case Management is the provision of a range of client-centered activities focused on improving health outcomes in support of the HIV care continuum. Activities may be prescribed by an interdisciplinary team that includes other specialty care providers. Medical Case Management includes all types of case management encounters (e.g., face-to-face, phone contact, and any other forms of communication). Key activities include: Initial assessment of service needs Development of a comprehensive, individualized care plan Timely and coordinated access to medically appropriate levels of health and support services and continuity of care
Continuous client monitoring to assess the efficacy of the care plan Re-evaluation of the care plan at least every 6 months with adaptations as necessary Ongoing assessment of the clients and other key family members needs and personal support systems Treatment adherence counseling to ensure readiness for and adherence to complex HIV treatments Client-specific advocacy and/or review of utilization of services In addition to providing the medically oriented services above, Medical Case Management may also provide benefits counseling by assisting eligible clients in obtaining access to other public and private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturers Patient Assistance Programs, other state or local health care and supportive services, and insurance plans through the health insurance Marketplaces/Exchanges). Ryan White Part A Federal
Program Guidance: Medical Case Management services have as their objective improving health care outcomes whereas Non-Medical Case Management Services have as their objective providing guidance and assistance in improving access to needed services. Visits to ensure readiness for, and adherence to, complex HIV treatments shall be considered Medical Case Management or Outpatient/Ambulatory Health Services. Treatment Adherence Services provided during a Medical Case Management visit should be reported in the Medical Case Management service category whereas Treatment Adherence services provided during an Outpatient/Ambulatory Health Service visit should be reported under the Outpatient/Ambulatory Health Services category.
MCM Summary Unit of Service: 1 unit = 15 minute client encounter Staffing FY15 11.94 FTEs at 5 agencies Spent FY14 $734,076.75 Clients Served FY14 1998 clients 23980 units Ryan White Part A Federal Substance Abuse Outpatient Care is the provision of outpatient services for the treatment of drug or alcohol use disorders. Services include:
Screening Assessment Diagnosis, and/or Treatment of substance use disorder, including: o Pretreatment/recovery readiness programs Harm reduction o Behavioral health counseling associated with substance use disorder o Outpatient drug-free treatment and counseling o Medication assisted therapy o Neuro-psychiatric pharmaceuticals o Relapse prevention Ryan White Part A Federal Program Guidance:
Acupuncture therapy may be allowable under this service category only when, as part of a substance use disorder treatment program funded under the RWHAP, it is included in a documented plan. Syringe access services are allowable, to the extent that they comport with current appropriations law and applicable HHS guidance, including HRSA- or HAB-specific guidance. See Substance Abuse Services (residential) Substance Abuse Outpatient Summary Unit of Service: 1 Unit = 1 individual or group encounter units are provided by FTE or medicaid/care rates Staffing FY15 .11 FTE at 3 agencies
Spent FY14 $27,945.03 Clients Served FY14 13 clients 1699 units Support Services
Emergency Financial Assistance Non-Medical Case Management Foodbank/Home Delivered Meals Medical Transportation Outreach Psychosocial support Substance Abuse residential Other Professional services (legal) Ryan White Part A Federal Emergency Financial Assistance provides limited one-time or short-term payments to assist the RWHAP client with an emergent need for paying for essential utilities,
housing, food (including groceries, and food vouchers), transportation, and medication. Emergency financial assistance can occur as a direct payment to an agency or through a voucher program. Program Guidance: Direct cash payments to clients are not permitted. It is expected that all other sources of funding in the community for emergency financial assistance will be effectively used and that any allocation of RWHAP funds for these purposes will be as the payer of last resort, and for limited amounts, uses, and periods of time. Continuous provision of an allowable service to a client should not be funded through emergency financial assistance. See AIDS Drug Assistance Program Treatments, AIDS Pharmaceutical Assistance, and other corresponding categories Emergency Financial Assistance
Unit of Service: 1 unit = 1 Prescription Staffing FY15 0 FTEs 3 agencies Spent FY14 $65,969.87 Clients Served FY14 76 client 134 prescriptions Dispensing fees average $10 per prescription Ryan White Part A Federal Non-Medical Case Management Services (NMCM) provide guidance and assistance in accessing medical, social, community, legal, financial, and other needed services. NonMedical Case management services may also include assisting eligible clients to obtain access to other public and private programs for which they may be eligible, such as
Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturers Patient Assistance Programs, other state or local health care and supportive services, or health insurance Marketplace plans. This service category includes several methods of communication including face-to-face, phone contact, and any other forms of communication deemed appropriate by the RWHAP Part recipient. Key activities include: Initial assessment of service needs Development of a comprehensive, individualized care plan Continuous client monitoring to assess the efficacy of the care plan Re-evaluation of the care plan at least every 6 months with adaptations as necessary Ongoing assessment of the clients and other key family members needs and personal support systems
Non-Medical Case Management Summary Unit of Service: 1 unit = 15 minute increment Staffing FY15 6.125 FTE only 1 benefit coordinator 3 agencies Spent FY14 $82,520.25 Clients Served FY14 326 Ryan White Part A Federal Food Bank/Home Delivered Meals refers to the provision
of actual food items, hot meals, or a voucher program to purchase food. This also includes the provision of essential non-food items that are limited to the following: Personal hygiene products Household cleaning supplies Water filtration/purification systems in communities where issues of water safety exist Program Guidance: Unallowable costs include household appliances, pet foods, and other non-essential products. Foodbank/Home Delivered Meals Summary Unit of Service: 1 unit = 1 bag or I meal
Staffing FY15 1.46 FTE 2 agencies Spent FY14 $82,520.25 Clients Served FY14 326 Ryan White Part A Federal Medical Transportation is the provision of nonemergency transportation services that enables an eligible client to access or be retained in core medical and support services. Program Guidance: Medical transportation may be provided through:
Contracts with providers of transportation services Mileage reimbursement (through a non-cash system) that enables clients to travel to needed medical or other support services, but should not in any case exceed the established rates for federal Programs (Federal Joint Travel Regulations provide further guidance on this subject) Purchase or lease of organizational vehicles for client transportation programs, provided the recipient receives prior approval for the purchase of a vehicle Organization and use of volunteer drivers (through programs with insurance and other liability issues specifically addressed) Voucher or token systems Ryan White Part A Federal Unallowable costs include: Direct cash payments or cash
reimbursements to clients Direct maintenance expenses (tires, repairs, etc.) of a privately-owned vehicle Any other costs associated with a privatelyowned vehicle such as lease, loan payments, insurance, license, or registration fees Medical Transportation Summary Unit of Service: 1 unit = voucher, taxi or parking Staffing FY15 0 staff 8 agencies Spent FY14 $63,767.64 Clients Served FY14
1291 Detailed summary provided November Planning Council Ryan White Part A Federal Outreach Services include the provision of the following three activities: Identification of people who do not know their HIV status and linkage into Outpatient/Ambulatory Health Services Provision of additional information and education on health care coverage options Reengagement of people who know their status into Outpatient/Ambulatory Health Services Program Guidance: Outreach programs must be: Conducted at times and in places where there is a high probability that individuals with HIV infection and/or exhibiting high-risk behavior
Designed to provide quantified program reporting of activities and outcomes to accommodate local evaluation of effectiveness Planned and delivered in coordination with local and state HIV prevention outreach programs to avoid duplication of effort Targeted to populations known, through local epidemiologic data or review of service utilization data or strategic planning processes, to be at disproportionate risk for HIV infection Funds may not be used to pay for HIV counseling or testing under this service category. Outreach Summary Unit of Service: 1 unit = 15 minute increment Staffing FY15 1.685 FTE 3 agencies
Spent FY14 $107,727.15 Clients Served FY14 406 Ryan White Part A Federal Psychosocial Support Services provide group or individual support and counseling services to assist eligible people living with HIV to address behavioral and physical health concerns. These services may include: Bereavement counseling Caregiver/respite support (RWHAP Part D) Child abuse and neglect counseling
HIV support groups Nutrition counseling provided by a non-registered dietitian (see Medical Nutrition Therapy Services) Pastoral care/counseling services Ryan White Part A Federal Program Guidance: Funds under this service category may not be used to provide nutritional supplements (See Food Bank/Home Delivered Meals). RWHAP-funded pastoral counseling must be available to all eligible clients regardless of their religious denominational affiliation. Funds may not be used for social/recreational activities or to pay for a clients gym membership. For RWHAP Part D recipients, outpatient mental health services provided to
affected clients (people not identified with HIV) should be reported as Psychosocial Support Services; this is generally only a permissible expense under RWHAP Part D. See Respite Care Services Psychosocial Summary Unit of Service: 1 unit = I5 minute increments Staffing FY15 0.615 FTE 3 agencies Spent FY14 $64,213.76 Clients Served FY14 176
Ryan White Part A Federal Substance Abuse Services (residential) is the provision of services for the treatment of drug or alcohol use disorders in a residential setting to include screening, assessment, diagnosis, and treatment of substance use disorder. This service includes: Pretreatment/recovery readiness programs Harm reduction Behavioral health counseling associated with substance use disorder Medication assisted therapy Neuro-psychiatric pharmaceuticals Relapse prevention Detoxification, if offered in a separate licensed residential setting (including a separately-licensed detoxification facility within
the walls of an inpatient medical or psychiatric hospital) Ryan White Part A Federal Program Guidance: Substance Abuse Services (residential) is permitted only when the client has received a written referral from the clinical provider as part of a substance use disorder treatment program funded under the RWHAP. Substance Abuse Services (residential) are not allowable services under RWHAP Parts C and D. Acupuncture therapy may be allowable funded under this service category only when it is included in a documented plan as part of a substance use disorder treatment program funded under the RWHAP. RWHAP funds may not be used for inpatient detoxification in a hospital setting, unless the detoxification facility has a separate license.
Substance Abuse Residential Summary Unit of Service: 1 unit = 1 day Staffing FY15 certified unit rate Spent FY14 $38,536.94 Clients Served FY14 7 Ryan White Part A Federal Other Professional Services allow for the provision of professional and consultant services rendered by members of particular professions licensed and/or qualified to offer such services by local governing
authorities. Such services may include: Legal services provided to and/or on behalf of the individual living with HIV and involving legal matters related to or arising from their HIV disease, including: Assistance with public benefits such as Social Security Disability Insurance (SSDI) Interventions necessary to ensure access to eligible benefits, including discrimination or breach of confidentiality litigation as it relates to services eligible for funding under the RWHAP Preparation of: Healthcare power of attorney Durable powers of attorney Living wills
Ryan White Part A Federal Permanency planning to help clients/families make decisions about the placement and care of minor children after their parents/caregivers are deceased or are no longer able to care for them, including: Social service counseling or legal counsel regarding the drafting of wills or delegating powers of attorney Preparation for custody options for legal dependents including standby guardianship, joint custody, or adoption Income tax preparation services to assist clients in filing Federal tax returns that are required by the Affordable Care Act for all individuals receiving premium tax credits Program Guidance: Legal services exclude criminal defense and class-action suits unless
related to access to services eligible for funding under the RWHAP. Legal Summary Unit of Service: 1 unit = 15 minute increments Staffing FY15 2.0 FTE plus hourly for additional staff Spent FY14 $82,746.68 Clients Served FY14 259 Services Not Funded
AIDS Drug Assistance Program Treatments Child Care Services Health Education/Risk Reduction Hospice Services Housing Linguistic Services Referral for Health Care and Support Services Rehabilitation Services
Respite Care AIDS Drug Assistance Program Treatments Description: The AIDS Drug Assistance Program (ADAP) is a stateadministered program authorized under Part B of the RWHAP to provide FDA-approved medications to low- income clients with HIV disease who have no coverage or limited health care coverage. ADAPs may also use program funds to purchase health insurance for eligible clients and for services that enhance access to, adherence to, and monitoring of antiretroviral therapy. RWHAP ADAP recipients must conduct a cost effectiveness analysis to ensure that purchasing health insurance is cost effective compared to the cost of medications in the aggregate.
Eligible ADAP clients must be living with HIV and meet income and other eligibility criteria as established by the state. Hospice Description: Hospice Services are end-of-life care services provided to clients in the terminal stage of an HIV-related illness. Allowable services are: a. b. c. d. e. Mental health counseling
Nursing care Palliative therapeutics Physician services Room and board Program Guidance: Services may be provided in a home or other residential setting, including a non- acute care section of a hospital that has been designated and staffed to provide hospice services. This service category does not extend to skilled nursing facilities or nursing homes. To meet the need for hospice services, a physician must certify that a patient is terminally ill and has a defined life expectancy as established by the recipient. Counseling services provided in the context of hospice care must be consistent with the definition of mental health counseling. Palliative therapies must be consistent with those covered under respective state Medicaid programs.
Child Care Services Description: The RWHAP supports intermittent child care services for the children living in the household of HIV-infected clients for the purpose of enabling clients to attend medical visits, related appointments, and/or RWHAP-related meetings, groups, or training sessions. Allowable use of funds include: A licensed or registered child care provider to deliver intermittent care Informal child care provided by a neighbor, family member, or other person (with the understanding that existing federal restrictions prohibit giving cash to clients or primary caregivers to pay for these services) Program Guidance: The use of funds under this service category should be limited and carefully monitored.
Direct cash payments to clients are not permitted. Such arrangements may also raise liability issues for the funding source which should be carefully weighed in the decision process. Health Education/Risk Reduction Description: Health Education/Risk Reduction is the provision of education to clients living with HIV about HIV transmission and how to reduce the risk of HIV transmission. It includes sharing information about medical and psychosocial support services and counseling with clients to improve their health status. Topics covered may include: Education on risk reduction strategies to reduce transmission such as preexposure prophylaxis (PrEP) for clients partners and treatment as prevention Education on health care coverage options (e.g., qualified health plans through the Marketplace, Medicaid coverage, Medicare coverage)
Health literacy Treatment adherence education Program Guidance: Health Education/Risk Reduction services cannot be delivered anonymously. Housing Description: Housing services provide limited short-term assistance to support emergency, temporary, or transitional housing to enable a client or family to gain or maintain outpatient/ambulatory health services. Housing-related referral services include assessment, search, placement, advocacy, and the fees associated with these services. Housing services are transitional in nature and for the purposes of moving or maintaining a client or family in a long-term, stable living situation. Therefore, such assistance cannot be provided on a permanent basis and must be accompanied by a strategy to identify, relocate, and/or ensure the client or family is moved to, or capable of maintaining, a long-term, stable living
situation. Eligible housing can include housing that provides some type of medical or supportive services (such as residential substance use disorder services or mental health services, residential foster care, or assisted living residential services) and housing that does not provide direct medical or supportive services, but is essential for a client or family to gain or maintain access to and compliance with HIV-related outpatient/ambulatory health services and treatment. Program Guidance: RWHAP Part recipients must have mechanisms in place to allow newly identified clients access to housing services. Upon request, RWHAP recipients must provide HAB with an individualized written housing plan, consistent with RWHAP Housing Policy 11-01, covering each client receiving short term, transitional and emergency housing services. RWHAP recipients and local decision making planning bodies, (i.e., Part A and Part B) are strongly encouraged to institute duration limits to provide transitional and emergency housing services. The US Department of Housing and Urban Development (HUD) defines transitional housing as up to 24 months and HRSA/HAB recommends that recipients consider using HUDs definition as their standard. Housing services funds cannot be in the form of direct cash payments to clients and cannot be used for
mortgage payments. Linguistic Services Description: Linguistic Services provide interpretation and translation services, both oral and written, to eligible clients. These services must be provided by qualified linguistic services providers as a component of HIV service delivery between the healthcare provider and the client. These services are to be provided when such services are necessary to facilitate communication between the provider and client and/or support delivery of RWHAP-eligible services. Program Guidance: Services provided must comply with the National Standards
for Culturally and Linguistically Appropriate Services (CLAS). Referral for Health Care and Support Services Description: Referral for Health Care and Support Services directs a client to needed core medical or support services in person or through telephone, written, or other type of communication. This service may include referrals to assist eligible clients to obtain access to other public and private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturers Patient Assistance Programs, and other state or local health care and supportive services, or health insurance Marketplace plans). Program Guidance:
Referrals for Health Care and Support Services provided by outpatient/ambulatory health care providers should be reported under the Outpatient/Ambulatory Health Services category. Referrals for health care and support services provided by case managers (medical and non-medical) should be reported in the appropriate case management service category (i.e., Medical Case Management or Non-Medical Case Management). Rehabilitation Services Description: Rehabilitation Services are provided by a licensed or authorized professional in accordance with an individualized plan of care intended to improve or maintain a clients quality of life and optimal capacity for self-care.
Program Guidance: Examples of allowable services under this category are physical and occupational therapy. Respite Care Description: Respite Care is the provision of periodic respite care in community or home-based settings that includes non-medical assistance designed to provide care for an HIVinfected client to relieve the primary caregiver responsible for the day-to-day care of an adult or minor living with HIV. Program Guidance: Recreational and social activities are allowable program activities as part of a respite care service provided in a licensed or certified provider setting including drop-in centers within HIV Outpatient/Ambulatory Health Services or satellite facilities. Funds may not be used for off premise social/recreational activities or to pay for a
clients gym membership. Funds may be used to support informal, home-based Respite Care, but liability issues should be included in the consideration of this expenditure. Direct cash payments to clients are not permitted. Grantee needs to know what service definitions are going to have changes for FY2017. Ryan White Part A Cleveland TGA