Ryan White HIV/AIDS Program Part A Manual

Administration/Use of Funds

The CEO establishes a mechanism to administer funds for the timely delivery of essential services to PLWHA throughout the Eligible Metropolitan Area/Transitional Grant Area (EMA/TGA). Ryan White HIV/AIDS Program funds must be used to address gaps in HIV services not being met by other programs. Services must be provided regardless of an individual's ability to pay. Local funding of Ryan White core services must be maintained at a level at least equal to the prior year's level to ensure that Ryan White funds are used to supplement, but not replace, local spending.

Other administrative responsibilities of Part A CEOs are as follows:

• CEOs must ensure that funding for services to women, infants, children, and youth with HIV/AIDS is in proportion to their representation among total AIDS cases in an EMA/TGA, if not provided through other programs.

• Establish intergovernmental agreements with other jurisdictions within the EMA/TGA that provide HIV-related services that account for at least 10 percent of the EMA's/TGA's reported AIDS cases.

• The CEO must assure that Clinical Quality Management programs are established to assess the extent to which HIV health services are consistent with the most recent Public Health Service (PHS) treatment guidelines and to develop strategies to ensure that these services are consistent with guidelines to improve access to and quality of HIV health services.
  

• CEOs must maintain appropriate relationships with "key points of entry" to assure referrals into care for PLWHA.

• The CEO must assure that outreach is conducted to inform clients of the availability of services.

• CEOs must assure that the maintenance of effort requirements are met and that existing services and funds are not supplanted with Ryan White funds.

CEOs must ensure that all funds are expended in accordance with established PHS regulations and Ryan White legislative requirements. This includes assuring that their administrative agent is in compliance with all fiscal requirements, including formally addressing grievances regarding the distribution of funds.

Administration/Use of Funds

The establishes a mechanism to administer funds for the timely delivery of essential services to PLWHA throughout the State. Ryan White HIV/AIDS Program programs must be used to address gaps in HIV services not being met by other programs. There are five program areas under which States can deliver Part B services, providing CEOs with flexibility to meet unique needs in their areas. Services must be provided regardless of an individual's ability to pay. State funding of Ryan White core services must be maintained at a level at least equal to the prior year's level to ensure that Ryan White funds are used to supplement, but not replace, State spending.

Other administrative responsibilities of Part B CEOs are as follows:

• CEOs must ensure that funding for services to women, infants, children, and youth with HIV/AIDS is in proportion to their representation among total AIDS cases in the State, if not provided through other programs.

• The CEO must assure that Clinical Quality Management programs are established to assess the extent to which HIV health services are consistent with the most recent Public Health Service (PHS) treatment guidelines and to develop strategies to ensure that these services are consistent with guidelines to improve access to and quality of HIV health services.

• The CEO must require Part B providers to participate in an HIV/AIDS consortium, if such exists, and to maintain appropriate relationships with "key points of entry" to assure referrals into care for PLWHA.

• The CEO must assure that outreach is conducted to inform clients of the availability of services.

• CEOs must assure that maintenance of effort requirements are met and that existing services and funds are not supplanted with Ryan White funds.

CEOs must ensure that all funds are expended in accordance with established PHS regulations and Ryan White legislative requirements. This includes assuring that their administrative agent is in compliance with all fiscal requirements.

CEO duties unique to Part B are as follows:

• Take administrative or legislative action to ensure that good faith efforts are made to notify a spouse of a known HIV-infected patient that such spouse may have been exposed to HIV and should seek testing.

• Assure that any State match requirements are met.

• Assure that the AIDS Drug Assistance Program is operated in a fair and efficient manner to enable the most patients to be served with available resources.

Planning

The CEO must establish a planning council and, once the planning council is established, appoint members through the planning council's nominations process. For the five new TGAs, the CEO has the option of establishing a planning council or a process for securing community input.

Planning council membership must meet legislative requirements for representation and be selected through an open nominations process that has been approved by HRSA.

Members must be trained to enable them to fulfill their responsibilities, in accordance with guidance from HAB/DSS.

CEOs must enable planning councils to carry out their legislatively mandated responsibilities:

• Conduct an assessment of local community needs

• Develop a comprehensive service plan, compatible with existing State and local plans

• Allocate funds according to service priorities set by the planning council

• Participate along with other Ryan White partners in the development a Statewide Coordinated Statement of Need (SCSN) to enhance coordination among Ryan White HIV/AIDS Program programs in addressing key HIV/AIDS care issues

• Coordinate with Federal, State, and locally funded grantees providing HIV-related services, and

• Assess the efficient administration of funds.

Planning

The CEO or designee must help ensure that health services planning is conducted with the broad and diverse input of key stakeholders, including PLWHA and historically underserved populations. Public hearings must be held concerning the intended use and distribution of Part B funds.

The CEO must assure that the following legislative responsibilities are carried out directly by the State:

• Participation in needs assessment activities to collect data for conducting HIV services planning.

• Help in establishing service priorities for the allocation of funds.

• Participation in the development of a comprehensive plan for the provision of HIV services throughout the State, which must be updated every three years.

• Periodic convening of a meeting of PLWHA, representatives of Ryan White Parts operating in the State, HIV service providers, and public agency representatives for the purposes of developing and updating the SCSN.

• Ensuring coordination between Ryan White and other Federal HIV programs operating in the State.