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. Within the RWHAP Part B grant there is:
- a base grant for core medical and support services;
- the AIDS Drug Assistance Program (ADAP) award;
- the ADAP Supplemental award;
- the Part B Supplemental award for recipients with demonstrated need;
- Minority AIDS Initiative funding for education and outreach to improve minority access to medication assistance programs, including ADAP; and
- supplemental grants to states with "emerging communities."
Part B funds core medical services and support services. The specific allowable services funded by each State/Territory are determined at the State/Territory level based on needs assessment and available funding. Core medical services include outpatient and ambulatory health services, ADAP, AIDS pharmaceutical assistance, oral health care, early intervention services, health insurance premium and cost-sharing assistance, home health care, medical nutrition therapy, hospice services, home and community-based health services, mental health services, outpatient substance abuse care, and medical case management, including treatment-adherence services.
Support services must be linked to medical outcomes and may include outreach, medical transportation, linguistic services, respite care for caregivers of people with HIV/AIDS, referrals for health care and other support services, non-medical case management, and residential substance abuse treatment services. Grant recipients are required to spend at least 75% of their Part B grant funds on core medical services and no more than 25% on support services.
In addition, all Part B recipients and subrecipients must vigorously pursue enrollment in available health coverage options for eligible clients.
Grant recipients are the chief elected official of a State/Territory who designates the state department of health or another state entity to implement and manage the RWHAP Part B grant.
All 50 states, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and the five U.S. Pacific Territories/Associated Jurisdictions are eligible for Part B funding. Emerging Communities funding is distributed to the state or territory for communities that report between 500 and 999 cumulative reported AIDS cases over the most recent five years.
- Part B Base and ADAP base awards are determined using a formula based on reported living cases of HIV in the state or territory in the most recent calendar year for which data is available.
- The ADAP base awards provide access to HIV-related medications through the purchase of medication and the purchase of health insurance coverage. A limited amount of ADAP funds can be pay for services that enhance access, adherence, and monitoring of drug treatments. Of the ADAP appropriation, 5% is reserved for additional funding to states and territories that have a severe need for medication assistance, which they can apply for through ADAP Supplemental.
- A competitive supplemental grant program, ADAP Emergency Relief Funds, was authorized in 2006 is also available based on demonstrated need criteria.