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Ryan White CARE Act Gazing into the Future

Florida All Titles Meeting April 7, 2005. 2. Presentation Overview. Importance of CARE ActChallenges of the CARE ActHRSA's Role in ReauthorizationPresident's View on ReauthorizationConclusion. Florida All Titles Meeting April 7, 2005. 3. Importance of Ryan White C

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Ryan White CARE Act Gazing into the Future

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    1. Ryan White CARE Act – Gazing into the Future Harold J. Phillips, MRP Phillips Solutions Boston, MA Florida All Titles Meeting April 7, 2005

    2. Florida All Titles Meeting April 7, 2005 2 Presentation Overview Importance of CARE Act Challenges of the CARE Act HRSA’s Role in Reauthorization President’s View on Reauthorization Conclusion

    3. Florida All Titles Meeting April 7, 2005 3 Importance of Ryan White CARE Act The CARE Act continues to provide primary care and essential support services to low-income, uninsured, and underinsured people living with HIV/AIDS. The CARE Act is still the largest federal program specifically designated to provide primary care and support services for people living with HIV/AIDS.

    4. Florida All Titles Meeting April 7, 2005 4 Importance of Ryan White CARE Act The CARE Act supports a continuum of care that reaches over 571,000 people a year. The demand for outpatient HIV services continues to grow.

    5. Florida All Titles Meeting April 7, 2005 5 Challenges of the CARE Act Increases in the number of uninsured and underinsured. Crisis among other safety-net programs. Need to balance primary care and life saving treatments with vital support services. Rising rates of infection among minority communities

    6. Florida All Titles Meeting April 7, 2005 6 Challenges of the CARE Act Need to measure success and evaluate outcomes. Address capacity development with few new resources and the rising costs of care.

    7. Florida All Titles Meeting April 7, 2005 7 What Are the Key Challenges To The CARE Act? Targeting of Resources: The Department recognizes that it has a particular obligation to assuring that resources available to the CARE Act are used effectively. The CARE Act, as the 3rd largest payer, can work more effectively to ensure: - Fair and equitable distribution of resources; - Prioritization of primary care services; - Expanded access to medications; - Flexibility for HRSA in allocating funds.

    8. Florida All Titles Meeting April 7, 2005 8 What Are the Key Challenges Around Strengthening the CARE Act? Administration of the Program: HRSA recognizes that its stewardship of CARE Act funds is the key to assuring that, regardless of appropriations levels, the Department is utilizing Federal funds in the best way possible. As administrators of the CARE Act, we can work more effectively to ensure: Improved planning, quality and evaluation of care, treatment and support services; Consistency in how we define expectations and costs across CARE Act programs; and, Sound fiscal management and stewardship.

    9. Florida All Titles Meeting April 7, 2005 9 HRSA’s Role and Reauthorization 3 Branches of Government Legislative – makes laws Executive – executes or administers Judicial – interprets the laws

    10. Florida All Titles Meeting April 7, 2005 10 What Is HRSA Doing To Prepare For Reauthorization? Slated for October 2005 Effort Coordinated by ASPE is HIV/AIDS Bureau providing guidance and support to the Department during reauthorization

    11. Florida All Titles Meeting April 7, 2005 11 Elicit Input from Program Staff and Constituency Since January 2003, internal meetings to understand the successes and challenges of the current Ryan White CARE Act legislation. HRSA hosted an all day meeting at the United States Conference on AIDS in September 2003, specifically focusing on what consumers perceive to be their role in CARE Act programs. Four Communities of Color consultations were held in January 2004 to seek input from African American, Latino, American Indian-Native American, and Asian–Pacific Islander communities. Host and participate in regular meetings with our National Partners.

    12. Florida All Titles Meeting April 7, 2005 12 Obtaining Input From Key Stakeholders Obtaining information on critical HIV/AIDS treatment and care issues from a broad group of stakeholders–including national AIDS organizations. Federal AIDS Policy Partnership (FAPP) and National Organizations Responding to AIDS (NORA) have convened their member organizations to discuss reauthorization of the CARE Act. Focused discussions with key constituent national groups National Alliance of State and Territorial AIDS Directors; Communities Advocating Emergency AIDS Relief Coalition; National Association of Community Health Centers; AIDS Alliance for Children Families & Youth; National Minority AIDS Council; The AIDS Institute.

    13. Florida All Titles Meeting April 7, 2005 13 Provide Support to the Secretary’s Advisory Committee CDC/HRSA Advisory Committee on HIV and STD Prevention and Care (CHAC), Ryan White CARE Act Reauthorization Workgroup Three public meetings in order to seek public comment about future directions in HIV/AIDS care and treatment programs and issues relating to reauthorization of the Ryan White CARE Act. The Advisory Committee adopted a set of formal recommendations relating to future program directions during its November 2003 and November 2004 meetings.

    14. Florida All Titles Meeting April 7, 2005 14 Provide Support to the Secretary’s Reauthorization Workgroup The Department has convened an Office of the Secretary (OS) Ryan White CARE Act reauthorization workgroup that includes representatives from key Offices including: Assistant Secretary for Planning and Evaluation; Assistant Secretary for Legislation; Office of General Counsel; Assistant Secretary for Budget, Technology and Finance; Assistant Secretary for Health; Intergovernmental Affairs; Office of HIV/AIDS Policy; HRSA’s HIV/AIDS Bureau.

    15. Florida All Titles Meeting April 7, 2005 15 President’s Reauthorization Principles Support for the reauthorization of the CARE Act Several guiding principles used to strengthen the care act Focus on primary care and treatment Increase flexibility to target resources Ensure accountability by measuring progress

    16. Florida All Titles Meeting April 7, 2005 16 Reauthorization – Focus on Primary Care and Treatment The reductions in morbidity and mortality are the results of access to primary care and treatment. Support services that reduce barriers and increase access to care are essential. There is a need to reduce the size of waiting list for life saving medications.

    17. Florida All Titles Meeting April 7, 2005 17 Reauthorization – Target resources towards the areas of greatest need Increase flexibility in programs to move resources to: Address community need especially underserved and vulnerable minority communities, and medically underserved areas Address ADAP waiting lists Ensure that the CARE Act is the payor of last resort by increasing service coordination and delivery. Increase Coordination across CARE Act and non-CARE act programs

    18. Florida All Titles Meeting April 7, 2005 18 Reauthorization – Measure Progress Evaluation and Quality Management Programs Six HAB evaluation Questions (effectiveness, quality and cost-effectiveness of services). Increased desire to know what is working well Assist in targeting resources

    19. Florida All Titles Meeting April 7, 2005 19 Conclusions No large scale changes CARE Act will continue to fill gaps in services and care Continue to keep pace with the changes in HIV care and treatment Greater flexibility to target resources to areas of greatest need Evaluation

    20. Florida All Titles Meeting April 7, 2005 20

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