Advocate-in-Chief | December 7, 2012

National and state AIDS advocates on December 5, 2012, urged U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius to leverage the expertise of providers funded by the Ryan White Program when developing new programs under the Affordable Care Act (ACA).

Advocates also thanked Sec. Sebelius for the pledge she made on World AIDS Day 2012 to add HIV/AIDS to the list of chronic conditions that states can manage through the Medicaid Health Home program.

Here’s an excerpt from the letter:

n order to realize maximum benefit [of Health Homes], we ask that HHS explicitly encourage states to craft Health Home proposals that leverage their established Ryan White HIV service systems in efforts to create more robust and effective networks that enjoy new support thanks to the ACA. It also will be important for guidance to address how states can ensure the Medicaid expansionpopulation benefits from the Health Home care models and to address continuity of care issues for people with HIV transitioning from Ryan White to Medicaid -funded care management, coordination and support services.

With more than two decades of sustained federal and state investment, Ryan White programs are literally a lifeline for hundreds of thousands of people with HIV across the U.S. HHS can play an important role in making sure Ryan White service systems transform and modernize with ACA support to achieve better health outcomes for this vulnerable population.

Put simply, ACA implementation is a unique opportunity to strengthen Ryan White programs and learn from their success so that people with other chronic health conditions may enjoy equally robust, comprehensive systems of wellness and care.

For years, the service providers, AIDS organizations and HIV experts comprising the Ryan White sector have collaborated to deliver streamlined, effective HIV care and other supportive services for HIV-positive people. They effectively assumed the health-home role before such a designation and its incentives were codified in federal law.

That was out of necessity. Many people with HIV are extremely vulnerable, battling mental health issues, substance abuse and homelessness. HIV is not the only problem for many HIV-positive people and therefore solutions must adequately meet the whole person and address an array of client-centered needs.

It would be a shame if those years of experience, government investment and the vast collective expertise in the Ryan White sector are not properly utilized by the ACA’s health home program. Designing new Health Home proposals for states is a rare and important opportunity to actively involve state AIDS directors, other public health officials, AIDS organizations, HIV medical providers, advocates and people living with the disease in an effort to close existing service gaps that discretionary Ryan White funding could never adequately address.

Too many lives are at stake for ambiguity or duplicative systems development given the historic and unprecedented investment in Ryan White systems of HIV care. It’s time to build on what we started more than 20 years ago, when the legacy of a little boy named Ryan White transformed the nation’s approach to care and support for those living with HIV/AIDS in need.