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Florida Ryan White CARE Act All Titles Meeting April 7, 2005

Florida Ryan White CARE Act All Titles Meeting April 7, 2005. Federal Updates – 2005 CARE Act Reauthorization Laura Hanen, National Alliance of State and Territorial AIDS Directors. Ryan White Reauthorization. President’s “Philadelphia” principles

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Florida Ryan White CARE Act All Titles Meeting April 7, 2005

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  1. Florida Ryan White CARE Act All Titles MeetingApril 7, 2005 Federal Updates – 2005 CARE Act Reauthorization Laura Hanen, National Alliance of State and Territorial AIDS Directors

  2. Ryan White Reauthorization • President’s “Philadelphia” principles • Prioritizing lifesaving services, including medications and primary care • Providing more flexibility to target resources to areas with greatest need • Encouraging the participation of any provider, including faith-based and other community organizations that show results • Recognizing the need for state and local planning and ensuring accountability by measuring progress

  3. Ryan White Reauthorization • Persistent Questions for Title II: • Adequate and equitable funding and distribution • Responding to the needs of metropolitan areas and rural communities • Consumer Participation • Addressing ADAP Crisis • Greater coordination to increase efficiency and maximize resources

  4. Title II Issues to Consider • Core Set of Services or “Medicalization” • HRSA defines “core services” in application guidance as • primary medical care consistent with PHS Guidelines • HIV-related medications • oral health • mental health treatment • substance abuse treatment • case management • Potential loss of supportive services • Detrimental to adherence and access to care

  5. Title II Issues to Consider • Core ADAP Formulary • Pros • Portability • Bring states up to a minimum • Address ADAP crisis • Cons • Disincentive for states to maintain high level contribution • Concern that core would become ceiling, not floor • Vacuum to which all CARE Act dollars would go to fill

  6. Title II Issues to Consider • Emerging Communities (ECs) • Unstable funding - Went from 39 to 28 ECs and 14 ECs eliminated • Title I and EC inequity • Incorporation of HIV cases into allocation formulas • Current Law Requires use in 2007 • CDC Estimates will be used

  7. Title II Issues to Consider • Attachment of social riders to RWCA • Increased focus on reducing perinatal transmission • Partner notification • “ABC “prevention messages • HIV/HCV co-infection • Increasing Accountability • Quality Management Programs • Individual level data collection • Outcome Evaluation • How can you prove the CARE Act is working? • Greater Coordination to reduce duplication

  8. Reauthorization Process • Congressional agenda full with SS reform and Medicaid • Need enough oxygen to do reauthorization • Simultaneous cuts in domestic health spending • Hill staff need basic education – focus of many organizations and coalitions • Senate HELP and House Energy and Commerce • Senate HELP taking the lead • Initial discussions with staff underway • AIDS is a global issue for most staff • ADAP “fix” to be a major focus

  9. What Can You Do? • Congress relies on experts to assess programs they fund and administer • You are that expert • You don’t have to come to Washington to interact with congressional offices • District offices • Town hall meetings • Mailings • Regular phone calls • Become a resource to staff

  10. Florida Ryan White CARE Act All Titles MeetingApril 7, 2005 Gazing into the Crystal Ball – Future of Federal Funding Laura Hanen, National Alliance of State and Territorial AIDS Directors

  11. FY2006 Discretionary Spending • Summary – President’s budget (Appropriations marker) • Increases for: • Global HIV/AIDS • ADAP • NIH HIV/AIDS research • Substance abuse treatment • Flat funding: • All Titles of the CARE Act, except for ADAPs • MAI • Cuts for: • CDC HIV/AIDS Prevention • HOPWA • Mental Health Services • Elimination of CDC Prevention Block Grant

  12. FY2006 Discretionary Funding

  13. FY2006 Discretionary Funding

  14. FY2006 Discretionary Funding

  15. FY2006 Discretionary Funding

  16. Contact Information Laura Hanen Director of Government Relations National Alliance of State and Territorial AIDS Directors 444 North Capitol Street, NW Suite 339 Washington, DC 20001 202.434.8091 lhanen@nastad.org www.NASTAD.org

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