Below is the text of an announcement from the National Association of People with AIDS (NAPWA) explaining the recent legislative action. The Ryan White CARE Act. The act disburses $2.1 billion to HIV/AIDS service providers around the country; it was reauthorized in 2006 but includes a sunset provision ending the program on Sept. 30, 2009. If the Senate approves the continuing resolution as expected, Congress will have an additional month to renew the act before it expires.
Ryan White Extension Progresses in Congress
Washington, DC -- September 30, 2009 -- Today, the United States Senate Committee on Health, Education, Labor and Pensions (HELP), passed by unanimous consent legislation to extend the Ryan White program for another four years. Thousands of persons living with HIV/AIDS, including those on AIDS Drug Assistance Programs (ADAP), rely on the Ryan White program for access to HIV primary medical care and supportive services, such as housing, case management, mental health and substance abuse services, and more.
With the vote in the Senate HELP Committee, the bill may now proceed to the full floor of the Senate for a vote. After that, the U.S. House of Representatives must also pass identical legislation. Once both chambers have completed their task, it is brought to the President for his signature.
NAPWA and many HIV advocates as well as persons living with HIV/AIDS had become increasingly concerned about the fate of Ryan White; the program is scheduled to sunset at midnight tonight. While this legislation voted out of committee today will definitely not complete its final rounds in Congress before tonight, a backup plan has also been put into place. While Congress deliberates on this bill to extend Ryan White for four years, language has also been attached to a budget bill, called a continuing resolution, which will fund the government for another 30 days. This will allow Congress the extra few weeks it needs to complete the legislative process. Essentially Congress is taking a two-track, parallel approach to continuing Ryan White; while they work on more longer-term legislation, they have also attached some language to a must-pass 30-day budget bill. The U.S. House has already voted on a continuing resolution, and the U.S. Senate is scheduled to take up the matter today.
Below is a brief summary of the major components of the bill the U.S. Senate HELP committee approved today:
Length of authorization -- The bill authorizes Ryan White for an additional four years.
Authorization levels -- All Parts will receive a five percent increase in their authorization level each year.
Code-based data -- States reporting their data directly to HRSA will be allowed to do so for the first three years of the new authorization period. In the third year the case penalty for states reporting cases to HRSA will increase from five to six percent. In the fourth year formulas will be driven solely by name-based data reported to CDC.
Hold Harmless -- In FY2010, funding will not be less than 95 percent of FY2009. In years FY2011 and FY2012, the hold harmless for Part B is 100 percent of the previous year's award. In FY2013, funding will not be less than 92.5 percent of FY2012 funding.
Transitional Grant Areas (TGAs) -- TGAs that do not meet the eligibility criteria will drop out of Part A. When they drop-out, their formula funding plus $500,000 will be added to the Part B pot for distribution. In the first year, 75 percent of a TGA's formula funding will go directly to the TGA's state. In the second year, that percent would decrease to 50 percent and decrease further to 25 percent in the third year. In addition, the backdoor prevalence test has been changed from 1,500 living AIDS cases to 1,400 cases to allow one of the TGAs to retain its eligibility since it was three cases under the current threshold. There are potentially up to five TGAs that may lose funding.
ADAP Rebate -- If states are facing an expenditure of rebate funds that would trigger an unobligated penalty or a higher penalty, states will be able to have the HHS Secretary deem the rebate dollar amounts as subtracted from the unobligated balance amount. The ADAP rebate issue was a source of much discussion and staff had difficulties reaching agreement on language. This language replaces previous language that would have restricted the use of ADAP rebate dollars to a great extent.
Unobligated Balances -- The unobligated threshold has been raised to five percent from two percent. The two penalties still apply. However, the penalty that reduces the formula award by the amount of unobligated has been altered. The new language states that the jurisdiction's formula award will be reduced only by the amount of unobligated funds that a jurisdiction was not allowed to carryover. In many cases, this should make the penalty obsolete.
Prevention -- One-third of the Part A supplemental criteria will be judged on the city's ability to identify new [HIV] positives and link them to care. States will need to incorporate information regarding their approach to testing individuals and linking those found to be HIV positive to care in their existing state plan. In addition, the language would set a national HIV testing goal of five million tests supported by federal funds. A review of existing government programs, primarily focusing on those at CDC, would be conducted to determine effectiveness.
Other -- Language regarding Emergency Responders and Partner Notification Services is reinserted in the bill.
As more information becomes available, we will keep you informed.
10/02/09
Source
M Lesieur, National Association of People with AIDS. Ryan White Extension Progresses in Congress. September 30, 2009. .
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