Our HIV/AIDS Bureau (HAB) carries out the Ryan White HIV/AIDS Program (RWHAP). HAB gives RWHAP grants to states, counties, cities, and community-based groups to pay for medical and support services for low-income people with HIV. This includes people who don't have health insurance or who have limited access to health care. More than 50% of people diagnosed with HIV--or about half a million people--get help from the program each year.
The goal of RWHAP is to improve health outcomes and reduce the spread of HIV.
What's in the legislation?
The legislation (PDF - 1 MB) started in 1990 as a law called the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The law has been updated four times to meet the changing needs of people with HIV.
The legislation is broken into parts that focus on different funding goals. Together, they give RWHAP recipients flexibility to address HIV care needs based on:
- Location - areas most affected, like states, cities, or communities
- Population - people most at risk of HIV
- Services - specific HIV-related care needs
- Program - service system needs such as technical assistance, clinical training, and research on innovative models of care
The legislation addresses these program elements:
- Planning and decision-making
- Types of available grants
- How to spend the funds
- Applying for grants
- Available technical assistance to help programs run better
What's in the current legislation?
The current legislation includes:
- Funding - While the RWHAP authorization expired in 2013, funding for RWHAP continues (as long as Congress approves the budget)
- Minority AIDS Initiative (MAI) - RWHAP Parts A and B Minority AIDS Initiative (MAI) provides money to areas with high HIV/AIDS rates. A formula is used to decide how much money is given to certain areas. The money is awarded in cycles.
- Identifying people with HIV - Programs that receive RWHAP Part A funding must keep track of how many people have HIV in their area. This includes people who don’t know they have HIV. One-third of the RWHAP Part A grant score depends on how well the program finds people with undiagnosed HIV.
- Reaching underserved communities - RWHAP Parts A and B grant recipients must develop strategic plans to find people with HIV who do not know their status. The grant recipients must help them find HIV care. These plans should make it easier for people to get tested and get HIV care, especially for minorities and underserved communities.
- RWHAP as payor of last resort - This applies to Parts A, B, C, and D. Part-D grants allows public and non-profit groups to provide care through agreements (memoranda of understanding) in addition to contracts.
- Quality care - The RWHAP Clinical Quality Management program makes sure HIV services meet the Guidelines for the Treatment of Opportunistic Infections in Adults and Adolescents with HIV. The program also works on ways to make it easier for people to access quality HIV care.
- Funding for core service - At least 75% of grant funds in Parts A, B, and C must go towards core medical services for people with HIV. This does not include administrative and quality management costs. There's a waiver process for programs that meet certain criteria.
1 For the purposes of the RWHAP statute, states includes, in addition to the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.