Health Care Reform Checklist for AIDS Service Organizations
Implementation of the Affordable Care Act will bring significant changes to the nation’s health care system, including the delivery of HIV/AIDS care and treatment. Health care providers and organizations, including AIDS service organizations, will need to monitor these changes and adapt their operations, and in some cases their structure, in order to thrive in this new environment and continue best serving people living with HIV/AIDS.
The following checklist will help AIDS service organizations successfully navigate and participate in this process. A PDF version is available in the Downloads box to the right.
- Apply for a HRSA Health Center Planning Grant if applicable.
- Sign up with www.grants.gov to get daily notifications of federal funding opportunities tailored to your preferences.
- Seek out federal workforce development grants to strengthen existing staff and bring in new staff.
- Seek out new CDC prevention grants.
- Track Affordable Care Act implementation of Medical Homes (2011) and Medicaid Expansion (2014)
- Defining of criteria (e.g., chronic conditions definition)
- Services included in the “Essential Benefits Package”
- Monitor timeline for the rollout of the Affordable Care Act via
www.healthcare.gov/law/timeline or http://healthreform.kff.org/timeline.aspx.
- Monitor comparative effectiveness efforts at federal agencies, nonprofit/advisory groups, such as the Institute of Medicine, and new organizations, such as the Patient-Centered Outcomes Research Institute.
- Follow state developments and connect with the designated person/office responsible for health care reform implementation in your state.
- Understand the system/process in your state by which ADAP will be covering True Out-of-Pocket (TrOOP) Expenses incurred through the Medicare D donut hole and begin to educate your staff and clients as appropriate.
- Explore the option of state Medicaid waivers to bill for Medical Case Management or other Ryan White services if they do not already exist. (Monitor developments in Primary Care Case Management pilots); get involved in state committees to redesign the care model and financing of care to reflect the needs of people living with HIV.
- Reach out to the designated person/office responsible for implementation of the Affordable Care Act in your state, or any state-wide planning groups concerned with the needs of low-income adults. Work with them to amend the state’s Medicaid provisions to provide access to Medicaid insurance for adults at 133% of the federal poverty rate sooner than the ACA requires in 2014. The benefit to the state will be greater if implemented sooner than 2014.
- Advocate for Ryan White Program “bridge” from 2013 to full implementation of health care reform in 2014.
- Educate your legislators on HIV/AIDS and how the Ryan White Program currently works in your community.
- Educate your legislators on how Ryan White Program works with other funding streams to create the HIV continuum in your community (some gaps may be closed by ACA but new gaps may appear and you need to be the resource they go to for finding out how people living with HIV/AIDS clients are impacted).
- Advocate maintaining and increasing current Ryan White Program funding to ensure continuity of care for all uninsured and under-insured people living with HIV/AIDS.
- Advocate for continued enhancements and refinements to ACA as it is implemented in the field to improve health care access for people living with HIV.