Ryan White HIV/AIDS Program Part B Manual U.S. Department of Health and Human Services Health Resources and Services Administration HIV/AIDS Bureau Revised 2015 Ryan White HIV/AIDS Program Part B Manual—Revised 2015 Preface The Ryan White HIV/AIDS Program (RWHAP) Part B Manual is for RWHAP Part B Program Directors and staff and others interested in the RWHAP Part B Program. The Ryan White HIV/AIDS Program is administered in the Federal government by the Health Resources and Services Administration (HRSA), an Operating Division within the U.S. Department of Health and Human Services (HHS). The RWHAP Part B Program awards grants to assist States and Territories in developing and/or enhancing access to a comprehensive continuum of high quality HIV care and treatment for low-income people living with HIV (PLWH). Each State and Territory operates a RWHAP Part B program, including an AIDS Drug Assistance Program (ADAP). RWHAP Part B programs, as well as the ADAPs, vary significantly in their administrative structures and the mechanisms used to ensure access to HIV care and to make HIV/AIDS medications available to eligible individuals living with HIV. This Manual is designed to serve as: • An orientation guide for new RWHAP Part B staff, with sections explaining how the RWHAP Part B and ADAPs are structured at the Federal and State level, and the key issues and strategies used by the RWHAP Part B and ADAPs to broaden access to HIV/AIDS care and treatment to persons in need. • A reference document for RWHAP Part B staff on legislative and program requirements. • A tool to guide RWHAP Part B programs in managing their fiscal and program components. How This Manual is organized The RWHAP Part B Manual includes sections that include a series of chapters that cover related topics. The information is presented in clearly labeled subsections so that RWHAP Part B staff can quickly find the information they need. • The first section is most helpful to those new to RWHAP Part B as it presents basic information about the Ryan White HIV/AIDS Program, including ADAP, and where to find information and assistance. Later sections cover more detailed RWHAP Part B management and technical issues. • Legislative and program requirements are included in the front sections of most chapters, providing RWHAP Part B staff with essential information in one place. Many chapters then present highlights (e.g., best practices, resources) on ways to address these requirements. • In-depth information on management of the ADAP Program is presented in HAB’s ADAP Manual and is not repeated in this Manual. Thus, the ADAP Manual and RWHAP Part B Manual should be used as companion documents. The ADAP Manual is available online at http://hab.hrsa.gov. Routine Updates to the RWHAP Part B Manual The RWHAP Part B Manual will be reviewed regularly and will be updated online as needed to reflect changes in RWHAP Part B requirements and conditions. State Part B Directors will continue to inform HRSA to make the RWHAP Part B Manual a living document. HRSA Project Officers will keep grantees informed about update releases. For further assistance, contact your HRSA Project Officer at 301-443-6745. 2 Ryan White HIV/AIDS Program Part B Manual—Revised 2015 CONTENTS SECTION I: OVERVIEW OF THE RYAN WHITE HIV/AIDS PROGRAM ......................................................................... 5 I. CHAPTER 1. INTRODUCTION .......................................................................................................................................... 5 I. CHAPTER 2. RYAN WHITE HIV/AIDS PROGRAM LEGISLATION ............................................................................................. 6 I. CHAPTER 3. RYAN WHITE HIV/AIDS PROGRAM MOVING FORWARD .................................................................................. 7 I. CHAPTER 4. RWHAP STRUCTURE .................................................................................................................................. 7 I. CHAPTER 5. RYAN WHITE HIV/AIDS PROGRAM ADMINISTRATION ...................................................................................... 9 I. CHAPTER 6. OVERVIEW OF THE RWHAP PART B PROGRAM ............................................................................................. 10 I. CHAPTER 7. THE DIVISION OF STATE HIV/AIDS PROGRAMS ............................................................................................. 12 I. CHAPTER 8. TECHNICAL ASSISTANCE FOR THE RWHAP COMMUNITY.................................................................................. 13 I. CHAPTER 9. REFERENCES, LINKS, AND RESOURCES ........................................................................................................... 13 SECTION II: HIV SERVICE DELIVERY SYSTEM ......................................................................................................... 14 II. CHAPTER 1. INTRODUCTION ....................................................................................................................................... 14 II. CHAPTER 2. LEGISLATIVE BACKGROUND ....................................................................................................................... 14 II. CHAPTER 3. NATIONAL HIV/AIDS STRATEGY AND THE RWHAP ...................................................................................... 16 II. CHAPTER 4. COMPREHENSIVE SERVICE DELIVERY SYSTEM FOR PLWH ................................................................................ 17 II. CHAPTER 5. RYAN WHITE HIV/AIDS PROGRAM CORE MEDICAL SERVICES ......................................................................... 18 II. CHAPTER 6. RYAN WHITE HIV/AIDS PROGRAM SUPPORT SERVICES ................................................................................. 19 II. CHAPTER 7. CONTINUUM OF HIV CARE........................................................................................................................ 20 II. CHAPTER 8. COORDINATION OF SERVICES AND FUNDING STREAMS .................................................................................... 21 II. CHAPTER 9. REFERENCES, LINKS, AND RESOURCES .......................................................................................................... 23 SECTION III. AIDS DRUG ASSISTANCE PROGRAMS (ADAPS) .................................................................................. 24 III. CHAPTER 1. INTRODUCTION ...................................................................................................................................... 24 III. CHAPTER 2. LEGISLATIVE BACKGROUND ...................................................................................................................... 25 III. CHAPTER 3. PURCHASING AND DISPENSING MEDICATIONS BY ADAPS .............................................................................. 27 III. CHAPTER 4. HEALTH INSURANCE PROGRAMS ............................................................................................................... 28 IX. CHAPTER 5. REFERENCES, LINKS, AND RESOURCES......................................................................................................... 32 SECTION IV: REPORTING REQUIREMENTS ........................................................................................................... 33 IV. CHAPTER 1. INTRODUCTION ..................................................................................................................................... 33 IV. CHAPTER 2. LEGISLATIVE BACKGROUND ..................................................................................................................... 33 IV. CHAPTER 3. THE ELECTRONIC HANDBOOK (EHB) AND THE SUBMISSION OF REPORTS.......................................................... 34 IV. CHAPTER 4. OVERVIEW OF RWHAP PART B REPORTING REQUIREMENTS ........................................................................ 34 IV. CHAPTER 5. PROGRAM AND FISCAL REPORTS .............................................................................................................. 36 IV. CHAPTER 6. BUDGET AND BUDGET NARRATIVE JUSTIFICATION GUIDELINES ....................................................................... 40 IV. CHAPTER 7. CLIENT LEVEL DATA REPORTING ............................................................................................................... 41 IV. CHAPTER 8. GRANTEE AND PROVIDER RESPONSIBILITIES FOR DATA REPORTING ................................................................. 42 IV. CHAPTER 9. TRAINING AND TECHNICAL ASSISTANCE FOR THE ADR AND RSR ..................................................................... 43 IV. CHAPTER 10. REFERENCES, LINKS, AND RESOURCES ..................................................................................................... 44 SECTION V: GRANTEE AND SUBRECIPIENT MONITORING..................................................................................... 45 V. CHAPTER 1. INTRODUCTION ....................................................................................................................................... 45 V. CHAPTER 2. LEGISLATIVE BACKGROUND ....................................................................................................................... 45 V. CHAPTER 3. RWHAP PART B NATIONAL MONITORING STANDARDS ................................................................................. 45 V. CHAPTER 4. MONITORING OF RWHAP PART B GRANTEES BY HAB ................................................................................. 46 V.