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Ryan White HIV/AIDS Treatment Extension Act

On October 21st, the House passed the Ryan White HIV/AIDS Treatment Extension Act (S.1793), reauthorizing the Ryan White program for four years. The Ryan White program has been serving people with AIDS and HIV for nearly two decades. Today, the program provides care, treatment and support services to nearly half a million people - most of whom are low-income.  Without this critical safety net, some of our nation's most vulnerable populations would not receive the care and treatment they need and rightfully deserve.  There are more than 50,000 new HIV/AIDS infections reported each year and according to the Centers for Disease Control and Prevention, approximately 1.1 million Americans are currently living with HIV/AIDS. All parts of the Ryan White program have been in desperate need of increased funding for the past three years.  Modern medical advancements have made it possible for more individuals to live full lives with an HIV/AIDS diagnosis, which means there are more individuals living with the disease and in need of services.

In order to respond to a growing level of need, it increases the authorization level for each part of the Ryan White program by 5 percent a year for the next four years - authorizing a total of $2.55 billion in FY 2010, $2.68 billion in FY 2011, $2.81 billion in FY 2012, and $2.95 billion in FY 2013. Below is an overview of some of the bill's key provisions.  

Emergency Relief Program

As with the other parts of the Ryan White programs, the bill increases the authorization of the Emergency Relief program (Part A of Ryan White) by 5 percent a year over the next four years - increasing it to $682 million in FY 2010, $716 million in FY 2011, $752 million in FY 2012, and $790 million in FY 2013.  This program provides grants to metropolitan areas with very high numbers of AIDS cases.   These grants fund comprehensive primary care and support services, including home health care, hospice care, housing, transportation and nutrition services.

Comprehensive Care Program

The bill increases the authorization of the Comprehensive Care program (Part B of Ryan White) by 5 percent a year over the next four years - increasing it to $1.3 billion in FY 2010, $1.4 billion in FY 2011, $1.5 billion in FY 2012, and $1.6 billion in FY 2013.  This program provides grants to states for health care and support services for persons with HIV/AIDS.  These grants fund home and community-based health care and support services, and an AIDS drug assistance program.

Early Intervention Program

The bill increases the authorization of the Early Intervention Program (Part C of Ryan White) by 5 percent a year over the next four years - increasing it to $247 million in FY 2010, $259 million in FY 2011, $272 million in FY 2012, and $286 million in FY 2013.  This program provides grants to public and non-public entities to pay for community-based programs that provide comprehensive primary care services intended to prevent or reduce HIV-related deaths.  The measure requires that grantees provide counseling and information about hepatitis A, B, and C.  It also requires them to develop an electronic information system to improve the ability to report data.

Pediatric AIDS Program

The bill increases the authorization of the Pediatric AIDS Program (Part D of Ryan White) by 5 percent a year over the next four years - increasing it to $75 million in FY 2010, $79 million in FY 2011, $83 million in FY 2012, and $87 million in FY 2013.   This program provides grants to improve and expand primary care and support services for women, infants, or children with HIV/AIDS and their families.

Minority AIDS Initiative

The bill increases the authorization of the Minority AIDS Initiative by 5 percent a year over the next four years - increasing it to $146 million in FY 2010, $153 million in FY 2011, $161 million in FY 2012, and $169 million in FY 2013.  The Minority AIDS Initiative funds efforts to address the disproportionate impact of HIV/AIDS on racial and ethnic minorities and to improve access, treatment, care, and outcomes for racial and ethnic minorities living with HIV/AIDS.

Name-Based Reporting

Most states initially collected surveillance data on HIV under a code-based system, which excluded any identifying information for individuals.  In the late 1990s, the Centers for Disease Control and Prevention recommended that all states switch to a name-based system, which decreases duplication and creates a more accurate count.  Today, every state collects name-based HIV data to some degree, which is reported to CDC on an annual basis.  However, because state systems evolved at different rates, there is substantial variation in the maturity of their name-based HIV reporting systems and the extent to which they fully reflect the current epidemic in each state.  Seven states - California, Hawaii, Illinois, Maryland, Massachusetts, Oregon - and D.C. do not yet have fully mature names-based HIV surveillance systems.

Under the 2006 reauthorization, states are allowed to continue to submit code-based HIV data directly to the Health Resources and Services Administration (HRSA), but they receive a 5% penalty to account for potential duplication.

The bill maintains these same provisions for states and jurisdictions with maturing names-based HIV case data during the first two years of the reauthorization period.  Jurisdictions that report code-based data to HRSA will continue to incur a 5% penalty.  In FY 2012, the 5% penalty will be increased to 6%.  Then, beginning in FY 2013, code-based protections will be eliminated and all states will be required to report cases using a name-based system.

National Testing Goal

The bill also requires the HHS Secretary to establish a national HIV/AIDS testing goal of 5 million tests per year by January 1, 2010 through federally-supported HIV/AIDS prevention, treatment, and care programs, both at the CDC and through other federal programs.  The Secretary is required to report to Congress each year on the progress made toward achieving the goal.