4268.0: Tuesday, November 14, 2000 - Board 9

Abstract #4493

HIV Services for American Indians and Alaska Natives and the Ryan White CARE Act Program

Alice M. Litwinowicz, MA, HIV/AIDS Bureau, Office of Policy and Program Development, US DHHS HRSA, Parklawn Building, Room 7-20, 5600 Fishers Lane, Rockville, MD 20857, (301) 443-5838, alitwinowicz@hrsa.gov

HIV infection is increasing among traditionally underserved and vulnerable populations. Challenges for the Ryan White CARE Act (RWCA) program, as the payer of last resort, include finding ways to work across programs to enhance access to care. Another challenge is to find ways to eliminate disparities in HIV/AIDS care in minorities who comprise 27 percent of the population, but account for more than 66 percent of new AIDS cases. American Indians and Alaska Natives (AIs/ANs) living with HIV disease face unique challenges obtaining appropriate health care.

The delivery of health care services varies across the over 500 federally recognized tribes in the U.S. Only about 20 percent of the AI/AN population lives on a reservation. Approximately two thirds live in urban areas, and movement between cities and reservations is common. HRSA's HIV/AIDS Bureau developed a policy to establish guidelines for the use of RWCA funds to provide services to AIs/ANs and for health care services provided by the Indian Health Service (IHS) programs or tribally run programs. Increasing and improving access to HIV-related services for AIs/ANs for programs funded by the RWCA was a primary objective. Working in collaboration with the IHS and tribal organizations, the Bureau addressed a number of issues raised in public comments on financing, eligibility, and statutory requirements. The benefits of the policy include 1) leveraging limited public funds to improve treatment; 2) increasing knowledge about the needs of HIV-positive AIs/ANs; and 3) developing a strategy for closer collaboration and cooperation among publicly-funded providers.

Learning Objectives: Identify how Ryan White CARE Act funds can be used for services provided to HIV infected American Indians and Alaska Natives and for health care services provided by IHS or tribally run programs. Identify the complex issues addressed in a policy developed to increase access to health care for American Indians and Alaska Natives living with HIV and AIDS. Describe the health policy strategy that was used to enhance collaboration between two agencies with different funding mechanisms, coverage, and statutory requirements established by Congress

Keywords: Ryan White, HIV/AIDS

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA