Ryan White and World AIDS Day
Ryan White and World AIDS Day
December 1, 2014 is World AIDS Day: Focus, Partner, Achieve: An AIDS-Free Generation. That theme fits the work underway over the past 25+ years by HRSA, Ryan White grantees, providers and consumers to establish a robust and clinically effective HIV care infrastructure and a comprehensive model of HIV/AIDS care focused on populations and individuals hardest hit and most underserved.
There are many elements to the Ryan White system of care, summarized in HRSA's five-pronged Zero New Infections framework of: service delivery, policy, assessment, capacity development and quality. Below are highlights, organized around the World AIDS Day 2014 theme Focus, Partner and Achieve and reflective of HRSA and Ryan White program implementation of the National HIV/AIDS Strategy.
For decades, HRSA has funded technical assistance and training activities that reflect HRSA's focus on hard hit populations and communities, to build capacity to deliver and expand access to quality care and manage complex care systems.
Following are examples from recent years:
- HRSA has developed clinical care guidelines to guide clinicians in the delivery of high quality care under its AETC clinical training network. Supporting these guidelines are accompanying protocols on care delivery for specific populations
- The HRSA-supported National Quality Center provides technical assistance and training to Ryan White agencies to improve the quality of care they deliver
- The Integrating HIV Innovative Practices (IHIP) project has taken findings from multiple Ryan White Special Projects of National Significance (SPNS) research and evaluation initiatives and turned them into replicable models, through curricula, training manuals and webcast trainings
- The Center for Engaging Black MSM Across the Care Continuum is a new HRSA initiative to identify best practices and models for engaging and retaining Black MSM in care. This project is the latest of many prior technical assistance and training projects to develop tools and best practices around engaging people in care to improve the quality of life and reduce new infections. They range from peer training to care engagement techniques like outreach and adherence protocols
Service delivery innovations have also been developed at the state and local level by Ryan White grantees and providers. They include system-wide models by Part A and Part B grantees and agency-specific models under community-based Ryan White grantees
- Health care reform has expanded access to public and private health coverage. To support Ryan White client access to new coverage options, HRSA is providing technical assistance and training to Ryan White agencies on enrolling and accessing Affordable Care Act coverage for underserved minority individuals through the ACE TA Center
The "partner" part of the theme of World AIDS Day 2014 is evident in the work of the Ryan White program, which has been driven by the concept of working together since the start of the program in 1991. Consumers work with clinicians and agencies to take an active part in their care and decision making.
Planning brings communities together to assess needs, set priorities, and implement services. Provider agencies work together to develop common systems for managing data, enhancing quality, and adhering to high standards of care. And Ryan White works with U.S. global HIV/AIDS programs under PEPFAR to share insights on effective ways plan and deliver care.
Partnering is also a core value in HRSA's delivery of technical assistance and training support, which occurs through cooperative agreement with national partners, particularly recent efforts to provide capacity development support for Ryan White agencies in adapting to health care reform.
Below are more recent examples selected from nearly a quarter century of such efforts:
- A recently concluded project provided support for Ryan White agencies in securing Patient Centered Medical Home accreditation
- Several new projects are building agency capacity adjust to health care reform changes. One, the National Center for Innovation in HIV Care, is helping ASOs and CBOs adopt strategies to enhance their operational effectiveness. The National Training and Technical Assistance Center for Contracting with Medicaid and Marketplace Insurance Plans is helping agencies enhance their contracting/third party payment mechanisms. Improvements in HIV/AIDS care planning, like coordination of prevention and care
- An ongoing project delivers training to build the fiscal health of Ryan White agencies
Individuals receiving HIV care from HRSA's Ryan White HIV/AIDS Program have higher rates of retention in care--and better viral suppression--in comparison to other national estimates, according to two recent reports. Findings document significant progress toward an AIDS-free generation.
- A 2014 study in Clinical Infectious Diseases found, for example, viral suppression among Ryan White clients was 76.2%.
- An earlier 2013 HRSA data report showed similar findings, with a viral suppression rate of approximately 70% among Ryan White clients.
See A Living History on the HRSA HIV/AIDS Bureau's website for more on the decades-long work of the Ryan White HIV/AIDS Program.