The Kansas Ryan White Part B Program


Providing Care and Support Services for Kansans Living with HIV-Infection


1000 SW Jackson, Suite 210
(785) 368-6567

Topeka, Kansas 66612
FAX (785) 291-3420

Jeni Mulqueen, Ryan White Part B Program Manager

Vacant, HIV Grants Manager

Carly Craig, Eligibility Specialist

Ebony Wardlaw, Quality Manager

Melanie Wright, Linkage-to-Care Coordinator

Kenny Cochrane, Linkage-to-Care Coordinator

 


Ryan White Program

In response to the AIDS crisis, Congress enacted the Ryan White CARE (Comprehensive AIDS Resources Emergency) Act in August 1990 to improve the availability of care for low-income, uninsured, and underinsured individuals and families affected by HIV and AIDS.

The Ryan White HIV/AIDS Treatment Modernization Act is the primary funder for HIV/AIDS health and social services including primary medical care, medication assistance, health insurance assistance, mental health counseling, substance use treatment, home health care, dental care and medical case management. Ryan White CARE funding and administration are managed by the Health Resources and Services Administration (HRSA), which is part of the U.S. Department of Health and Human Services. The State of Kansas Department of Health and Environment (KDHE) is the state-level agency within Kansas that distributes and manages Ryan White Part B and the AIDS Drug Assistance Program (ADAP) as mandated by the Ryan White HIVAIDS Treatment Modernization Act.

Part B medical case management services provide clients with linkages to health, social and wrap-around services from key access points across Kansas. It should be noted, however, that Ryan White funding is considered the payor of last resort, meaning if a client has access to other forms of support (i.e. private insurance or Medicaid), those forms of support must be utilized first prior to accessing Ryan White funding.

In 2006, the Ryan White HIV/AIDS Treatment Modernization Act of 2006 was passed. The 2006 law changed how Ryan White funds may be used with an emphasis on providing life-saving and life-extending services for people living with HIV/AIDS across the country. Key changes in the 2006 legislation included the following:

  •  The programs are no longer identified as Title I, II, III, IV and V. Instead they are identified as Part A, B, C, D, and F.
  •  A new method for determining eligibility for Part A funds gives priority to urban areas with the highest number of people living with AIDS, while also providing assistance to mid-size cities and areas with emerging needs. The Kansas City Transitional Grant Area (TGA) receives Part A funding.
  •  A new method for distributing Part A funds directs money to metropolitan areas with the highest number of people who are HIV positive. It also encourages outreach/testing, getting people into treatment sooner and saving more lives.
  •  More money is spent on direct health care for Ryan White clients. Grantees receiving funds under Parts A, B, and C must spend at least 75% of funds on "core medical services," which include ambulatory outpatient medical care, oral health, mental health, outpatient substance abuse treatment, medical nutritional therapy, medical case management and drug assistance.
  •  The 2006 law recognizes that HIV/AIDS has had a devastating impact on racial and ethnic minorities in the U.S. The 2006 law incorporates the aspects of the Minority AIDS Initiative (MAI) to address the unique needs of minority populations.

The Ryan White Program in Kansas

The Ryan White Part B Program in the State of Kansas has been assisting Kansans living with HIV before the enactment of The Ryan White HIV/AIDS Treatment Modernization Act in 1990. These resources included private donations, community-based organizations throughout the state and federal funding for a statewide ADAP (1987). Since this time, the Part B Program has received federal and state funding for assistance with the following:

  •  Medications through the statewide AIDS Drug Assistance Program (ADAP);
  •  Medical Case Management;
  •  Primary Care services;
  •  Dental Care services; and
  •  Mental Health and Substance Abuse services through the HOPWA program;

The purpose of these funds is to provide care for persons living with HIV infection who are not covered by public or private sources. These funds also assure that all Kansans living with HIV infection throughout the state have access to the resources to monitor, adhere, and treat infection, in order to achieve the highest quality of life possible.

The Kansas Department of Health and Environment HIV/AIDS Section Ryan White Part B Program is responsible for administration of Part B activities.

Part B funds are to be accessed only when no other support is available, serving as payer of last resort. It should also be noted that services might not be available for the entire year if funds become limited.


Client Eligibility

The following requirements must apply:

  •  Reside in Kansas

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  •  Have proof of HIV infection

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  •  Documentation noting family income is at or below 300% of Federal poverty guidelines

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  •  Not be institutionalized or living within a facility that is primarily responsible for medical and health care services; and

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  •  Provide updated information through a twice yearly renewal process with their Medical Case Manager. Any changes prior to this renewal process must be reported immediately.

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Linkage-to-Care Program

The Linkage-to-Care (LTC) Program is a standard service to navigate HIV-positive individuals through care once they know their HIV positive result. The primary goal of LTC is to link the newly diagnosed individual into medical care. Delays in seeking medical care have obvious implications both for treatment and prognosis of HIV-infected patients, and for the further propagation of the epidemic. In recognition of this problem, LTC is the primary prevention/care model that will be utilized to link HIV-infected persons to appropriate medical care, prevention services, local resources and treatment soon after testing HIV positive.


Medical Case Management Services

Medical Case Management is a comprehensive service delivery system designed to link individuals with needed care components. Enhancing client self-care, independence and self-determination are the primary goals of this program. Clients are expected to be involved in all aspects of their care, including problem-solving functions to the maximum extent possible. Proactive, coordinated efforts by healthcare providers in community-based organizations will assist clients in obtaining optimum wellness, as well as making the best possible use of available resources. Attention to continuity of care will decrease service inaccessibility and fragmentation.
The role of the Medical Case Manager is multi-faceted. In addition to outreach and intake, the Medical Case Manager is responsible for the following:

  •  Assessing the individual's need for services;
  •  Determining availability and feasibility of services;
  •  Developing a plan of care that includes home and community-based services appropriate to the individual's medical, social, and financial condition;
  •  Arranging for service delivery;
  •  Monitoring service delivery;
  •  Maintaining confidentiality of client records with the service delivery system; and
  •  Conducting ongoing evaluation of the effectiveness of the plan of care; and
  •  Coordinating ongoing medical care with other services providers through case consultations|

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AIDS Drug Assistance Program (ADAP)

The Kansas AIDS Drug Assistance Program (ADAP) is a statewide program that assists eligible clients obtain medications for the treatment of HIV/AIDS. The Kansas ADAP works collaboratively with the Division of Health Care Finance (DHCF), also referred to as the state’s Medicaid Program. Through this partnership, the Kansas Ryan White Part B Program maintains the eligibility of the ADAP while the Medicaid Program oversees the claims processing of the program.

The Kansas ADAP is funded through a variety of sources. Although a majority of funding is received through HRSA, the program also receives funding from the State of Kansas and rebates through pharmaceutical companies. Those clients identified through the Kansas ADAP and the Kansas Medically Needy program (Medicaid) with an unmet spenddown are additionally benefited through these funding sources. State funds are used for claims on these individuals in order to meet a spenddown even though the client is not obligated for the expense. Those clients accessing ADAP services and have Medicaid Medically Needy are automatically eligible for spenddown assistance.

Services

Services are available to all eligible clients within the Kansas Ryan White Part B Program. These services provide reimbursement for medications listed on the Kansas ADAP Medication Formulary. This formulary currently includes all FDA-approved medications for the treatment of HIV infection, including other medications that are utilized for prevention and treatment of secondary infections.

Medication Co-Pay Assistance Program (for clients with private insurance)

The Co-Pay Assistance Program is designed for those clients who currently have insurance yet find the out-of-pocket expenses for medications a barrier to maintain medication adherence. Although the insurance plan is offered through an employer or high-risk pool, the prescription benefit plan is designed for individuals who are not “high utilizers” of prescription medications. These types of plans can be very harmful to clients in maintaining their adherence to a multi-drug therapy. The following are NOT allowable expenses to the Co-Pay Assistance Program:

  •  Payment of co-pays already paid by the clients;
  •  Co-pays for medications not on the ADAP Formulary at the time of service; and
  •  Payment of co-pays where the pharmacy or pharmaceutical company is not contracted with Kansas Medicaid.

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Dental Care Services

The Kansas Ryan White Part B Program Dental Care Program assists clients in preventative oral hygiene and infection control that can pose a greater burden on the immune system. As health care professionals, dentists have the moral, ethical and legal obligation to attend to the oral health needs of all patients.

The "healthy" HIV-infected patient with a CD-4 count above 200 can usually receive routine dental treatment in the office of a general practitioner. No special procedures -- only universal precautions -- are required. An individual’s HIV-status should be obtained in every health history, but it must not be used as a "barrier" to access dental care. It is privileged information and must not be disclosed by the dentist or office staff.

The Dental Care Provider Network is made up of limited providers throughout the State of Kansas that are willing to provide these services.  Dental services are available to any Ryan White Part B approved client who does not have access to other dental coverage. |


Primary Medical Care Services

The Kansas Ryan White Part B Program allows clients to access qualified medical professionals throughout the state for treatment of HIV infection and illnesses related to the progression of the infection. The Primary Care Services Network is one of the cornerstones of HIV care in the State of Kansas. As eligible clients access these services, they can be monitored and treated by physicians with the expertise in treating HIV infection.

Services

Services are available to eligible Ryan White Part B clients for any service related to the diagnosis, monitoring and treatment of HIV-infection and those disease states/illnesses associated with this infection. These include, but are not limited to:

  •  Physician and nurse visits;
  •  Routine bloodwork; and
  •  Preventive care services.

Services outside of those listed above need to be prior authorized by calling (785) 368-6567 or emailing Carly Craig.

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Mental Health Services (through coordination with HOPWA)

Mental Health services allow clients to address needs and coping mechanisms that not only range from painful emotions that typically accompany an anti-body test result to decision making in a number of important areas of their lives in which there is a great deal of uncertainty. This includes uncertainty about medical prognosis, health care options, how best to spend one's time/plan for the future and how to share the news of being seropositive with others.

Services

Services are available to all eligible Part B clients who do not have access to other mental health coverage. Mental health services provide clients with the means to address issues related to challenges faced with living with HIV infection. These services include, but are not limited to: individual counseling, pain management, and medication adherence counseling. |

Substance Abuse Services (through coordination with HOPWA)

Substance Abuse services allow clients to address needs and coping mechanisms (alcohol and drugs - legal or otherwise) that may be restricting better health. While mental health counseling can provide a viable resource for clients, those enduring the addictive results of drug and alcohol dependency may require other means of treatment.

Services

Substance abuse services are available to all eligible Ryan White Part B Program clients who do not have access to other substance abuse coverage and are provided as a means of assisting clients address issues related to challenges faced with living with HIV-infection. These services include, but are not limited to: outpatient drug/alcohol treatment, individual counseling, and pain management.

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Premium Assistance Program

The Premium Assistance Program is designed for those clients who have chosen to extend their current medical/health benefits from a previous employer due to a number of factors (including but not limited to termination, leave of absence, and/or layoffs). The following are NOT allowable expenses of the Premium Assistance Program:

  •  Payment of premiums directly to clients;
  •  Premium assistance for clients returning to work by which insurance is provided;
  •  Assistance for premiums that have not be found cost effective for their AIDS Drug Assistance Program and other state and federal programs that will be accessed as a result of lack of coverage; and
  •  Premiums towards state and federally funded programs (such as Medicare).

Certification of Medical Case Management Services

As the front line in providing vital service linkages for people living with HIV/AIDS, medical case managers, medical case manager assistants and students must be adequately and appropriately experienced and trained. Training and certification of the skills and knowledge of medical case managers is closely monitored by the state Ryan White Part B Program offices.

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Regional Medical Case Management Sites

Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 6 Region 6 Region 4 Region 4 Region 4 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 6 Region 6 Region 6 Region 4 Region 4 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 7 Region 6 Region 4 Region 4 Region 3 Region 1 Region 3 Region 1 Region 2 Region 9 Region 9 Region 9 Region 9 Region 9 Region 9 Region 7 Region 7 Region 7 Region 4 Region 7 Region 7 Region 7 Region 8 Region 4 Region 4 Region 3 Region 2 Region 9 Region 9 Region 9 Region 9 Region 9 Region 9 Region 8 Region 8 Region 8 Region 4 Region 5 Region 5 Region 5 Region 5 Region 5 Region 9 Region 9 Region 9 Region 9 Region 9 Region 9 Region 8 Region 8 Region 8 Region 8 Region 8 Region 8 Region 5 Region 5 Region 5 Region 9 Region 9 Region 9 Region 9 Region 9 Region 9 Region 8 Region 8 Region 8 Region 8 Region 8 Region 5 Region 5 Region 5 [Region 1] [Region 2] [Region 3] [Region 4] [Region 5] [Region 6] [Region 7] [Region 8] [Region 9]

This is an image of the State of Kansas where you can click on a county to view the case management site in that region.

Linkage-to-Care Coordinators

Kenny Cochrane
200 Main St, Ste B
Lawrence, KS 66044
(785) 213-6851 phone
kcochrane@kdheks.gov

Melanie Wright
130 S Market, Suite 6050
Wichita, KS 67202
316-213-2309 phone
mwright@kdheks.gov


Regions 1 and 2

Kansas City, Missouri Health Department
2400 Troost, Suite 3100
Kansas City, MO 64108
Phone: (816) 513-8230

For more information: Missouri Department of Health and Senior Services

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DCAP

Region 3

Douglas County AIDS Project
Medical Arts Building
346 Maine Street Suite #160
Lawrence, KS 66044
Phone: (785) 843-0040
Fax: (785) 843-2669
www.douglascountyaidsproject.org |

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Region 4

Positive Connections
1001 SW Garfield Ave
Topeka , KS 66604
Phone: (785) 232-3100
Fax: (785) 232-3186

For more information: http://pcneks.org/

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Region 5

Crawford County Health Department
410 East Atkinson, Suite A
Pittsburg, KS 66762
Phone: (620) 235-7191
Fax: (620) 235-7137

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Region 6

Riley County Health Department
2030 Tecumseh Road
Manhattan , KS 66502
Phone: (785) 776-4779 x. 250
Fax: (785) 565-6565

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HelpNet

Region 7

Salina-Saline County Health Department
625 E North
Salina , KS 67401
Phone: (785) 826-6600
Fax: (785) 826-6605

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Positive Directions

Region 8

Positive Directions, Inc.
414 S Commerce
Wichita , KS 67202
Phone: (316) 263-2214
Fax: (316) 263-5214

For more information: http://www.pdiks.com/


KU Med

University of Kansas MPA HIV Program
KU Internal Medicine - Midtown
1001 N Minneapolis
Wichita, KS 67214
Phone: (316) 293-2652
Toll Free: (877) 472-8227
Fax: (316) 293-1838

For more information: http://www.kumc.edu/

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United Methodist Western Kansas Mexican-American Ministries

Region 9

United Methodist Mexican-American Ministries
712 St. John Street
Garden City , KS 67846
Phone: (620) 275-1766 x. 233
Fax: (620) 275-4729

For more information: http://www.ummam.org/

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Housing Opportunities for People With AIDS (HOPWA)

Kansas Care through Housing administers the HOPWA program. This program is funded through HUD (Housing and Urban Development). The program sponsor is The University of Kansas School of Medicine - Wichita Medical Practice Association, a non-profit organization. Funds are granted through the Kansas Department of Health and Environment (KDHE). All guidelines established are in compliance with HUD and HOPWA. Assistance is provided regardless of race, religion, color, sex, sexual preference, disability, veteran's status, national origin or ancestry.

Detailed information can be found on the following printable PDF brochure:

All housing resources can be accessed through the Ryan White Program. Follow this link to find information about medical case management services in your area:


Other Resources

The CDC National AIDS Hotline can be reached by calling:
1-800-342-AIDS (2537) or
1-800-342-SIDA (7532) for Spanish

Links:

For other care needs not addressed by the information on this site, through your local health department call the Kansas Ryan White Part B Program Office (phone number at the top of this page).

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