This document provides an overview of the Ryan White HIV/AIDS Program and the Ryan White Planning Council (RWPC) in the Philadelphia Eligible Metropolitan Area. It describes the key parts and funding of the Ryan White legislation. The RWPC is responsible for conducting needs assessments, setting service priorities, allocating Part A funds, monitoring the administrative mechanism, and developing a comprehensive plan. It outlines the membership, committees, activities, and processes of the RWPC in carrying out these responsibilities.

1. RWPC Primer
12-14-16

2. Ryan White HIV/AIDS
Program

3. Ryan White Legislation
• Currently, Title XXVI of the Public Health Service Act, HIV
Health Care Services Program
o Originally enacted in 1990
• “The Ryan White HIV/AIDS Program provides a
comprehensive system of care that includes primary medical
care and essential support services for people living with HIV
who are uninsured or underinsured. The Program works with
cities, states, and local community-based organizations to
provide HIV care and treatment services to more than half a
million people each year. The Program reaches approximately
52% of all people diagnosed with HIV in the United States.”
(HRSA HAB website)

4. Ryan White Legislation
• The legislation is divided in to several portions,
called Parts. The Ryan White Planning Council is
concerned with Part A.
• Parts B-F provide funding for states; early
intervention; programs for children, youth, and
women; and education/training.

5. Ryan White Part A
Program
• Ryan White Part A provides funding for EMAs (Eligible Metropolitan
Areas) and TGAs (Transitional Grant Areas) that are most severely
affected by the HIV epidemic
• The Philadelphia EMA is made out of 9 counties in PA and NJ:
Philadelphia, Bucks, Chester, Delaware, Montgomery, Burlington,
Camden, Gloucester, and Salem
• Part A Funding based on numbers of PLWHA (A total of more than
2,000 cases in the most recent 5 years and a cumulative total of
3,000 living cases as of 12/31 for the most recent calendar year) in
Philadelphia EMA compared to other EMAs in the US
o The Philadelphia Ryan White Part A EMA received $21 million in funding in 2015
o The EMA also receives Minority AIDS Initiative (MAI) funding that is used to fund programs
serving minority populations (approx. $2 million)

6. Ryan White Part A
Program
• Clients who meet certain qualifications (HIV status,
income and residency) can apply for Ryan White
certification
• Clients must recertify every 6 months to use Ryan White
services
• No one is turned away from Ryan White providers,
regardless of their ability to pay

7. Part A Legislative
Requirements
• Ryan White is the payer of last resort
o Ryan White cannot be used to pay for any service that is
covered or can be covered by another funding source

8. Ryan White Planning
Council Structure and
Membership

9. Planning Council
Nominations Process
• Conducted by the RWPC Nominations Committee
• Applications are accepted throughout the year and
reviewed twice annually, typically in the Fall and Spring
o Applications are scored numerically by members of the nominations panel, and
scores are averaged
o Accepted applicants are reviewed and appointed by the CEO
• The Nominations Committee also periodically reviews
membership demographics and attendance

10. Planning Council
Composition
• Planning Council must be at least 33%
unaligned Ryan White consumers
o Unaligned consumers are not paid staff, consultants, or board members
of Part A funded agencies, but they may receive services at these
agencies
o In the Philadelphia EMA, we aim for 50% consumer representation

11. Planning Council
Composition
• Membership reflects demographics of local HIV epidemic
o 17 categories for membership
• Health care providers, including
federally qualifying health centers
(FQHCs)
• CBOs serving affected
populations/ASOs
• Social service providers (including
housing and homeless services)
• Mental health providers
• Substance abuse providers
• Local public health agencies
• Hospital/health care planning agencies
• Affected communities (PLWH and
historically underserved sub-
populations)
• Non-elected community leaders
• State Medicaid agency
• State Part B agency
• Part C grantees
• Part D grantees
• Grantees of other Federal HIV
programs (including prevention)
• Formerly incarcerated PLWH or their
representatives
• Members of Federally Recognized
Indian Tribe

12. Membership &
Expectations
• Members are expected to attend the Planning Council
meeting each month on the second Thursday of the
month
• Members are also expected to choose a subcommittee
and attend meetings
• RSVPs are required for meetings. Absences will only be
excused with prior notification.
o Members with too many absences will receive a warning and may be
removed from the RWPC

13. Planning Council
Activities

14. RWPC Activities
• Conducts Needs assessment activities to determine
needs of consumers
• Sets HIV-related service priorities
• Allocates Part A funds
• Monitors the administrative mechanism
• Develops a comprehensive plan

15. Needs Assessments

16. Needs Assessments
• Monitored and developed by the Needs Assessment
Committee
• Used to determine unmet needs of PLWHA in the EMA,
including those who are not in care
o Focus on extent of the need, available services, and service gaps by
population segment and geographic area
• Used for priority setting, comprehensive planning,
completing grant applications, documenting need, and
collecting data

17. Needs Assessment
Activities
• Focus Groups
o held at the OHP in 2014-2015 concerning healthcare access for young
men who have sex with men (YMSM) and high-risk heterosexuals
• Surveys
o provider and consumer transportation surveys conducted in 2015
o Local Pharmaceutical Assistance Program 2016
o Currently, a Consumer Survey is being distributed by providers in the
EMA to measure demographics, healthcare utilization, unmet need, etc.

18. Needs Assessment
Activities
• Epidemiological profile
o Completed annually
o Contains wide-reaching data and analysis
• Demographics (age, race, sex, geography)
• Social determinants of health (e.g. poverty, education,
insurance status, housing, risk behaviors)
• Statistics specific to HIV (for instance, incidence and
prevalence rates).

19. Needs Assessment
Activities
• Resource Inventory
o Includes a workforce profile, which reveals gaps
o A list of Ryan White funded and private providers in the EMA that serve
PLWHA
o Categorized by service category, with additional information like
address, phone number, website, accepts insurance, etc.
o Online resource inventory currently being developed, which will be
available on the OHP website in the future
• Town halls and other activities

20. Priority Setting

21. Priority Setting
• Carried out by the Comprehensive Planning Committee
• Establishes priorities for the allocation of funds
consistent with locally identified needs
• Philadelphia EMA priority-setting process is quantifiable,
objective, and uses factors and weights

22. Service Categories
Services eligible for Ryan White funding, ranked during
priority setting:
• AIDS Drug Assistance Program Treatments
• AIDS Pharmaceutical Assistance
• Child Care Services
• Early Intervention Services (EIS)
• Emergency Financial Assistance (DEFA)
• Food Bank/Home Delivered Meals
• Health Education/Risk Reduction
• Health Insurance Premium and Cost Sharing
Assistance
• Home and Community-Based Health Services
• Home Health Care
• Hospice Services
• Housing
• Legal Services
• Linguistic Services/Interpretation
• Medical Case Management
• Medical Nutrition Therapy
• Medical Transportation
• Mental Health Services
• Non-medical Case Management
• Oral Health Care
• Other Professional Services
• Outpatient/Ambulatory Health Services
• Outreach Services
• Permanency Planning
• Psychosocial Support Services
• Referral for Health Care and Support services
• Rehabilitation Services
• Respite Care
• Substance Abuse Outpatient Care
• Substance Abuse Services (residential)
**Bold denotes core medical services
**Not all services on this list are currently funded

23. Priority Setting Factors
• Weights recently altered due to expansion of Medicaid
related to the Affordable Care Act
• Consumer Survey (25%)
• Care Continuum (30%)
o Plots services along the care continuum, developed by the Comprehensive
Planning Committee
• Unmet Need (30%)
o Numbers gathered from various data sources
• Essential Health Benefits (15%)
• All factors are quantifiable. Values for each service/factor
are tabulated to determine rankings.

24. Allocations

25. Allocations
• Process of distributing fiscal resources across Part A
funded service categories in the EMA based on
documented need
o Based on size, demographics, and needs of PLWHA
• 75% minimum of the grant total must be allocated to
core medical services, 25% max for supportive services

26. Allocations Process
• Allocations are carried out at 3 separate regional
meetings
• All Planning Council members can attend and vote at the
regional meetings
• Allocations are overseen and reviewed by the Finance
Committee, followed by the Planning Council

27. Allocations Process, cont.
• Each region can also make instructions/directives to the
recipient (AACO)
• Instructions may direct the recipient to provide more
information or direct the recipient to provide a particular
service, focus services to a population or geographic
area, request a needs assessment, etc.

28. Recipient Responsibilities
• Recipient issues Requests for Proposals (RFPs) and
procures contracts with agencies to conduct the work
• The Planning Council cannot be involved in the selection of providers
(subrecipients) that receive Part A funding
• The recipient is mandated to follow the Planning
Council’s allocations for each service category

29. Other RWPC
Responsibilities

30. Assessing the
Administrative Mechanism
• Finance Committee reviews spending and
underspending reports quarterly, approves
reallocation requests, which are then presented
to the RWPC
o Ensure funds are rapidly distributed
o Make sure spending and priorities, instructions to recipients, and
allocations match
o Ensure that services are delivered to areas of greatest need and
contracts are procured efficiently/effectively

31. Comprehensive Planning
• Comprehensive Plan for 2017-2021 was recently
released
• Includes:
o Strategies for identifying individuals who know their HIV status and are not
receiving services
o Process for getting people in care
o Particular attention to eliminating disparities in access and services among high-
risk groups and historically underserved communities
o Includes discrete goals, a timetable, and appropriate allocation of funds
• Staff, AACO, and Comprehensive Planning Committee
work together to complete the Comprehensive Plan

32. More Information

33. Schedule
• First Thursday of each month
o Finance Committee, 2-4pm
• Second Monday of each month
o Positive Committee, 12-2pm
o Needs Assessment Committee, 2-4pm
• Second Thursday of each month
o RWPC Nominations committee, 12-2pm
o RWPC, 2-4pm
• Third Thursday of each month
o Comprehensive Planning Committee, 2-4pm

34. Positive Committee
• Committee for people living with HIV and AIDS
• Holds regular trainings, educational presentations, and
group discussions
• Gathers consumer feedback
• Helps PLWHA participate in the planning process and
potentially become involved in the RWPC
• Participants develop flyers, brochures, and newsletters
to distribute to the community

35. Additional Planning
Council Activities
• The Planning Council routinely hears
presentations from outside agencies, AACO, Co-
Chairs, and staff
o Kathleen Brady’s annual Epidemiological Presentation
o AACO CSU and Prevention Reports
o All slides are posted on the OHP website and Slideshare
accounts

36. Current and Recent
Planning Council Topics
• Housing
• Social Determinants of Health
• PrEP
• Medicaid/Medicare/ACA Insurance Plans
• Health Insurance Premium/Cost-Sharing Assistance
• Opioid Crisis