Joey Wynn, Chair of the South Florida AIDS Network (SFAN) considers the most important issue facing HIV service providers in the coming year to be the integration of HIV services with the Affordable Care Act. As people enroll in the new health care exchanges of the Affordable Care Act, these new plans will have to develop working relationships with HIV service providers. People will have develop ways for HIV services to “accommodate those folks” and figure out ways to “get the word out, so we can make this the easiest transition possible,” according to Joey Wynn. This accommodation and communication will depend on the community input processes. In order to understand how this community can benefit from community planning, it helps to understand the structure of the Ryan White Care Program.
It’s convenient but inaccurate to think about Ryan White Care as if it were one program. It has seven parts:
1. Comprehensive care services for Eligible Medical Areas (EMAS), such as Broward County
2. Essential services, including ADAP, for states
3. Early intervention, counseling, and testing
4. Programs for youth, women and children with HIV infection
5. Dental Reimbursement Program
6. Education and training for health care providers
7. Research and demonstration projects. Two other programs have significance for HIV services: Housing Opportunities for People with AIDS (HOPWA), and AIDS Insurance Continuation Project (AICP). HOPWA provides temporary housing assistance to low income people with HIV infection. AICP pays insurance premiums for low-income people with health insurance and HIV.
Planning councils and community input lie at the heart of Ryan White Care, locally and at the state level. The Florida Community Planning Network (FCPN) forms the planning and community input body at the state level. In Broward two groups constitute the local planning and community input process: The South Florida AIDS Network (SFAN) and the Broward HIV Planning Council. SFAN functions as the planning/community input body for essential services, such as ADAP, administered by the state; the Broward HIV Planning Council functions as the planning/community input body for comprehensive care services for Eligible Medical Areas (EMAS), such as Broward County. SFAN and the HIV Planning Council have joint working committees to plan, set priorities, manage client-related issues, and monitor funding issues. All meetings are open to the public.
Changes in the epidemic also drive changes in HIV services. By law, the Ryan White Care Program has to focus its activities on treatment. In recent years, however, the lines between treatment and prevention have begun to blur. Effective treatments for people with HIV infection tends to make them less likely to infect others, resulting in lower rates of new HIV infections. Joey Wynn described this as another challenge in SFAN, “Trying to get other programs from the local Department of Health (especially HIV Prevention) to be involved, keep us informed, and attend the meetings to get a first-hand view of what the community is experiencing in their challenges and concerns. “
While the Affordable Care Act holds out great hope for improving the lives of people living with HIV, it presents opportunities and challenges. Fortunately, an input process exists that makes participation and communication easier. Joey Wynn described SFAN as “an open process, we keep people informed about what is going on in the service delivery of HIV for folks, and a great place to come learn about and discuss the issues facing the HIV community in Broward County.”