The Emory Ryan White Program At Crawford Long Hospital

The Ryan White Care Act provides funding for HIV/AIDS related care for persons meeting certain income and residency requirements.

The Emory Infectious Diseases Clinic at Emory Crawford Long Hospital receives federal grant funding through the Ryan White Treatment Modernization Act. These grants set us apart from private doctor's offices such that it allow us to provide other specialty services such as nutrition, mental health, medical social work, short-term/long-term medication copayment assistance and other support services to those who are uninsured or underinsured, in addition to primary care services. All patients, however, regardless of insurance status or income, benefit from the funds since they are directed toward staff resources and other services.

The Emory Infectious Disease Clinic at Emory Crawford Long Hospital has been providing Ryan White Part C services since 1993 and Part A services since 2002. Ryan White Part C services are a part of the Ryan White Treatment Modernization Act which provides funds to health care facilities for HIV Early Intervention Services and primary care in outpatient settings. Both Part A and C funding make it possible for healthcare providers to offer HIV counseling, testing, and referral; counseling and education on living with HIV disease, including availability and use of treatment therapies; appropriate medical evaluation and clinical care such as laboratory tests and medication to prevent and treat illness; and direct services for oral health care, mental health care, outpatient substance abuse treatment, nutritional services, and other specialty medical care.

The intention of the Ryan White Grant is to provide access to medical care and treatment to those people living with HIV/ AIDS who are under-insured or uninsured. It does not replace other third-party payers. In the event that you become eligible for insurance coverage, please let your social worker or any other staff know this information. Knowing this information and switching your status from a Ryan White Case to insured, presents an available slot for others who are on a waiting list. Additionally, there may be other Ryan White resources available to assist you with deductibles, co-insurance, or out-of-pocket medical costs.

In addition, these federal grants require that we collect and maintain income and residency documentation bi-annually. If we are unable to obtain this information from you, the above named specialty services will not be available to you. This information is kept confidential and in a locked file cabinet in the social workers’ office. This information is also used to establish patient’s medical cap for services. The Ryan White legislation limits the annual cumulative charges to an individual for HIV-related services to:

Individual/Family Annual Gross Income	Total Allowable Annual Charges
Equal to or below the official poverty line	no charges permitted
101-200% of the official poverty line	5% or less of gross annual income
201-300% of the official poverty line	7% or less of gross annual income
More than 300% of the official poverty line	10% or less of gross annual income

Our program is currently in the process of establishing a system to ensure that these annual caps on charges to patients are not exceeded.

NOTE: If you have an outstanding Emory Clinic balance, you may still be seen. Please contact your social worker or clerical staff regarding this.

Ryan White Client Eligibility Requirements

In order to receive services funded by Ryan White, clients must meet eligibility criteria which include:

• Positive HIV sero-status
• Residency within the 20-county eligible metropolitan area (part A)
• Income no greater than 300% of Federal poverty level
• Enrollment in primary medical care
• Residency within the service area (part C)

The Atlanta EMA includes the following counties: Barrow, Bartow, Carroll, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding, Pickens, Rockdale, Spalding, and Walton.

Ryan White Grant Coverage Terms

• Ryan White is the payer of last resort
  • Payer of Last Resort Requirement
    • CARE Act grant funds cannot be used to make payments for any item or service if payment has been made, or can reasonably be expected to be made, with respect to that item or service, under any State compensation program, under any insurance policy, or under any Federal or State health benefits program; or by an entity that provides prepaid healthcare.
• Coverage is one year and then re-evaluated at that time
• If you receive a bill, please let one of the SWs know so that we can reconcile any discrepancies

What the Ryan White Grant Does Not Cover

• The Ryan White Grant does not cover inpatient or ER costs ever.
• The Ryan White Grant does not cover any other specialty service that has not been referred by their HIV Primary Care MD
• The Ryan White Grant does not cover all non-HIV related medication and are addressed on a case-by-case basis
• Other specialty procedures are evaluated on a case-by–case basis and are referred to ECLH Charity Care Program

Termination from the Ryan White Program

• Failure to report third-party coverage
• Receiving primary care HIV services from another program/ agency/ MD office
• Exceeding the income requirements
• Living outside the service area