Ryan White Part A Program
I. The Ryan White Program
- Who was Ryan White?
Ryan White was diagnosed with AIDS on December 17, 1984. He was one of the first children, and one of the first hemophiliacs to come down with AIDS. This was a time when there was no education and little information on AIDS.
When Ryan was diagnosed, he was given 3 to 6 months to live. His mother worried that every cough, every fever, was going to be his last. No one expected Ryan to become healthy enough to return to school, but after a while, he was ready. Unfortunately, the school system was not as ready for his return. It took a year and a half of court hearings and proceedings before Ryan could return to school. Ryan and his mother Jeanne White Ginder fought for his right to attend school, and their courageous fight against AIDS-related discrimination helped educate the nation about HIV.
Ryan White was diagnosed with AIDS at age 13. He died April 8, 1990, at the age of 18. Four months after his death, Congress passed the AIDS bill that bears his name – The Ryan White CARE (Comprehensive AIDS Resources Emergency) Act. The legislation has been reauthorized four times since and is now called the Ryan White HIV/AIDS Program. Ryan White’s legacy is that all people with HIV today can now have access to getting medical care, treatment, and medications to help them live longer and healthier lives.
For more information on Ryan White click https://hab.hrsa.gov/about-ryan-white-hivaids-program/who-was-ryan-white.
- Ryan White HIV/AIDS Program Legislation
The Ryan White HIV/AIDS Program legislation was first enacted in 1990 as the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. It is codified in title XXVI of the Public Health Service Act. It has been amended and reauthorized four times in 1996, 2000, 2006, and 2009. The legislation has been amended with each reauthorization to accommodate new and emerging needs, such as an increased emphasis on funding core medical services and changes in funding formulas.
The Ryan White HIV/AIDS Program legislation is administered by the U.S. Department of Health and Human Services (HHS), Health Resources and Service Administration (HRSA), HIV/AIDS Bureau (HAB).
The Key provisions of the 2009 legislation:
- The 2009 Ryan White HIV/AIDS Program legislation continues the Ryan White HIV/AIDS Program through fiscal year 2013 and beyond, so long as Congress appropriates funds.
- Minority AIDS Initiative (MAI) funds under Parts A and B are distributed according to a formula (based on the distribution of populations disproportionately impacted by HIV/AIDS) and coincide with grant cycles under each Part.
- Part A authorizes grant awards to Eligible Metropolitan Areas (TGAs) and Transitional Grant Areas (TGAs). For TGAs lose their eligibility status, the state in which the former TGA is located shall receive a one-time transfer of funds.
- Part A recipients are required to determine not only the size and demographics of HIV infected individuals but also those individuals who are unaware of their HIV status. One-third of Part A supplemental grants are to be based on the area’s ability to demonstrate its success in identifying individuals with HIV who are unaware of their status and bringing attention to their status.
- Part A and Part B grant recipients must develop comprehensive plans that include a strategy for identifying individuals with HIV who do not know their status and helping them seek medical services. The strategy must focus on reducing barriers to routine testing and disparities in access to services for minorities and underserved communities.
- The law eliminates hold harmless protections for Part A and Part B grant recipients after fiscal year 2013.
- The law retains Part A and Part B unobligated balances (UOB) provisions, with the trigger for penalty provisions set at 5% of unobligated formula funds.
3. The Ryan White Program
The Ryan White Program provides a comprehensive system of HIV primary medical care, essential support services, and medications for low-income people with HIV. The Program funds grants to states, cities, counties, and local community-based organizations to provide care and treatment services to people with HIV to improve health outcomes and reduce HIV transmission among hard-to-reach populations. The Ryan White Program is a payor of last resort.
The Program was first authorized in federal legislation in 1990 and continues to be funded today. The Ryan White HIV/AIDS Program is divided into five parts: A, B, C, D, and F.
Part A funds medical and support services to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs). EMAs and TGAs are counties/cities that are most severely affected by the HIV/AIDS epidemic. The City of Jacksonville/Duval County and its surrounding counties including Nassau, Clay, and St. Johns County make up the Jacksonville TGA.
Part B administers funds for states and territories to improve the quality, availability, and organization of HIV health care and support services. Recipients include all 50 states, the District of Columbia, Puerto Rico, and the US. Virgin Islands, and the six U.S. Pacific territories/associated jurisdictions. Part B includes grants for the AIDS Drug Assistance Program (ADAP).
Part C administers funds for local community-based organizations to provide comprehensive primary health care and support services in an outpatient setting for people with HIV through Early Intervention Services program grants. Part C also funds Capacity Development grants, which help organizations more effectively deliver HIV care and services.
Part D administers funds for local, community-based organizations to provide outpatient, ambulatory, family-centered primary and specialty medical care for women, infants, and youth with HIV. The funding may also be used to provide support services to people living with HIV and their affected community members.
Part F funds support clinician training, technical assistance, and the development of innovative models of care to improve health outcomes and reduce HIV transmission. The programs include: The Special Projects of National Significance Program, the AIDS Education and Training Centers Program, The Dental Programs, and the Minority AIDS Initiative. More information can be found at: https://hab.hrsa.gov/about-ryan-white-hivaids-program/about-ryan-white-hivaids-program . The Jacksonville TGA has Minority AIDS Initiative (MAI) funding which improves access to HIV care and health outcomes for disproportionately affected minority populations, including black/African Americans.
National HIV/AIDS Strategy
- Development
The National HIV/AIDS Strategy is a five-year plan that details principles, priorities, and actions to guide our collective national response to the HIV epidemic. The Strategy was first released in 2010 and identified a set of priorities and strategic action steps tied to measurable outcomes for moving the Nation forward in addressing the domestic HIV epidemic. It was updated in 2015 to reflect the time to 2020. The updated Strategy reflects the work accomplished and the new scientific developments since 2010 and charts a course for collective action across the federal government and all sectors of society to move us close to the Strategy’s vision.
The National HIV/AIDS Strategy (2022–2025) provides stakeholders across the nation with a roadmap to accelerate efforts to end the HIV epidemic in the United States by 2030. The Strategy reflects President Biden’s commitment to re-energize and strengthen a whole-of-society response to the epidemic while supporting people with HIV and reducing HIV-associated morbidity and mortality.
The White House’s Office of National AIDS Policy (ONAP), part of the Domestic Policy Council, facilitated development of and published the Strategy, which builds on the 2021 HIV National Strategic Plan and the two prior National HIV/AIDS Strategies (2010, 2015).
- Vision and Goals
The Strategy articulates a clear vision to guide the nation’s response to HIV:
The United States will be a place where new HIV infections are prevented, every individual knows their status, and every person with HIV has high-quality care and treatment, lives free from stigma and discrimination, and can achieve their full potential for health and well-being across the lifespan.
This vision includes all individuals, regardless of age, sex, gender identity, sexual orientation, race, ethnicity, religion, disability, geographic location, or socioeconomic circumstance.
The Strategy sets bold targets for ending the HIV epidemic in the United States by 2030, including a 75% reduction in new HIV infections by 2025 and a 90% reduction by 2030.
To guide the nation toward realizing the vision, the Strategy focuses on four goals:
- Prevent new HIV infections.
- Improve HIV-related health outcomes of people with HIV.
- Reduce HIV-related disparities and health inequities.
- Achieve integrated, coordinated efforts that address the HIV epidemic among all partners and interested parties.
Administrative and Programmatic Structure(s)
Jacksonville Transitional Grant Area
The Jacksonville Transitional Grant Area (JTGA) is in the northeastern corner of Florida and is made up of four counties – Nassau, Clay, Duval, and St. Johns. Duval County is a consolidated government with the City of Jacksonville and is the hub of the epidemic in Northeast Florida. The City of Jacksonville has an estimated population over 1.5 million and is the largest city by area in the continental United States as it is over 875 square miles and is the 13th largest city in the country. Duval County accounts for 62% of the JTGA total population, with 89% of people with AIDS (PWA), and 90% of people with HIV (PWH). St. John’s County represents 19% of the JTGA’s population with 5% of PWA and 4% of PWH. Clay County ‘s population represents 14% of the JTGA’s population with 4% of PWA, and 4% of PWH. Nassau County’s population represents 6% of the JTGA’s population with 2% of PWA, and 2% of PWH.
The Ryan White Program in the JTGA serves over 4,000 individuals annually. Since 1995, the JTGA has received over $100 million in Ryan White Program funding.
Areas Affected by Project:
(Duval, Clay, Nassau, and St. Johns Counties, of Northeast Florida)
- Duval County -- Population 1,051,278
People with HIV (PWH) 7,780
2. Clay County -- Population 231,042
People with HIV (PWH) 518
3. Nassau County -- Population 100,763
People with HIV (PWH) 167
4. St. Johns County -- Population 315,317
People with HIV (PWH) 476
Programmatic/Funding Structure
The Ryan White Part A Program is administered by the City of Jacksonville Social Services Division, under the Parks, Recreation, and Community Services Department. The City of Jacksonville Mayor is the Chief Executive Officer of the Ryan White Part A Administrative Office. The Administrative Agency does not provide any medical, case management, emergency, housing, or other direct services to individuals. Instead, the office performs the day-to-day administration that includes programmatic and fiscal monitoring of the Ryan White Part A Program, reporting milestones to the Health Resources and Services Administration (HRSA) and paying invoices from local agencies who provide the actual services to people with HIV (PWH). The City of Jacksonville is considered the Recipient as the one who receives the grant funds from the federal government. The Ryan White Part A Program Administrative Office works to ensure that low-income individuals in the Jacksonville Transitional Grant Area (JTGA) receive the care and support services they need while living with HIV. While the JTGA includes the counties of Clay, Duval, Nassau, and St. Johns, the Part A Administrative Office is based in the City of Jacksonville. Sub recipients, also known as community providers, are in and provide services in any county included in the JTGA. Ryan White Part B services are administered through the State of Florida Department of Health in the respective counties in the JTGA. Part C, D, and F are distributed to various providers in the community.
The Ryan White Part A Program is funded directly by the United States Department of Health and Human Services, Health Resource and Services Administration (HRSA), HIV/AIDS Bureau (HAB) as a Transitional Grant Area (TGA) for Part A. The Ryan White Part A Program collaborates with the Metropolitan Jacksonville Area HIV Health Services Planning Council (the Planning Council). The Planning Council Priority and Allocations Committee with input from the sub recipients and individuals receiving services determines how the Part A money in the approved eligible service categories is spent. The sub recipients use the money to support the JTGA Continuum of Care. Part A funds must be used to provide a continuum of care for PWH. According to HRSA Policy Notice 16-02, the following service categories may be funded with Ryan White Part A grant dollars:
- Core Services consists of AIDS Pharmaceutical Assistance, Early Intervention Services (EIS), Health Insurance Premium and Cost Sharing Assistance for Low-Income Individuals, Home and Community-Based Health Services, Home Health Care, Hospice, Medical Case Management – including Treatment Adherence Services, Medical Nutrition Therapy, Mental Health Services, Oral Health Care, Outpatient/Ambulatory Health Services and Substance Abuse Outpatient Care.
- Support Services include Child Cares Services, Emergency Financial Assistance, Food Bank/Home Delivered Meals, Health Education/Risk Reduction, Housing, Legal Services, Linguistic Services, Medical Transportation, Non-medical Case Management Service, Other Professional Services, Outreach Services, Permanency Planning, Psychosocial Support Services, Referral for Health Care and Support Services, Rehabilitation Services, Respite Care, and Substance Abuse Services (residential).
The Ryan White Part A Program Recipient (City of Jacksonville) along with the Planning Council will make the final decision regarding the specific services to be funded under the Ryan White Part A Grant. The core medical and support service categories are important to assist in the diagnosis of HIV infection, linkage to and entry into care for PWH, retention in care, and the provision of HIV care and treatment.
II. MetroJAX Planning Council
Metropolitan Jacksonville HIV Health Services Planning Council
The Metropolitan Jacksonville HIV Health Services Planning Council (Planning Council) was created as a planning body for Ryan White CARES act funding in the City of Jacksonville by Executive Order 94-186. Created under Mayor Ed Austin, the Executive Order ensured that Planning Council follow the mandated responsibilities:
- Establish priorities for the allocations of funds.
- Develop a comprehensive plan, compatible with any existing state or local plans, for the organization and delivery of HIV health services.
- Assess the efficiency of the administrative mechanisms to rapidly allocate funds to the areas of greatest need.
The Executive Order also dictates that the Planning Council is comprised of at least 17 members but no more than 35. All members are individuals who are appointed by the mayor and represent ethnically diverse populations. These individuals may represent the following categories:
- The affected communities, including individuals with HIV
- Community-based organizations providing services to people with HIV and AIDS service organizations
- Social service professionals engaged in providing services to people affected by HIV
- Mental health service providers
- Local public health agencies
- Hospital planning agencies or health care planning agencies
- Health care providers
- Non-elected community leaders involved with the HIV community
- Representatives of a state governmental agency providing services to HIV-positive individuals
- If available, an individual from Part B grantee.
- If available, an individual from other HRSA HIV-related grantees.
- An individual from each of the three counties of Clay, Nassau, and St. Johns.
- An individual from the Ryan White consortia (to encourage and assist in fostering communication between the consortia and the Planning Council)
- Other individuals from the community at large, which may include any of the above categories
No member shall represent more than one category. The Planning Council must be made up of at least 33% of individuals who are PWH.
The Planning Council determines the needs of the HIV community in the four counties – Duval, Nassau, St. Johns, and Clay. They conduct needs assessment; gather input of community members through community meetings and other community events. The Planning Council is responsible for prioritizing needs and allocating by percentage how much Ryan White funding is disbursed to each HIV service category.
Planning Council Responsibilities
Planning Council deliverables include but are not limited to:
a. Priority Setting: The process used to rank priorities among service
categories. These rankings are to ensure consistency with locally
identified needs. The process should also address how best to meet
each priority.
b. Resource Allocation: The legislatively mandated responsibility of
assigning Ryan White Program amounts or percentages to
established priorities across specific service categories, geographic
areas, populations, or subpopulations.
c. Comprehensive Plan: The process of determining the organization
and delivery of HIV services. Planning bodies use this strategy to
improve decision-making about services and maintain a continuum
of care for PWH/A
d. Needs Assessment: A systematic process to determine the service
needs of a defined population. The needs assessment reviews the
extent of HIV and AIDS cases in a service area by population and
geographic area and includes an analysis of available services and
any service gaps.
e. Statewide Coordinated Statement of Need (SCSN): The SCSN is a
written statement of need for the entire State developed through a
process designed to collaboratively identify significant HIV issues and
maximize Ryan White Program coordination. The SCSN process is
convened by the Part B Recipient, with equal responsibility and input
by all programs. Representatives must include all Ryan White funded
programs and Part F managers, contractor/providers, PWH/A, and
public health agency(s).
f. Special Studies: The Care Council can request the Ryan White
Program Administrator/Manager to conduct any special studies of
emerging HIV/AIDS needs within a particular service area.
III. Resources
Part A Funded Providers and Service Categories (2024-2027)
The City of Jacksonville as Grantee, along with the Social Services Division (Administrative Agency) and the Ryan White Part A Office, works to ensure that low-income people in the Jacksonville Transitional Grant Area (TGA) receive the care and support services they need to fight HIV. The Jacksonville TGA includes the counties of Clay, Duval, Nassau, and St. Johns.
The City of Jacksonville Ryan White Part A administrative staff, in partnership with the Metropolitan Jacksonville Area HIV Health Services Planning Council, and the Florida Department of Health offices in Clay, Duval, Nassau, and St. Johns Counties, coordinates the delivery of these services to over 5,600 people living with HIV, and their families.
Click here to download the A Safety Net for Persons Living With HIV Resource Guide.
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Ryan White Service Providers 2024/25- 2026/27
Provider Name, Address & Contact | Services Provided |
|---|---|
| AIDS Health Care Foundation (AHF) 2 Shircliff Way, Jacksonville, FL 32204 Phone: (904) 381-9651 Website: AHF Healthcare Center Jacksonville: Visit your AHF Healthcare Center store (hivcare.org) |
|
| CAN Community Health 4615 Philips Hwy Jacksonville, FL 32207 Phone: (904) 508-0710 Website: CAN Community Health – Jacksonville |
|
| Florida Department of Health – Duval 515 W. 6th Street Jacksonville, FL 32206 Phone: (904) 253-1000 Website: DOH-Duval Central Health Plaza | Florida Department of Health in Duval (floridahealth.gov) |
|
| Gateway Community Services 555 Stockton Street, Jacksonville, FL 32204 Phone: (904) 387-4661 Website Addiction Treatment Center | Jacksonville, FL | Gateway Community Services |
|
| Jacksonville Area Legal Aid 126 W Adams St, Jacksonville, FL 32202 Phone: (904) 356-8371 Website Home - Jacksonville Area Legal Aid, Inc. (jaxlegalaid.org) |
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| Lutheran Social Services 4615 Philips Hwy, Jacksonville, FL 32207 Phone: (904) 448-5995 Website: Lutheran Social Services of Northeast Florida | Jacksonville, FL (lssjax.org)www.myepic.org |
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| Northeast Florida AIDS Network (NFAN) 751 Oak Street, Suite 520, Jacksonville, FL 32204 Phone: (904) 356-1612 Website: NFAN – Northeast Florida Aids Network (nfanjax.org) |
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| UF CARES 655 W 8th St Fl 3, Jacksonville, FL 32209 Phone: (904) 244-2120 Website: UF Center for HIV/AIDS Research, Education and Service (UF CARES) | UF Health Jacksonville | University of Florida Health (ufhealthjax.org) |
|
For further information regarding Ryan White Part A, or its administrative agency, please contact:
Sandy Arts, Program Manager
Social Services Division
1809 Art Museum Dr., Suite 100
Jacksonville, FL 32207
Phone: (904) 255-3342
Fax: (904) 255-3362
Email: sarts@coj.net
Planning Council Email: PlanningCouncil@coj.net
Ryan White Eligibility is now provided through:
CAN Community Health
Appointments can be made by calling (904) 508-0710, ext. 26925
This website is partially funded through the Ryan White HIV/AIDS Treatment Extension Act of 2009