Major Changes In Ryan White Assistance

The Ohio Department of Health (ODH) has announced changes to the Ryan White program, which provides assistance to eligible Ohioans living with HIV/AIDS. The planned changes are being implemented because of a combination of decreasing resources and increasing enrollment, costs of health insurance premiums and medications. These changes will impact current and potential future clients, and are designed to maintain core services for those most in need, both financially and medically.

Changes to the program include:

Eligibility Criteria

  • Eligibility criteria will take into account a combination of both financial and medical need. After the financial assessment, the controlling factor will be based on the results of medical tests, to provide services to the most vulnerable clients. Clients who meet the criteria for medical exceptions may be enrolled.
  • All Ohioans diagnosed with HIV, regardless of income level, will be eligible for Ryan White case management services such as assistance in applying for patient assistance programs.
  • Existing clients, who are specifically impacted by financial eligibility changes effective July 1, will be notified and given the opportunity to provide updated financial documents within 30 days.
  • New program applicants above 300 percent federal poverty level will not be eligible for HIV medications from the Ryan White program.  Case managers will assist them in applying for Patient Assistance programs sponsored by the pharmaceutical manufacturers.
  • Client eligibility will be reviewed every six months for access to medications.

Implementation of a waiting list for new applicants

  • New potential clients at 300 percent poverty level and below, applying to the program, will be prioritized based on medical eligibility, effective July 1. Applicants who do not meet medical eligibility criteria will be placed on a waiting list.

Change in drug formulary

  • The revised formulary will still exceed national public health service guidelines for HIV care. 
  • All currently available antiretroviral agents will remain on the formulary.
  • Medications removed from the formulary, for health problems including cardiac conditions, management of diabetes, management of acid reflux and diarrhea, while clearly important in the care of all clients, were removed to preserve resources to pay for HIV medications.

Other program reductions

  • Elimination of non-core services (e.g. housing, utilities, transportation, nutrition).
  • Reduction of dental services except for emergencies.
  • Reductions in internal ODH funding.

Ohio HIV Drug Assistance Program (OHDAP) main line is 1-800-777-4775

Complete article can be read at  http://www.ohioaidscoalition.org

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