Ryan White Program 
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 (Public Law 101-381) provides funding to States and other public or private nonprofit entities. The funding is to develop, organize, coordinate, and operate more effective and cost-efficient systems for the delivery of essential health care and support services to medically underserved individuals and families affected by HIV.
The CARE Act was reauthorized in 2000 and the CARE Act Amendments of 2000 made legislative changes designed to improve and expand access to care, increase accountability, and enhance service capacity in underserved urban and rural communities.
The newly enacted Ryan White HIV/AIDS Treatment Modernization Act of 2006 provides the Federal HIV/AIDS programs in the Public Health Service (PHS) Act under Title XXVI flexibility to respond effectively to the changing epidemic. The new law changes how Ryan White funds can be used, with an emphasis on providing life-saving and life-extending services for people living with HIV/AIDS across this country. The law sunsets in three years or on December 31, 2009, unless new legislation reauthorizes these services.
The HIV/AIDS Bureau of the Health Resources and Services Administration (HRSA), is the largest single source, next to the Medicaid and Medicare programs, of federal funding for HIV/AIDS care for low-income, un- and underinsured individuals. HRSA administers all Ryan White Parts for HIV care and treatment and is the federal agency to which the Nebraska Ryan White Program reports.
Nebraska receives funding from Part B of the Ryan White CARE Act. Funds are utilized to provide economic assistance for rent, utilities, transportation, health insurance, food, and nutritional supplements to individuals infected with HIV disease. Part C healthcare and healthcare related services are offered through the University of Nebraska Medical Center (UNMC) in Omaha which provides services to the eastern two-thirds of the State and Western Community Health Resources (WCHR), located in Chadron which provides services in the panhandle region. Together these services allow individuals who do not qualify for Medicaid, Medicare, or private insurance to access needed services.
The AIDS Drug Assistance Program (ADAP) provides medications to low-income individuals in all 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam who are infected with HIV disease. Qualified individuals have limited or no coverage under Medicaid, Medicare, or private insurance which may provide access to medications for the treatment of HIV disease.
As of February 21, 2007, Nebraska’s ADAP formulary includes approximately 120 medications including medications currently approved by the FDA for the treatment of HIV disease. In addition to Federal funding, ADAP receives an additional State funding for HIV medications. The UNMC acts as the ADAP provider for Nebraska. Qualified individuals statewide receive medications either through walk-in pharmacy services at the hospital or through a mail order system.
Nebraska's Ryan White Part B Program does not currently have a waiting list for its ADAP.
The Nebraska Medicare Part D Program is coordinated through UNMC in conjunction with the ADAP. Eligibility requirements must be met in order for the Program to assist clients with services. It is a requirement that all Medicare Part D eligible clients who are enrolled in ADAP be enrolled in Medicare Part D. Since Medicare is a Federal health benefits and entitlement program, the CARE Act payer-of-last-resort requirement applies. The Program is directed by the federal government and requires all Medicare-eligible ADAP clients to enroll in the prescription drug benefit.
Nebraska Ryan White Part B funds may be utilized for the payment of Medicare Part D Insurance Premiums and other services for ADAP enrolled clients who are eligible for Medicare Part D in accordance with Program requirements. Please contact the Program for more information and updated eligibility information.
The Nebraska Ryan White Program also offers psychosocial HIV Case Management. Eligibility for services is 200% of the Federal Poverty Level. To receive services, clients must be enrolled through case management, with proof of HIV status, proof of income, and other federally required documentation. Case management services must be accessed through the Nebraska AIDS Project, Inc (NAP). NAP can be reached at 800/782-2437 or 402/552-9260.
The Nebraska HIV CARE & Prevention Consortium (NHCPC) was established as of March 1, 2000, to meet the federal requirements of the cooperative agreements awarded to Nebraska by the Health Resources Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC).
The future of HIV treatment is wide open. New medications continue to be developed and approved by the FDA (U.S. Food and Drug Administration) on an annual basis. Advances in therapeutics enable individuals with HIV to take fewer pills with fewer side effects. It is hoped that advances such as these will eventually bring the cost of providing these medications to manageable levels with the end goal of improving the health and well-being of individuals with HIV in Nebraska.
Any questions regarding Nebraska’s HV care and treatment services can be directed to the Ryan White Program via email at RyanWhite.Program@dhhs.ne.gov.
Documents May 2008
