Ryan White Part B - FAQs

What does the Ryan White Part B Program Do?

The Nevada Division of Public and Behavioral Health Ryan White HIV/AIDS Part B Program (RWPB) provides medications and services to eligible Nevadans living with HIV/AIDS. Nevada’s AIDS Drug Assistance Program (ADAP) Formulary is geared toward optimum patient care; medications are maintained in coordination with and by recommendation of the Medical Advisory Committee (MAC).

Who funds Ryan White Part B?

Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program Part B and Nevada State General Fund.

Part B of the Ryan White HIV/AIDS Treatment Modernization Act provides grants to all 50 States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and 5 U.S. Pacific Territories or Associated Jurisdictions. 

Click here for additional information on the Part B Ryan White HIV/AIDS Treatment Modernization Act. 

What is the Ryan White Part B (RWPB) Eligibility Process?

The eligibility screening process will qualify clients for available Ryan White services. There are two locations for statewide access to the eligibility screening process:

Reno, Carson City, Tahoe, Elko and Rural Areas: contact Access to Healthcare Network (AHN) at (775) 284-8989 or toll free at 1-877-385-2345;

Clark (Las Vegas) and Nye Counties: contact Access to Healthcare Network (AHN) at (702) 489-3400 or toll free at 1-877-385-2345 to schedule an appointment. 

Clients are placed in the medication program that is most appropriate for their circumstances and in keeping with the cost-effectiveness of the plan.


Ryan White is payer of last resort.

What are the RWPB Eligibility Criteria?

Eligibility criteria for the RWPB program are determined on a state-by-state basis according to the federal guidelines. Anyone moving to Nevada from another state will need to re-apply for RWPB, and benefits are administered under the policies of Nevada. The statewide eligibility criteria are reviewed periodically to determine if the program has been successful in providing medication and other medical services to low-income HIV+ and AIDS patients. 

 

Current eligibility criteria include, but are not limited to:  

 

  • Client income must not exceed 400% of Federal poverty Guidelines (FPG) at approximately $47,080/year. 
  • Client may have one single-family, owner-occupied home and one car (two cars if married.) 
  • Additional liquid assets of the client may not exceed $10,000. 
  • Confirmed diagnosis of HIV/AIDS & documented laboratory tests for T-Cell counts and viral load must be done every six months. 
  • RWPB recertification, including ADAP, must be done every six months. 
  • Applicant must be a Nevada resident with two forms of government issued identification. 
  • Retirement accounts that currently do not provide income unless the applicant is over 59.5 years of age are not included in assets.   

 

RWPB/ADAP Eligibility Forms and Information  

 

  • Common Patient Assistance Program Application (HIV) (pdf) 
  • RWPB Insurance Verification Form – HICP (pdf) 
  • RW Employer Insurance Verification Letter (pdf) 
  • RWPB Confirmation of Dependent Support (pdf)   
  • ADAP Formulary #37 (pdf)  

 

What is the AIDS Drug Assistance Program (ADAP)?

The ADAP can help pay for all or part of your HIV medications if you meet the program requirements.

What is the Health Insurance Continuation Program (HICP)?

The Health Insurance Continuation Program (HICP) is a statewide program for persons who are diagnosed with AIDS or are HIV positive with symptoms and who, because of their illness, are unable to maintain their private health insurance coverage.  This program pays health insurance premiums to continue coverage when clients can no longer work or can work only part time.

What is the Premium Payment Program?

The ADAP Private Insurance program can pay co-pays for HIV medications if you have private health insurance, but can’t afford to pay for them yourself. You must meet the program requirements.    

What are the Eligibility Requirements for RWPB ADAP?

¨ Client income must not exceed 400% of Federal Poverty Guidelines-approx $47,080/year for one.

¨ Client may own a single-family home and a car.

¨ Additional assets of the client may not exceed $10,000.

¨ Lab tests for T-Cell and Viral Load must be done every six months.

¨ ADAP eligibility recertification every six months. 

Core Ryan White Part B Services

What is Outpatient/Ambulatory Medical Care (Health Services)

This is the provision of professional diagnostic and therapeutic services rendered by a physician, physician's assistant, clinical nurse specialist, or nurse practitioner in an outpatient setting. Settings include clinics, medical offices, and mobile vans where clients generally do not stay overnight. Emergency room services are not outpatient settings. Services includes diagnostic testing, early intervention and risk assessment, preventive care and screening, practitioner examination, medical history taking, diagnosis and treatment of common physical and mental conditions, prescribing and managing medication therapy, education and counseling on health issues, well-baby care, continuing care and management of chronic conditions, and referral to and provision of specialty care (includes all medical subspecialties). Primary medical care for the treatment of HIV infection includes the provision of care that is consistent with the Public Health Service’s guidelines. Such care must include access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies. NOTE: Early Intervention Services provided by Ryan White Part C and Part D Programs should be included here under Outpatient/ Ambulatory medical care.

What is ADAP?

AIDS Drug Assistance Program (ADAP treatments) is a State-administered program authorized under Part B of the Ryan White Program that provides FDA-approved medications to low-income individuals with HIV disease who have limited or no coverage from private insurance, Medicaid, or Medicare.

What is AIDS Pharmaceutical Assistance (Local)?

AIDS Pharmaceutical Assistance (local) includes local pharmacy assistance programs implemented by Part A or Part B Grantees to provide HIV/AIDS medications to clients. This assistance can be funded with Part A grant funds and/or Part B base award funds. Local pharmacy assistance programs are not funded with ADAP earmark funding.

What is considered Oral Health Care?

Oral health care includes diagnostic, preventive, and therapeutic services provided by general dental practitioners, dental specialists, dental hygienists and auxiliaries, and other trained primary care providers.

What are Early Intervention Services?

Early intervention services (EIS) include counseling individuals with respect to HIV/AIDS; testing (including tests to confirm the presence of the disease, tests to diagnose to extent of immune deficiency, tests to provide information on appropriate therapeutic measures); referrals; other clinical and diagnostic services regarding HIV/AIDS; periodic medical evaluations for individuals with HIV/AIDS; and providing therapeutic measures. NOTE: EIS provided by Ryan White Part C and Part D Programs should NOT be reported here. Part C and Part D EIS should be included under Outpatient/ Ambulatory medical care.

What is Health Insurance Premium and Cost Sharing Assistance?

Health Insurance Premium & Cost Sharing Assistance is the provision of financial assistance for eligible individuals living with HIV to maintain a continuity of health insurance or to receive medical benefits under a health insurance program. This includes premium payments, risk pools, copayments, and deductibles.

What is Home Health Care?

Home Health Care includes the provision of services in the home by licensed health care workers such as nurses and the administration of intravenous and aerosolized treatment, parenteral feeding, diagnostic testing, and other medical therapies.

What are Home and Community-Based Health Services?

Home and Community-based Health Services include skilled health services furnished to the individual in the individual’s home based on a written plan of care established by a case management team that Includes appropriate health care professionals. Services include durable medical equipment; home health aide services and personal care services in the home; day treatment or other partial hospitalization services; home intravenous and aerosolized drug therapy (including prescription drugs administered as part of such therapy); routine diagnostics testing administered in the home; and appropriate mental health, developmental, and rehabilitation services. Inpatient hospitals services, nursing home and other long term care facilities are NOT included.

What is Hospice?

Hospice services include room, board, nursing care, counseling, physician services, and palliative therapeutics provided to clients in the terminal stages of illness in a residential setting, including a non-acute-care section of a hospital that has been designated and staffed to provide hospice services for terminal clients.

What are Mental Health Services?

Mental health services are psychological and psychiatric treatment and counseling services offered to individuals with a diagnosed mental illness, conducted in a group or individual setting, and provided by a mental health professional licensed or authorized within the State to render such services. This typically includes psychiatrists, psychologists, and licensed clinical social workers.

What is Medical Nutrition Therapy?

Medical nutrition therapy is provided by a licensed registered dietitian outside of a primary care visit and includes the provision of nutritional supplements. Medical nutrition therapy provided by someone other than a licensed/registered dietitian should be recorded under psychosocial support services.

What are Medical Case Management Services?

Medical case management services (including treatment adherence) are a range of client centered services that link clients with health care, psychosocial, and other services. The coordination and follow-up of medical treatments is a component of medical case management. These services ensure timely and coordinated access to medically appropriate levels of health and support services and continuity of care, through ongoing assessment of the client’s and other key family members’ needs and personal support systems. Medical case management includes the provision of treatment adherence counseling to ensure readiness for, and adherence to, complex HIV/AIDS treatments. Key activities include (1) initial assessment of service needs; (2)development of a comprehensive, individualized service plan; (3) coordination of services required to implement the plan; (4) client monitoring to assess the efficacy of the plan; and (5) periodic reevaluation and adaptation of the plan as necessary over the life of the client. It includes client specific advocacy and/or review of utilization of services. This includes all types of case management including face-to-face, phone contact, and any other forms of communication.

What are Substance Abuse Services?

Substance abuse services outpatient is the provision of medical or other treatment and/or counseling to address substance abuse problems (i.e., alcohol and/or legal and illegal drugs) in an outpatient setting, rendered by a physician or under the supervision of a physician, or by other qualified personnel.

What is Non-Medical Case Management?

Case Management (non-Medical) includes the provision of advice and assistance in obtaining medical, social, community, legal, financial, and other needed services. Non-medical case management does not involve coordination and follow-up of medical treatments, as medical case management does.

What are Child Care Services under RWPB?

Child care services are the provision of care for the children of clients who are HIV-positive while the clients attend medical or other appointments or Ryan White Program-related meetings, groups, or training.

(NOTE: This does not include child care while a client is at work.)

What is Emergency Financial Assistance?

Emergency financial assistance is the provision of short-term payments to agencies or establishment of voucher programs to assist with emergency expenses related to essential utilities, housing, food (including groceries, food vouchers, and food stamps), and medication when other resources are not available. (NOTE: Part A and Part B programs must be allocated, tracked and report these funds under specific service categories as described under 2.6 in DSS Program Policy Guidance No. 2 (formally Policy No. 97-02).

How does RWPB handle Food Bank/Home-Delivered Meals?

Food bank/home-delivered meals include the provision of actual food or meals. It does not include finances to purchase food or meals. The provision of essential household supplies such as hygiene items and household cleaning supplies should be included in this item; includes vouchers to purchase food.

What is Heath Education/Risk Reduction?

Health education/risk reduction is the provision of services that educate clients with HIV about HIV transmission and how to reduce the risk of HIV transmission. It includes the provision of information; including information dissemination about medical and psychosocial support services and counseling to help clients with HIV improve their health status.

How are Housing Services handled under RWPB?

Housing services are the provision of short-term assistance to support emergency, temporary or transitional housing to enable an individual or family to gain or maintain medical care. Housing related referral services include assessment, search, placement, advocacy, and the fees associated with them. Eligible housing can include both housing that does not provide direct medical or supportive services and housing that provides some type of medical or supportive services such as residential mental health services, foster care, or assisted living residential services.

How are Legal Services handled under RWPB?

Legal services are the provision of services to individuals with respect to powers of attorney, do not-resuscitate orders and interventions necessary to ensure access to eligible benefits, including discrimination or breach of confidentiality litigation as it relates to services eligible for funding under the Ryan White Program. It does not include any legal services that arrange for guardianship or adoption of children after the death of their normal caregiver.

What are Linguistics Services?

Linguistics services include the provision of interpretation and translation services.

What are Medical Transportation Services?

Medical transportation services include conveyance services provided, directly or through voucher, to a client so that he or she may access health care services.

What are Outreach Services?

Outreach services are programs that have as their principal purpose identification of people with unknown HIV disease or those who know their status so that they may become aware of, and maybe enrolled in care and treatment services (i.e., case finding), not HIV counseling and testing or HIV prevention education. These services may target high-risk communities or individuals. Outreach programs must be planned and delivered in coordination with local HIV prevention outreach programs to avoid duplication of effort; be targeted to populations known through local epidemiologic data to be at disproportionate risk for HIV infection; be conducted at times and in places where there is a high probability that individuals with HIV infection will be reached; and be designed with quantified program reporting that will accommodate local effectiveness evaluation.

What are Psychosocial Support Services?

Psychosocial support services are the provision of support and counseling activities, child abuse and neglect counseling, HIV support groups, pastoral care, caregiver support, and bereavement counseling. Includes nutrition counseling provided by a non-registered dietitian but excludes the provision of nutritional supplements.

What is Referral for Health Care/Supportive Services?

Referral for health care/supportive services is the act of directing a client to a service in person or through telephone, written, or other type of communication. Referrals may be made within the nonmedical case management system by professional case managers, informally through support staff, or as part of an outreach program.

What are Rehabilitation Services?

Rehabilitation services are services provided by a licensed or authorized professional in accordance with an individualized plan of care intended to improve or maintain a client’s quality of life and optimal capacity for self-care. Services include physical and occupational therapy, speech pathology, and low-vision training.

What is Respite Care?

Respite care is the provision of community or home-based, non-medical assistance designed to relieve the primary caregiver responsible for providing day-to-day care of a client with HIV/AIDS.

What are Substance Abuse Services?

Substance abuse services – residential is the provision of treatment to address substance abuse problems (including alcohol and/or legal and illegal drugs) in a residential health service setting (short term).

What is Treatment Adherence Counseling?

Treatment adherence counseling is the provision of counseling or special programs to ensure readiness for, and adherence to, complex HIV/AIDS treatments by non-medical personnel outside of the medical case management and clinical setting.

Find HIV/AIDS
Prevention & Service
Providers

Enter your location, such as: "Washington, DC", or "20002".

For more information on this widget, please visit AIDS.gov.

Please contact contact@aids.gov with any comments or concerns.

    Contact Us

    Office of HIV/AIDS
    4126 Technology Way
    Suite 200
    Carson City, NV 89706
    Fax: (775) 684-4056

    Last Updated: 10/5/2016