April 4, 2013
This article was provided by the National Minority AIDS Council; Paul Kawata is the organization's executive director.
The Affordable Care Act (ACA) will transform healthcare in America. Is your mix of services aligned with what will be funded? As we get closer to the start of enrollment and implementation of the ACA, the federal government has started to examine how their programs will compliment and not duplicate ACA services.
The HIV/AIDS Bureau at the Heatlh Resources and Services Administration (HRSA) recently posted guidance on their website that highlights which Ryan White HIV/AIDS Program services can be used to pay for outreach, benefits counseling and enrollment services. Study this page carefully. Do your services align with what they will be funding?
State health exchanges and/or the federal government will be issuing requests for proposals to support Patient Navigators (PN). PNs will operate similarly to case managers in many AIDS service organizations, except they will be focsuing on ensuring eligible individuals gain access to the health insurance they need. The Ryan White Program aleady pays for many navigation services provided often times by people living with HIV. The federal RFP will be out shortly; however, it is only for those states that have opted out of the ACA. Maryland, New York and Nevada have already issued their RFPs. You may want to review them to get an idea of what to expect.
A good resource on PNs was developed by Families USA.
According to Families USA:
Skills of Navigators:
Finally, Families USA makes recommendations for successful programs:
If you have an existing case management infrastructure, you may be able to modify your programs to fit the criteria for PNs. This will allow you to move beyond the RWCA for funding and help your constituents enroll in these new programs. The value of enrolling our constituents into the health marketplace is directly related to our work to end the epidemic. Before you begin treatment, you need to ensure PLWHA have access to healthcare. This must remain our primary mission.