The CARE Act addresses the health needs of persons living with HIV disease (PLWH) by funding primary health care and support services that enhance access to and retention in care. The following principles were crafted by HAB to guide CARE Act programs in implementing CARE Act provisions and emerging challenges in HIV/AIDS care:
Revise care systems to meet emerging needs. The CARE Act stresses the role of local planning and decision making-with broad community involvement-to determine how to best meet HIV/AIDS care needs. This requires assessing the shifting demographics of new HIV/AIDS cases and revising care systems (e.g., capacity development to expand available services) to meet the needs of emerging communities and populations. A priority focus is on meeting the needs of traditionally underserved populations hardest hit by the epidemic, particularly PLWH who know their HIV status and are not in care. This entails outreach, early intervention services (EIS), and other needed services to ensure that clients receive primary health care and supportive services-directly or though appropriate linkages.
Ensure access to quality HIV/AIDS care. The quality of HIV/AIDS medical care-including combination antiretroviral therapies and prophylaxis/treatment for opportunistic infections-can make a difference in the lives of PLWH. Programs should use quality management programs to ensure that available treatments are accessible and delivered according to established HIV-related treatment guidelines.
Coordinate CARE Act services with other health care delivery systems. Programs need to use CARE Act services to fill gaps in care. This requires coordination across CARE Act programs and with other Federal/State/local programs. Such coordination can help maximize efficient use of resources, enhance systems of care, and ensure coverage of HIV/AIDS-related services within managed care plans (particularly Medicaid managed care).
Evaluate the impact of CARE Act funds and make needed improvements. Federal policy and funding decisions are increasingly determined by outcomes. Programs need to document the impact of CARE Act funds on improving access to quality care/treatment along with areas of continued need. Programs also need to have in place quality assurance and evaluation mechanisms that assess the effects of CARE Act resources on the health outcomes of clients