American Academy of HIV Medicine Encouraged by Senator Tom Coburn's (R-OK) Introduction of The Ryan White CARE Act Amendments of 2006
February 28, 2006
Washington, D.C. -- With today's introduction of the Ryan White CARE Act Amendments of 2006 by Senator Tom Coburn (R-OK), the members of the American Academy of HIV Medicine (AAHIVM) are encouraged by this step -- thus far the only legislative language we have seen in nearly six months after the expiration of the CARE Act -- toward reauthorization of this critical legislation benefiting Americans living with HIV/AIDS. As our nation's front-line health care providers to those living with the disease, AAHIVM's physicians, nurse practitioners and physician assistants know first-hand how vital the Ryan White CARE Act is to the health -- and in many cases the survival -- of our patients with HIV/AIDS. Senator Coburn clearly cares about this program and we are grateful that he wants to move the process forward.
A number of the bill's features reflect many of the improvements our members have deemed necessary to transforming the health care they provide for their patients living with HIV/AIDS. We are glad to see the proposed improvements to the AIDS Drug Assistance Program (ADAP), namely the minimum formulary under ADAP as well the increases in funding authorizations for the program. We are also pleased by the proposed coverage of care and treatment for those co-infected with Hepatitis B and Hepatitis C.
AAHIVM also salutes the provision for "Special Projects of National Significance," and, along with our colleagues in the HIV Medicine Association (HIVMA), would welcome the opportunity to serve as expert resources in the development of a standard electronic data system or the study of best practices in disease management. Between our two organizations, we serve the majority of people living with HIV in this country.
AAHIVM does have concern about the potential impact of several proposed sections of this bill on the wellness of our patients living with HIV/AIDS. For instance, we certainly appreciate that care and treatment has been prioritized, but mandating that 75% of the funds go toward primary care and treatment as defined by this bill would be shortsighted with respect to the total health and wellness needs of our patients with HIV/AIDS. Our members, who provide care for more than 350,000 patients, are very clear in the message they communicate to us: Primary care includes more than drugs and doctors' visits. AAHIVM strongly recommends that primary care be more broadly defined to include other critical aspects of care like treatment adherence counseling and substance abuse counseling and are happy to engage in developing a more accurate definition of "primary care" than the one the bill currently offers.
AAHIVM also suggests revisiting the provisions regarding partner notification, particularly the punitive measures that could mean the loss of critical funding for those agencies and the patients they serve that need it most; AAHIVM strongly encourages the exploration of a more collegial approach that helps providers to do proper reporting.
Though the AAHIVM has reservations about several sections of the bill, we certainly applaud Senator Coburn for his willingness to push the debate forward toward reauthorization, and view much of the proposed legislation as a sincere, well-intentioned modernization of the Ryan White CARE Act that reflects the epidemiology of HIV/AIDS in the United States today. We look forward to working with any member of Congress on improving the Ryan White CARE Act and ensuring that the legislation is reauthorized with the financial increases that are so crucial to helping us as physicians, nurse practitioners and physician assistants provide the highest quality care to the greatest number of Americans in our communities living with HIV/AIDS.
Dr. Howard Grossman is Executive Director of the American Academy of HIV Medicine.
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