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Public Policy Efforts Move Forward

Advocating for the Best Interests of HIV Patients and Frontline HIV Medical Care Providers

Fall 2004

The Academy's Public Policy Committee has had a busy summer and this fall will prove even more active. Recently, Dr. Michelle Roland, from UCSF, became Chair of the Public Policy Committee and leads a growing group of energetic staff and health care providers committed to addressing critical needs in the coming months:

  • Developing and finalizing the Academy's position statements on the reauthorization of the Ryan White CARE Act

  • Identifying the Academy's contributions to helping state ADAP programs provide quality service

  • Designing and funding the second White Coat Day, a large federal advocacy event to be held in Washington, DC in May 2005


  • Responding to the request by the Centers for Medicare & Medicaid Services (CMS) to comment on the new prescription drug benefit regulation under Medicare

  • Advocating for an increased federal response to the growing hepatitis C epidemic

In the upcoming months, Ryan White, ADAP and White Coat Day will require the most attention. There are many ways you can help. Watch your e-mail alerts for opportunities to get involved or simply send e-mail to

Ryan White Reauthorization

Congress is expected to take up the Ryan White CARE Act's reauthorization once the 109th Congress convenes in January 2005. Regardless of who is in office next year, medical services are expected to be prioritized, with an emphasis on access, flexibility, accountability and quality.

For AIDS community advocates, reauthorization is contentious. Heavy debate surrounds the title structure of the act and funding levels and formulas for the programs. The release of the second of two reports mandated by Congress in 2000, from the Institute of Medicine (IOM) of the National Academies, will undoubtedly shape the debate over the CARE Act.

On May 13th, an IOM committee, charged with examining the current state of the public financing of HIV care and to recommend changes, released Public Financing and Delivery of HIV/AIDS Care: Securing the Legacy of Ryan White. The committee noted that despite our best efforts to provide HIV care through the current patchwork of Ryan White, private insurance, Medicare and Medicaid, 20 percent of all individuals with HIV/AIDS are still uninsured.

Finding the current funding of HIV care inefficient and relatively ineffective, the committee recommended creating a federally funded entitlement program, the Comprehensive Care Program (CCP), for low-income people with HIV disease. The entitlement program is estimated to provide the only access to HIV care for more than 58,000 individuals with HIV disease.

The IOM committee defined four secondary objectives for HIV care funding, addressing the essential concepts of access, quality, accountability and efficiency:

  • Ensure low-income HIV-infected individuals early and continuous access to an appropriate, comprehensive set of medical and ancillary services that meet the standard of care

  • Promote the delivery of high-quality services

  • Ensure financing system and service delivery accountability for meeting established standards of treatment and health outcomes for all eligible individuals

  • Facilitate the provision of services with a minimum of administrative costs (for payers and providers) and a minimum of duplication of effort

Next Steps for the Academy

The Academy has formed a Ryan White CARE Act Reauthorization Task Force and is currently crafting a position paper that will endorse many of the principles of the IOM report. The Academy is also working in concert with other organizations such as the HIV Medical Association (HIVMA) on joint statements of policy that might have a more collective impact on Congress and the current administration. The Academy hopes to have this position paper finalized by November. Academy staff members continue to work with Senate staff and other advocates to construct the best bill possible.

What Can You Do?

The Academy is looking for additional members to work together on the Ryan White CARE Act Reauthorization Task Force. If you are interested, please send an e-mail to

AIDS Drug Assistance Program (ADAP)

The Academy's ADAP subcommittee of the Public Policy Committee has introduced three main goals addressing public policy, provider education and communication:

  • Advocate for adequate resources for state ADAPs

  • Educate HIV medical providers regarding resource challenges for ADAPs and provider roles in responsible resource use

  • Foster better coordination and communication across the states' ADAP medical advisory committees

Next Steps for the Academy

The ADAP subcommittee has been working in consultation with a number of state ADAP agencies and advocacy and research organizations to fine-tune objectives and tasks within these goals. The Academy hopes to identify an ideal minimum standard of care for ADAP programs. Further, the Academy aims to identify and support cost-conscious prescribing practices that do not compromise care, and then educate AAHIVM members about these resource challenges and recommendations to help lessen the burden on the system.

What Can You Do?

The Academy is looking for additional members to work together on the ADAP subcommittee. If you are interested, please send an e-mail to

White Coat Day

On May 11 of this year, 20 HIV medical providers from around the country came to Washington, DC for a day of lobbying Capitol Hill on domestic HIV issues. White Coat Day -- the first coordinated day of lobbying ever for HIV medical providers -- was widely regarded as a success, by both participants and Congressional staff. The Academy partnered with HIVMA, the AIDS Institute, and the International Association of Physicians in AIDS Care (IAPAC) to co-sponsor the one-day event. Our specific goal was to target those members of Congress who sit on the committees most likely to affect domestic HIV policy and funding streams, such as labor/health and human services committees. After a brief overview of lobbying strategies (see "Lobbying 101" in this issue), the medical providers visited the offices of their senators and representatives, discussing their views on Medicaid, Ryan White, the CDC Prevention Initiative and a host of other issues.

A much larger event is planned for next year, with a goal of 100 medical providers lobbying Capitol Hill over two days in May. The expanded event will include more lobbying preparation, more conversation with health officials, and scheduled addresses by members of Congress and the administration.

Next Steps for the Academy

The proposed budget for the 2005 White Coat Day is $150,000, to be shared by all three co-sponsors, so securing the Academy's share of the funds is its first priority. The Academy and its partners have also initiated discussions with the Kaiser Family Foundation about potential sponsorship of a briefing on the state of HIV care and delivery in the United States during this event. Watch for upcoming announcements regarding dates and scheduled meetings, interviews and addresses.

What Can You Do?

Once a date is finalized, prioritize participating in this critical lobbying event. The Academy needs to raise $50,000 to support this event, so if you would like to make a targeted donation, or if you know of potential funding sources, please contact us at

Back to The Nexus Fall 2004 contents page.

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This article was provided by American Academy of HIV Medicine. It is a part of the publication The Nexus. Visit AAHIVM's website to find out more about their activities and publications.