HIV/AIDS Health Care Funding Programs

Prepared by the Northeast Florida AIDS Network

There are currently three programs available in the State of Florida to assist people living with HIV in accessing health care. They are the AIDS Insurance Continuation Program (AICP), the State of Florida's Project AIDS Care (PAC) Medicaid Waiver Program, and the Ryan White CARE Act.

Determining which of the funding mechanisms is appropriate for an individual is a critical first step in establishing health care services for that patient. The following is a brief description of the three programs and an organizational chart outlining the evaluation process (below).

AIDS Insurance Continuation Program (AICP)

The AIDS Insurance Continuation Program (AICP) is a state program for persons who are diagnosed with AIDS or are HIV symptomatic, and who cannot afford to pay their private insurance premiums. The program makes direct payments (up to $600/month) to participant's employer or insurance company for continuation of medical, dental, and vision coverage.

AICP is funded by Florida's Department of Health and managed by the Health Council of South Florida, Inc., a private nonprofit agency. It is administered through regional community-based organizations. Northeast Florida AIDS Network (NFAN) administers the grant for the First Coast area. Through this statewide program, Florida has saved a substantial amount of money that would have been spent on health care had participants lost their insurance coverage and been forced to use other health care programs.

Project AIDS Care (Medicaid Waiver)

Project AIDS Care is Florida's Medicaid Waiver Program for individuals with AIDS. This program funds services not covered under the State's regular Medicaid program through its provision of an array of Home Health and other supportive services. Eligibility requirements for PAC are:

• Proof of HIV positive sero-status;
• A disability documentation signed by a physician indicating a diagnosis of AIDS and risk of institutionalization (long term hospital or nursing home care); and
• Income eligibility (<$1,500 gross monthly income).

Patients may already have Medicaid benefits through SSI (Supplemental Security Income). If SSI payments are terminated when patients begin receiving SSD, they may lose their Medicaid benefits. The AIDS Waiver program will maintain them on Medicaid under the community based Medicaid system.

Ryan White CARE Act

On August 18, 1990, the federal government enacted Public Law 101-381, titled Ryan White Comprehensive AIDS Resource Emergency (CARE) Act. The Jacksonville area (including Duval, Clay, St. Johns, Baker and Nassau Counties) currently receives approximately four million dollars in funding from the CARE Act to provide outpatient medical and support services to people with HIV/AIDS.

Provided no other resources are available, anyone with HIV or AIDS is eligible for services under the Ryan White CARE Act. Access to some services requires a referral from a physician, health care worker or case manager. All Ryan White CARE Act services are subject to a sliding scale fee.

Currently, in Duval County, all primary health care services funded under the Ryan White CARE Act Title I and II must be accessed through the Duval County Health Department's Boulevard Comprehensive Care Center. The Rainbow Center for Women, Children and Adolescents at the the University of Florida provides CARE Act services for HIV positive women and their families.