On February 2, 2015, President Obama’s budget for 2016 was released: Following last year’s disturbing precedent, the budget yet again proposes the elimination of Part D of the Ryan White HIV Program, which serves women, infants, children, and youth living with HIV. Positive Women’s Network – USA is deeply concerned about this proposal and demands to see the evidence that drove this recommendation. From the Ryan White Program to the whole spectrum of care for people with HIV, services and care designed to meet women’s needs are not disposable.
Last year, following an outcry from the community, Congress rejected this proposal. Stay tuned to PWN-USA’s website for more opportunities to take action to oppose these proposed cuts.
Public Comments Delivered at the February 12 Meeting of the Presidential Advisory Council on HIV/AIDS (PACHA):
Comments on Proposed Consolidation of Ryan White Part D into Ryan White Part C (Delivered by Vanessa Johnson on behalf of PWN-USA) (PDF format)
President Obama’s FY2016 Budget Proposal to Consolidate Ryan White Parts C & D (Delivered by Martha Cameron on behalf of The Women’s Collective) (PDF format)
Articles Opposing the Proposed Elimination of Ryan White Part D
“Without the support of Ryan White Program services, particularly Part D, we would never have been able to grow and thrive as a family as well as we have. I now know that HIV isn’t the end of the story; it’s merely a new beginning.“ Ryan White. Real Lives. Meet Morenike Giwa – February 10, 2015
Resources for Taking Action
#SaveRyanWhitePartD All-Day Social Media Advocacy Event! – Hosted by HIV Advocacy and Awareness – March 17, 2015 (Tentative)
Below are some talking points for advocates to consider when talking about the proposed elimination of Ryan White Part D.
Ryan White Part D Elimination Proposal – PWN-USA Talking Points (Full List) – March 25, 2014
- All parts of the Ryan White Program serve women, and need to offer women-centered services. Part D grew out of a need to tailor, and fund, specific services for women and families. This need is still very real — but it does not let other parts of Ryan White off the hook in their responsiveness to the care and service needs of women. Women-centered services are needed across all parts of Ryan White.
- The Ryan White Program is successful at retaining people with HIV in care and should be maintained, not eliminated, as the Affordable Care Act (ACA) changes the landscape of care. Although only 41% of women living with HIV nationally are retained in care, the Ryan White HIV/AIDS Program retains 77% of its female clients in care, according to a recent report by the Health Resources and Services Administration (HRSA). In addition, Part D has helped drastically reduce rates of vertical HIV transmission through proactive outreach to and coordinated care for pregnant women living with HIV and their families. Eliminating Part D could negatively impact those outcomes.
- Supportive services are not extra, they are essential for many women and young people to remain in HIV care. We cannot achieve the care and treatment goals of the National HIV/AIDS Strategy without maintaining supportive services including medical and non-medical case management, peer-based programming, transportation, housing, childcare, mental health and substance use services, food vouchers and other vital services. The HIV Cost Services and Utilization study showed that 76% of women with HIV had at least one child under the age of 18 in their homes. In addition, young people, the fastest growing population living with HIV, need stable, coordinated care and specialized services, including culturally competent medical care and psychosocial support, to maintain their health. When supportive services are absent, women and young people living with HIV are likely to face increased barriers to staying in medical care. Programs delivering these supportive services for women and families are at risk of being decimated under the proposed elimination of Part D.
- Community-based and culturally relevant services may be at risk if Ryan White Part D is eliminated. If Part D is subsumed under Part C, community-based providers who have developed years of culturally relevant expertise may not be funded to provide these services.Many services provided through Part D come through subcontracts with community-based organizations and collaboratives. There is currently no mechanism for this in Part C. How will HRSA assess the impact of this proposed consolidation on community-based services and community-based organizations?
- In the event that there is a consolidation of Part D services into Part C, Part C programs must be prepared to provide culturally relevant, gender-sensitive sexual and reproductive health care during all parts of the lifespan of women living with HIV, not only when a woman is pregnant. In addition, we need to understand what will happen to all the services currently provided by community-based organizations under Part D.
- Administrative problems cannot be solved by cutting vital services. More paperwork, site visits, oversight, and other facets of administrative burden take people away from the work of care, and these very real barriers need to be addressed. But administrative concerns should not be solved by cutting essential programs for women living with HIV.
- In closing: Ryan White Part D is a vital source of funding for services focused on women and families. However, it is necessary that women’s unique needs be addressed across all parts of the Ryan White Program, and across the full spectrum of HIV care and services in the U.S.