Thursday, March 27, 2014

What's the big deal about being consolidated into Part C?"

What's the big deal about being consolidated into Part C?"

It seems a large part of the argument for eliminating the program is the fact that many areas (~2/3) are dually funded by Part C and D. So the argument is that there is duplication of administrative efforts, etc because of that. 

I believe that they are wrong. Part C funds Early Intervention Services (EIS). In theory, the EIS portion of Part C does seem to have similarities to Part D because it focuses on medical care: "The Part C Early Intervention Services (EIS) component of the Ryan White HIV/AIDS Program funds comprehensive primary health care in outpatient settings for people living with HIV disease."

However, how Part C's EIS is administered is variable in different areas; in our area, for example, we receive a decent amount of Part C funds, but the program is only housed in the county jail.

Part C also funds Capacity Development: "The Part C Capacity Development Grant Program assists public and nonprofit entities in efforts to strengthen their organizational infrastructure and their capacity to develop, enhance, or expand access to high-quality HIV primary health-care services for people living with HIV/AIDS or at risk of infection in underserved or rural communities. For the purposes of the grant program, capacity development refers to activities that promote organizational infrastructure development leading to the delivery or improvement of HIV primary care services."

That is very, very different from Part D. Part D funds the following, according to HRSA: "Ryan White HIV/AIDS Program Part D grantees provide outpatient or ambulatory family-centered primary medical care (directly or through contracts or memoranda of understanding) for women, infants, children, and youth with HIV/AIDS. Part D funds (1) family-centered primary and specialty medical care and (2) support services."

And I would even argue that Part C EIS is extremely different. Just because there are cities they have both Part C and D funds doesn't mean the same agencies are offering the services; in most cases, they probably aren't. Part D's medical services are EXPLICITLY family centered. Part C's are not.

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