The Ryan White HIV/AIDS Program is the largest Federal program for HIV/AIDS care. First created in 1991 through the enactment of the Comprehensive AIDS Resources Emergency Act, or CARE Act, this legislation has been reauthorized four times (in 1996, 2000, 2006 and 2009) and is now called the Ryan White HIV/AIDS Treatment Extension Act. The Program is administered by the Human Resources and Services Administration (HRSA

The Ryan White HIV/AIDS Program was designed to provide care for individuals with HIV/AIDS who have no health insurance (public or private), have insufficient health care coverage, or lack financial resources to get the care needed. The program is divided into different components (Parts A, B, C, D, F) each of which addresses a specific aspect of the HIV/AIDS epidemic. The Ryan White Program acts as the payer of last resort, filling in the gaps in care not covered by other funding sources. 

Part A

Part A of the Ryan White program funds health care and support services for uninsured and underinsured persons living with HIV/AIDS in 56 U.S. urban areas most adversely affected by the HIV/AIDS epidemic. Communities use Part A funds to support community based care systems that provide outpatient healthcare and a range of critical support services. The guiding philosophy behind this integrated and comprehensive system of care is that people living with HIV/AIDS can best manage their illness and adhere to life saving medications if their full set of care and related needs are met.

The recent reauthorization of the Ryan White Program requires that 75% of spending for Part A funds be used on the following core medical services: 

  • Outpatient/Ambulatory Health Services Care;
  • AIDS Drug Assistance Program (ADAP);
  • AIDS Pharmaceutical Assistance;
  • Oral Health;
  • Early Intervention Services;
  • Health Insurance Premium and Cost Sharing Assistance for Low-Income Individuals;
  • Medical Nutrition Therapy;
  • Hospice Services;
  • Home and Community-based Health Services;
  • Mental Health Services;
  • Substance Abuse Outpatient Care;
  • Home Health Care; and
  • Medical Case Management, including Treatment Adherence Services.

The remaining 25% of funds that are awarded to various regions may be spent on critical support services. These support services must be linked to medical outcomes and may include: 

Support Services

  • Medical Transportation
  • Emergency Financial Assistance
  • Psychosocial Support Services
  • Non-Medical Case Management
  • Linguistic Services
  • Respite Care
  • Housing Services
  • Health Education
  • Outreach Services
  • Referrals for Health Care/Supportive Services
  • Home and Community Based Health Services
  • Rehabilitation Services
  • Child Care Services
  • Food Bank/Home Delivered Meals
  • Other Professional Services (Legal)

How Funds Are Distributed

There are 56 Part A jurisdictions in 24 states, Puerto Rico and the District of Columbia that receive part A funding. These funds include formula and supplemental components, as well as Minority AIDS Initiative (MAI) funds targeted for services to minority populations. Funding is distributed by the HIV/AIDS Bureau of the Health Resources and Services Administration to the chief executive of the lead city or county in each jurisdiction. In the Nassau Suffolk region, Nassau County has been designated as the grantee to receive funding on behalf of the two county region through an intergovernmental agreement (IGA) between Nassau and Suffolk Counties. Between 2005 and 2010, the EMA has been awarded more than $34 million in federal dollars to care for Long Islanders living with HIV/AIDS. 

To assist in the administration of Ryan White Part A, the Nassau County Department of Health (NCDOH) has contracted with United Way of Long Island to serve as the technical support agency to distribute funds and monitor programs. 

See the Part A service map for the list of services funded in the Long Island region.