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Author Topic: Ryan White recertification  (Read 900 times)

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Offline sovereign1

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Ryan White recertification
« on: April 13, 2018, 01:52:36 pm »
Here's a question for any of you with expertise in this area:
 
If a client meets all the basic requirements for Ryan White coverage (i.e., residency, income, HIV status, insurance, etc.), can they be denied recertification solely on the basis of not taking their HIV meds?  It seems this is an issue to be addressed between the client and their HIV doctor.

Also, is recertification generally determined by the local/state agency that receives the federal Ryan White funding, or perhaps directly through HRSA?

Thanks in advance for any information you can provide!

Offline JimDublin

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Re: Ryan White recertification
« Reply #1 on: April 13, 2018, 02:12:27 pm »
Hi

Are you the client? Or are you asking for a client of yours?

Jim
HIV 101 - Everything you need to know
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Offline sovereign1

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Re: Ryan White recertification
« Reply #2 on: April 13, 2018, 03:51:24 pm »
I am the client.

Offline J.R.E.

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Re: Ryan White recertification
« Reply #3 on: April 13, 2018, 04:19:19 pm »
Hey,..

First question I'd like to ask, is why you are not taking your medication as prescribed by you doctor ?

Ray
Current Meds ; Triumeq, 20mg of Atorvastatin, 25 mg of Hydrochlorothiazide.
Amlodipine Besolate 5mg-- Updated 11/26/18

Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 11/26/18,  Viral load remains <40
CD 4 @600 /  CD4 % @ 55

  
 67 years young.

Offline J.R.E.

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  • Joined Dec-2003 Living positive, since 1985.
Re: Ryan White recertification
« Reply #4 on: April 13, 2018, 04:31:16 pm »

I also found this in the Ryan White handbook.  I am also not certain if this has been revised: NOTE THIRD POINT.

III. RESPONSIBILITIES
You are responsible for assisting your case manager in developing your Individualized Service Plan.

You are responsible for keeping scheduled appointments and accepting offered and necessary services.

You are responsible for adhering to patient care treatment, including medical provider appointments and
pharmaceuticals.

You are responsible for demonstrating behavior that is cooperative, assertive, and respectful of others.

You are responsible for notifying your case manager when you have problems in obtaining services or
when you are dissatisfied with your care.

You are responsible for following health care instructions to the best of your ability.
If you are designated a minimal co-payment based on the department's respective sliding fee scale you are
responsible for making all co-payments as instructed prior to receiving services.
My rights and responsibilities have been explained to me and I will agree to the conditions established."

Ray


Current Meds ; Triumeq, 20mg of Atorvastatin, 25 mg of Hydrochlorothiazide.
Amlodipine Besolate 5mg-- Updated 11/26/18

Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 11/26/18,  Viral load remains <40
CD 4 @600 /  CD4 % @ 55

  
 67 years young.

Offline J.R.E.

  • Member
  • Posts: 7,568
  • Joined Dec-2003 Living positive, since 1985.
Re: Ryan White recertification
« Reply #5 on: April 13, 2018, 04:38:14 pm »

Also This: ( Notice last Point )

Purpose: The purpose of this policy is to identify the circumstances where services may be
denied and/or terminated for individuals utilizing Ryan White Part B funded services.


a. Ryan White Part B funded services may be denied to individuals for the following
reasons:

1. Individual is not eligible for services in accordance with the Ryan White Part B
Program Policy “Client Eligibility.”

2. Individual fails to substantiate an HIV medically related need for Ryan White Part
B funded services in accordance with the Ryan White Part B Program Policy
“Direct Emergency Assistance” and the HRSA National Monitoring Standards
(see link above).

3. Individual fails to maintain measurable progress or to follow their individual
service plan as documented by individual’s case manager.  

4. Lack of available federal, state, or private funding utilized for the provision and
delivery of Ryan White Part B services.

5. Programmatic decisions made by NDHHS Ryan White Program which changes,
reduces, or eliminates a currently provided service.

b. Ryan White Part B funded services may be terminated (defined by documentation and
closure of client file terminating the relationship with the serving agency) for individuals
currently eligible for Ryan White Part B funded services for the following reasons:
1. Client has violated the Ryan White Part B Program Policy “Waste, Fraud, and
Abuse of Ryan White Part B funding.”

 Continual failure to maintain measurable progress on an individual’s service plan may lead to termination.
Current Meds ; Triumeq, 20mg of Atorvastatin, 25 mg of Hydrochlorothiazide.
Amlodipine Besolate 5mg-- Updated 11/26/18

Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 11/26/18,  Viral load remains <40
CD 4 @600 /  CD4 % @ 55

  
 67 years young.

 


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