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    HIVMA 2012 Policy and Advocacy Priorities

    Approved by the HIVMA Board of Directors on March 4, 2012

    Goal: End AIDS by ensuring access to effective HIV prevention, care and treatment for everyone who needs it. 


    1. Secure Adequate Federal Funding for HIV/AIDS Care and Treatment, Research Programs and Prevention, including the Global Fund and PEPFAR: 

    Advocate the highest funding levels possible for care and treatment through the Ryan White program, HIV and viral hepatitis programs at the CDC, research at the National Institutes of Health (NIH). In addition to calling for the recommended funding levels for the Global Fund, the President’s Emergency plan for AIDS Relief (PEPFAR), the Defense Department’s Military Research Project and the Agency for Health Research and Quality’s (AHRQ’s) HIV Research Network. Oppose deficit reduction proposals that fail to take a balanced approach that includes revenue increases or that disproportionately affect funding for health care and public health programs.

    2. Preserve the Affordable Care Act (ACA) and Ensure ACA Implementation Meets the Needs of Individuals with HIV:

    Advocate against legal and Congressional challenges to the ACA and urge full funding of the health reform law. Oppose efforts by Congressional members to reduce or eliminate federal support for women’s reproductive health services, including limiting access to contraceptives and screenings for HIV and other sexually transmitted diseases.

    Ensure the new law meets the needs of people living with HIV and their medical providers by responding to implementing regulations and guidance and meeting with key Administration staff. Key issues include:

    • the inclusion of HIV and Ryan White providers in provider networks and standards that support, streamlined access to HIV medical providers as primary care providers or specialists,
    • adequate Medicaid and Medicare payment levels,
    • reasonable meaningful use standards for safety-net providers, including Ryan White providers,
    • Essential Health Benefits and cost sharing standards that meet the needs of people with HIV infection,
    • policies that support the integration of HIV/Ryan White providers into reforms, such as accountable care organizations, and
    • support for a Center for Medicare and Medicaid Innovation demonstration project to evaluate the Ryan White/HIV care model in terms of outcomes and cost-effectiveness to inform new Medicaid payment models.

    Advance these priorities as co-chair of the Federal AIDS Policy Partnership’s HIV Health Care Access Working Group – a coalition of more than 100 national, state and community-based organizations committed to improving access to HIV care and treatment through health reform and the Medicaid and Medicare programs

    3. Ensure an Adequate and Well-Trained HIV Medical Workforce:

    Continue to advocate federal resources and attention to address HIV medical workforce issues with the Department of Health Human Services, including the Health Resources and Services Administration (HRSA) and the HIV/AIDS Bureau.

    Pursue a formal mechanism to recognize HIV expertise with the American Board of Internal Medicine, the American Board of Medical Specialties, the American Board of Family Medicine and other interested medical specialty Boards.

    4. Support Effective Implementation of the National HIV/AIDS Strategy:

    HIVMA will monitor and comment on implementation of the National HIV/AIDS Strategy (NHAS) and ensure clinicians and researchers are included in the process, with an emphasis on:  HIV medical workforce development issues; earlier diagnosis and linkage to care through expansion of routine HIV testing; greater coordination of federal programs and resources to support the delivery of HIV care through medical homes; and the reduction of administrative burden to more efficiently utilize limited resources.

    5. Improve and Ensure Access to Quality Care Under Ryan White:

    HIVMA’s Ryan White advocacy is led by the Ryan White Medical Providers Coalition. RWMPC will:

    • advocate the highest funding level possible for the Ryan White program and urge Congress to adopt the President’s request for Part C that is $30 million over the Congressional 2012 appropriation;
    • prepare for the extension or reauthorization of the Ryan White Program in 2013;
    • assist Part C providers with transitioning to a new health care financing and delivery system; and
    • work with HIV/AIDS Bureau to reduce grantee administrative burden and streamline data reporting for Part C programs.

    6. Expand Access to Routine HIV Testing with Linkage to Care for Individuals with HIV:

    Continue to support efforts to expand coverage and implementation of routine HIV screening. Pursue development and implementation of clinical quality measures for linkage to care and routine HIV screening – pending the results of the U.S. Preventive Services Task Force review of their routine HIV testing recommendation.

    7. Ensure Evidence-Based Federal Policies:

    Advocate that federal policies be grounded in science and not discriminate against people with HIV. Specific issues are noted below.

    • Support a removal of the federal ban on use of federal funding for syringe exchange programs.
    • Oppose funding for abstinence-only-until-marriage programs.
    • Support removal of the federal ban on HIV-infected organ donation to allow clinical research on the safety and efficacy of transplanting HIV-infected organs in people with HIV infection.
    • Support human rights advocacy efforts against the ongoing persecution and criminalization of gay, bisexual and other men who have sex with men (MSM) in the United States and around the world, which undermine efforts to control the global HIV/AIDS pandemic.

    8. Maintain Federal and State Support for the Medicaid Program:

    Advocate that the federal government maintain its commitment to the Medicaid program by opposing efforts to shift costs to states and Medicaid beneficiaries through block grants, changes to the federal matching formula, lessening of minimum federal standards or other measures.

    Oppose state efforts that restrict access to care by reducing benefits, eligibility or provider payment levels. Support state efforts to expand access to Medicaid to people with HIV infection regardless of disability status through Section 1115 waivers and to adopt the new health home benefit for Medicaid beneficiaries with HIV infection.

    9. Advocate Medicare Part D Policies that Facilitate Access to Medications for People with HIV:

    Monitor Medicare Part D policies and regulations and respond with comments to the Centers for Medicare and Medicaid Services as appropriate.

    10. Support Implementation of the 2011 Action Plan to Address Viral Hepatitis in the U.S.:

    Support implementation of Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care and Treatment of Viral Hepatitis by participating on coalitions, such as the National Viral Hepatitis Roundtable.

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