Who Was Ryan White?

Ryan White courageously fought AIDS-related discrimination and helped educate the Nation about HIV/AIDS.

Ryan White and his mom courageously fought AIDS-related discrimination and helped educate the Nation about his disease.

Ryan White was diagnosed with AIDS at age 13. He and his mother Jeanne White Ginder fought for his right to attend school, gaining international attention as a voice of reason about HIV/AIDS. At the age of 18, Ryan White died on April 8, 1990, just months before Congress passed the AIDS bill that bears his name – the Ryan White CARE (Comprehensive AIDS Resources Emergency) Act. The legislation has been reauthorized four times since – in 1996, 2000, 2006, and 2009 – and is now called the Ryan White HIV/AIDS Program.

Listen to Jeanne White Ginder recount those early years of struggle, pain, and triumph. Scroll down to listen to all five dialogs:

About the Ryan White HIV/AIDS Program

The Ryan White Program works with cities, states, and local community-based organization to provide HIV-related services to more than half a million people each year. The program is for those who do not have sufficient health care coverage or financial resources for coping with HIV disease. Ryan White fills gaps in care not covered by these other sources.

Learn More About Each Program click Program Fact Sheets.

Image of a mother and daughter embracing outdoors.

The majority of Ryan White funds support primary medical care and essential support services. A smaller but equally critical portion funds technical assistance, clinical training, and research on innovative models of care.

The Ryan White legislation created a number of programs, called Parts, to meet needs for different communities and populations affected by HIV/AIDS. Each is described below.

Part A provides emergency assistance to Eligible Metropolitan Areas and Transitional Grant Areas that are most severely affected by the HIV/AIDS epidemic.

Part B provides grants to all 50 States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and 5 U.S. Pacific Territories or Associated Jurisdictions. In Arkansas, this is managed by the Arkansas Department of Health (ADH) and through their subcontractors (ARcare and Jefferson Comprehsive Care).

Part C provides comprehensive primary health care in an outpatient setting for people living with HIV disease. Part C Grantees in Arkansas include ARcare in Northeast Arkansas, Jefferson Comprehensive Care in Southeast Arkansas, and East Arkansas Family Clinic in West Memphis.

Part D provides family-centered care involving outpatient or ambulatory care for women, infants, children, and youth with HIV/AIDS. Part D Grantees in Arkansas include ARcare and Jefferson Comprehensive Care.

Part F provides funds for a variety of programs:

The Special Projects of National Significance Program grants fund innovative models of care and supports the development of effective delivery systems for HIV care.
The AIDS Education and Training Centers Program supports a network of 11 regional centers and several National centers that conduct targeted, multidisciplinary education and training programs for health care providers treating people living with HIV/AIDS. ARcare and Jefferson Comprehensive participate.
The Dental Programs provide additional funding for oral health care for people with HIV. No programs are in Arkansas since there is no dental school in the state.
The Minority AIDS Initiative provides funding to evaluate and address the disproportionate impact of HIV/AIDS on African Americans and other minorities. All 3 Part C Grantees are also funded under the Minority AIDS Initiative.

A Living History click here

Ryan White is administered by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB). Federal funds are awarded to agencies located around the country, which in turn deliver care to eligible individuals under funding categories called Parts, as outlined below. First authorized in 1990, the Ryan White HIV/AIDS Program is currently funded at $2.1 billion.

Legislation

The Ryan White HIV/AIDS Program is the largest Federal program focused exclusively on HIV/AIDS care. The program is for individuals living with HIV/AIDS who have no health insurance (public or private), have insufficient health care coverage, or lack financial resources to get the care they need for their HIV disease. As such, the Ryan White HIV/AIDS Program fills gaps in care not covered by other funding sources.

The legislation is called the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87, October 30, 2009). The legislation was first enacted in 1990 as the Ryan White CARE (Comprehensive AIDS Resources Emergency) Act. It has been amended and reauthorized four times: in 1996, 2000, 2006, and 2009. The Ryan White legislation has been adjusted with each reauthorization to accommodate new and emerging needs, such as an increased emphasis on funding of core medical services and changes in funding formulas.

Overview of the Ryan White Legislation

The legislation authorizes programs, called Parts. The purpose is to provide a flexible structure under which this national program can address HIV/AIDS care needs on the basis of:

Different geographic areas (large metropolitan areas, States, and communities across the Nation)
Varying populations hit hardest by the epidemic
Types of HIV-AIDS-related services, and
Service system needs (e.g., technical assistance for programs, training of clinicians, research on innovative models of care).

Legislative provisions (called Sections) address, for example, planning and decision-making, type of grants that are available, what funds may be used for, requirements for entities submitting applications for funding, and available technical assistance to help programs run more effectively.

The Ryan White HIV/AIDS Program is administered by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB).

Highlights of the 2009 Ryan White Legislation

Following is a summary of select provisions in the 2009 legislation, with references to key changes from the 2006 legislation.

The 2009 Ryan White legislation continues the Ryan White HIV/AIDS Program through fiscal year 2013.
Authorization levels increase 5 percent for each fiscal year but are dependent on annual appropriations.
Minority AIDS Initiative (MAI) funds under Parts A and B will be distributed according to a formula (based on the distribution of populations disproportionately impacted by HIV/AIDS), a change from the former competitive process. Also, MAI awards now coincide with grant cycles under each Part.
Under Part A, the law continues issuance of grant awards to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs). For TGAs that lose their eligibility status, the State in which the former TGA is located shall receive incremental transfers of funding for three years.
In addition to existing Part A planning council responsibilities, the law adds a new requirement to determine not only the size and demographics of HIV/AIDS infected individuals but also those individuals who are unaware of their HIV status. One-third of Part A supplemental grants are to be based on the area’s ability to demonstrate its success in identifying individuals with HIV/AIDS who are unaware of their status and bringing attention to their status.
Part A and Part B grantees must develop comprehensive plans that include a strategy for identifying individuals with HIV/AIDS who do not know their status and helping them seek medical services. The strategy must focus on reducing barriers to routine testing and disparities in access to services for minorities and underserved communities.
The law continues hold harmless protections for Part A and Part B grantees for fiscal years 2009-2013.
Part A and B grantees currently using code-based data reporting will have three more years to convert to names-based data reporting. Penalties will remain for Part A and Part B areas that report code-based data in fiscal years 2009 through 2012. In fiscal year 2013, only name-based data reporting will be accepted.
The law makes adjustments in Part A and Part B unobligated balances (UOB) provisions. It retains the three penalties, but with some changes. The trigger for the penalty provisions changed from 2% to 5% of unobligated formula funds. If triggered, grantees are subject, in a future year, to: an offset of the amount of UOB less the amount of approved carryover, a reduction of the amount of UOB less the amount of approved carryover, and ineligibility for a supplemental award. Implementation of the UOB provisions was simplified by providing the Secretary with the option to offset unobligated funds rather than cancel those funds.
Part D funds are not required to be used for primary care services if payments for such services can be provided from other sources (including titles XVIII, XIX, and XXI of the Social Security Act). Public and nonprofit private entities funded under Part D can now provide care through memoranda of understanding in addition to contracts.