Characteristics of Ryan White and non-Ryan White funded HIV medical care facilities across four metropolitan areas: results from the antiretroviral treatment and access studies site survey

Abstract

The Ryan White Comprehensive AIDS Resources Emergency Act 1990 (CARE Act) is one of the largest federal programmes funding medical and support services for individuals with HIV disease. Data that report services and gaps in service coverage from the organizational perspective are very limited. The Antiretroviral Treatment and Access Studies included a mail survey of 176 HIV medical care facilities in four US inner cities on clinic characteristics, services and practices, and patient characteristics. Characteristics of 143 (85%) responding Ryan White (RW) funded and non-RW funded facilities are described. RW funded facilities reported offering more services than non-funded facilities including evening/weekend hours (49% vs. 18%), transportation (71% vs. 22%), and on-site risk reduction counselling (88% vs. 55%). More RW funded facilities reported offering on-site adherence support services, such as support groups (44% vs. 12%), formal classes (20% vs. 2%), and pillboxes (83% vs. 43%), and served a larger proportion of uninsured patients (41% vs. 4%) than non-funded facilities. Our analysis showed that the RW funded HIV care facilities offered more clinic, non-clinic, and adherence support services than non-RW funded facilities, indicating that the disparities in services were still related to CARE Act funding, controlling for private-public facility type.

Ongoing Risk Behavior Among Persons With HIV in Medical Care

“…This is consistent with a study which found that 80% of Ryan White funded clinics, like ours, provide some type of risk reduction counseling (Valverde et al, 2004). However, as in previous studies (Marks et al, 2002;Morin et al, 2004;Myers et al, 2004), only a minority of patients reported discussing topics such as HIV status disclosure with providers.…”

Exploring the Medical Home in Ryan White HIV Care Settings: A Pilot Study

“…Other studies support our findings related to the scope of services reported by KIs, such as a survey of 143 RWP and non-RWP funded HIV clinics (Valverde et al, 2004). After controlling for facility type and public versus private clinics, Valverde et al (2004) found that RWP clinics offered significantly more services for most measures, including extended hours, adherence support, risk-reduction counseling, and on-site support services such as nutrition counseling, medical and support service coordination, transportation assistance, and child care.…”

“…Primary care and mental health services were provided at each KI’s clinic in our study. Comparably, Valverde et al (2004) reported that 90% of RWP clinics provided primary care and that 74% offered mental health services. Sixty percent of KI clinics in our study had on-site pharmacies compared to 61% of RWP clinics in the Valverde et al (2004) study.…”

“…After controlling for facility type and public versus private clinics, Valverde et al (2004) found that RWP clinics offered significantly more services for most measures, including extended hours, adherence support, risk-reduction counseling, and on-site support services such as nutrition counseling, medical and support service coordination, transportation assistance, and child care. Of the 69 RWP clinics surveyed, 90% offered case management (Valverde, et al, 2004). Similarly, all KIs in our study reported the provision of case-management services and lauded the case managers as imperative to care coordination.…”

“…In 2004, 143 RWP-funded and non–RWP-funded clinics were surveyed (Valverde et al, 2004). RWP-funded sites reported providing statistically significantly more services, including transportation assistance, case management, multilingual staff, mental health and substance abuse therapy, risk-reduction counseling, on-site pharmacies, and medication adherence support compared with non–RWP-funded clinics (Valverde et al, 2004). Although this study did not evaluate services offered by RWP clinics through the lens of the medical home model, findings suggested that RWP care was consistent with some characteristics of the medical home.…”