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Frequently Asked Questions (FAQs)jump to content on this page:
Q. What is the magnitude of HIV/AIDS
in the American Indian / Alaska Native population? (Please also refer to ‘Fact
Sheets’) When population size is taken into account, AI/AN rank third in the US (among all ethnicities) in rates of HIV/AIDS cases. The rates have been higher than that of whites since 1995 and have not decreased since the late 1990s. Present in both urban and rural populations. Surveys of sexually transmitted diseases (STD), sexual behavior and alcohol and drug abuse treatment programs as well as inherent health disparities have proven the vulnerability for HIV in virtually all AI/AN communities. Q. How is the IHS funded for HIV/AIDS prevention and treatment? Activities largely encompassed within the health services provided locally. Primary source of funding for medical services is the Hospitals and Health Clinics budget (H&C). The H&C budget funds the salaries and expenses of most of the health care providers within a hospital or clinic, staff, pharmaceuticals, medical supplies, etc., for a myriad of health problems and diseases (including HIV/AIDS). HIV activities may also be a component of other programs including Health Education, Public Health Nursing, HPDP, etc. The Minority AIDS Initiative (see link on webpage) funds a select number of projects within the IHS dealing with training, epidemiology, technology and telemedicine. Proposals are submitted annually. Q. What HIV/AIDS prevention and treatment services are
provided at IHS facilities?
Q. Does IHS have clinical guidelines for treating HIV/AIDS? Q. How do IHS facilities track and report their HIV/AIDS
cases? An automated reporting mechanism exists through the Clinical Reporting System (CRS). This is not a mandated GPRA measure at this time. The RPMS HIV Management System (HMS) is another automated mechanism, however is new and not mandated at this time.. Non-automated data mining tools also exist for identifying patients with a diagnosis of HIV. The current GPRA measure dealing with HIV/AIDS is prenatal screening. Q. Are AI/AN routinely screened for HIV/AIDS? Q. When services are unavailable through IHS, what other sources of
care are available for AI/AN people with HIV/AIDS? Resources: Medicaid and Medicare (M/M) likely are the main payers of health care (as they are in any population). Private Insurance (PI) is also available to some. The VA is also a likely source of care. Over 50% of our patients have one of these resources. For those without M/M or PI, then Ryan White eligibility criteria may apply. The newly authorized Ryan White Treatment Modernization Act of 2006. An AI/AN person does not require and is not required to inform IHS of their seeking care (See more detailed info below). Locations: HIV care is an emerging specialty though the practitioners are often generalists with a specific interest in the disease. Locations range from hospital based to free standing community clinic settings. County public health agencies are frequent testing and counseling sites as with most STDs. AI/AN are eligible for the Ryan White CARE Act, including AIDS Drugs Assistance Program (ADAP). The AI/AN are seen as any other applicant at a state ADAP facility and eligibility is also the same. These guidelines have been in existence for a few years now and have helped to ease the burden of an AI/AN seeking care/prescription drugs for his/her HIV/AIDS infection. Q. Can you provide more details about the Ryan White Care
Act (RWCA)? AI/AN individuals are/were always eligible for RWCA services if requirements were met – same requirements as non AI/AN. IHS federally operated Health Facilities will now be eligible to apply for services (as a direct grantee) under Title III and IV through the RWMA (in addition to previously authorized Urban Programs and 638 Tribal Facilities under RWCA). Here are links to services provided under Title III and IV: http://hab.hrsa.gov/programs/CapacityDevelopment/, http://hab.hrsa.gov/programs/PlanningGrant/ , http://hab.hrsa.gov/programs/EarlyIntervention/ , and http://hab.hrsa.gov/programs/women/. IHS facilities are exempt from the “Payer of Last Resort” restriction for Titles I, II and III. Although RWCA grantees are the payer of last resort, this amendment exempts I/T/U facilities from reimbursement, regardless of referral. The new legislature supports access for all AI/AN under RWMA regardless of I/T/U utilization/affiliation or geographic location. (Previously, HRSA Policy 00-01 stated that AI/AN could not be turned away from RWCA services, now, the RWMA codifies (that IHS is exempt from the Payer of Last Resort restriction) this language into law. Planning council representation should include members from federally recognized Indian tribes as represented in the population. Language surrounding AIDS Education and Training Centers (AETCs) now specifically names “Native Americans” as person(s) to be trained. Q. What is the IHS Mission and Goal? The Goal is to ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to all American Indian and Alaska Native people. Q. What type(s) of facilities and
providers make up the “IHS”? Federal system - 33 hospitals, 52 health centers, 38 health stations, 2 school health centers, 4 residential treatment centers, 34 urban Indian health projects (direct care, CHS). Tribal system - 15 hospitals, 220 health centers, 116 health stations, 8 residential treatment centers, 9 school health centers, 180 Alaska village clinics (contract, compact). Indian Health Service clinical staff (roughly)- 2,615 nurses, 896 physicians, 512 pharmacists, 387 engineers, 305 dentists, 171 sanitarians, 75 physician assistants, and other allied health professionals - nutritionists, health administrators, and medical records administrators. Q. What are the estimates of the number of people who use IHS services (user population)? |