The Center for HIV Law and Policy (CHLP) submitted these comments on August 7, 2012, to the HIV/AIDS Bureau of the Health Resources and Services Administration (HRSA) of the United States Department of Health and Human Services (DHHS) regarding the 2013 reauthorization of the Ryan White Treatment and Modernization Act (Ryan White). Ryan White provides funds for HIV-related services for those without sufficient health care coverage or income by filling gaps in care not met by other funding streams.
CHLP identifies legal services as a central component in ensuring access to and continuity of basic medical care and related programs for persons living with HIV/AIDS (PLWHA). Despite numerous reports – including one released by HRSA in 1999 – supporting this position, provider organizations struggle to maintain funding sources. Current HRSA policy states that Ryan White funds may be used only for "legal services directly necessitated by an individual's HIV/AIDS serostatus." Inconsistent application of this policy has resulted in the deprivation of crucial services for PLWHA. Many providers around the country are prohibited from using Ryan White funds to provide housing, immigration, family, and domestic violence-related legal services, despite incontrovertible evidence that these services are necessary to ensuring the health and well-being of PLWHA.
CHLP recommends that HRSA clarify its policies such that Ryan White funds may be used to provide all legal services that help to remove barriers to essential programs related to PLWHA's health and well-being, and that the decision of whether a service is "directly necessitated" by a person's HIV status should be left to the provider, whose expertise and individual case assessment will inform this decision. CHLP also recommends that HRSA prohibit grantees from unnecessarily narrowing this definition by restricting the type and scope of civil legal services allowable under Ryan White funding.