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Introduction
The federal Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was originally enacted on August 18, 1990. The CARE Act is named for Ryan White, an 18 year old Indiana teenager with hemophilia who died of AIDS in 1990. The primary goal of the CARE Act, which is made up of five program areas know as "titles", is to improve the quality and availability of care for individuals and families affected by HIV disease.

Title I
Provides emergency funding to localities disproportionately affected by the HIV/AIDS epidemic. Eligible localities must report to CDC more than 2,000 cumulative cases of AIDS for the most recent five years. The reauthorized CARE Act has capped the number of cities eligible for Title I funding. Wisconsin does not contain a Title I Eligible Metropolitan Area (EMA), however two western counties, Pierce and St. Croix are included in the Minneapolis EMA.

Title II
Provides formula grants to all 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands to provide home and community-based care, assistance with the continuation of health insurance coverage, and treatment and drugs that prolong life and/or prevent hospitalization. The AIDS Drug Assistance Program (ADAP) earmarked portion of the Title II award must be spent on HIV related medications.

Title III
Provides funding to community-based health care providers who provide early intervention and primary care services to affected individuals with HIV and AIDS. Services include early health care intervention, primary care, education, counseling, testing, and treatment. The UW Health HIV Care Program, Milwaukee Health Services, AIDS Resource Center of Wisconsin, and Sixteenth Street Community Health Center are Title III grantees currently funded in Wisconsin (see contact information below).

Title IV
Provides support for maternal and pediatric HIV services and coordination with clinical research affecting women children, adolescents, and families. The Title IV grantee is the Wisconsin HIV Primary Care Support Network, located at Children’s Hospital of Wisconsin (Milwaukee) and administered by the Medical College of Wisconsin.

Title V
Provides funding for special programs, which advance the knowledge and skills in the delivery of HIV health and support services including education and training for health care providers and reimbursement for schools of dentistry. The Midwest AIDS Training and Education Center (MATEC) located at the University of Wisconsin - Madison and the AIDS Resource Center of Wisconsin (ARCW) in Milwaukee is the Title V grantee.

Under Title II, states may elect to use funds in four categories:

• to establish and operate HIV CARE consortia within areas most affected by HIV disease, designed to provide a comprehensive continuum of care to individual and families;
• to provide home-and community-based care services for individuals with HIV disease;
• to provide assistance to assure the continuity of health insurance coverage for individuals with HIV disease; and
• to provide treatment (drug therapies) that have been determined to prolong life or prevent serious deterioration of health for individuals with HIV disease.
  

The Wisconsin Division of Public Health (DPH) uses Ryan White Title II funds to support consortium activities, drug reimbursement, insurance continuation, grant administration, and planning and evaluation. The Division has three goals in the allocation of Ryan White Title II funds.

These include:

• ensuring that combination antiretroviral therapy is available to HIV-infected persons eligible for the Wisconsin AIDS Drug Assistance Program (ADAP) without capping services or resorting to a waiting list.
• providing funds to local agencies and communities to ensure that community-based care, treatment, and supportive services are available statewide; and
• providing program and administrative support to the AIDS/HIV Program to adequately meet its obligations as the Title II grantee, contract administrator, and provider of drug and insurance service.

Wisconsin AIDS/HIV Drug Assistance Program
Ryan White ADAP and formula funds purchase Food and Drug Administration (FDA) approved, HIV-related treatment medications. Title II funds are used by the AIDS/HIV program to support staff within the AIDS/HIV Program responsible for the direct provision of drug reimbursement services statewide. This includes one professional staff responsible for the administration and oversight of the ADAP and one program assistant responsible for claims processing and program support.

AIDS/HIV Health Insurance Premium Subsidy Program
Ryan White formula funds are used to support program operations associated with the direct provision of insurance continuation services statewide.

Administration
Title II funds support the overall administration and coordination of the Title II grant this includes the Ryan White CARE Grant Coordinator position and program support staff to assist with data collection and contract monitoring.

Planning & Evaluation
Title II funds support planning and evaluation activities related to care, treatment and supportive service programs. This includes activities to support the Statewide Coordinated Statement of Need (SCSN). As part of the Division of Public Health’s 1997 Ryan White Grant, the AIDS/HIV Program was required by the federal Health Resources and Service Administration to convene a meeting to develop a SCSN. The goal of the SCSN process is to collaboratively develop a statement that identifies the HIV care, treatment and supportive service issues of people living with HIV, and to encourage collaboration and information sharing among the other Ryan White CARE Act Titles in the state. The process is intended to enhance and support the planning and needs assessment activities currently being undertaken by local HIV CARE consortia and other HIV service providers.

Wisconsin Comprehensive Plan for Ryan White Services  2006-2009
(PDF, 1.2 MB)

Wisconsin HIV/STD/Hepatitis C Information and Referral Center
A portion of the Ryan White Grant is used to support the Wisconsin HIV/STD/Hepatitis C Information and Referral Center to promote access and referral to HIV care, treatment and supportive services. The Information and Referral Center is operated by the AIDS Resource Center of Wisconsin in Milwaukee. 

Questions regarding Ryan White Title II should be directed to Michael McFadden at 608-266-0682.

Questions regarding the other Ryan White Programs should be directed to the following:

Title III
Milwaukee Health Services
2555 N Martin Luther King Drive
Milwaukee, WI 53212
414-267-3700

University of Wisconsin Hospitals & Clinics
HIV Clinic
600 Highland Ave.
Madison, WI 53705
608-262-9414

AIDS Resource Center of Wisconsin
820 N. Plankinton Ave
Milwaukee, WI   53203
414-273-1991

Sixteenth Street Community Health Center
1032 S. 16th Street
Milwaukee, WI   53204
414-672-1353

Title IV
Wisconsin HIV Primary Care Support Network
Department of Pediatrics
Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226
414/456-4199

Last Revised: October 16, 2007