Paying for Sexual and Reproductive Health Services for PLWHA Jennifer Marshall Pepper Program & Quality Manager, Ryan White Part A Program Shelby County.

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Presentation transcript:

Paying for Sexual and Reproductive Health Services for PLWHA Jennifer Marshall Pepper Program & Quality Manager, Ryan White Part A Program Shelby County Government Memphis, TN

 Part A funded services are available to residents of Crittenden County, AR  Part B funded services are available to all Arkansas state residents  Part C Grantees:  East Arkansas Family Health Center, West Memphis, AR  ARCare, Batesville, Conway, Jonesboro, and Kensett, AR  Jefferson Comprehensive Care Systems, Inc., Pine Bluff, AR  Part D Grantees:  ARCare, Batesville, Conway, Jonesboro, and Kensett, AR  Jefferson Comprehensive Care Systems, Inc., Pine Bluff, AR Ryan White Parts A, B, C, D

 Outpatient/Ambulatory medical care = the provision of professional diagnostic and therapeutic services rendered by a physician, physician's assistant, clinical nurse specialist, or nurse practitioner in an outpatient setting…. referral to and provision of specialty care (includes all medical subspecialties).  Health Insurance Premium & Cost Sharing Assistance = the provision of financial assistance for eligible individuals living with HIV to maintain a continuity of health insurance or to receive medical benefits under a health insurance program. This includes premium payments, risk pools, copayments, and deductibles. Ryan White Parts A, B, C, D

 AIDS Drug Assistance Program (ADAP treatments) = State- administered program under Part B provides FDA- approved medications  Resource: ousDisease/hivStdHepatitisC/Documents/ADAPDrugFormul ary.pdf ousDisease/hivStdHepatitisC/Documents/ADAPDrugFormul ary.pdf  AIDS Pharmaceutical Assistance (local) = local pharmacy assistance programs implemented by Part A or Part B to provide HIV/AIDS medications to clients. Ryan White Parts A, B, C, D

 Title X Grantee is Arkansas Department of Health, Women’s Health Services  Contraception  STI Testing and Treatment  Preconception Counseling  Anyone, male or female, needing family planning services can be seen at any local health unit.  All services are private and confidential.  No one will be refused services because they do not have money to pay. Title X Family Planning

 Women who have a family income at or below 200 percent of the federal poverty guidelines and who are of childbearing age.  The target population is women aged 14 to 44, but all women at risk of unplanned pregnancy may apply.  Enrollees are Medicaid-covered for family planning services only.  Women must be re-evaluated annually to continue receiving benefits. Arkansas Medicaid: Women’s Health Waiver

 FREE pelvic exams, pap tests, and mammograms for all ages  Includes coverage of Implanon® and IUD insertions and removals and sterilization procedures  Resource: Waiver_ProvBrochure.pdf Waiver_ProvBrochure.pdf Arkansas Medicaid: Women’s Health Waiver

 There are Essential Health Benefits of every Qualified Health Plan, including:  Sexually Transmitted Infections counseling for sexually active women and men, including Syphilis Screening  HAV, HBV, and HPV vaccinations  Breast Cancer Mammography screenings every 1 to 2 years for women over 40  Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women  Cervical Cancer screening for sexually active women Affordable Care Act

 There are Essential Health Benefits of every Qualified Health Plan, including:  HIV screening and counseling for sexually active women and men  Domestic and interpersonal violence screening and counseling for all women  Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older  Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users  Well-woman visits to get recommended services for women under 65 Affordable Care Act

 Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.  These plans must cover the services without charging a copayment or coinsurance when they’re provided by an in- network provider.  Health plans sponsored by certain exempt “religious employers,” like churches and other houses of worship, don’t have to cover contraceptive methods and counseling. Affordable Care Act

 All Food and Drug Administration-approved contraceptive methods prescribed by a woman’s doctor are covered, including:  Barrier methods (used during intercourse), like diaphragms and sponges  Hormonal methods, like birth control pills and vaginal rings  Implanted devices, like intrauterine devices (IUDs)  Emergency contraception, like Plan B® and ella®  Sterilization procedures  Patient education and counseling  Plans aren’t required to cover:  Drugs to induce abortions  Services related to a man’s reproductive capacity, like vasectomies Affordable Care Act

 Mirena® and Skyla®   Paragard®   PrEP  access/truvada%20for%20prep%20medication%20assistan ce%20program Patient Assistance Programs