Despite earlier fears of Republican cuts and freezes in spending on AIDS programs, healthcare providers can expect increased financial help through the Ryan White program.
After President Clinton last week signed a reauthorization bill for the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, or CARE, funding levels increased to $736.1 million for fiscal 1996 from $633 million in fiscal 1995. The legislation solidifies CARE as the largest dollar investment made by the federal government for the provision of services for people with HIV, the virus that causes AIDS.
"This represents bipartisan support for the concept of caring fairly and comprehensively for the hundreds of thousands of people who are HIV-infected in the country," said Fred Miller, interim executive director of the Washington-based AIDS Action Council, an advocacy group.
CARE money is allocated through four titles: Title I, for hard-hit metropolitan areas; Title II, for states to allocate through their health departments; Title III, for early intervention; and Title IV, for children, women and families programs. In addition, the new law creates a fifth title designed to establish AIDS education centers and creates a dental reimbursement program.
For hospitals, CARE is ready-made to alleviate budgets for underinsured and indigent AIDS patients. CARE money generally is used when healthcare providers have exhausted all other forms of payment-private insurance, Medicaid or Medicare.
CARE supporters showed their program had been successful in reducing federal costs for treating AIDS patients by $47,000 per person, per year, said Javier Salazar, AIDS Action Council's legislative representative. It costs an average of $1,085 per inpatient day to care for an AIDS patient, Salazar said.
"We were able to show (Congress) that Ryan White keeps people out of hospitals and from having unnecessary hospitalizations," Salazar said. "Many patients don't have access to an (AIDS) physician through their health plan, so they access one through Ryan White programs."
Many hospitals use CARE dollars in the form of grants to begin outpatient clinics or supplement their AIDS programs. Many have created programs that cut in half hospital stays of up to 12 days.
While the average costs for treating a patient with the AIDS virus from diagnosis until death vary, they are estimated at between $150,000 and $200,000, analysts say.