Florida HIV/AIDS Ryan White Part B Eligibility Procedures .
Florida HIV/AIDSRyan White Part BEligibility ProceduresManual
TABLE OF CONTENTSSECTION 1PURPOSEGOALSSTAFF PROCEDURES MANUALSTATUTORY AND PROGRAMMATIC AUTHORITYFLORIDA STATUTESHIV/AIDS STATUTESFLORIDA ADMINISTRATIVE CODE (F.A.C.)STATE/FEDERAL LAWS/REGULATIONSALLOWABLE SERVICES (ATTACHMENT A)SECTION 2AUTHORITYPOLICY AND PROCEDUREFORMDH 1120 (ATTACHMENT B)PHONE CALLSMAILINGFAXESEMAILFIELD SECURITYWORK SPACESTORAGECLIENT FILE RETENTIONELECTRONIC FILES AND COMPUTERSADDITIONAL INFORMATIONSECTION 3ELIGIBILITY STAFFSTAFF RESPONSIBILITIESSUPERVISORY OVERSIGHTSUPERVISOR RESPONSIBILITIESTRAINING REQUIREMENTSSECTION 4WHO MAY APPLY FOR SERVICESMINORS SEEKING SERVICESGENERAL LIGIBILITY PERSONNEL11111ELIGIBILITY REQUIREMENTS11
1ELIGIBILITY REQUIREMENTSSECTION 5ELIGIBILITY BROCHURE AND APPLICATIONCORE ELIGIBILITY REQUIREMENTS YCAREWARE INSTRUCTIONSSECTION 611122ELIGIBILITY DETERMINATION AND RE-DETERMINATIONINITIAL CONTACTINITIAL ELIGIBILITY REQUIREMENTSAPPLICATION REQUIREMENTTIME LIMITSREFERRALS AND LINKAGEELIGIBILITY STAFF ASSESSMENT WORKSHEET (ATTACHMENT E)REQUIRED DOCUMENTATION IN ELIGIBILITY CHARTRE-DETERMINATION (ATTACHMENT F)ELIGIBILITY STAFF REQUIREMENTS FOR RE-DETERMINATIONAPPOINTMENT REMINDERSLOCATION OF ELIGIBILITY FILEINELIGIBLENOTICE OF INELIGIBILITY (NOI)HEARING PROCEDURESCLOSING THE FILECAREWARE INSTRUCTIONSSECTION 7ACCEPTABLE PROOFUSE OF PRISMEXPOSED INFANTSNOT ACCEPTABLE PROOFCAREWARE INSTRUCTIONSSECTION 8LIVING IN FLORIDA DEFINITIONDOCUMENTATIONHOMELESSIMMIGRATION STATUSUSE OF SOCIAL SECURITY NUMBERCREATING PSEUDO IDENTIFICATION NUMBERSCAREWARE INSTRUCTIONS1112222333334445PROOF OF HIV11112LIVING IN FLORIDA1122223
SECTION 9SCREENING FOR OTHER PROGRAMSPAYER OF LAST RESORTSCREENING FOR HEALTH INSURANCEMEDICAIDMEDICAID SCREENINGMEDICALLY NEEDY (SHARE OF COST MEDICAID)MEDICAID PROJECT AIDS CARE (PAC) WAIVER PROGRAMMEDICAREOTHER TYPES OF MEDICAREADAP PREMIUM PLUS INSURANCE SERVICESCO-PAYS AND DEDUCTIBLESTEMPORARY CASH ASSISTANCE FOR NEEDY FAMILIES (TANF)SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)VETERANS AFFAIRS (VA)CHILDREN’S MEDICAL SERVICES (CMS) NETWORKFLORIDA KIDCARESUPPLEMENTAL SECURITY INCOME (SSI)SOCIAL SECURITY DISABILITY INSURANCE (SSDI)PRESCRIPTION DISCOUNT CARD PROGRAMPATIENT ASSISTANCE PROGRAM (PAP)EXPANDED ACCESS PROGRAM (EAP)CLINICAL TRIALSLOCAL ASSISTANCE PROGRAMSCAREWARE INSTRUCTIONSSECTION 10GROSS INCOME VERSUS NET INCOMEFEDERAL POVERTY GUIDELINESAUTOMATIC INCOME ELIGIBILITYDECLARING NO INCOMENO INCOME (INCLUDING DOCUMENTATION)STEP 1: DETERMINING HOUSEHOLD SIZECOUNTEDNOT COUNTEDSTEP 2: DETERMINING HOUSEHOLD INCOMEINCOME COUNTED (INCLUDING DOCUMENTATION)INCOME NOT COUNTEDSELF-EMPLOYED (INCLUDING DOCUMENTATION)HOW TO CALCULATE INCOMESTEP 3: CALCULATING THE FEDERAL POVERTY LEVEL (FPL)FINAL INCOME DETERMINATIONSTATE HOPWA EXCEPTIONREFUSAL TO DIVULGECAREWARE 455677888
SECTION 11STATE CAREWARE INSTRUCTIONS FOR ELIGIBILITYENTERING INTO CAREWAREDATABASE ACCESS RESTRICTIONSINFORMATION SECURITY REQUIREMENTSDOMAINS AND SHARING OF ELIGIBILITY DATAPAPER ENROLLMENTCAREWARE FORMSDELETING FORMSSCANNING DOCUMENTSDELETING SCANNED DOCUMENTSSCANNING FOR SIX MONTH RE-DETERMINATIONSAVING/STORING SCANNED DOCUMENTSDISPLAY SETTINGS111112223344ATTACHMENTSATTACHMENT AATTACHMENT BATTACHMENT CATTACHMENT DATTACHMENT EATTACHMENT FATTACHMENT GATTACHMENT HATTACHMENT IATTACHMENT JRYAN WHITE PROGRAM DEFINITIONS OF ELIGIBLE SERVICESDH 1120, COMPUTER USE AND CONFIDENTIALITY AGREEMENTCORE ELIGIBILITY REQUIREMENTS BROCHURE (ENGLISH, SPANISH, CREOLE)DH 150-884, ELIGIBILITY APPLICATIONELIGIBILITY STAFF ASSESSMENT WORKSHEETSIX MONTH RE-DETERMINATION REVIEW FORMDH 8000-PHSPM, NOTICE OF ELIGIBILITYNOTICE OF INELIGIBILITYINSURANCE WAIVER FORMSELF-EMPLOYMENT TRACKING SHEET
Florida HIV/AIDS Eligibility Procedures ManualSection 1 – General InformationSECTION 1: General InformationNOTE: The Florida HIV/AIDS Ryan White Part B Eligibility Procedures Manual is anevolving document.This project is supported by the Health Resources and Services Administration (HRSA) of the U.S.Department of Health and Human Services (HHS), and the Ryan White Care Act Title II. Thisinformation or content and conclusions are those of the author; and should not be construed as theofficial position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S.Government.As per Chapter 64D-4, Florida Administrative Code (F.A.C.), Eligibility Requirements for HIV/AIDSPatient Care Programs, this manual standardizes the eligibility requirements for all programs fundedthrough the HIV/AIDS Section. These procedures can be used in both centralized and non-centralizedeligibility determination systems.PurposeThe purpose of the patient care programs within the HIV/AIDS Section is toprovide primary health care and support services to low-income personsliving with HIV disease based on availability, accessibility, and funding. Thepatient care programs are responsible for ensuring services are provided tothose intended by establishing eligibility requirements and procedures thatwill be fairly applied to all who request eligibility for services.Goals Staff ProceduresManualTo provide a standardized system of core eligibility across HIV/AIDSpatient care programs.To prevent duplication of effort.When determining eligibility, this manual: Provides eligibility staff with standardized procedures and forms. Ensures persons requesting services from the patient care programshave been appropriately determined eligible or ineligible. Applies only to the patient care programs under the Florida Departmentof Health (DOH), HIV/AIDS Section, in conjunction with Chapter 64D-4,F.A.C. Does not preclude local, state, or federal programs from adopting therequirements and procedures referenced in this document.Programmatic qualifications and requirements can be found in eachprogram’s respective manual or guidelines.Revised June 20161
Section 1 – General InformationStatutory andProgrammaticAuthorityFlorida HIV/AIDS Eligibility Procedures ManualThe statutory authority for the HIV/AIDS Section eligibility requirements,process, and procedures is stated in Chapter 381, Florida Statutes (F.S.),and Chapter 64D-4, F.A.C., hereinafter referred to as the “eligibility rule.”This manual is developed in conjunction with the statute and the eligibilityrule requirements.HIV/AIDS patient care programs include the following: Ryan White Part B Consortia. Ryan White Part B AIDS Drug Assistance Program (ADAP). Ryan White Part B ADAP Premium Plus Insurance. State Housing Opportunities for Persons With AIDS (HOPWA) Program. Patient Care Networks (PCN) and county health departments (CHD).Not included under the eligibility rule authority are the HIV/AIDS servicesprovided by other local, state, or federal HIV/AIDS patient care programs,such as: Ryan White Part A (Eligible Metropolitan Areas). Ryan White Part C. Ryan White Part D. Ryan White Part F. Medicaid, Project AIDS Care (PAC) Waiver, and Medicare. City HOPWA. Local indigent programs.Florida StatutesChapter 381, F.S., Public Health, establishes the DOH’s responsibility forthe state's public health system, which shall be designed to protect,promote, and improve the health of all people in Florida. Chapter 381, F.S.,is often referred to as Florida’s Public Health Law, which provides thestatutory authority for the DOH HIV/AIDS Section to establish the eligibilityrequirements and procedures developed through the administrativerulemaking process for the HIV/AIDS patient care programs.HIV/AIDS Statutes 2Section 381.0042, F.S. - Patient care for persons with HIV infection.This section provides the authority for the DOH to establish HIV patientcare networks to plan for the care and treatment of persons withHIV/AIDS.Section 381.0037, F.S. – Findings; intent. This section is specific toHIV/AIDS, and addresses the unique nature of the disease byestablishing programs and requirements related to HIV/AIDS. Care andtreatment programs must balance medical necessity, the right to privacy,and protection of the public from harm.Revised June 2016
Florida HIV/AIDS Eligibility Procedures ManualFloridaAdministrativeCode (F.A.C.)Section 1 – General InformationChapter 64D-4, F.A.C., Eligibility Requirements for HIV/AIDS Patient CarePrograms, is the “eligibility rule” for the patient care programs; and wasdeveloped through a process that included statewide input, workshops,public hearings, and notification to the affected parties. An administrativerule or code is a legal binding document based on statutory authority. Theeligibility rule can be found at the following sp?Chapter 64D-4.It is important that all staff read Chapter 64D-4, F.A.C., in its entirety.State/FederalLaws/RegulationsOther laws and regulations affecting the patient care programs under theDOH, HIV/AIDS Section, include the Ryan White Treatment Extension Act of2009 and the AIDS Housing Opportunity Act.AllowableServices(Attachment A) The HIV/AIDS patient care programs are eligibility programs and notentitlement programs, such as Medicaid; therefore, the services providedby these programs are subject to accessibility, availability, and fundingstatewide. Local areas have the authority to determine funding priorities,limitations, and resources. Consequently, services vary widely acrossthe state.The services provided are listed in the most current Annual Ryan WhiteHIV/AIDS Program Services Report (RSR) Instruction anual), and have been adapted to include onlythose service categories that are allowable in the Florida Ryan WhitePart B HIV/AIDS Program (refer to Attachment A).Please Note: Core eligibility is a prerequisite for enrollment in the specialtyprograms of ADAP, ADAP Premium Plus Insurance, and State HOPWA;however, there are additional program-specific qualifications andrequirements.Revised June 20163
Florida HIV/AIDS Eligibility Procedures ManualSection 2 – ConfidentialitySECTION 2: ConfidentialityStaff must take prudent and reasonable steps to protect applicant/client confidential information. Thissection provides minimum criteria regarding the security of records and the management of confidentialinformation.AuthoritySection 384.29, 392.65, and 456.057, F.S.; and Health Insurance Portabilityand Accountability Act (HIPAA).This section provides the minimum criteria regarding security of records andthe management of confidential information. Florida Statutes, FloridaAdministrative Code, and HIPAA are the guiding authorities for DOHsecurity policies.The U.S. Department of Health and Human Services (HHS) issued thePrivacy Rule to implement the requirements of HIPAA. The Privacy Ruleaddresses the use and disclosure of individuals’ health information (called“protected health information”) by organizations subject to the Privacy Rule(called “covered entities”). The rule also ensures that individuals understandand control how their health information is used.Policy andProcedureAll written and verbal communications with applicants during and aftereligibility must be maintained in strict confidence as required by law. Theseprocedures are the same for eligibility and case management agencies.The DOH has written security policies, protocols, and procedures to ensurethe security of information; and to protect confidentiality, data integrity, andaccess to information in accordance with the Florida Statutes. Revised June 2016These policies are entitled “Department of Health, Information Securityand Privacy Policy, DOHP 50-10-16.” To request a copy of DOHP 5010-16, lead agencies may contact the local DOH contract manager.Contracted and subcontracted providers for DOH HIV/AIDS programsmay create their own security policies, protocols, and procedures;however, they must be consistent with the DOHP 50-10-16.All employees and volunteers with access to client information mustreceive annual training on confidentiality, the proper exchange ofinformation, and required consent. Documentation of training must bemaintained in personnel records.1
Section 2 – ConfidentialityFormFlorida HIV/AIDS Eligibility Procedures ManualThe following form has been developed by the DOH for the purpose ofsecuring confidential information. Eligibility staff is required to use thefollowing DOH form.DH 1120, Acceptable Use and Confidentiality Agreement (Attachment B) Must be completed by the employee and their supervisor after review ofeach section, and must be included in the employee’s personnel record.Should be completed within the first 30 days of employment.Should be modified to meet the needs of the agency.If modifying form DH 1120, the agency should submit to the contractmanager for approval and address, at a minimum, the following subjects: An internal and external response to a breach of confidentiality, includingthe understanding by the employee that they can be prosecuted.Review the use of DOH software and hardware (form DH 1120 coversthis), if applicable.Review and access to the agency policies and procedures.Review and access to the agency personnel handbook.Review and access to the Florida Statutes and Administrative Rulespertaining to HIV/AIDS services and confidentiality, which can beaccessed on the Internet by going to www.MyFlorida.com.Procedures to ensure that the protection and confidentiality of allconfidential materials shall be consistent with the DOHP 50-10-16.Phone CallsAll phone calls in which confidential information is discussed must be madefrom an area that ensures confidentiality is maintained. The employee must determine the identification of the caller and whatinformation may be disclosed. Confidential information is discussed by phone only in areas where theconversation cannot be overheard. Conversations held over cellular phones are not considered to besecure, and should not be used for confidential phone calls unless theclient consents. Confidential conversations should be limited. The client should be advised that the discussion is taking place on acellular phone.MailingA secured mail intake site must be used to receive incoming confidentialmail. Mailrooms and mailboxes must be secured to prevent unauthorizedaccess to incoming and outgoing mail.2Revised June 2016
Florida HIV/AIDS Eligibility Procedures Manual Section 2 – ConfidentialityDouble enveloping is required when mailing confidential or sensitiveinformation. Only the DOH’s logo and required addresses should beincluded on the exterior envelope. No specific program should beidentified. The outside envelope is addressed to the recipient. Theinside envelope is marked “confidential” and specifies the recipient.FaxesConfidential information may be faxed using appropriate administrative,technical, and physical safeguards. Protected health information may befaxed for the purpose of treatment, payment, and health care operations; orwith specific authorization from the client. Fax machines designated to receive or transmit confidential informationmust be maintained in a secured area. Fax machines designated fortransmitting confidential information must have the ability to generateactivity reports or a call shall be made to confirm receipt. A cover sheet marked “confidential” and containing the followingparagraph must accompany all confidential transmissions: “Thistransmission may contain material that is CONFIDENTIAL underfederal law and Florida Statutes, and is intended to be delivered toonly the named addressee. Unauthorized use of this informationmay be a violation of criminal statutes. If this information isreceived by anyone other than the named addressee, the recipientshall immediately notify the sender at the address or the telephonenumber above and obtain instruction as to the disposal thereof.Under no circumstances shall this material be shared, retained, orcopied by anyone other than the named addressee.” Medical information that is faxed must have a permanent copy in therecord and documentation in the progress notes.Email Revised June 2016DOH employees (including county health department staff) should avoidemailing confidential information (or replying to a client’s emailcontaining confidential information) if possible. If not, then theconfidential information must be encrypted during transmission over anynetwork not owned by the DOH. If unencrypted email containingconfidential information has been sent outside the DOH network, notifyyour Information Security and Privacy Coordinator immediately.If encryption is not possible and the only way to contact a client isthrough email, then a statement must be signed by the client saying thatit is okay for confidential information to be emailed to the client from theagency.Clients should be informed that email is not secure, especially from acounty health department where all emails are considered public recordfor three years.Email usage by staff in community-based agencies as a method ofcommunication is at the discretion of each agency regardless of aconsent form. The agency’s policies and procedures manual should3
Section 2 – ConfidentialityFlorida HIV/AIDS Eligibility Procedures Manualprovide guidance on agency-specific limitations regarding email.Agencies should be sure to have proper forms and documentation tosupport use of email for the purposes of communicating with clients.Field SecurityConfidential information shall only be transported by persons authorized todo so in their position description or as authorized by law. In addition: Confidential information transported must be secured using physicalsafeguards, and not left unattended or in a visible area of the vehicle. All confidential information taken into the field must be tracked, includingwho, what, when, why, where, and expected date of return. DOHworkforce must sign out all information removed from the secured area.Sign-out documentation must be retained by the information custodian inaccordance with the record retention and disposition scheduledeveloped by the Department, Records Management Policy DOHP 2502. Confidential information carried into the field shall be limited to theminimum required to perform that day’s responsibilities. Prior permission must be obtained if information will not to be returnedby the close of the same business day, and must be secured in amanner that does not risk the disclosure of confidential information.Work Space Storage 4Eligibility staff must be provided with office space that allows business tobe conducted in a timely and confidential manner.If private office space with a door is not available, the provider mustensure all communications remain confidential.Information with employee identifiers, client identifiers, or otherconfidential content shall not be left unattended or unsecured.Consultations involving confidential information must be held in areaswith restricted access.Confidential information must be printed using appropriateadministrative, technical, and physical safeguards to preventunauthorized viewing.Offices and staff must maintain confidentiality of all data, files, andrecords, including client records related to the services; and shall complywith state and federal laws, including but not limited to, Sections 384.29,392.65, and 456.057, F.S.Appropriate storage systems for hard copy client records are required.Storage systems must include, at a minimum, file folders that are kept inlocked file cabinets.Revised June 2016
Florida HIV/AIDS Eligibility Procedures ManualClient FileRetention Section 2 – ConfidentialityFile retention must follow the Florida Department of State, Bureau ofArchives and Records Management, storage and disposition proceduresas mandated in Chapters 119 and 257, F.S.File retention schedule f
staff procedures manual 1 statutory and programmatic authority 2 florida statutes 2 hiv/aids statutes 2 florida administrative code (f.a.c.) 2 state/federal laws/regulations 3 allowable services (attachment a) 3 section 2 confidentiality authority 1 policy and procedure 1 form 2 dh 1120 (attachment b) 2 phone calls 2 mailing 2 faxes 3 email 3
5600 FISHERS LANE, ROCKVILLE, MARYLAND 20857 301-443-6745 . HIV/AIDS Bureau . Division of State HIV/AIDS Programs . AIDS DRUG ASSISTANCE PROGRAM (ADAP) MANUAL . 2016. ADAP Manual - 2016 . . The AIDS Drug Assistance Program (ADAP) Manual is for ADAP Directors and staff, Ryan White HIV/AIDS Program (RWHAP) Part B Program Directors and staff .
Resource pack on gender and HIV/AIDS. (Operational guide; fact sheets; WHO: integrating gender into HIV/AIDS programme, a review paper). UNAIDS Interagency Task Team on Gender and HIV/AIDS. Amsterdam, The Netherlands. 2005. Pack of 2 reports; 16 fact sheets. KEYWORDS: gender; HIV/AIDS manuals. Location: WHO. 0004 - UNAIDS HIV/AIDS: its your .
I am pleased to present this study report on Socio-economic impact of HIV/AIDS on people living with HIV/AIDS and their families' . This study is significant as it was carried out by networks of People Living with HIV/AIDS (PLWHA) in four Indian states. I would like to compliment the PLWHA networks, particularly their members,
This study's main objective is to show the impact of HIV/AIDS on mortality and insurance packages for an infected person. SPECIFIC OBJECTIVE 1. To determine a comprehensive maternity health insurance package for a HIV/AIDS infected person. 2. To estimate premiums payable by a HIV/AIDS infected individual on whole life policy.
NATIONAL HIV/AIDS STRATEGY 2011 ‐ 2016 9 CHAPTER I: INTRODUCTION AND SITUATION ANALYSIS INTRODUCTION National HIV/AIDS Strategy, 2011‐2016 The National HIV/AIDS Strategy is a national guiding document for all sectors, institutions and partners involved in the response to HIV and AIDS in Nepal.
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The Difference Between HIV and AIDS Now that we have discussed the symptoms of HIV, we will discuss the differences between HIV and AIDS. First of all it is important to reiterate that HIV is the virus that causes the disease AIDS.
A resource pack for unions www.itfglobal.org. HIV/AIDS and civil aviation: A resource pack for unions V . 23 Mainstreaming HIV and AIDS in core union business 26 Persuading employers that AIDS is a workplace issue 29 Tackling stigma and discrimination 32 No solutions without gender equality 35 ILO Recommendation 200 concerning HIV and AIDS (2010)
