Welcome to Central Ohio AIDS Consortium

Central Ohio HIV Consortium Client Services
Access Guidelines
Funding Year 17
March 31, 2007 – March 30, 2008

RW assistance is limited to individuals living with the HIV disease who are experiencing an HIV-Related Emergency. An HIV-Related Emergency is defined as: An unexpected situation that is either caused by or negatively impacts the client's HIV status and there is no other resource available to provide the needed service.

Guidelines are determined by members of the Ryan White Consortium (consumers and those working in the field of HIV/AIDS care) and are subject to change. Emergency funding is contingent upon availability of funds. Guidelines are reviewed periodically in order to better meet the needs of consumers in the Central Ohio region.

Note: All services need to be pre-approved by a RW Case Manager prior to the date of service.

Assistance is determined by, but not limited to:

•	Each request for services will be evaluated on a case-by-case basis and will assure that the RW program is the payer of last resort
•	Assistance is based on the availability of funds (funds are monitored monthly and adjusted as necessary).

Once eligibility and necessity are determined, services may be approved under the categories of services listed below.

Medical-Related Emergency Needs:

HIV Medical Services/Diagnostics and Monitoring

•	Follow ODH guidelines; HIV-related medical visits and care: associated lab costs according to national standards of care.
•	Cannot be used for hospital inpatient, emergency room, urgent care or ambulatory surgical procedures. OHDAP formulary medications cannot be purchased without exception from OHDAP; no vitamins.
•	Specific medical and pharmaceutical co-pays may be eligible.
•	Chiropractic care with documentation from HIV or primary care physician verifying HIV-related need and approval from the Ohio Department of Health. Must be documented emergency. Determined on a case by case basis.
•	Genotype and Phenotype testing must be pre-approved by the Ohio Department of Health by exception only.

Substance Abuse

•	On a case-by-case basis, by exception only.
•	Approval will be based on outpatient substance abuse treatment if timely access to treatment and counseling is not available.
•	Funds may not be used for inpatient detoxification in a hospital setting.
•	If detoxification is offered in a separate licensed residential setting (including a separately licensed detoxification facility within the walls of a hospital), CARE Act funds may be used for this activity.
•	If the residential treatment service is in a facility that primarily provides inpatient medical or psychiatric care, the component providing the drug and/or alcohol treatment must be separately licensed for that purpose.

Mental Health

•	If local MH community resources are unavailable, may refer to other mental health services to provide client with up to 6 emergency stabilization visits per year, with no more than 3 visits at a time.
•	Sessions over 6 will need to be approved via exception to ODH/HCS.

Dental

•	Dental Services to include cleanings, semi annual exams, X-Rays.
•	Fillings and extractions by approved treatment plan.
•	Treatment plans over $500 must be pre-approved via the exception process to ODH/HCS.

Health-Related Emergency Needs:

Housing/Utilities

•	All housing related expenses to be paid from HOPWA funds. Housing is not a RW category. Clients are expected to have a housing plan to cover expenses beyond emergency episode.

Transportation

•	Emergency transportation may be in the form of a day bus pass, gas voucher, or another available option. Assistance limited to HIV-related medical, dental, mental health, or public assistance appointments in emergency situation.

Rehabilitation

•	Physical therapy, adaptive equipment.
•	Co-pays on these services when needed.

Medical Supplies

•	Medical supplies to include gloves, pads, incontinence supplies.

Nutrition

•	Food vouchers: Maximum of 2 food vouchers per year based on emergency situation and determined on a case by case basis.
•	Home-delivered meals: Up to a 3-month emergency supply per client per year. Only available for those unable to prepare or access nutritious meals (exceptions made on approval).
•	Liquid Nutritional Supplements: Limited to Boost; available only through Project Open Hand Columbus for an amount to be determined as a result of nutritional assessment and/or orders from Doctor.
•	Nutritional Assessments: Based on need and available funding.

Family Services and Child Welfare

Provides for short term child welfare and family services such as:

•	Emergency supplies (diapers, some medical supplies).
•	Short respite care.
•	Bereavement counseling for infected clients.
•	Individual and family mental health crisis counseling - up to 6 visits.
•	Childcare provided by a licensed provider or facility.
•	Health Insurance Premium (HIP) (1 per year only).
•	Attendance at Healing Weekend (1 per lifetime).