HIV Care Services

Last Updated: May 06, 2022.
See Section(s): Policy Announcement; Virginia Ryan White Part B Unified Eligibility; Policy Highlights; Medicaid Updates

The Virginia Department of Health (VDH), Division of Disease Prevention has administered Ryan White Part B funding for HIV care services to persons living with HIV/AIDS in Virginia since 1991.  A major part of Part B funding is the Virginia Medication Assistance Program (VA MAP) that provides medications for low-income, uninsured individuals with HIV/AIDS.  The remaining funds provide HIV care services, targeted to deliver medical care and support services to eligible individuals living with HIV/AIDS.  Ryan White funding is the payer of last resort.

Use the navigation at the top of the page to access other HIV Care Services pages, including the VA MAP web page for Medicaid and ACA Open Enrollment Updates.  

Policy Announcement

Effective May 06, 2022.

Virginia Ryan White Part B Unified Eligibility Policy & Procedures

We have exciting news! The Virginia Ryan White HIV/AIDS Program Part B (RWHAP B) implemented Unified Eligibility (UE) that will have clients conduct eligibility every 24 months for all RWHAP B services, including ADAP services coordinated through VA MAP. This is a major policy and procedure shift for RWHAP B client eligibility as this removes the 6-month recertification requirement and changes client eligibility to a 24-month period. Clients and providers no longer have to do four eligibility assessments per year! Agencies not contracted with the Virginia RWHAP B program are not able to conduct these client assessments at this time, but can make referrals to the agencies that can.

Documents related to the UE policy and procedures are listed below.

Policy Highlights

♦ This policy replaces any prior policies and guidance regarding Virginia’s RWHAP B and VA MAP client eligibility processes. For the Full Unified Eligibility Policy and Procedures please click here.

♦ Virginia RWHAP B clients will need to verify their eligibility status every 24 months.  The new process does not require 6-month recertifications. These changes align with the requirements and flexibilities in HRSA’s PCN #21-02.

♦ VDH requires RWHAP B-contracted agencies to conduct period checks called Client Access Reviews (CARs) for anything that potentially changes the client’s eligibility for services. Subrecipients will need to document CARs and upload any changes discovered that affect client eligibility into Provide® within 7 days.

♦ Virginia RWHAP B-contracted agencies will conduct all client eligibility assessments for all RWHAP B services, including ADAP. To access a list of these contracted agencies please click here for the VDH Resource Connection website.

♦ Virginia RWHAP B-contracted agencies will use the state’s new client-level data system called Provide Enterprise®. These contracted agencies must create client records and upload supportive documentation that supports each eligibility criterion which remains the same for VA RWHAP B. At this time, if agencies are not a Virginia RWHAP B-contracted agency, then they will not have access to Virginia RWHAP B's Provide Enterprise® system. Virginia will explore this possibility with the system’s vendor for future integration. For information about the Virginia Provide Enterprise® system, please click here.

♦ Eligibility criteria includes: Proof for Virginia residency; Household income at or below 500% of FPL; Insurance coverage status for services requested to help ensure RWHAP is payer of last resort; and One-time proof of a diagnosis with HIV disease documented. See the new and updated Supportive Documentation for Unified Eligibility Checklist by clicking here.

♦ As of May 09, 2022 and going forward, VA MAP will no longer process eligibility assessments for medication access. Through UE, VA MAP will be reviewing eligibility assessments to determine the appropriate VA MAP service option for a client to access their medication. Eligibility for medication access will be determined through the eligibility assessments conducted by a Virginia RWHAP B-contracted agency. To access a list of these contracted agencies please click here for the VDH Resource Connection website.

Virginia RWHAP B eligibility and non-RWHAP B agencies

Agencies not contracted with Virginia RWHAP B to provide services cannot conduct unified eligibility assessments at this time.  If an agency provides services from other RWHAPs A, C, and/or D and does not contract with Virginia RWHAP B, then the agency must refer clients to these Virginia RWHAP B-contracted agencies to conduct eligibility assessments for any Part B services, including ADAP.  Clients can also contact any of the contracted agencies of their choice to complete their eligibility assessment for Part B services. Any one can access a list of these contracted agencies by clicking here for the VDH Resource Connection website..

Resources for Virginia Ryan White Service Providers