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Services for People with HIV

If you are living with HIV or AIDS and you need support with the costs of your medical care and other services, there are services throughout Colorado for which you may be eligible.

 

The Ryan White HIV/AIDS Treatment Extension Act of 2009 provides funding for agencies throughout Colorado to support care and treatment services for people living with HIV or AIDS (PLWH/A). For residents of the Denver metropolitan area, the Denver Office of HIV Resources administers this federal funding (Part A); Colorado Department of Public Health and Environment administers funding throughout the state (Part B), but concentrates on services for PLWH/A who reside outside the Denver metropolitan area. This assistance is distributed through many sub-grantees such as AIDS Service Organizations (ASO), medical, dental, mental health and substance abuse treatment facilities that serve the various geographic regions of Colorado.

 

Having access to life-sustaining HIV medications and health insurance can be especially challenging for lower income PLWH/A. To help meet this need, Colorado Department of Public Health and Environment also administers the AIDS Drug Assistance Program (ADAP) statewide, which is partially funded by the federal government and partially funded by the State of Colorado.

 

To ensure accountability for these funds, the staff of the Colorado HIV Care and Treatment Program monitors contracts, collects and reports data, and promotes quality improvement. Staff also survey clients and invite public participation in the planning and implementation of services.

 

Eligibility for services varies by type of service and place of residence. Please contact the providers listed below for more information.

Having a case manager is extremely important for PLWH/A. A case manager can help you navigate the very complicated systems of HIV care and support and can support you in making well-informed decisions. Case management agencies also have other support available for eligible clients, such as food bank, housing, medical transportation, and assistance with short-term emergency needs.

 

If you reside outside the Denver Metropolitan area, please contact the agency assigned to your county of residence:

 

Boulder County AIDS Project (BCAP)
Boulder, Broomfield, Clear Creek and Gilpin Counties
303-444-6121

 

Northern Colorado AIDS Project (NCAP)
Larimer, Logan, Morgan, Philips, Sedgwick, Washington, Weld, and Yuma Counties
800-464-4611

 

Southern Colorado AIDS Project (SCAP)
Alamosa, Baca, Bent, Chaffee, Cheyenne, Conejos, Costilla, Crowley, Custer, El Paso, Elbert, Fremont, Huerfano, Kiowa, Kit Carson, Las Animas, Mineral, Otero, Park, Prowers, Pueblo, Rio Grande, Saguache, and Teller Counties
800-241-5468

 

Western Colorado AIDS Project (WCAP)
Archuelta, Delta, Eagle, Dolores, Garfield, Grand, Gunnison, Hinsdale, Jackson, Lake, La Plata, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, and Summit Counties
800-765-8594

 

If you reside in the Denver metro area (Adams, Arapahoe, Broomfield, Denver, Douglas and Jefferson counties) please refer to one of the following links:

 

Denver HIV Resources Planning Council

 

http://dhrpc.org/default/index.cfm/resources/participating-providers/case-management/

 

Denver Office of HIV Resources (DOHR) – Ryan White Part A Grantee
General 720-865-5420
Fax: 720-865-5533 

There are HIV Specialty Clinics in several Colorado communities.

 

If you reside outside the Denver Metropolitan area, please contact the following agencies for outpatient medical care:

 

Beacon Center for Infectious Disease (BCAP and NCAP Service Area)
Guy Lively Part C Program Manager
1136 Alpine
Boulder, CO 80304
Phone: (303) 938-5336
Fax: (720) 214-0267


The Children’s Hospital
CHIP Team - B055
13123 E. 16th Ave.
Aurora, CO 80045
(720) 777.8233
Toll-free (800) 624.6553 x8233

 

Infectious Disease Group Practice

University of Colorado
P.O. Box 6510, Mail Stop B-163
Aurora, CO 80045
(720) 848-0191
fax (720) 848-0191

 

Peak Vista Community Health Center (Colorado Springs area)

Community Clinic at Union

 

Susan Schweickert-Janty RN, ACRN

225 S. Union Blvd.

Colorado Springs, CO 80910

Phone (719) 866-6790

Susan.Schweickert-Janty@peakvista.org 

 

 

Pueblo Community Health Center 
JoAnn Grove, RN
EIS Case Manager
1302 E. 5th St.
Pueblo, CO 81001
Phone: (719) 543-8718 ext 727
Fax: (719) 542-1639
joann.grove@pueblochc.org

 

Western Colorado HIV Specialty Care Clinic (West CAP Service Area)
Lucy Graham, RN, MPH
St. Mary’s Family Medicine
1160 Patterson Road
Grand Junction, CO 81506
Phone: (970) 255-1735
Fax: (970) 255-6289
lucy.graham@stmarygj.org

If you reside in the Denver Metropolitan area, please contact the following agencies for outpatient medical care:


The Children’s Hospital
CHIP Team - B055
13123 E. 16th Ave.
Aurora, CO 80045
(720) 777.8233
Toll-free (800) 624.6553 x8233

 

Clinica Tepayac

5075 Lincoln Street
Denver, CO 80216
Phone: 303-458-5302

 

Denver Health Eastside Clinic

501 28th Street

Denver, CO 80205

Appointment Line (303) 436-4600

HIV Primary Care (303) 880-5747

 

Denver Health Medical Center
605 Bannock
Denver, CO 80204-4507
Message Phone: (303) 602-8710
Must be a Denver resident unless eligible for Medicare or Medicaid.

 

Infectious Disease Group Practice

University of Colorado
P.O. Box 6510, Mail Stop B-163
Aurora, CO 80045
(720) 848-0191
fax (720) 848-0191

 

MCPN North Aurora Family Health Services Clinic
3292 Peoria Street
Aurora, Colorado 80010
(303) 360.6276 ext. 2066

Part D: Enhances access to comprehensive care and research of potential clinical benefit for children, youth, women and their families with or at risk for HIV. The Part D Program in Colorado is administered by The Children’s Hospital’s Children’s HIV Immunodeficiency Program.

 

Part F: Includes the HIV/AIDS Education and Training Centers (AETC) that support training for health care providers to identify, counsel, diagnose, treat and manage individuals with HIV infection and to help prevent high-risk behaviors that lead to infection. The Colorado AETC at University of Colorado at Denver Health Sciences Center serves Colorado.

 

Part F also includes two dental programs. The Dental Reimbursement Program provides support to dental schools, postdoctoral dental education programs and dental hygiene programs for non-reimbursed care provided to PLWH. The goal of the Community-Based Dental Partnership is to address the unmet oral health needs of underserved PLWH and to train new generations of dental providers to manage the oral health care of PLWH. Program sites include Howard Dental Center, Marillac Clinic in Grand Junction, Salud Clinics in Fort Morgan and Longmont, and Pueblo Community Health Center. The University of Colorado School of Dentistry is the grantee for both dental programs.

 

Special Projects of National Significance: Supports the development of innovative HIV/AIDS service delivery models that have the potential for replication in other areas.

 

Minority HIV/AIDS Initiative (MAI): Was created in 1999 to provide funding and services for African American communities as a result of an emergency declared by the Congressional Black Caucus as a response to the alarming rates of HIV/AIDS in this community. In 2000, support for the program was given by the Congressional Hispanic and Asian American Caucuses to include all communities of color. The MHAI goals are to expand the infrastructure of community-based organizations and HIV service delivery to people of color living with HIV/AIDS, expand services in historically underserved minority communities and ensure sustainability in an effort to reduce persistent health disparities. Each Part of the Care Act has a MHAI component.

 

There are a great variety of entities (some funded by the Colorado Department of Public Health and Environment, others not) that offer services to PLWH and their caregivers. The AIDS Coalition for Education has provided a detailed list of these providers.

Ryanwhite

 
 
Ryan White (1971-1990)
Ryan White HIV/AIDS Treatment Extension Act (2009)


The Ryan White HIV/AIDS Treatment Extension Act (2009) is Federal legislation that addresses the unmet health needs of persons living with HIV disease (PLWH) by funding primary health care and support services. The Act was named after Ryan White, an Indiana teenager whose courageous struggle with HIV/AIDS and against AIDS-related discrimination helped educate the nation.

 

In 1990 Congress enacted the Ryan White Comprehensive AIDS Resources Emergency to address the unmet health needs of persons living with HIV disease (PLWH) by funding primary health care and support services that enhance access to care and retention in care services. The Ryan White legislation has been amended and reauthorized in 1996, 2000, and 2006. In 2009, Congress passed the Ryan White HIV/AIDS Treatment Extension Act . This bill extends the Ryan White program for an additional four years. Ryan White services reach over 500,000 individuals each year, making it the federal government's largest program specifically for people living with HIV disease.

 

Like many health problems, HIV disease disproportionately strikes people in poverty, racial/ethnic populations, and others who are underserved by healthcare and prevention systems. HIV often leads to poverty, due to costly healthcare or an inability to work that is often accompanied by a loss of employer-related health insurance. Ryan White-funded programs are the "payer of last resort." They fill gaps in care not covered by other resources. The most likely users of CARE Act services include people with no other source of healthcare and those with Medicaid or private insurance whose care needs are not being met.

 

Ryan White services are intended to reduce the use of more costly inpatient care, increase access to care for underserved populations and improve the quality of life for those affected by the epidemic. Ryan White grantees work toward these goals by funding local and state programs that provide primary medical care and support services; healthcare provider training; and technical assistance to help funded programs that address implementation and emerging HIV care issues.

 

The legislation provides for significant local and State control of HIV/AIDS healthcare planning and service delivery. This has led to many innovative and practical approaches to the delivery of care for PLWH. Additionally, in response to an increasing need, the State of Colorado legislature has provided generous support toward acquiring HIV medications for PLWH, now exceeding 4 million dollars annually.

 

The HIV Care and Treatment program at the Colorado Department of Public Health and Environment administers Ryan White Part B funding for the state of Colorado. The Ryan White Part B funds and funding from the State of Colorado are utilized to deliver services in four core areas:

 

  • HIV Medication Assistance Program

  • Medicare Part D State Pharmaceutical Assistance Program

  • Health Insurance Assistance Program

  • HIV Care and Case Management

 

Housing Assistance for PLWH is funded by the US Department of Housing and Urban Development (HUD). This assistance is administered locally through the various AIDS Service Organizations. See the HIV Services in Colorado segment for information on these entities. 

The Colorado AIDS Drug Assistance Program (ADAP) is a program to provide AIDS-specific medications at no cost on an outpatient basis to Colorado residents who qualify for the program.

 

How do you qualify for ADAP?

There are five qualifications for the program:

 

 

1.     You must be a Colorado resident.
 
2.     You must have proof of HIV positive diagnosis from a doctor or testing facility.
 
3.     You must be at or below 400 percent of the Federal Poverty Level, (see below).
 
4.     The Ryan White ADAP system must be the payer of last resort. If you are eligible for insurance through your employer, a COBRA policy, or on an individual program, you will need to receive assistance through Colorado ADAP’s Health Insurance Assistance Program (HIAP)  if you would be able to access medications in an affordable manner through that insurance.
 
5.     If you are eligible for Medicare, you will also need to join Colorado ADAP’s Bridging the Gap, Colorado (BTGC) plan for assistance with the costs of Medicare prescription drug premiums and related co-payments.
 
6.     If you cannot access any other insurance, you will be enrolled in the HIV Medication Assistance Program, or HMAP.
 
7.   If you are on Medicaid (only), you must access HIV medications through that program.

 

 

 

 

Persons in
Family or Household
400%
1
$44,680
2
$60,520
3
$76,360
4
$92,200
*For each additional family member, add $15,580

 

 

HIV Medication Assistance Program (HMAP)
 
Eligible enrollees who have no access to any form of other insurance will be placed on the HIV Medication Assistance Program (or HMAP). They will receive the HMAP formulary medications free of charge through a very limited network of pharmacies. If you receive your HIV Medical Care at Denver Health, University of Colorado Hospital, or Children’s Hospital, you may access the pharmacy at the Infectious Disease Pharmacy of these facilities. If not, you would access your medications through the Walgreens Pharmacy at Rose Hospital, often via mail order.
 
What medications are on the ADAP Formulary?
 
The ADAP formulary contains the vast majority of HIV specific treatment therapies, as well as many medications that are needed to combat opportunistic infections and side effects of those HIV medications. Some medications that are prescribed for clients who are also diagnosed with mental health issues are covered as well.
 

 

 

Federal Poverty Level: Based on 2012 figures
400 percent of Federal Poverty:

How do you get enrolled in the program?

 

COMPLETE  and SUBMIT an APPLICATION FOR COLORADO ADAP:
 
For assistance in enrolling in Colorado ADAP, Call the ADAP HELP DESK at 303-692-2716, or contact the appropriate Colorado AIDS Service Organization in your region:

Boulder County AIDS Project
Boulder, Broomfield, Clear Creek and Gilpin Counties
303-444-6121
www.bcap.org

 

Colorado AIDS Project
Adams, Arapahoe, Denver, Douglas, and Jefferson Counties
303-837-0166
www.coloradoaidsproject.org

 

Northern Colorado AIDS Project
Larimer, Logan, Morgan, Philips, Sedgwick, Washington, Weld, and Yuma Counties
800-464-4611
www.ncaids.org

 

Southern Colorado AIDS Project
Alamosa, Baca, Bent, Chaffee, Cheyenne, Conejos, Costilla, Crowley, Custer, El Paso, Elbert, Fremont, Huerfano, Kiowa, Kit Carson, Las Animas, Mineral, Otero, Park, Prowers, Pueblo, Rio Grande, Saguache, and Teller Counties
800-241-5468
www.s-cap.org

 

Western Colorado AIDS Project
Archuelta, Delta, Eagle, Dolores, Garfield, Grand, Gunnison, Hinsdale, Jackson, Lake, La Plata, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, and Summit Counties
800-765-8594
www.westcap.info

 

More information on the Colorado AIDS Drug Assistance Program

The Colorado Department of Public Health and Environment hosts a monthly meeting of the ADAP Review Committee. These meetings are open to the public, and are intended to allow for input into the policies, practices, and formulary of the Colorado ADAP. In order to find information on the date, location, or organizational structure of the ADAP Review Committee, call 303-692-2737.

 

 

 

 Health Insurance Assistance Program

 What is the Health Insurance Assistance Program (HIAP)?
 Many of those living with HIV disease are able to continue employment at a business which offers healthcare and medication coverage while they manage their treatment. Others are able to maintain a COBRA policy through a former employer while they are transitioning to a new job or to disability. The HIAP is intended to assist eligible participants to maintain access to these benefits. The insurance coverage must provide “creditable” pharmaceutical coverage, and be cost-neutral to the HIV Medication Assistance Program (HMAP) to provide the same coverage. This program has the additional benefit of providing access to medical treatment for its participants.

  

Federal Poverty Level: Based on 2012 figures
400 percent of Federal Poverty:
Persons in
Family or Household
400%
1
$44,680
2
$60,520
3
$76,360
4
$92,200
*For each additional family member, add $15,580

 How do you qualify for the Insurance Program?

  • You must be a Colorado resident
  • You must have proof of HIV positive diagnosis from a doctor or testing facility. You may also access the program if a family member that is not HIV positive can acquire insurance from their employer on your behalf.
  • You or your family must be at or below 400 percent of the Federal Poverty Level, (see below).
  • You must be eligible for medical insurance or a COBRA policy through which you would be able to access medications in an affordable manner. This includes Pre-existing Condition Insurance Plans (Cover Colorado and GettingUSCovered).
  • If you are eligible for Medicaid, you must access your medications through that system. The ADAP system must be the payer of last resort.
  • If you are eligible for Medicare, you must receive assistance through the Medicare Part D assistance program (Bridging the Gap, Colorado State Pharmaceutical Assistance Program). See the Medicare Part D tab to the left.

 What medications are on the HIAP Formulary?

Individuals on the HIAP may access any of the medications that are on the current formulary listed at the link below. It contains the vast majority of HIV specific treatment therapies, as well as many medications that are needed to combat opportunistic infections and side effects of those HIV medications. Some medications that are prescribed for clients who are also diagnosed with mental health issues are covered as well.

 

CURRENT APPLICATIONS FOR COLORADO HIAP SHOULD BE OBTAINED FROM YOUR REGIONAL AIDS SERVICE ORGANIZATION:
 
For assistance in enrolling in the Colorado ADAP Health Insurance Program, Call the ADAP HELP DESK at 303-692-2716, or contact the appropriate Colorado AIDS Service Organization in your region:

 

Boulder County AIDS Project
Boulder, Broomfield, Clear Creek and Gilpin Counties
303-444-6121
www.bcap.org
 
Denver Colorado AIDS Project
Adams, Arapahoe, Denver, Douglas, and Jefferson Counties
303-837-0166
www.coloradoaidsproject.org
 
Northern Colorado AIDS Project
Larimer, Logan, Morgan, Philips, Sedgwick, Washington, Weld, and Yuma Counties
800-464-4611
www.ncaids.org
 
Southern Colorado AIDS Project
Alamosa, Baca, Bent, Chaffee, Cheyenne, Conejos, Costilla, Crowley, Custer, El Paso, Elbert, Fremont, Huerfano, Kiowa, Kit Carson, Las Animas, Mineral, Otero, Park, Prowers, Pueblo, Rio Grande, Saguache, and Teller Counties
800-241-5468
www.s-cap.org
 

Western Colorado AIDS Project
Archuelta, Delta, Eagle, Dolores, Garfield, Grand, Gunnison, Hinsdale, Jackson, Lake, La Plata, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, and Summit Counties

 

INSURANCE ASSISTANCE AVAILABLE:Participants can receive up to $10,000 for insurance premiums, as well as medical and pharmaceutical co-pays and deductibles annually*.
*In general, HIAP is not permitted to provide financial assistance with premium payments for the Cover Colorado and GettingUSCovered plans, but can assist with paying deductibles, co-pays, and co-insurance for them.
How Do I Find Out More About the Program?
You do not have to be case managed to participate in the program, but enrollment in the program is managed by the contracted agency in your region. If you think that you qualify for the Health Insurance Assistance Program, inquire at one of the five agencies listed below. You may also call the Health Insurance Assistance Program Administrator at the Colorado Department of Public Health and Environment at (303) 692-2783. You will be asked to complete the AIDS Drug Assistance Program application.

 

In 2008, The State of Colorado Ryan White Part B Program began a new program to assist Medicare Part D eligible People Living with HIV/AIDS to acquire and pay for medications through a Medicare Prescription Drug Plan (PDP) and Medicare Advantage Plans (HMO, PPO, Private Fee For Service).

 

Current ADAP Medicare Advantage (with Prescription Drug Benefits - MAPD) and Medicare Part D participants are eligible to apply for this program by submitting an application (see below).

 

  • If you qualify for the AIDS Drug Assistance Program (see Colorado ADAP page for eligibility) and are eligible for Medicare, you may receive assistance through the Colorado HIV specific State Pharmaceutical Assistance Program; Bridging the Gap, Colorado.

  • Bridging the Gap, Colorado “wraps around” MAPD and Medicare Part D coverage by paying for participants’ premiums, co-pays, deductibles and co-insurance, including fees in the so-called “coverage gap.” This allows participants to access the entire formulary of their prescription drug plan at significant cost savings.

  • Additionally, by paying these costs for the participants, Bridging the Gap, Colorado realizes a significant cost savings for the ADAP and for taxpayers.

  • Bridging the Gap, Colorado will assist with any Centers for Medicare and Medicaid Services- approved Medicare MAPD or Part D Plan as long as they will contract with the ADAP pharmacies.

  • In addition to regular Colorado ADAP pharmacies, Bridging the Gap, Colorado members may fill prescriptions at Kaiser Permanente network pharmacies in Colorado, many Walgreens locations, as well as at Colorado Pharmacy in Denver. Call 1-888-311-7632 to find the location closest to you.

 

How Do I Find Out More?
You do not have to be case managed at a Ryan White funded agency in order to receive Medicare Part D assistance, but you do need to meet the eligibility requirements of the ADAP. If you think you may qualify for the Bridging the Gap, Colorado, you may contact the Insurance Program Project Administrator at the Colorado Department of Public Health and Environment at 303-692-2783.

 

Please see the links below for Bridging the Gap, Colorado documents