Medicaid Plan to Address HIV

February 27, 2014

Note: Story updated with March 10 comments

In a significant victory for HIV advocates, a new Medicaid plan advanced by Illinois Governor Pat Quinn plan will include a provision that will improve care for people living with HIV.

The HIV-specific provision — an HIV health home — was included after concerted advocacy by the AIDS Foundation of Chicago (AFC) and our allies, including State Reps. Greg Harris, La Shawn Ford, and Sara Feigenholtz.

The provision is included in a proposed 1115 waiver developed by Governor Quinn and his team. The proposal, which must be approved by the federal government, would allow the state to make changes to the Medicaid program. The goal is to obtain additional federal funding for health and social services, improve care coordination, boost the health care workforce, enhance supports for people living in the community, and improve population health.

The waiver was open for several rounds of public comments in which 85 organizations submitted nearly a thousand comments or recommendations. AFC submitted three sets of comments (see round 1, round 2, and round 3) and testimony.

While early drafts did not mention HIV, the state finally accepted AFC's recommendation to include a health home for people with HIV. HIV health homes would provide enhanced funding to provide patient-centered medical care for people living with HIV that is comprehensive, coordinated, accessible, and committed to quality and safety.

The state proposed significant funding ($50 million a year) for the new program, which would also include people with chronic diseases. Other states, including Washington, Oregon, Wisconsin and New York, are implementing health home programs for people with HIV.

After a comment period that ends March 10, the federal government will review the waiver proposal and the state and federal government will negotiate changes. It could take up to two years for the waiver to be finalized, so AFC is committed leading continued advocacy on this issue.

Click here for the waiver text on HIV health homes and budget chart, and follow the progression of the 1115 waiver here.




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