About Ryan White Part B and HOPWA Services
The Ryan White Program provides support services to people living with HIV/AIDS. Support services include case management, dental care, direct emergency financial assistance, housing assistance, medication assistance, counseling, substance abuse treatment and transportation assistance.
The Housing Opportunities for Persons with AIDS (HOPWA) Program is the only Federal program dedicated to the housing needs of people living with HIV. Under the HOPWA Program, the U.S. Department of Housing and Urban Development (HUD) makes grants to local communities, states, and nonprofit organizations for projects that benefit low-income persons living with HIV and their families.
Ryan White and HOPWA Administrative Requirements
Service Definitions are designed to ensure that Community Based Organizations are able to correctly assess and report the type of services that are being provided to clients.
- Ryan White Part B Service Definitions
- Documentation of Ryan White Part B and HOPWA Services
- Encounter Topics and Service Entry Guidance
Service Standards outline the requirements for documentation associated with service provision.
Documents for Payment
Staff from the Office of Public Health STD/HIV program will make an annual visit to organizations providing support services for monitoring purposes.
Case Management Supporting Documents
Ryan White Part B Services
First Visit Activity
Assessment Paperwork–To be completed during the first meeting with a client.
Client Eligibility Forms–To be completed annually except proof of positivity.
- Eligibility and Requirements Checklist
- Part B Proof of Positivity
- MAGI Worksheet
- Documentation of No Income or Cash Only Income
- Employer Income Verification
- NMCM Care Plan
- Single Provider Statement
- Sample Client Confidentiality Acknowledgement
- Release of Confidential Information
Eligibility Attestation–Self attestation is allowed every 6 months for RWHAP.
Reassessment Paperwork–To be completed every 6 months for RWHAP.
Direct Services Only Reassessment–to be used for non case managed clients upon eligibility recertification.
- Food Bank Allowed Product List 2018
- Part B Sample Request and Consent to Text Message
- Entering Referral Services in CAREWare
- Entering Acuity Scores in CAREWare
- LDH HOPWA Program Manual
- Form A Documentation of No Income or Cash Only Income
- Form B Self-Declaration of Residency
- Form C Household Income Eligibility Worksheet
- Form D Program Agreement
- Form E Demographic and Statistical Data
- Form F Release of Information
- Form G Housing Quality Standards Certification
- Form H Rent Standard and Rent Reasonableness Certification
- Form I Rental Assistance Worksheet
- Form J Housing Choice Voucher Other Affordable Housing Waiver
- Form K 1 STRMU Tracking Sheet
- Form K 2 STHS Tracking Form
- Form L PHP Intent to Lease Worksheet
- Form M Interim Recertification Worksheet
Violence Against Women Act Requirements
- VAWA Lease Addendum
- Optional VAWA Certification Form
- VAWA Emergency Transfer Plan
- VAWA Notice of Occupancy Rights
Quality Management Webinar Series
- Quality Management 101 Module 1- Quality Improvement Overview
- Quality Management 101 Module 2- Quality Program Infrastructure
- Quality Management 101 Module 3- Performance Measurement
- Quality Management 101 Module 4- QI Project Steps and PDSA
August 2018 Ryan White New Contract Trainings
- Monitoring, Invoicing and Reporting
- New Activities and Paperwork Training
- Data Management Updates Training
- Quality Management Presentation for Services CBOs