HIV Medical and Support Service Categories

Updated HIV Medical and Support Service Categories Standards of Care – Public Comment


The service categories below are fundable though Ryan White HIV/AIDS Program (RWHAP) Part B grant, DSHS State Services, and HOPWA formula funds awarded to the State only. Listed service categories may not fully reflect services fundable through other RWHAP Parts, direct HOPWA, or other funding sources. Certain services listed in Section 2 and all services listed in Section 3 are fundable only through DSHS State Service funds.

The service categories are subject to revision as new information, requirements, and/or guidance is received from the Health Resources and Services Administration (HRSA), U.S. Public Health Service (USPHS), the State of Texas, and/or DSHS.

Section 1. Core Medical Services
Section 2. Support Services
Section 3. Support Services (State Services Funds Only)
Section 4. Health Insurance Program (HIP)
Section 5. HOPWA
Section 6. Minority AIDS Initiative (MAI)
Section 7. Universal Standards – Monitoring Tools – Templates
Section 8. Corrective Action Plan (CAP) Templates and Resources

Contact your local Administrative Agency or your DSHS Services Consultant with questions.

Guidance for the Use of Telemedicine, Teledentistry, and Telehealth for HIV Core and Support Services


Section 1. Core Medical Services

Service Category Revised
Early Intervention Services (Part B) April 2023
Health Insurance Premium and Cost Sharing Assistance April 2023
Home and Community-Based Health Services April 2023
Home Health Care April 2023
Hospice Services April 2023
Local AIDS Pharmaceutical Assistance (LPAP) April 2023
Medical Case Management (including Treatment Adherence Services) April 2023
Medical Nutritional Therapy April 2023
Mental Health Services April 2023
Oral Health Services April 2023
Outpatient/Ambulatory Health Services April 2023
Substance Abuse Outpatient Care April 2023

 

Section 2. Support Services

Some services listed here may not be funded with Ryan White Part B funds.

Service Category Revised
Child Care Services April 2023
Emergency Financial Assistance (EFA) April 2023
Food Bank/Home-Delivered Meals April 2023
Health Education/Risk Reduction (HE/RR) April 2023
Housing Services April 2023
Linguistic Services April 2023
Medical Transportation Services April 2023
Non-Medical Case Management April 2023
Other Professional Services April 2023
Outreach Services April 2023
Psychosocial Support Services April 2023
Referral For Health Care and Support Services April 2023
Rehabilitation Services April 2023
Respite Care April 2023
Substance Abuse Services (Residential) April 2023

 

Section 3. Support Services (State Services Funds Only)

These services may not be funded with Ryan White Part B funds.

Service Category Revised

Other Services
Activities not associated with current HRSA Service Categories to be provided under this service category. Activities must be approved by DSHS prior to allocating State Service funds.

N/A

 

Section 4. Health Insurance Programs (HIP)

Health insurance payments made with Ryan White CARE Act funds should be reported under the CARE/HIPP; health insurance payments made with State Services funds should be reported under the State Services - Insurance.

Service Category CARE/HIPP & State Services Insurance Service Units

Outpatient / Ambulatory Medical Care – Revised 3/31/2017
Co-payments for Outpatient / Ambulatory Medical Care Services when a client has private insurance.

Ambulatory/Outpatient Medical Care Per payment
Dermatology Per payment
Infectious Disease Per payment
Neurology Per payment
Ob/Gyn Per payment
Oncology Per payment
Opthamaology Per payment
Other Specialty Per payment
Radiology Per payment
Laboratory - Service Per payment
CD-4 T-Cell Count Per payment
Viral Load Test Per payment

Insurance – Medical
Premium and deductible payments for a client’s medical insurance with a private insurance provider. Do not report payments to public payers (e.g. Medicare/Medicaid) here.

Deductible Payment Per payment
Premium Payment Per month

Oral Health Care
Co-payments for Oral Health Care when a client has private dental insurance.

Routine Treatment Per payment
Prophylaxis Per payment
Specialty Per payment

Insurance – Oral Health Care
Premium and deductible payments to a private insurer for dental insurance.

Deductible Payment Per payment
Premium Payment Per month

AIDS Pharmaceutical Assistance (Local) (not Medicare, Medicaid or Part D)
Co-payments for a client’s medications when a client has drug coverage from a private insurer.

Co-Payment Per prescription

Insurance – Prescription Drugs (not Medicare, Medicaid or Part D)
Premium and deductible payments for prescription drug benefits with a private insurer.

Deductible Payment Per payment
Premium Payment Per month

Medicare/Medicaid Supplement
Premium, deductible or co-payments to Medicare/Medicaid.

Deductible Payment Per payment
Co-Payment Per payment
Premium Payment Per month
Deductible Payment – Part D Per payment
Co-Payment – Part D Per payment
Premium Payment – Part D Per month

Other Health Insurance
Premium, deductible or co-payments to other health insurers.

Deductible Payment Per payment
Co-Payment Per payment
Premium Payment Per month

 

Section 5. HOPWA

The goals of the DSHS HOPWA Program are to help low-income persons living with HIV and their households establish or maintain affordable and stable housing, reduce their risk of homelessness, and improve their access to health care and supportive services. HOPWA Project Sponsors can visit the DSHS HOPWA Program page for information and resource materials applicable to the activities they are carrying out.

The service categories below are funded through annual formula grants to the State from the U.S. Department of Housing and Urban Development (HUD). They may not reflect services funded through other Ryan White Program Parts, direct HOPWA, or other funding sources. Certain services listed in Section 2 and all services listed in Section 3 are funded only through DSHS State Service funds.

Each service at the subcategory level will allow entry of a total cost amount that is the result of the agency’s unit cost calculation outside the data management system Take Charge Texas (TCT).

The service categories are subject to revision as new information and guidance is received from HUD.

Service Category Subcategories Service Units

Permanent Housing Placement (PHP)
Assistance for reasonable security deposits, related application fees, and other initial move-in costs associated with placement in housing.

Permanent Housing Placement Per payment

Short-Term Rent, Mortgage and Utility Assistance (STRMU)
Housing subsidy for short-term rent, mortgage and utility payments to prevent homelessness of the tenant or mortgagor of a dwelling. This program provides assistance for a period not to exceed 21 weeks (147 days) worth of assistance in any 52 week period. These payments are for eligible individuals and their household beneficiaries who are already in housing and who are at risk of becoming homeless. STRUM was previously known as Emergency Assistance.

Short Term Rental Assistance Per payment
Mortgage Assistance Per payment
Utility Assistance Per payment

Supportive Services
The DSHS HOPWA Program currently limits the use of Supportive Service funds to Housing Case Management (HCM). Supportive Services may be provided in conjunction with HOPWA housing assistance or as a standalone service (Supportive Services Only).

Case Management Per 15 Minutes

Tenant Based Rental Assistance (TBRA)
Housing subsidy for tenant based rental assistance, including assistance for shared housing arrangements. It assists income eligible clients and their beneficiaries with rent and utilities until they are able to secure affordable, stable housing. TBRA was previously known as Rental Assistance.

Tenant Based Rental Assistance Per payment

 

Section 6. Minority AIDS Initiative (MAI)

 
Service Category Revised
Health Education-Risk Reduction (HERR) May 2020
Outreach Services May 2020

 

Section 7. Universal Standards – Monitoring Tools – Templates

Tools
Universal Standards
Service Standards Review Crosswalk 2023
DSHS Master Service Category Monitoring Tools 2023
DSHS MAI Monitoring Tools
HOPWA Monitoring Tool
2023-24 Ryan White Part B and State Services Monitoring Logistics Guide

 

Section 8. Corrective Action Plan (CAP) Templates and Resources

Tools and Resources
2023/2024 Ryan White Part-B/State Services Program Monitoring - Evaluation and Deficiency Response Plan

Corrective Action Plan (CAP) Template - A provider or agency may use their own CAP template with approval of their Administrative Agency (AA)