HIV, STD, and Viral Hepatitis Program

Ryan White Provider Links

• Federal Ryan White Guidance Details
  • Ryan White HIV/AIDS Treatment Extension Act of 2009 - information from HRSA on the public law that funds HIV care services in Maine
  • Clinical Care Guidelines/Protocols - information from HRSA on the latest clinical practices and protocols
  • HAB Performance Measures - HRSA's HIV/AIDS Bureau has released four (4) sets of performance measures in the areas of clinical care, medical case management, oral health and AIDS Drug Assistance Programs.
  • Monitoring Standards - Fiscal, Program, and Universal Monitoring Standards for Part B programs are at the bottom of the page.

• Clinical Guidelines for the Treatment of HIV/AIDS (Some available in PDF and PDA formats) Details
  • Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents - 12/1/09
  • Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States - 4/29/09
  • Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection - 2/23/09
  • Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents (pdf*) - 4/10/2009
  • Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children - 8/26/2009

• Drug Lists and Formularies Details
  • ADAP Formulary (pdf*)
  • MaineCare Preferred Drug List

• ADAP Policies Details
  • ADAP Policy (pdf*)
  • ADAP/MaineCare Policy (pdf*)
  • ADAP/Medicare Policy (pdf*)
  • ADAP/Private Insurance Policy (pdf*)
  • ADAP Vitamin Policy (pdf*)

• Laws/Rules Details
  • Rules governing HIV/AIDS Case Management Programs (word*)
  • MaineCare Targeted Case Management Services (word*)

• Applications Details
  • ADAP Application (pdf*)
  • ADAP Release of Information (pdf*)
  • MaineCare Application (pdf*)
  • PHIP Application (pdf*)
  • Maine Rx Plus Application (pdf*)

• Program-Specific Contract Riders Details
  • Rider A (word*)
  • Rider E (word* | also in pdf*)

• Standard Forms Details
  • Required at Intake
    • New Client Intake Form (word* | also in pdf*)
  • Required at Intake and Annually
    • Annual Assessment (word* | also in pdf*)
    • Client Rights and Responsibilities (pdf*)
  • Required as Needed
    • Client Contact Information (word* | also in pdf*)
    • Discharge Summary (word* | also in pdf*)
  • Required at Intake and Semiannually
    • Semiannual Certification (word* | also in pdf*)
    • Semiannual Care Plan (word* | also in pdf*)
  • Agency Forms As Needed
    • Grievance Summary (word*)
    • Training and Supervision Record (word*)
  • Optional Forms
    • Quarterly Assessment Update (word* | also in pdf*)
    • Budgeting Worksheet (word* | also in pdf*)
    • Medication Adherence Monitoring Tool (pdf*)
    • Medication Tracking Sheet (pdf*)
    • Documentation of HIV Status (word*)
  • Forms for Northern Maine Providers
    • New Client Intake Form (word* | also in pdf*)
    • Annual Assessment (word* | also in pdf*)
    • Client Rights and Responsibilities (word* | also in pdf*)
    • Discharge Summary (word* | also in pdf*)
    • Quarterly Assessment Update (word* | also in pdf*)
    • Semiannual Certification (word* | also in pdf*)
    • Semiannual Care Plan (word* | also in pdf*)

• CAREWare Details
  • State of Maine CAREWare Manual (word* | Also in pdf*) - User Guidance Manual for Current Part B Providers April 12, 2013
  • Appendix A (pdf*) - Reports
  • Appendix B (pdf*) - Service Sharing
  • CAREWare trainings
    • Part B Intro training (pdf*)
    • CAREWare update, Feb. 2012 (pdf*)
    • Data Entry Rules, Oct. 2012 (pdf*)

• Standard Reports Details
  • Agency Quarterly Report (word*)
    • All reports are due 30 days after the end of the quarter - 7/30/13, 10/30/13, 1/30/14, and 4/30/14
  • Quarterly Record Review Summary (excel*)
  • Individual Record Review (excel*)
    • Record Review Summaries are due 30 days after the end of the quarter - 7/30/13, 10/30/13, 1/30/14, and 4/30/14
  • Quarterly Financial Report (excel*)
    • All reports are due 30 days after the end of the quarter - July 30, October 30, January 30 - with the exception of the final, year end report, which is due 45 days after the end of the contract year - May 15. A budget projection for 4th quarter must accompany the submission of 3rd quarter fiscal report.
  • Agreement Closeout Report (excel*)
    • A financial settlement that reconciles total Department agreement payments issued to the provider to the total amount of Department agreement funds earned by the provider. The Report shall correspond to the Rider F-1 Agreement Settlement Form (ASF) Pro Forma - Budget and the settlement method entered in the Rider F-2 Agreement Compliance Section of the agreement.

• Training Details
  1. Ryan White Review Training, 3/29/13 (pdf*)
  2. Case Manager Training, 3/28/12 (pdf*)
  3. New Case Manager Curriculum
     1. Services and Paperwork (pdf*)
     2. Adherence and Prevention (pdf*)
     3. Information Sharing & Confidentiality (pdf*)
     4. Other Resources (pdf*)
     5. Contract Riders (pdf*)