Incorporation and Implementation of PHS Guidelines

Below are examples of HCFA efforts to incorporate and implement PHS guidelines:

  • In March 1994, less than a month after ACTG 076 results were published, HCFA sent a letter to its regional AIDS coordinators informating them of the study results and recommending improved outreach to pregnant women so that they can be evaluated and offered ZDV as early in the pregnancy as possible.
  • In a July 1994 "Medicaid Letter," HCFA conveyed its policy of providing an enhanced federal match of 90% for HIV testing and counseling claimed as a family planning service.
  • In March 1998, HCFA sent a notice to state Medicaid agencies and welfare offices informing these agencies about Ryan White CARE Act provisions relating to counseling and testing of pregnant women for HIV/AIDS. The notice urged Medicaid agencies to work closely with Ryan White grantees to assure optimal counseling and testing.
  • In May 1996, HCFA conducted a survey of regional AIDS coordinators that looked at: state laws addressing HIV counseling and testing of pregnant women; access to HIV testing, counseling and treatment in the state; the nature of HIV provisions in Medicaid managed care contracts; and state Medicaid agency collaboration with other state agencies, providers, and consumers in implementing PHS guidelines. One of the goals of this survey was to help raise awareness of the role of state Medicaid agencies in promoting the PHS guidelines and the need to work with others in the state toward this end.
  • Finally, HCFA also has undertaken a consumer information program (CIP), which started with a four-state pilot in January 1996. In its CIP, HCFA has focused on (1) developing informational materials to alert Medicaid-eligible HIV-infected women, pregnant women, and women of childbearing age to the benefits and implications of ZDV therapy; (2) assisting women in making an informed decision about ZDV therapy and (3) informing women that they may be eligible for Medicaid, which covers this treatment. As part of the campaign, HCFA has developed and disseminated consumer information materials in several languages, including posters, videos, and brochures. A preliminary evaluation of the campaign has been undertaken in the pilot states and results are being analyzed.

Patient Perspectives

Laquitta Bowers and Kay Armstrong provided preliminary findings from focus groups they are conducting as part of the AIDS Policy Center for Children, Youth and Families (APCCYF) study on HIV testing of pregnant women and newborns. Joseph Kelly provided an update on a review of state efforts. Rebecca Denison provided her perspective as an HIV-positive woman.

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