Sustainability Strategies

There are several different strategies for sustaining HIV/AIDS prevention and treatment programs.

Federal Funding

Many HIV/AIDS programs in rural communities receive federal funding. The categories for domestic HIV funding are healthcare services and treatment for people living with HIV/AIDS, cash and housing assistance for individuals with disabilities living with HIV, prevention, and research (primarily carried out by the National Institutes of Health).

Funding is distributed across multiple federal agencies, each with its own purpose. These include the U.S. Department of Health and Human Services, U.S. Department of Housing and Urban Development, U.S. Department of Justice, U.S. Department of Veterans Affairs, and U.S. Department of Defense. A summary of mandatory and discretionary funding for HIV/AIDS is available by agency.

The Ryan White HIV/AIDS Program is a critical federal program that funds healthcare and support services for people living with HIV/AIDS. For more information about this program, please see the Ryan White HIV/AIDS Program in Module 1.

Medicare and Medicaid are large payers of HIV care in the United States. Most people with HIV/AIDS who qualify for Medicaid have low incomes and a permanent disability. Medicare is also an important payer for people living with HIV/AIDS — including people living with HIV/AIDS who are 65 years of age and older and people under age 65 who have a permanent disability and receive Social Security Disability Insurance. Social Security Disability Insurance and Supplemental Security Income are two programs available for people who are unable to work because of HIV/AIDS. The Affordable Care Act has expanded access to care for people at risk for and living with HIV/AIDS.

Reimbursement

Rural HIV/AIDS programs may be able to seek reimbursement from insurance providers for services such as telehealth. Telehealth can facilitate access to HIV care specialists in rural areas. Laws on reimbursement for telehealth services vary by state.

Foundations

Funding from philanthropic organizations can also be used to sustain rural HIV/AIDS programs. Grants for HIV/AIDS prevention and treatment generally last only a few years, which can make it difficult to continue a successful program after the end of the grant period. Foundations funding domestic HIV/AIDS programs or rural health programs include:

• Elton John AIDS Foundation
• Ford Foundation
• Elizabeth Taylor AIDS Foundation
• Comer Family Foundation - Syringe Service Program
• Levi Strauss Foundation

Partnerships

Rural HIV/AIDS programs are leveraging their funding and increasing sustainability of their services by collaborating with local partners like health departments and community-based organizations. Partner organizations can contribute funding, time, staff/volunteers, or space for meetings and classes.

Organizations that Fund Rural HIV/AIDS Programs

Specific examples of organizations that have funded HIV/AIDS programs and services are listed below.

• Funding from private corporations or their philanthropic arm:
  • Kaiser Permanente
• Funding from HIV/AIDS-focused organizations:
  • AIDS United
  • Broadway Cares/Equity Fights AIDS
  • Design Industries Foundation Fighting AIDS
• Funding from federal agencies:
  • The Centers for Disease Control and Prevention maintains a list of funding opportunities available for organizations supporting HIV/AIDS-related work.
  • The U.S. Department of Housing and Urban Development offers funding to communities and nonprofit organizations in support of housing opportunities for people living with HIV/AIDS.
  • The Health Resource & Services Administration administers the Ryan White CARE Act, which provides HIV/AIDS care and support for those who are low-income or have insufficient health insurance coverage.
• State departments of human services and departments of health may offer funding for all or part of the program once its value has been demonstrated during the initial grant.
• Private insurance may also cover HIV screenings for people at an increased risk of contracting the virus.

The Rural Community Health Toolkit provides information about general Sustainability Strategies. In addition, the Rural Health Information Hub provides a list of active and inactive funding opportunities related to HIV/AIDS.

Resources to Learn More

NNED Funding Opportunities
Website
A regularly updated listing of grants and funding opportunities for behavioral health, equity, HIV/AIDS, mental health, social justice, and substance use programs. Categorizes funding by focus area, source of funding, population, and funding amount.
Organization(s): National Network to Eliminate Disparities in Behavioral Health (NNED)