Spreadsheet: 23541807-9014-4922-a195-6d8a4953d6e4
Sheet: Sheet1

Orange County Ryan White Services  Requirements to be eligible and qualify for services as of January 1, 2014 (Updated 03/25/14) | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9
(Available at: http://ochealthinfo.com/phs/about/dcepi/hiv/service/docs)
Eligibility must be screened at a minimum every six months unless otherwise specified in contract/scope of work.
[NAME] must be the payer of last resort, clients must not have other sources of insurance or funding for service.
 |  | Requirements to be [NAME] |  |  | Service Qualification Requirements
Priority FY14 | Service Category | Proof of HIV | Proof of Orange County Residency | Proof of Medical Insurance | Disability Requirement | Income Restrictions | Case Management Requirement | Other | Service Provider(s)
 |  | Must be verified via ARIES Eligibility [NAME] | Must be verified via ARIES Eligibility [NAME] | Must be verified via ARIES Insurance Tab | If applicable, must be verified by service provider | If applicable, must be verified via ARIES [NAME] | if applicable, must be verified by service provider | If applicable, service provider must screen for prior resources before providing services
1 | Outpatient/Ambulatory Medical Care
 | Outpatient/Ambulatory Medical Care | Yes | Yes | Yes | No | No | No | AltaMed: Part D-funded medical care income restriction is 400% FPL | 17th Street Care Clinic AltaMed Medical Center (Part D-funded)
 | Specialty Services | Yes | Yes | Yes | No | No | No | Authorized by HCA Clinic physician. | 17th Street Care Clinic
2 | Case Management
 | Case Management | Yes | Yes | No | No | No |  |  | AIDS Services Foundation Delhi Center REACH Shanti Orange County
3 | Health Insurance Premium/Cost Sharing
 | Health Insurance Payments | Yes | Yes | No | No | 400% of Federal Poverty Level* | No | Recommended referral through a case manager or health care provider, but not required.   Service provider must screen for OA-HIPP prior to services being rendered. | AIDS Services Foundation
3 | Emergency Financial Assistance (EFA)
 | Medications | Yes | Yes | No | No | 400% of Federal Poverty Level* | No | Recommended referral through a case manager or health care provider, but not required.   Service provider must screen for Emergency assistance under CalWorks prior to services being rendered. | AIDS Services Foundation
4 | Oral Health Care
 | General & Specialty Dental Care | Yes | Yes | Yes | No | No | No | Referral through client's physician or case manager.   Service provider must screen for Medical Services Initiative (MSI) Dental and Private Dental Insurance prior to services being rendered. | 17th Street Dental Clinic Various community providers
5 | Mental Health Services
 | Mental Health Services | Yes | Yes | Yes, Service provider must verify if insurance covers Mental Health Services | No | 300% of Federal Poverty Level* | No | If case managed, referral is required.  Service provider must screen for Medi-Cal and Private Insurance prior to services being rendered. | 17th Street Care Clinic (Psychiatry) AltaMed Medical Center (Part D-funded) AIDS Services Foundation APAIT Health Center Shanti Orange County
8 | Home Health Care
 | Home Health Care | Yes | Yes | Yes | Yes - symptoms impairing ability to carry on normal daily activities | 300% of Federal Poverty Level* | Medical Case Management or recommended Nurse Case Management oversight | If case managed, referral is required.  Service provider must screen for Medi-Cal and Private Insurance prior to services being rendered. | AIDS Services Foundation
9 | Food Bank / Home Delivered Meals
 | Food Pantry | Yes | Yes | No | Yes - any disability | 150% of Federal Poverty Level* | No | Service provider must screen for SNAP (Food Stamps) and Women, Infants, and [NAME] (WIC) prior to services being rendered. | AIDS Services Foundation
 | Home-Delivered Meals | Yes | Yes | No | Yes - homebound due to physical disability and/or unable to independently prepare meals | 150% of Federal Poverty Level* | Must be nurse case managed | Service provider must screen for screen for other Meals programs prior to services being rendered.   Service necessity must be reassessed at minimum quarterly. | Shanti Orange County
10 | Nutritional Supplements
 | Nutritional Supplements | Yes | Yes | No | Yes - any disability | 150% of Federal Poverty Level* | No | Recommended in writing by the client's physician, registered dietitian, or nurse case manager.  Authorization is valid for up to 90 days. | AIDS Services Foundation
11 | Medical Transportation
 | Medical Transportation | Yes | Yes | No | No | 150% of Federal Poverty Level* | No | Transportation only for core medical services  related to HIV.  Taxi rides for medical services only.   Client must meet OCTA eligibility requirements to receive reduced fare bus passes and ACCESS fare coupons. | AIDS Services Foundation REACH
13 | Legal Services
 | Legal Services | Yes | Yes | No | No | 75% of HUD low income limit** | No | Referrals welcomed, but not required. | Public Law Center
*Federal Poverty Level (FPL) is determined by the U.S. Department of Health and Human Services; these guidelines are available at http://aspe.hhs.gov/poverty/. Based on 2014 Federal Poverty Guidelines, 400% is $46,680, 300% is $35,010, and 150% is $17,505 for a single person household.
**Area median income as determined by U.S. Department of Housing and Urban Development (HUD); these limits are available at http://www.hcd.ca.gov/hpd/hrc/rep/state/incNote.html.  Based on 2014 HUD income limits, the low income limit ("80%") is $50,600 for a single person household and 75% of the low income limit is $37,950.  The very low income limit ("50%") is $31,650 for a single person household; based on the very low income limit, 35% of area median income is $22,155; and 20% of area median income is $12,660 for a single person in Orange County.