Health Quality Partners of Southern California

Ryan White

Ryan White HIV & AIDS Treatment Extension Act Specialty Pools

Health Quality Partners contracts with the San Diego County Health & Human Services Agency HIV STD & Hepatitis Branch to administer the Ryan White HIV & AIDS Treatment Extension Act Specialty Pools. 

The RW Specialty Pools were developed to provide specialty care services to HIV-positive individuals who have no other source to cover expenses for these services.


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Services are available from the following three pools:

Medical Specialty Pool

Covers medically necessary, HIV-related, diagnostic, consultative and therapeutic outpatient services.

Dental Specialty Pool

Covers limited dental specialty services.

Home Health/Home Hospice Pool

Covers HIV-related home health care services, including end-of-life care.


Eligibility

Clients who have been screened at the Primary Care clinic and determined to be eligible for RW Primary Care services are eligible for RW Specialty Pools services. Clients must be HIV-positive, and in general have no other coverage that could pay for the services.


Limitations

The Specialty Pools, in general, do to not cover any in-patient, emergency, cosmetic, experimental or primary care services. Also, there are restrictions by pool as follows:

Dental Pool

  • Specialty Pool services are limited to oral surgery.

Home Health/Home Hospice Pool

  • Length and amount of services should be determined by an assessment done by an intake nurse or other authorized staff at the home health/home hospice agency and coordinated with the referring party (usually the patient’s case manager).
  • Authorizations are issued to cover one month at a time.
  • Infusion services done in home are covered.  The medication is included if not covered by another funding source. Infusion services done in a clinical setting are also allowed, but should be covered by the Medical Specialty Pool.
  • Durable medical equipment (DME), such as a cane or walker, is allowed.  Also supplies, such as for colostomy care, are allowed if obtained from a supplier of DME.  Other non-DME is not allowed.
  • Requests should not exceed a total of $2,500 per month.


HQP Does Not Cover Medications 

Most oral medications, creams, gels, or lotions not listed on the ADAP or Ryan White Primary Care Program formularies can be obtained by submitting Drug Prior Authorization Requests to AmeriChoice.


For more information on this program, please contact: Carolyn Relac