The intent of all Ryan White HIV/AIDS Program funds is to ensure that eligible HIV-infected
persons gain or maintain access to HIV-related care and treatment. This policy recognizes that
many incarcerated persons will ultimately be the responsibility of the Ryan White HIV/AIDS
Program, so early detection, entry into care, and access to and continuity of care are important
reasons to use Ryan White HIV/AIDS Program funds for incarcerated persons who meet the
qualifications specified above.
The purpose of this policy is to provide grantees flexibility in providing necessary, and otherwise
unavailable, transitional primary care and social support services to incarcerated persons in the
custody of a local, State, or Federal correctional system who are either nearing release or
whose incarceration is of short duration. Grantees who want to develop these linkages should
become familiar with local prisons or jails and the State and Federal correctional facilities as
well as the procedures established to prepare inmates for release into the community. These
systems could vary greatly across localities and regions. Grantees should work with the
appropriate corrections administrators to determine what health services are legally expected to
be provided within the correctional system and how, and whether, the correctional system
addresses the discharge planning needs, continuity of treatment, and community linkages for
inmates infected with HIV/AIDS.
We envision grantees who establish transitional social services will link the inmate to HIV/AIDS
care and treatment and transitional primary care services. These services could be provided in
the correctional facility prior to release as part of discharge planning. In the case of a short term
facility, like a local jail, which does not provide discharge planning, services would be outside of
the facility. In either situation, these services are not covered by the correctional system.
Transitional primary care services can also be provided on a short term basis in an outpatient
setting. Working with the correctional system, grantees must determine 1) What the release
date of the inmate is; 2) what health care services are provided by the correctional system; and
3) what services the Ryan White HIV/AIDS Program funds can provide.
There is an important statutory point of reference that defines under what circumstances the
Ryan White HIV/AIDS Program-funds can be used by grantees to provide services for
incarcerated persons. Specifically, the payer of last resort statutory provision found in Sections
2605(a)(6), 2617(b)(7)(F), and 2664(f) of Title XXVI of the Public Health Service Act requires
that funds received under a Ryan White grant award not be utilized to make payments for any
item or service to the extent that payment has been made, or can reasonably be expected to be
made. With respect to such item or service covered under other programs, these include those
covered under any State's compensation program, an insurance policy, or under Federal and
State health benefit program (except for a program administered by or providing the services of
the Indian Health Service). In 1996, the Office of the Inspector General's (OIG) audit of a