Ryan White HIV/AIDS Treatment Extension Act of 2009, Minn. Stat. §256.9365

Minor child: For the purposes of this page, “minor child” is a person younger than age 18 who is a biological child, step child, adopted child, foster child or other child for whom the person (or their legal spouse) is a legal guardian.

Legal dependent: For the purposes of this page, “legal dependent” refers to a person older than age 18 but younger than age 24 who is a full-time student and is claimed as a dependent for the person’s taxes.

The Ryan White HIV/AIDS Treatment Extension Act of 2009 codifies a variety of core medical and support services provided to eligible people with HIV. The Minnesota Department of Human Services (DHS) directly administers Ryan White program services for eligible people with HIV under Program HH.

Program HH provides access to crucial medications and care services for people with HIV in Minnesota. It includes:

To be eligible for Program HH, a person must complete an application and provide documents proving they:

A person must provide complete and accurate information on required application forms. They may be ineligible for Program HH if they refuse to provide information, withhold information or provide false information. For more information about the application process, refer to Program HH Policy Manual – Application process.

Acceptable HIV status documentation for Program HH include any of the following:

Note: Undetectable viral load tests are not proof of HIV.

Household size is a factor in determining household income, as it relates to FPG. People count toward household size as follows.

Adult applicants

For adults (i.e., people age 18 and older), Program HH counts the following people toward their household size:

Other tax dependents not named in the list above are not included in household size.

If the person has children younger than age 18 or for whom the person pays child support, the person has the option to take a deduction on child support payments made or count the number of dependents as part of their household.

Minor applicants

For minors (i.e., people younger than age 18), Program HH counts the following people toward household size:

Note about other household members

Additional information about other household members may be needed for insurance assessment purposes, related to federal Affordable Cares Act (ACA) rules.

To be eligible for Program HH, a person cannot have a household income that exceeds 400% of the FPG. Earned and/or unearned income received by any of the following people is counted toward overall household income.

Adult applicants

For adults (i.e., people age 18 and older), Program HH counts the following as household income:

The following income does not count toward the overall household income for adults.

Minor applicants

For minors (i.e., people younger than age 18), Program HH counts the following as household income:

A parent, guardian or case worker assigned to the person should reach out to Program HH staff if there are concerns about HIV disclosure, violating minor consent law (as described on Minnesota Department of Health – Consent and confidentiality laws in Minnesota) or other circumstances that impact the ability to provide proof of eligibility documentation.

Note about other household members

Additional income information about other household members may be needed for insurance assessment purposes, related to federal ACA rules.

Household income and size are used to determine the person’s income as it relates to the FPG, which is updated annually by Feb. 1. Only people with incomes at or below 400% of the FPG are eligible for Program HH.

People who are employed

People applying for Program HH who earn wages through employment must calculate their annual income using the following method:

1. Add together the gross income from all pay stubs received in the last 30 days.

2. Divide the result from step 1 by the number of pay stubs to get the average.

3. Multiply the result from step 2 by the number of times the person is paid in a year:

If the most recent 30 days of income is unusually high or low for some reason, or if the person believes it is not a fair representation of their normal income, they may use the year-to-date weekly/biweekly/semi-monthly gross average instead (if they know the start date of employment).

If the person is employed seasonally, with or without unemployment compensation in the off season, the person may use their most recently filed federal 1040 tax return if it is for a full year.

People who receive pensions, SSDI, SSI and/or public assistance

People applying for Program HH who receive monthly income from sources such as pensions, SSDI, SSI and/or public assistance must calculate their annual income by multiplying the monthly amount by 12.

People who receive unearned income on behalf of a minor child

People applying for Program HH who receive monthly income from SSDI, SSI, child support and/or survivor’s benefits on behalf of a minor child must calculate the minor child’s annual income by multiplying the monthly amount by 12.

People who receive unemployment or worker’s compensation

People applying for Program HH who receive unemployment and/or worker’s compensation must calculate their annual income by multiplying the amount received by the frequency received:

People who are self employed

People applying for Program HH who receive income from a business they own must submit their most recent federal 1040 tax filings and all related schedules if they have a prior year of self-employment income and have filed taxes.

If a person is reporting new self-employment and has not filed federal taxes yet, they should provide a statement of income and expenses from the date the business started (or at least six months if they have it). In this situation, a person can contact Program HH staff to obtain a self-employment worksheet for their use by calling the Program HH Customer Care Line at 651-431-2398 or by emailing Program HH at dhs.programhh@state.mn.us.

Note about income

To avoid errors in calculations or delays caused by the need to request more information, the person applying for Program HH should:

Program HH Policy Manual – Sources of income and acceptable verification documents identifies countable sources of household income and acceptable income verification documents.

Finances not counted as income for Program HH include:

1. Money from the sale of an asset (e.g., house or car).

2. Money received from:

People with no income must document how they receive financial support on the application or change form (in the applicable section/question) or in a separate signed statement. The individual/organization that supports the person (i.e., the individual/organization giving the person money) also may provide a written statement.

People must live in Minnesota to be eligible for Program HH. Any of the following documents are acceptable to prove Minnesota residence:

The documents listed above will only be accepted as proof of residency if they:

If a person does not reside in Minnesota, Program HH staff will deny the application.

If a person fails to submit documents proving Minnesota residency with the application, Program HH staff will send written notification requesting the documents. The person has 30 days from the date of the letter to submit the documents. Once Program HH staff receives the verification, they will approve the application. If Program HH staff does not receive the verification within 30 days, the person will be denied or terminated from the program. The person may reapply at any time.

People in prison are not eligible for Program HH because the Minnesota Department of Corrections/county jail provides health services, including prescription medications.

People in prison who are within six months of their scheduled release date may submit a Program HH application. These people are also eligible for medical case management services. At the time of application, the person may provide a statement from the prison or jail to verify Minnesota residence. The person will be required to provide documents proving Minnesota residence (refer to verification of Minnesota residency section) at their next annual renewal submission.

Program HH is an outpatient program. This means Program HH cannot pay for formulary medications when a person is admitted to a hospital, rehabilitation hospital or long-term care hospital.

If a person is admitted to a skilled nursing facility (SNF) and receives skilled nursing care (i.e., around-the-clock care from nurses), Program HH considers this care “inpatient care” and will not provide medication assistance. In this situation, if the person is on Medicare, Medicare is responsible for the cost of inpatient medications.

Exception

If a person lives in a Housing Support or Housing With Services (HWS) establishment in which they are responsible for medical decisions and medication management, Program HH will cover the cost of formulary medications, as long as a Minnesota Health Care Programs (MHCP)-enrolled pharmacy dispenses the medications. As with any other person receiving Program HH, if the person has health insurance with prescription drug coverage, the insurance pays first and Program HH provides secondary coverage.

People who submit a Program HH application and meet all of the eligibility requirements are eligible for Program HH beginning the first day of the month all application requirements are met and received by Program HH staff. Program HH staff may approve a 90-day backdate if the person requests coverage for previously dispensed medications and other Program HH services listed in the overview section.

Termination

People may be terminated from Program HH at any time due to: