All applicants to the Ryan White Part C and D Programs must meet the following requirements. Patients eligible for Part D include women, infants, children and youth under age 24, as well as affected family members of HIV+ persons.

Be HIV positive

 Provide complete name-linked verification of HIV+ status within 30 days of initial intake using one of the following:

  • Positive Western blot result
  • Signed and dated written statement from a medical care provider (please use the medical documentation form)
  • A counseling and testing provider may sign and verify HIV status
  • A discharge summary or other hospital record that verifies diagnosis
  • Medicaid or Social Security documentation that verifies status

Provide verification of one full year of household income


  • Pay stubs that represent a full year of income

  • Most recent W-2 form
  • Award letter from Social Security Disability/Supplemental Security Income
  • Check stub from Social Security Disability/Supplemental Security Income
  • Signed statement of no income (for applicants who report having no income)
  • If applicant has zero income, he-she must report how needs of daily living are being met

Proof of Kentucky residency

Proof of residency by bringing one of the following:

  • valid KY driver's license or state ID card
  • copy of signed lease agreement
  • current utility bill
  • statement from person providing room and board

Sign and date the Informed Participation Agreement Form

Provide sufficient factual information to complete the initial intake and assessment form within 30 days of initial interview

Provide documentation of health insurance, if applicable