Ryan White CARE Act: Program Changes Affecting Minority AIDS Initiative and Part D Grantees Page: 3 of 11
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Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today as you discuss reauthorization of Ryan
White Comprehensive AIDS Resources Emergency Act of 1990 (CARE
Act) programs and consider the results of some of the changes that were
instituted by the 2006 reauthorization of CARE Act programs. The CARE
Act, administered by the Department of Health and Human Services'
(HHS) Health Resources and Services Administration (HRSA), was
enacted to address the needs of jurisdictions, health care providers, and
people with human immunodeficiency virus/acquired immunodeficiency
syndrome (HIV/AIDS) and their family members.' In December 2006 the
Ryan White HIV/AIDS Treatment Modernization Act of 2006 (RWTMA)
reauthorized CARE Act programs for fiscal years 2007 through 2009.2 Each
year CARE Act programs provide assistance to over 530,000 mostly low
income, underinsured, or uninsured individuals living with HIV/AIDS.
Under the CARE Act, approximately $2.2 billion in grants were made to
states, metropolitan areas, and others in fiscal year 2009.
There are five primary sections of the CARE Act under which HRSA
awards grants-Parts A, B, C, D, and F. Part A provides for grants to
selected metropolitan areas-known as eligible metropolitan areas (EMA)
and transitional grant areas (TGA)-that have been disproportionately
affected by the HIV/AIDS epidemic.3 Part B provides for grants to states
and territories and associated jurisdictions to improve the quality,
availability, and organization of HIV/AIDS services. Part C provides for
grants to public and private nonprofit entities to provide early intervention
services, such as HIV testing and ambulatory care. Part D provides for
grants to organizations for family-centered medical and support services
'Pub. L. No. 101-381, 104 Stat. 576 (codified as amended at 42 U.S.C. 300ff through 300ff-
121). The 1990 CARE Act added Title XXVI to the Public Health Service Act. Unless
otherwise indicated, references to the CARE Act are to the current Title XXVI.
2Pub. L. No. 109-415, 120 Stat. 2767. The CARE Act programs had previously been
reauthorized by the Ryan White CARE Act Amendments of 1996 (Pub. L. No. 104-146, 110
Stat. 1346) and the Ryan White CARE Act Amendments of 2000 (Pub. L. No. 106-345, 114
3An EMA is a metropolitan area with a population of 50,000 or more that had more than
2,000 AIDS cases reported in the most recent 5-year period. The 2,000 AIDS cases criterion
does not include cases of HIV that have not progressed to AIDS. RWTMA created a new
program for TGAs. A TGA is a metropolitan area with a population of 50,000 or more,
which had 1,000 to 1,999 AIDS cases reported in the most recent 5-year period. In fiscal
year 2007, there were 22 EMAs and 34 TGAs according to HRSA.
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United States. Government Accountability Office. Ryan White CARE Act: Program Changes Affecting Minority AIDS Initiative and Part D Grantees, text, September 9, 2009; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc295014/m1/3/: accessed April 21, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.