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HEHS-00-189R 1 (2000-08-24)

handle is hein.gao/gaobaalle0001 and id is 1 raw text is: ~G A 0 Accountabiity I Integry * Reliability United States General Accounting Office Health, Education, and Washington, DC 20548 Human Services Division B-286131 August 24, 2000 The Honorable Tom A. Coburn Vice Chair Subcommittee on Health and Environment Committee on Commerce House of Representatives Subject: Ryan White CARE Act: Title I Funding for San Francisco Dear Mr. Coburn: This letter responds to your request for additional information regarding funding for San Francisco under the Ryan White CARE Act. Specifically, you asked that we compare San Francisco's fiscal year 2000 title I grant award, which was determined using the act's hold-harmless provision,' with what the award would have been had deceased AIDS cases been included in the calculation. You also asked how funding for San Francisco that was based on the inclusion of deceased AIDS cases would have compared with the amount San Francisco would have received if the fiscal year 2 2000 hold-harmless level had been reduced by 25 percent. In brief, San Francisco's fiscal year 2000 title I grant award would have been 26 percent less had both living and deceased AIDS cases been used to calculate the award instead of the current hold-harmless provision. The reason for this result is the substantial decline in newly reported AIDS cases in San Francisco compared with other eligible metropolitan areas (EMA). Therefore, a 25-percent reduction in the current hold-harmless level would have provided San Francisco with funding comparable to what it would have received if title I grants had been calculated on the basis of both deceased and living cases. 1The hold-harmless provision limits the amount that the funding of an eligible metropolitan area may decline from its fiscal year 1995 level. From fiscal year 1996 through fiscal year 2000, eligible metropolitan areas were guaranteed that their funding would not decline more than 5 percent below their fiscal year 1995 level. 2Under H.R. 4807, The Ryan White CARE Act Reauthorization Act for 2000, the hold-harmless level would be reduced by 25 percent over 5 years. GAO/HEHS-00-189R Ryan White CARE Act

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