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GAO-08-137R 1 (2007-10-05)

handle is hein.gao/gaocrptavpf0001 and id is 1 raw text is: Sai Accountability * Integrity * Reliability United States Government Accountability Office Washington, DC 20548 October 5, 2007 Congressional Requesters Subject: Ryan White Care Act: Impact of Legislative Funding Proposal on Urban Areas The Ryan White Comprehensive AIDS Resources Emergency Act of 1990 (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 reauthorized CARE Act programs for fiscal years 2007 through 2009.2 In July 2007, the House of Representatives passed H.R. 3043, the Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act for fiscal year 2008, which contains a hold-harmless provision covering funding for urban areas that receive funding under the CARE Act.3 This bill has not been passed by the Senate. Under the CARE Act, funding for Eligible Metropolitan Areas (EMA) and Transitional Grant Areas (TGA) is primarily provided through three categories of grants:4 (1) formula grants that are awarded based on the case counts of people with HIV/AIDS living in an urban area; (2) supplemental grants that are awarded on a competitive basis based on an urban area's demonstration of need, including criteria such as HIV/AIDS prevalence; and (3) Minority AIDS Initiative (MAI) grants, which are supplemental grants awarded on a competitive basis 'Pub. L. No. 101-381, 104 Stat. 576 (codified as amended at 42 U.S.C. §§ 300ff through 300ff-121). Unless otherwise indicated, references to the CARE Act refer to current law. 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 Stat. 1319). 3H.R. 3043, 110th Cong. (2007). For purposes of this report, unless otherwise specified we use the term H.R. 3043 to refer to the bill as passed by the House of Representatives. 4In this report, we use the term urban areas to refer to both EMAs and TGAs. An 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. In fiscal year 2007, there were 22 EMAs. The Modernization Act of 2006 created a new program for TGA. 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. Under this program urban areas that were eligible for EMA funding in fiscal year 2006 but that no longer meet the eligibility criteria for either EMAs or TGAs maintain their eligibility for funding and are considered TGAs for fiscal year 2007. In fiscal year 2007, there were 34 TGAs. GAO-08-137R Ryan White CARE Act Funding

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