The Health Resources and Services Administration (HRSA) is one of eight agencies in the U.S. Department of Health and Human Services. Within HRSA four bureaus provide funding for the delivery of HIV/AIDS care, services (including case management), and training - the Bureau of Health Resources Development (BHRD), Bureau of Primary Health Care (BPHC), Bureau of Maternal and Child Health (MCHB), and Bureau of Health Professions (BHPr).

Each of the four HRSA bureaus conducts programs to benefit low-income, uninsured, and underinsured individuals and families affected by HIV/AIDS through the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. HRSA's AIDS Program Office (1) provides direction; (2) coordinates HIV/AIDS health care-related activities across the bureaus; and (3) works with other federal and state agencies, providers, and constituent groups to identify emerging issues and needs and to facilitate integrated, client-oriented HIV/AIDS services.

Signed into law on August 18, 1990, the Ryan White CARE Act was named after the Indiana teenager, Ryan White, who became an active public educator on HIV/AIDS after he contracted the disease. He died that same year. The act, which was amended in May 1996, provides assistance to improve the quality and availability of care for people with HIV/AIDS and their families.

HRSA administers HIV/AIDS programs under four titles and Part F of the act, which are described as follows:

Title I - HIV Emergency Relief Grant Program for Eligible Metropolitan Areas Title I is administered by BHRD's Division of HIV Services. This program provides formula and supplemental grants to Eligible Metropolitan Areas (EMAs) that are disproportionately affected by the HIV epidemic. For an area to be eligible, it must have a population of 500,000 or more and have reported more than 2,000 AIDS cases in the preceding 5 years.

Title II - HIV Care Grants to States Title II is also administered by BHRD's Division of HIV Services and provides formula grants to states, U.S. territories, the District of Columbia, and Puerto Rico to provide health care and support services for people with HIV/AIDS. Grants are awarded based on (1) the estimated number of living AIDS cases in the state or territory; and (2) the estimated number of living AIDS cases within the state or territory but outside of Title I EMAs (that is, outside an area with 500,000+ population and 2,000+ AIDS cases/previous 5 years). Additionally, grantees must provide therapeutics to treat HIV/AIDS under the AIDS Drug Assistance Program (ADAP).

Title III(b) - HIV Early Intervention Services BPHC's Division of Programs for Special Populations administers Title III(b) of the act through the Early Intervention Services Program. This program supports outpatient HIV early intervention services for low-income, medically underserved people in existing primary care systems. Medical, educational, and psychosocial services are designed to prevent the further spread of HIV/AIDS, delay the onset of illness, facilitate access to services, and provide psychosocial support to people with HIV/AIDS.

Title IV - Coordinated HIV Services and Access to Research for Children, Youth, Women, and Families Title IV is a special grant program directed by MCHB to coordinate HIV services and access to research for children, youth, women, and families in a comprehensive, community-based, family-centered system of care.

Part F - Special Projects of National Significance Program BHRD's Office of Science and Epidemiology administers the Special Projects of National Significance (SPNS) Program to support the development of innovative models of HIV/AIDS care. These models are designed to address special care needs of individuals with HIV/AIDS in minority and hard-to-reach populations. Additionally, they are expected to be replicable and have a strong evaluation component. Integrated service delivery models were funded in Fiscal Year 1996 to create formal linkages to integrate health and support services.

Part F - AIDS Education and Training Centers Fifteen AIDS Education and Training Centers (AETCs) have been established under BHPr. The AETCs are a national network of centers that conduct targeted, multidisciplinary education and training programs for health care providers in designated geographic areas. The AETCs increase the number of health care providers who are educated and motivated to counsel, diagnose, treat, and manage care for individuals with HIV/AIDS and to help prevent high risk behaviors that may lead to further HIV transmission.

Part F - AIDS Dental Reimbursement Program BHPr also administers the AIDS Dental Reimbursement Program. This grant program assists accredited dental schools and post-doctoral dental programs with uncompensated costs incurred in providing oral health treatment to HIV-positive patients.

For additional information on the Ryan White CARE Act, contact

HRSA AIDS Program Office
5600 Fishers Lane, Room 14A-21
Rockville, MD 20857
Phone: 301-443-4588
Fax: 301-443-1551