Section 3: Comorbidity
The Reauthorized CARE Act of 2000 provides additional guidance on how
HRSA’s HIV/AIDS Bureau is to consider the severe-need factor in
distributing Title I supplemental grant funds among Title I EMAs. The
Manager’s Statement, which accompanies the CARE Act Amendments of 2000,
defines areas most in need of Title I funding as having “the greatest or
expanding public health challenges in confronting the epidemic.”
In setting service priorities and allocating CARE Act funding, Title
I planning groups are required to consider epidemiologic data on
comorbid conditions. They must especially consider how these conditions
may increase the cost and complexity of delivering HIV/AIDS primary
medical care and support services to PLWH in the EMA.
A useful epidemiologic profile provides information on HIV/AIDS
prevalence among populations identified by a comorbid condition, such as
STDs, hepatitis B or C, TB, substance use, or severe mental illness. It
will also be important to provide information on increases or decreases
in comorbid conditions among PLWH in the HIV/AIDS care system. When
possible, match the cost of comorbidities with the HIV/AIDS population
data to document the additional treatment costs.
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