America Living With AIDS

AMERICA Living

The Ryan White Comprehensive
AIDS Resources Emergency
(CARE) Act
The federal government should fund
the Ryan White CARE Act at the fully
authorized level. Creating the authority for federal programs to respond to
the crisis of the HIV epidemic is one
thing-actually providing the dollars
to pay for them is another. While the
Commission commends the Congress
for establishing the Ryan White CARE
Act programs, the Commission is very
concerned about the small amount of
money actually appropriated to implement the programs. Full funding is
required to assure the availability and
success of these desperately needed
programs. The funds for the Ryan
White CARE Act should be new
money and not money shifted from
other federal health and human services programs.
Full funding of the Ryan White
CARE Act would encourage the provision of ambulatory care services to
people with HIV disease by increasing
compensation for outpatient care in
hospitals, migrant and community
health centers, community clinics, and
other entities. This would increase
support for hospitals in areas serving a
disproportionate share of individuals
with HIV disease, but it would also
bolster migrant and community
health centers and community-based
organizations, which currently provide a substantial share of outpatient

care for individuals with HIV disease.
Financial relief for these institutions
will enable them to care better for
underserved and indigent patients.
They are an important last resort for
many uninsured people and for Medicaid patients who have difficulty finding providers willing to accept the
Medicaid reimbursement rates.
This funding is earmarked for outpatient preventive services and clinical
care. These alternative care strategies
have been designed to reduce the number of unnecessary hospital admissions
involving essentially preventable conditions such as Pneumocystis carinii
pneumonia. Such outpatient care, if
integrated into a larger network of services including mental health care,
housing, family services, clinical care,
and hospice care will ensure that
patients receive services appropriate to
their needs as their HIV disease progresses.
INTERIM STEPS TO IMPROVE
ACCESS TO EXPENSIVE DRUGS
There is a precedent for federal assistance with the cost of expensive HIVrelated drugs. Prior to the Ryan White
CARE Act, the federal government
provided discretionary dollars,
through the AIDS Drug Reimbursement Program, to each state to help
pay for AIDS-related drugs. This program was expanded by some states
and now, under the Ryan White CARE
Act, all states and other eligible jurisdictions may use grant funds for this
purpose.
The following interim steps should
also be taken to improve access to

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