A Guide to Fiscal Year 1991 Federal Funding for HIV Disease: How Dollars are Spent How to Access Them

treatment activities with community/migrant health
centers, including: prevention, treatment, on-going
primary care, surveillance of risk and serologic
status, education, intensive support for risk reduction, and case management.
HRSA/NIDA Demonstration Program. HRSA
and NIDA award financial assistance to organizations
and state and local agencies to improve access and
increase effectiveness of drug abuse treatment for
populations most at-risk for acquiring or spreading
HIV through intravenous drug abuse, sexual
behavior or conditions surrounding birth. This program integrates community-based primary health
care with drug abuse treatment.
Drug Reimbursement Program. This program
provides money to states to reimburse low-income
patients for FDA-approved drugs determined to prolong life or prevent serious deterioration of health
arising from AIDS/HIV not covered by Medicare,
Medicaid or private insurance. States determine individual eligibility for the program.
Home and Community-Based Health Services. Under the authority of Public Law 100-607, formula grants have been awarded to states, territories,
and Indian tribes and tribal organizations to help provide home health services to chronically dependent
and medically dependent low-income HIV-infected
individuals. The award formula was based on the
number of AIDS cases reported to the CDC in each
state and the ratio of state to national per capita
income. Funds were used to cover services defined
in written plans of care established by health-care
professionals; coordination of services with other
health services provided by public and private entities; and to identify eligible individuals.
Education and Training Centers. The AIDS
Education and Training Center (ETC) Program
awards funds to develop centers to train health-care
personnel to counsel, diagnose and provide case
management for AIDS/HIV patients and their
families. Centers train local primary-care providers

to incorporate AIDS/HIV treatment and prevention-including substance abuse initiatives-into
clinical priorities; train community/migrant health
center personnel; and provide case management and
home care training and other means of offering continuity of care for persons with AIDS/HIV. Since FY
'89, 15 ETCs have been established to serve areas
of high AIDS-case incidence and populations at high
risk for HIV infection. ETCs collaborate with the
NIAID and the FDA in community-based clinical
trials for HIV-infected persons.
Curriculum Additions in Health Professions
Training Programs. The BHPr sponsors ongoing
health professions training grant programs that have:
encouraged curricula to include HIV infection topics;
highlighted ways to improve public-health education
and practice; established linkages between education
programs and public health agencies; and encouraged
collaboration between public health education programs and public health agencies working toward
achieving the goals identified in Promoting Health/
Preventing Disease: Year 2000 Objectives for the
Nation. HRSA personnel have collaborated with
other Federal agencies, professional associations and
organizations on training efforts. A contract effort
titled HIV/AIDS Training Curriculum for Administrators of Health Care Facilities is underway under
this initiative, intended for use by HRSA ETCs.
Enactment of the Comprehensive AIDS Resources
Emergency (CARE or Ryan White) Act in late 1990
impacted HRSA's programs directly, providing funding for specific programs just discussed by incorporating them into the specific initiatives of Title I,
Title II, and Title III. The net effect was an increase
in overall funding, with ongoing programs being
assured priority although somewhat reconfigured as
to program title and funding source. The following
comparison of HRSA FY '90 and FY '91 HIV budgets
will illustrate these adjustments:

HRSA HIV FUNDING

FY '90

FY 91

Education Training Centers (ETCs) $ 13,932,000
Community Health Care Services 10,318,000
HIV Health Service Grants 16,476,000
Pediatric Health Care Demonstrations 14,171,000
Formula Grants to States 18,900,000
AIDS Drug Reimbursement 28,347,000
AIDS Facilities Renovation Grants 4,155,000
Sub-acute Care 1,418,000
Emergency Assistance-Title I -0 -Comprehensive Care Program-Title II -0 -Early Intervention- Title III -0 -TOTALS $ 107,717,000
*This total provided by HRSA is a variance of $4,786,000 from the total used by DHHS.

$ 17,029,000
-0 --0 -19,518,000
-0 --0 -4,029,000
-0 -87,831,000
87,831,000
44,891,000
$ 261,129,000*

58

Reproduction By Permission Only

~1991 ASAP

58 Reproduction By Permission Only ~1991 ASAP