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

The following section describes in more detail
HRSA's four bureaus, their overall functions, and
extramural HIV-funding activities.
General information on HRSA's overall AIDS/HIV
activities is available through the HIV Services office
at 301/443-6745.
Bureau of Health
Resources Development
The Bureau of Health Resources Development
(BHRD) oversees three major programs: Health
Facilities, Organ Transplantation, and AIDS
Services.
The Health Facilities program monitors health-care
facility compliance with assurances and/or obligations
resulting from grants and loans, or construction
grants. The program also administers the Housing
and Urban Development section 242 mortgage insurance program of loans to hospitals for construction
projects.
The Organ Transplantation program awards and
manages a grant program for organ procurement
organizations and other nonprofit entities to increase
the number of organ donors in the United States and
encourage public involvement.
BHRD's AIDS/HIV program is responsible for the
AIDS Service Demonstration Projects, AIDS Drug
Reimbursement Program, Home and CommunityBased Health Services Program, and Sub-Acute Care
Demonstration Program already described. In FY '91
new program responsibilities have been added under
Titles I and II of the CARE Act.
The BHRD FY '91 HIV budget is $179,691,000.
FY '91 will be a transition year for the funding of
AIDS programs. FY '90 awards for Service
Demonstration Projects, Sub-Acute Care Demonstrations, and Home and Community-Based Services are
permitted continuation through September 30, 1991;
HRSA will continue to monitor and manage these
programs. A "hold harmless" provision for currently
funded AIDS Service Demonstration and Drug Reimbursement grantees ensures that these projects
receive top priority for future funding at current
levels.
Title I. * Title I of the CARE Act creates formula
and supplemental competitive grants to provide
emergency assistance to metropolitan areas with the
highest levels of reported AIDS cases. Congress ini
tially authorized $275,000,000 for the program in FY

'91, and appropriated $87,831,000 for actual expenditures. Areas eligible for assistance under Title I are
those which, according to CDC's HIV/AIDS
Surveillance Report, report a per capita incidence of.0025 (25 cases per 100,000 persons). The date for
establishing eligibility for FYs '92 to '95 will be March
30 of the previous fiscal year. Thus, areas with CDC
reported incidence of.0025 on March 30, 1991 will
be eligible for FY '92 Title I funding, and so on.
The 16 cities receiving funds in FY '91 are:

Atlanta, Ga.
Boston, Mass.
Chicago, Ill.
Dallas, Tx.
Ft. Lauderdale, Fla.
Jersey City, N.J.
Houston, Tx.
Los Angeles, Calif.

Miami, Fla.
Newark, N.J.
New York, N.Y.
Philadelphia, Pa.
San Diego, Calif.
San Francisco, Calif.
San Juan, Puerto Rico
Washington, D.C.

Funds are provided to the "chief elected official of
the city or urban county that administers the public
health agency that provides outpatient and ambulatory services to the greatest number of individuals
with AIDS." Based on a formula, one-half of monies
appropriated for Title I were to be distributed to each
eligible area within 90 days of the FY '91 appropriation (this timeline is reduced to 60 days in FY '92 to
FY '95). The balance of the funds are available to
eligible areas as competitive supplemental grants
within 150 days of an appropriation. Funding decisions for the supplemental awards are made on the
basis of: distribution of funds and plans for use of
formula-awarded monies; the need for additional
funds; the commitment of local financial and in-kind
resources; the ability to disperse supplemental funds
quickly and efficiently; and use of funds commensurate with local demographic incidence of AIDS,
including allocation for services for infants, children,
women and families with HIV disease.
To receive funds under this initiative, the local
official must adhere to guidelines and stipulations,
including: an application submitted within a specified
time from the announcement of funds availability;
establishment of an intergovernmental mechanism
for allocating funds; assurance that funds will supplement, not replace, funds already allocated for
HIV; establishment of a Health Services Planning
Council to oversee programs; and assurance that the
plan established by the Health Services Planning
Council will be followed.
Funds under Title I may be used to: enhance or
deliver outpatient and ambulatory health and support
services, including case management and comprehensive treatment services; and provide inpatient
services which prevent unnecessary hospitaliza
~1991 ASAP

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~1991- ASA RerdcinB Pri3inOl

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