CAEAR Coalition




	Press Releases July 7, 1999 FOR IMMEDIATE RELEASE Congress Must Reauthorize the Ryan White CARE Act to Meet the Growing Needs of Low Income, Uninsured and Underinsured People Living with HIV/AIDS Consensus Position Paper from Leading AIDS Coalition Lays Foundation for Legislative Process The services provided through the federal Ryan White CARE Act are crucial to the health and living conditions of people with HIV/AIDS throughout the U.S. and Congress must maintain the program's structure and emphasis on local control to ensure its continued success, according to a position paper released today by the Cities Advocating Emergency AIDS Relief (CAEAR) Coalition. The paper represents input from hundreds of individuals and organizations throughout the U.S, including people with HIV/AIDS, community leaders, public health departments, community health clinics, and AIDS service organizations, and offers consensus on a number of important policy issues that will be faced by Congress during reauthorization of the CARE Act. "The CARE Act is truly how America responds to AIDS and next year's reauthorization is the best opportunity the nation has to recommit itself to providing people with HIV and AIDS with services that will extend and improve their lives," said Matthew McClain, Chair of the CAEAR Executive Committee. An estimated 600,000-900,000 individuals are living with HIV/AIDS in the U.S. and, after the Medicaid program, the CARE Act represents the single largest federal investment in the care and treatment of people with HIV/AIDS. Title I of the CARE Act provides emergency assistance to the 51 communities hardest hit by the HIV epidemic and Title III provides direct funding to 181 community-based and public health centers in 43 states, the District of Columbia and Puerto Rico. Two-thirds of those served through Titles I and III are people of color. The CARE Act was first passed by Congress in 1990 and reauthorized in 1996 for five years through September 30, 2000. "This paper reflects the real world experiences of hundreds of people living and working on the frontlines and the recommendations, if implemented, will make the CARE Act even more effective and efficient in delivering meaningful services to those in greatest need," said McClain. Key coalition positions regarding CARE Act reauthorization include support for: Updating the formula for distributing CARE Act Title I Funds: Title I funds should be disseminated according to the Centers for Disease Control's (CDC) living AIDS case data report, replacing the current "10-year weighted AIDS case band." In moving to this new formula, dramatic shifts in funding should be avoided by the retention of a hold harmless provision. The Coalition supports doubling the 1% per year limit on formula reductions to 2% per year for a maximum of 10% over five years. Maintaining the 50/50 funding ratio for Title I formula and supplemental grants: This funding breakdown guarantees that funding will reach both those areas most heavily impacted by the AIDS epidemic and those areas using Title I funding in the most creative and efficient manner and facing particularly severe needs. Providing a sufficient fiscal authorization to assure that HIV primary care providers meet the minimum standard of care: The U.S. Public Health Service guidelines on HIV care and the prophylaxis of opportunistic infections should be used as a minimum standard for medical care and treatment provided by CARE Act funded providers. Maintaining strong local control of spending priorities: The identification of a core set of services is by definition an outgrowth of good local planning. Services should not be mandated from the federal level with set-asides or limits for particular services. Title I has a long-standing commitment to prioritizing for HIV health care and increasing access to HIV services. Title I areas regularly allocate over 60 percent of their funding to health care services including medications; Title III, mandated to allocate at least 50% of funds to health care services, actually allocates 74% of funding for health care and medications. Continuing direct grants to public and community-based health centers through Title III: Title III grants improve access to HIV early intervention medical and related supportive care-with special emphasis on underserved and geographically isolated communities. Increasingly Title III grants are targeted outside of urban areas-focusing on geographically isolated communities that have been traditionally underserved. Instituting a formal approach to addressing disparate health outcomes: The Secretary of Health and Human Services should be directed by congress to evaluate the success of grantees in identifying health outcome disparities and implementing plans to address them, and beginning in fiscal year 2003, use such evaluation as one measure in determining Title I supplemental awards and Title III grants. Altering Title III Administrative caps: The administrative cap for the directly funded Title III programs should be increased to 10% from their current level of 7.5% to correspond to the similar 10% cap on individual contractors in Title I. CAEAR is a national coalition that advocates for sound public health policies and resources related to the critical health care and supportive service needs of people living with HIV disease in the United States. The Coalition is a national representative organization focusing on the needs of individuals and programs dependent on resources from Title I and Title III of the CARE Act. An overview of the policy positions is attached and the full text of the position paper is available at: http://www.hivdent.org/publicp/caearc/ppfinv10699.htm
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