Part A of the Ryan White HIV/AIDS Treatment Extension Act of 2009 provides assistance to Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs)—locales that are most severely affected by the HIV/AIDS epidemic.
To qualify for EMA status, an area must have reported at least 2,000 AIDS cases in the most recent 5 years and have a population of at least 50,000. To be eligible for TGA status, an area must have reported 1,000 to 1,999 AIDS cases in the most recent 5 years and have a population of at least 50,000. EMAs and TGAs range in size from one city or county to more than 26 different political entities; some span more than one State. The boundaries of EMAs and TGAs are based on the U.S. Census designation of Metropolitan Statistical Areas.
Grants are awarded to the chief elected official (CEO) of the city or county that provides health-care services to the greatest number of people living with AIDS in the EMA or TGA.
Part A grants to EMAs and TGAs include formula and supplemental components as well as Minority AIDS Initiative (MAI) funds, which supports services targeting minority populations.
Formula grants are based on reported living HIV/AIDS cases as of December 31 in the most recent calendar year for which data are available.
Supplemental grants are awarded competitively on the basis of demonstrated need and other criteria.
MAI funding is awarded using a formula that is based on the distribution of living HIV/AIDS cases among racial and ethnic minorities.
Part A funds may be used to provide a continuum of care (i.e., medical and support services) for people living with HIV disease. Core medical services are limited to the following:
Support services must be linked to medical outcomes and may include outreach, medical transportation, linguistic services, respite care for caregivers of people with HIV/AIDS, referrals for health care and other support services, case management, and substance abuse residential services. Grantees are required to spend at least 75 percent of their Part A grant funds allocated for services on core medical services and no more than 25 percent on support services.
Each EMA Planning Council sets HIV/AIDS related service priorities and allocates Part A funds on the basis of the size, demographics, and needs of people living with or affected by HIV, with particular focus on individuals who know their HIV status but are not in care. Planning Councils are required to jointly develop a comprehensive plan with the Part A Grantee for the provision of services; the plan must include strategies for identifying HIV-positive persons not in care and strategies for coordinating services to be funded through existing HIV prevention and substance abuse treatment programs. The 2009 Ryan White HIV/AIDS Treatment Extension Act requires Planning Councils to include in their comprehensive plan a strategy for the identification, diagnosis, and referral to care of all those who are unaware of their HIV status.
Planning Council membership must reflect the local epidemic demographically and include members with specific expertise in health-care planning, housing for the homeless, health care for incarcerated populations, and substance abuse and mental health treatment or members who represent other Ryan White and Federal programs. At least 33 percent of the members must be consumers of Ryan White HIV/AIDS Program services. TGAs are required to use a community planning process; use of Planning Councils is optional.
Part A grants to EMAs and TGAs include formula and supplemental components as well as Minority AIDS Initiative (MAI) funds, which support services targeting minority populations. Formula grants are based on reported living HIV/AIDS cases in the EMA or TGA as of December 31 in the most recent calendar year for which data are available. Supplemental grants are awarded competitively on the basis of demonstrated need and other selective criteria. MAI funding is awarded by formula according to the distribution of living HIV/AIDS cases among racial and ethnic minorities. Approximately $672.5 million was appropriated in FY 2012.
Grants are awarded to the chief elected official (CEO) of the city or county that provides health care services to the greatest number of people living with AIDS in the EMA or TGA.
|Ryan White Program EMAs||Ryan White TGAs|
Ft. Lauderdale, FL
Los Angeles, CA
Nassau Suffolk, NY
New Haven, CT
New Orleans, LA
New York, NY
San Diego, CA
San Francisco, CA
San Juan, PR
Tampa-St. Petersburg, FL
West Palm Beach, FL
Baton Rouge, LA
Ft. Worth, TX
Jersey City, NJ
Kansas City, MO
Las Vegas, NV
Minneapolis-St. Paul, MN
Orange County, CA
Riverside-San Bernardino, CA
San Antonio, TX
San Jose, CA
St. Louis, MO
The first HRSA-funded AIDS Service Demonstration Grants, in 1986, brought care to four urban centers.
When the first Part A grants were awarded in FY 1991, there were 16 EMAs. Today, 24 EMAs and 32 TGAs receive funding.
In FY 2010, approximately $679.1 million was appropriated for Part A spending.
Of the 2,157 providers submitting data to HAB for 2008: 1,213 received Part A funds; 1,160 received Part B funds; 444 received Part C funds; and 263 received Part D funds.
Part A Publications