HIV/AIDS Bureau - 15 Years of the Care Act

Ryan White CARE Act: Ryan White HIV/AIDS Program: 1990-Present

1990		The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act is passed. There are over 150,000 reported AIDS cases in the U.S.

1991		The first CARE Act funds are awarded for Fiscal Year 1991and include 16 Title I Eligible Metropolitan Areas, State Title II grants, Title III early intervention projects, and Special Projects of National Significance (SPNS).

1992		Two more EMAs are added to the list of eligible Title I grantees.

1993		The AIDS definition is revised by CDC and 7 more EMAs become eligible as Title I EMAs, increasing the total to 25.

1994		HRSA releases its program advisory outlining specific steps for implementing Public Health Service (PHS) recommendations for offering AZT (ZDV) to pregnant women with HIV. Title IV evolves from Pediatric AIDS Demonstration Grants, which started in 1988, to funding under the CARE Act.

1997		The HIV/AIDS Dental Reimbursement Program started as AIDS dental reimbursements in 1994, are funded under the CARE Act for the first time. AETCs are funded under the CARE Act for the first time.

1998		HRSA brings all CARE Act programs under the new HIV/AIDS Bureau, consolidating activities under the same administrative structure for the first time.

1999		Three national AETC centers are funded: National Resource Center; National Evaluation Center; and National Minority AETC. Targeted Provider Education Demonstration (TPED) grants are awarded to train non-clinicians to support HIV/AIDS education and training for health and support service providers working in racial and ethnic minority communities highly impacted by HIV/AIDS.

2000		The CARE Act Amendments of 2000 reauthorize the CARE Act.

2001		HRSA's HIV/AIDS Bureau implements 2000 Amendments through programs like the new AIDS Drug Assistance Programs (ADAP) funding for areas with severe need and new Title II emerging community grants.

2002		International AIDS Education and Training Center (AETC) funded, creating a new link between U.S. and international HIV/AIDS care provider training.

2003		HRSA's Global HIV/AIDS Program started. Clinical Guide on Supportive and Palliative Care for People with HIV/AIDS produced.

2004		Institute of Medicine report, Measuring What Matters, recommends continued use of AIDS data for allocating CARE Act dollars until HIV surveillance systems have further evolved. Initiation of the AETC National Clinicians Consultation Center “Perinatal Hotline” in collaboration with CDC. Guide to the Primary Care of People With HIV/AIDS

2005		New SPNS demonstration projects to explore innovations in HIV care: (1) integration of buprenorphine and substance abuse treatment in HIV primary care and (2) linking MSM of color into care. A Guide to the Clinical Care of Women with HIV/AIDS updated HAB collaborates with other federal and private partners to update national HIV antiretroviral treatment guidelines Institute of Medicine report, Public Financing and Delivery of HIV/AIDS Care: Securing the Legacy of Ryan White, recommends U.S. government subsidization of HIV/AIDS care for all people living with HIV with incomes below 250% of the Federal poverty level. SPNS Initiative, OPTIONS Project: A physician-delivered intervention for HIV Positive Patients in Clinical Care

2006		SPNS Initiative to explore new strategies in delivery of HIV dental care. CARE Act reauthorized in December as the Ryan White HIV/AIDS Treatment Modernization Act

2007		2007 HRSA/HAB awards new Minority AIDS Initiative funds to grantees under Parts A and B. Funding of five new TGAs (Transitional Grant Areas) and recategorization of Part A grantees as EMAs and TGAs--reauthorization issues. Draft Severity of Need Index released to improve the way Ryan White HIV/AIDS funds are distributed to cities (Part A) and States (Part B).