TITLE II: GRANTS TO STATES AND TERRITORIES
itle II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act provides grants to all 50 States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and five newly eligible U.S. Pacific Territories and Associated Jurisdictions.* Title II also funds the AIDS Drug Assistance Program (ADAP) and grants to States for Emerging Communities—those reporting between 500 and 1,999 AIDS cases over the most recent 5 years.* On May 5, 2006 a press release was issued to announce the FY 2006 Title II grant awards; www.hhs.gov/news/press/2006.html.
Title II funds may be used to provide a variety of services, including:
- Ambulatory health care;
- Home-based health care;
- Insurance coverage;
- Medications;
- Support services;
- Outreach to HIV-positive individuals who know their HIV status;*
- Early intervention services;* and
- HIV Care Consortia, which assess needs and contracts for services.
FUNDING
In FY 2006, a total of $1.13 billion was appropriated to Title II programs, of which $790 million was earmarked for the AIDS Drug Assistance Program (ADAP).
- Base Title II grants are awarded to States and Territories using a formula that, historically, has been based on reported AIDS cases. HIV prevalence (AIDS cases and HIV infections that have not yet progressed to AIDS) will be used to calculate grants as soon as data are adequate for doing so.* CARE Act provisions also require that States with more than 1 percent of total AIDS cases reported in the United States during the previous 2 years must provide matching funds with their own resources using a formula outlined in the legislation.
- Additional Title II funds are “earmarked” for State AIDS Drug Assistance Programs (ADAPs), which primarily provide medications. Fundable services also include treatment adherence and support as well as health insurance coverage with prescription drug benefits.* Three percent of the ADAP earmark is reserved for grants to States and Territories that have a severe need for medication assistance.*
- Title II provides $10.0 million in supplemental grants to States for Emerging Communities—cities with between 500 and 1,999 reported AIDS cases in the most recent 5 years.*
- Title II provides $7 million for the Minority AIDS Initiative to increase minority participation in ADAPs.
- Two newly eligible U.S. Pacific Territories (American Samoa and the Common-wealth of the Northern Mariana Islands) and three Associated Jurisdictions (the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau) each will receive a $50,000 Title II award.*
PROVIDERS
Title II providers may include public or nonprofit entities. For-profit entities are eligible only if they are the sole available providers of quality HIV care in the area.
Most States provide some services directly, but others work through subcontracts with Title II HIV Care Consortia. A consortium is an association of public and nonprofit health care and support service providers and community-based organizations that plans, develops, and delivers services for people living with HIV disease.
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