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Ryan White Comprehensive AIDS Resource (CARE) ACT

Enacted by Congress on August 18, 1990, the CARE Act represents the largest investment made by the Federal Government to date specifically for the provision of services for people living with HIV disease.

The CARE Act is intended to help communities and States increase the availability of primary health care and supportive services, in order to reduce utilization of more costly inpatient care, increase access to care for underserved populations, and improve the quality of life of those affected by the epidemic.

The Act directs assistance through five channels.

Title I
eligible Metropolitan Areas with the largest numbers of reported cases of AIDS. No areas in South Carolina.

Title II
All States, District of Columbia, Puerto Rico, and eligible US territories to improve the quality, availability, and organization of health care and support services for individuals living with HIV disease and their families.

Title II funds may be used to support a wide range of services, including:
Home and community-based health care and support services;
Continuation of health insurance;
Pharmaceuticals treatments through an AIDS drug Assistance Program (ADAP);
Local consortia that assesses needs, organize and deliver HIV services in consultation with service providers, and contract for services;
Direct health and supportive services.

A consortium must submit an application assuring that is has done the following:
Conducted a needs survey;
Developed a plan to meet identified needs;
Promoted coordination and integration of community resources addressing the needs of all affected populations;
Assured the provision of comprehensive outpatient health and support services;
Arranges to evaluate the success and cost effectiveness of consortium in responding to services needs.

Title III
Public and private nonprofit entities to support outpatient early intervention HIV services for PLWH. AID Upstate, Greenville Community Health Center and Greenville Hospital System are developing application to request funding for primary and specialty medical care and supportive services.

Title IV
Public and private nonprofit entities for projects to coordinate services to, and provide enhanced access to research for children, youth, women, and families with HIV/AIDS. GHS receives Title IV funding.

Part F
Special Projects of National Significance to support development of innovative models of care that are designed to be replicated and have a strong evaluation component; AIDS Education and Training Centers to conduct education and training for health care providers (USC School of Public Health); and HIV?AIDS Dental Reimbursement Program to assist accredited dental schools with uncompensated costs incurred in providing oral health treatment to HIV-positive patients (Charleston is only locality in SC).

Future
HRSA expects that CARE Act programs are looking at the changing epidemic within their areas and realigning or revising current systems of care, as necessary, to reflect the needs of vulnerable populations. Recognize the disparity between economic classes, substance use/abuse, race; and develop services to reach and encourage adherence to treatment. Additionally, methods of reporting cost effectiveness and outcomes has become a requirement of funding.