Changes Needed to Improve the Distribution of Ryan White CARE Act and Housing Funds HIGXYZ64HIGZYX

Among federal efforts to address the HIV/AIDS epidemic are the CARE Act of 1990 and the Housing Opportunities for Persons with AIDS program  administered by the Departments of Health and Human Services and Housing and Urban Development, respectively. Both use formulas based upon a grantee’s number of AIDS cases, rather than HIV and AIDS cases, to distribute funds to metropolitan areas, states, and territories. HIV cases must be incorporated with AIDS cases in CARE Act formulas not later than fiscal year 2007.

GAO was asked to examine (1) how CARE Act and HOPWA funds are allocated among types of services, (2) the extent of funding distribution differences among CARE Act and HOPWA grantees, and how funding formula provisions contribute to these differences, and (3) what distribution differences could result from incorporating HIV case counts in CARE Act and HOPWA funding formulas.

What GAO Recommends

If Congress wishes CARE Act and HOPWA funding to more closely reflect the distribution of persons living with AIDS, it should consider taking actions that lead to more comparable funding per case by revising the funding formulas. HHS and HUD generally agreed with GAO’s identification of issues in the funding formulas.