Health Resources and Services Administration

The Health Resources and Services Administration (HRSA) directs national health programs which improve the health of the Nation by assuring quality health care to underserved, vulnerable and special-need populations and by promoting appropriate health professions workforce capacity and practice, particularly in primary care and public health.

The HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA) was formed in August 1997 to consolidate all programs funded under the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The CARE Act was signed into law on August 15, 1990 to improve the quality and availability of care for people with HIV/AIDS and their families. Amended and reauthorized in May 1996, the Act is named after the Indiana teenager, Ryan White, who became an active public educator on HIV/AIDS after he contracted the syndrome. He died the same year the legislation was passed.

The HIV/AIDS Bureau conducts CARE Act programs to benefit low-income, uninsured and underinsured individuals and families affected by HIV/AIDS. Total appropriations for HRSA-funded CARE Act programs since FY 1991 is approximately $6.4 billion.

In serving people and families affected by HIV/AIDS, the Bureau, headed by HRSA Associate Administrator Joseph F. O'Neill, M.D., M.P.H., has identified four factors that have significant implications for HIV/AIDS care, services and treatment:

• The HIV/AIDS epidemic is growing among traditionally underserved and hard-to-reach populations.
• The quality of emerging HIV/AIDS therapies can make a difference in the lives of people living with HIV.
• Changes in the economics of health care are affecting the HIV/AIDS care network.
• Policy and funding increasingly are determined by outcomes.

The HIV/AIDS Bureau administers CARE Act HIV/AIDS programs that provide:

• HIV emergency relief grant program for eligible metropolitan areas (EMAs) under Title I
• HIV care grants to States and eligible U.S. territories under Title II
• HIV early intervention services and planning grants under Title III
• Coordinated HIV services and access to research for children, youth, women, and families under Title IV
• Special Projects of National Significance (SPNS) Program, HIV/AIDS Dental Reimbursement Program, and AIDS Education and Training Centers (AETC) Program under Part F

Within the Bureau, the Division of Service Systems administers Titles I, II and the AIDS Drug Assistance Program (ADAP); the Division of Community Based Programs administers Titles II, IV and the HIV/AIDS Dental Reimbursement Program; and the Division of Training and Technical Assistance administers the AIDS Education and Training Centers Program. The Bureau's Office of Science & Epidemiology (OSE) administers the Special Projects of National Significance Program and data and evaluation activities.

AIDS Education and Training Centers (AETCs)
The AIDS Education and Training Centers (AETC) Program is funded under Part F of the Ryan White CARE Act. Part F also funds the Special Projects of National Significance (SPNS) Program and the HIV/AIDS Dental Reimbursement Program.

The AETC Network
The AIDS Education and Training Centers Program is a network of 15 regional centers (and 75 associated sites ) that conduct targeted, multi-disciplinary education and training programs for health care providers. The AETCs, which serve all 50 States, the Virgin Islands, and Puerto Rico, increase the number of health care providers who are educated and motivated to counsel, diagnose, treat, and manage care for individuals with HIV/AIDS and help prevent high risk behaviors that may lead to infection.

AETCs focus on training those in primary health care (physicians, nurses, dentists) and, with a lesser emphasis, on training for mental health and allied health providers. The majority of AETC resources have been focused on areas of high HIV prevalence and incidence, with remaining resources allocated on suburban and rural needs. AETC activities are based upon assessed local needs. Each AETC involves at least one CARE Act Title I metropolitan area with high incidence of the disease.

AETCs collaborate with other CARE Act-funded organizations, Area Health Education Centers (AHECs), community-based HIV/AIDS organizations, medical and health professional schools, local hospitals, health departments, community and migrant health centers, medical societies, and other professional organizations.

Since 1991, more than 700,000 providers have been trained by the AETC program. A 1993 study showed that providers trained in AETCs were more competent with regard to HIV issues and more willing to treat persons living with HIV than other primary care providers.

From FY 1987 to FY 1995, $125.4 million was appropriated to the AETC Program. Starting in FY 1996, AETCs were funded under the CARE Act; from FY 1996 through FY 1999, $65.6 million has been appropriated. In FY 1999, the program received $20 million. The total appropriation through FY 1999 is $191 million.

Targeted Provider Education Demonstration Program (TPED)