Recommendations to Guide the 2005 Reauthorization of the Ryan White CARE Act

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act has had a tremendous impact on the lives of people with HIV/AIDS throughout the nation, improving the availability and quality of health care services for these individuals and their families. As the largest federal program for people living with HIV/AIDS, the CARE Act is an essential source of support for HIV/AIDS care and treatment services. As NASTAD's Principles for Reauthorization state, assuring that all persons with HIV/AIDS, regardless of geographic location, have equal access to appropriate and high-quality HIV/AIDS services is our highest priority.

Disparities in the availability of resources affect the accessibility and quality of HIV services, both within and between states. NASTAD recognizes that the structure of the Ryan White CARE Act contributes to the challenges faced by some states in effectively addressing the needs of persons living with HIV/AIDS. In many states, the current structure is a contributing factor to funding disparities that affects availability, accessibility and quality of services, both within and between states, as well as the coordination of HIV care and the efficient delivery of essential services. While the Ryan White CARE Act cannot be viewed as the sole mechanism for equalizing these inherent differences, the current structure of the CARE Act leaves many states struggling with the delivery and coordination of HIV services, while trying to meet legislative mandates to provide for the public health of citizens within their respective jurisdictions.

NASTAD recognizes that alternative proposals for serving persons living with HIV/AIDS have been developed, including the Institute of Medicine's report Securing the Legacy of Ryan White. This report attempts to respond to these challenges. These proposals are worthy of and warrant further study, consideration and discussion.

At this time, NASTAD recommends retaining the current structure of the CARE Act. It does so while establishing the following two goals which are reflective of NASTAD's vision for improved HIV care services in the nation: (1) to enhance the availability of ADAP resources and services for persons living with HIV/AIDS in need in all areas of the nation, and (2) to address inequities in per-capita overall CARE Act funding among states.

NASTAD strongly supports further discussion and study of the structure of the CARE Act, and reserves the right to make recommendations regarding changing the structure of the Act in pursuit of improved HIV care services for all persons living with HIV disease. The Ryan White CARE Act must strive to provide funding in an equitable manner to assure that individuals throughout the United States, regardless of state or jurisdiction of residence, have access to comprehensive HIV health and medical care of the highest quality.