Title II base awards are determined by a formula. Eighty percent of the base grant is based on each state’s proportion of the total number of ELCs. The remaining 20 percent is based on the number of ELCs in each state outside any EMAs, in proportion to the total number of such cases nationwide4 (HRSA, 2001). The base award also includes a minimum award: $200,000 for states with fewer than 90 ELCs, $500,000 for states with more than 90 ELCs, and $50,000 for all United States territories, regardless of the number of AIDS cases (HRSA, 2001). The base award formula includes a hold-harmless provision that declines annually according to a schedule established in the legislation.
States must match a portion of the Title II base award if they report more than 1 percent of the total number of AIDS cases for the two preceding fiscal years. The number of years that a state has been matching determines the percentage that it must match (20 percent the first year, 25 percent the second year, 33 percent the third year, and 50 percent in the fourth year). Puerto Rico is exempt from this requirement (HRSA, 2001).
The AIDS Drug Assistance Program (ADAP) award is based on a state’s proportion of the total ELCs in all states and territories. Unlike the Title II base award, this award does not include an 80–20 split. The formula includes a hold-harmless provision that declines annually according to a schedule established in the legislation (HRSA, 2001).
Before the ADAP award is calculated, 3 percent of the appropriated earmark is set aside for the ADAP Supplemental Award, given to states in severe need (HRSA, 2002b). A state’s supplemental ADAP award is based on its proportion of the total ELCs in qualifying states and territories. A state must match 25 percent of these federal funds to receive the award. If a qualifying state does not agree to do so, HRSA runs the formula again after deleting the nonparticipating states (HRSA, 2001).