case management. Title I grantees must establish HIV Health Services Planning Councils to set service priorities for the allocation of funds. In FY 2001, there were 51 EMAs in 28 states/territories.
Title II ($977 million in FY 2002, including ADAP funds) grants are awarded on a formula basis to states, the District of Columbia, Puerto Rico, and eligible U.S. territories and associated jurisdictions to provide health care and support services for people living with HIV disease, including home- and community-based services, continuation of health insurance coverage, prescription drugs (states receive earmarked funds to support ADAP), and direct health and support services. Some states are required to provide matching funds, depending on their AIDS case burden. In FY 2002, these matching funds are estimated to total close to $400 million.81 As part of the year 2000 reauthorization, supplemental funds are also available through Title II for “emerging communities,” urban areas within states that are not eligible for Title I funds but have a certain level of reported AIDS cases.
AIDS Drug Assistance Programs ($639 million in FY 2002, included in Title II funding above). Title II funds also support ADAPs, which provide prescription medications to individuals with HIV disease who have limited or no coverage for medications through other insurance mechanisms. ADAPs began serving clients in 1987, when Congress first appropriated funds to help states purchase AZT, the only approved antitretroviral at that time. In 1990, Congress incorporated ADAP into Title II of the Ryan White CARE Act and, since 1995, Congress has specifically earmarked funding for ADAP, and states are permitted to spend some of their general Title II funds to support these programs. There are 56 ADAPs in all 50 states, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, the Northern Mariana Islands, and the Marshall Islands. Each state administers its own ADAP program including establishing financial and clinical eligibility criteria and ADAP formularies.
Title III ($194 million in FY 2002) supports early intervention services (EIS) for individuals who have been diagnosed with HIV disease. Currently, there are 310 Title III EIS-funded programs in 50 states/territories.
Title IV ($71 million in FY 2002) provides community-based, and family centered services to children, youth, and women living with HIV and their families. Services include primary and specialty medical care, psychosocial services, and outreach and prevention services.
Dental Assistance ($13 million in FY 2002). The dental reimbursement program assists accredited dental schools, post-doctoral dental programs, and dental hygiene education programs by reimbursing them for nonreimbursed costs incurred in the provision of oral health care to patients with HIV infection.