trials and research. In FY 2003, $74.5 million was appropriated for this program (HRSA, 2003a).

The Dental Reimbursement Program was added to the CARE Act in 1996. The program provides funding to improve access to oral health care for people with HIV/AIDS by providing reimbursement to educational programs. The funds help to offset the cost of uncompensated dental HIV care provided by the programs (HRSA, 2002f). The program was appropriated $13.4 million in FY 2003 (HRSA, 2003a).

In addition to these programs, two additional Ryan White CARE Act programs are designed to assist in improving the quality of care provided by the Ryan White programs and to assist community providers in improving the delivery of care. A total of $60.6 million was appropriated to these programs in FY 2003.

The AIDS Education and Training Centers (AETC) programs fund a network of 11 regional centers and associated sites that conduct multidisciplinary education and training for providers who care for persons with HIV/AIDS. The centers are designed to expand the number of providers who can counsel, diagnose, treat, and medically manage individuals with HIV, and who can help prevent high-risk behaviors that transmit HIV (HRSA, 2002g). The program disbursed $35.6 million in FY 2003 (HRSA, 2003a).

The Special Projects of National Significance (SPNS) Programs were established to advance knowledge and skills needed to deliver health and support services to underserved populations with HIV infection. SPNS programs evaluate the effectiveness of models of care, support the design of innovative care programs, and help replicate effective models (HRSA, 2002h). Funding for this program is provided through a set-aside from Titles I–V that cannot exceed $25 million (HRSA, 2003).

Clients Served by the Ryan White CARE Act

CARE Act providers serve an estimated 533,000 individuals each year (HRSA, 2003a).8 CARE Act providers, compared to non-CARE Act providers, typically serve more women, minorities (Ashman et al., 2000), and persons with no insurance (GAO, 2000). CARE Act providers also provide some services to Medicaid-only and dual-eligible beneficiaries whose needs are not met by these programs.

Data from HRSA’s Client Demonstration Project present similar findings. The project uses unique identifiers to track the service use of all HIV-


It is impossible for HRSA to determine the exact number of clients served because individuals may receive care under several parts of the CARE Act and most grantees do not report unduplicated client-level data.

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