addressed. The current Ryan White model of care, which provides a wide range of medical and nonmedical services, allows for task shifting across provider levels to the extent permitted by state regulations, and supports the provision of comprehensive services, offers an example of the type of integrated delivery system that serves HIV/AIDS clients well and upon which future care systems could be modeled.

Regardless of the approach taken, the committee was impressed by the urgency of addressing these HIV/AIDS care capacity issues. With each additional HIV infection detected, the care system inherits a responsibility to counsel, refer, treat, and monitor an additional patient, at an average per-infection cost of $19,912 per year (Gebo et al., 2010). Interruptions in care, such as have occurred with the freeze on some ADAP programs, and the provision of inadequate care due to long waiting periods and provider shortages are costly not only in human suffering and lost productivity, but also in increased transmission, with each new infection adding a very costly liability for the future ($355,000 for HIV treatment alone [CDC, 2010a]).

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