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HIV CARE Formula Grants

Program Descriptions

Program Number



HIV CARE Formula Grants


Federal Agency




Public Health Service Act, Title XXVI, Part B, as amended, Public Law 106-415, Ryan White HIV/AIDS Treatment Modernization Act of 2006.






To enable States to improve the quality, availability, and organization of health care and support services for individuals and families with Human Immunodeficiency Virus (HIV) disease.


Types of Assistance

Formula Grants.


Uses and Use Restrictions

Funds received under a grant are to be used to fund 75 percent core medical services and 25 percent support services. Core medical services include: outpatient and ambulatory health services, AIDS Drug Assistance Program, AIDS, pharmaceutical assistance, oral health care, health insurance premium, home health care; home and community-based health services, early intervention services, medical nutritional therapy, substance abuse treatment and mental health treatment, medical case management, including treatment and adherence services. Support services for individuals with HIV/AIDS to achieve medical outcomes (such as respite care for persons caring for individuals with HIV/AIDS, outreach services, medical transportation, linguistic services and referral for health care and support services). Funds may be used to establish and operate HIV Care Consortia within areas most affected by HIV disease that shall be designed to provide a comprehensive continuum of care to individuals and families with HIV disease; provide home and community-based care services for individuals with HIV disease; provide assistance to assure the continuity of health insurance coverage for individuals with HIV disease; and provide therapeutics to treat HIV disease to individuals with HIV disease. A State shall use a percentage of the grant, determined by the percentage of infants, children, and women with acquired immune deficiency syndrome in the State, to provide health and support services to infants, children, and women with HIV disease, including treatment measures to prevent the perinatal transmission of HIV. Funds may not be used to purchase or improve land, or to purchase, construct or make permanent improvement to any building except for minor remodeling. Funds may not be used to make payments to recipients of services. A State may not use more than 10 percent of amounts received under this grant for administration, planning and evaluation activities. If a State receives the minimum allotment, it may not use more than the amount required to support one full-time equivalent employee for these activities. Seventy-five (75) percent of grant funds must be obligated within 120 days of the budget period start date.


Eligibility Requirements

Applicant Eligibility

All 50 States of the United States, and the District of Columbia and U.S. Territories (and possessions) of the United States, the Commonwealths of Puerto Rico, Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam, American Samoa and the Republic of the Marshall Islands, Federated States of Micronesia, the Republic of Palau.

Beneficiary Eligibility

Individuals and families with HIV disease.


Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.


Application and Award Process

Preapplication Coordination

This program is excluded for coverage under E.O. 12372.

Application Procedure

Grant applications and required forms for this program can be obtained from Please visit the Web site at to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator for the Bureau of HIV/AIDS. The Associate Administrator has the authority to make final selections for awards.

Award Procedure

Applications will undergo an internal review process. Grants will be awarded to States who prepare and submit an application containing the required documents.


Range of Approval/Disapproval Time






Assistance Considerations

Formula and Matching Requirements

All States, the Commonwealth of Puerto Rico, the District of Columbia, and U.S. territories are eligible to receive Title II grants. All Title II grants are determined by formula. The grant amount is determined by multiplying the amount appropriated for Title II, less any set-asides, by the distribution factor determined for the State or territory. This distribution factor is comprised of two components that are added together. The first component, the State Distribution Factor, is determined by dividing the estimated number of living AIDS cases for the State or territory by the estimated number of living AIDS cases for all States and territories and multiplying the result by .75. The second component, the Non-EMA Distribution Factor, is determined by dividing the estimated living AIDS cases in the State or territory but outside of EMAs within that State or territory by the sum of all estimated living AIDS cases within States or territories but outside EMAs/TGAs within States or territories and multiplying the result by .20 plus .5 of State or territory share of HIV/AIDS cases from states with no EMAs/TGAs. There is no minimum grant amount of $50,000 for U.S. territories. To achieve this minimum grant amount, funds are redistributed from other States and territories in proportion to their distribution factors. In addition, States and territories receive the greater of the formula amount, considering the minimum grant amount, or an amount equal to a set statutory percentage of the amount the State or territory received in fiscal year 1996. To achieve this minimum grant amount, funds are redistributed from other States in proportion to their distribution factors. The proportion of the funds allocated within a State or territory to provide services to infants, children and women must be at least equal to the proportion of infants, children and women with AIDS in the State or territory to the population of individuals with AIDS in the State or territory. Matching funds are required from States with more than one percent of the total U.S. AIDS cases reported to the CDC during the previous 2 years.

Length and Time Phasing of Assistance

Grants are awarded for a 12-month budget period.


Post Assistance Requirements


Semiannual progress reports are required. The Financial Status Report is due 90 days following the end of each budget period. An interim financial status report is due for the current budget period showing 75 percent obligation of the FY awards (5 months of the budget period start date). A final progress report and expenditure report are due 120 days after budget period end date.


In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.


All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.


Financial Information

Account Identification



(Grants) FY 07 $1,104,710,500; FY 08 $1,103,104,015; and FY 09 est not available.

Range and Average of Financial Assistance

$50,000 to $171,786,592; $17,963,976.


Program Accomplishments

In FY 06, FY 07 and 08 59 awards were to be made.


Regulations, Guidelines and Literature

This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.


Information Contacts

Regional or Local Office

Douglas Morgan, Director, Division of Service Systems, HIV/AIDS Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Room 7A-55, Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-6745.

Headquarters Office

Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: (301) 443-2385; Research and Training Branch: (301) 443-3099; Government and Special Focus Branch: (301) 443-3288.

Web Site Address


Related Programs

93.914, HIV Emergency Relief Project Grants


Examples of Funded Projects

Programs were funded to establish and operate HIV care consortia to provide a continuum of care to individuals and families with HIV disease; provide home and community based care services; provide drug treatment; and provide assistance to assure the community of health insurance coverage.


Criteria for Selecting Proposals

Grants will be awarded to applicants that submit; (1) An acceptable detailed description of the HIV-related services provided in the State to individuals and families with HIV disease during the year preceding the year for which the grant is requested, and the number of individuals and families receiving such services; (2) a comprehensive plan for the organization and delivery of HIV health care and support services to be funded with assistance received under this part that shall include a description of the purposes for which the State intends to use such assistance; (3) an assurance that the public health agency administering the grant for the State will periodically convene a meeting of individuals with HIV, representatives of grantees receiving both HIV Emergency Relief and HIV CARE Grants, providers, and public agency representatives to develop a statewide coordinated statement of need; and (4) an assurance by the State that; (A) the public health agency that is administering the grant for the State will conduct public hearings concerning the proposed use and distribution of the assistance to be received; and (B) the State will (a) to the maximum extent practicable, ensure that HIV-related health care and support services delivered pursuant to a program established with assistance provided under this part will be provided without regard to the ability of the individual to pay for such services and without regard to the current or past health condition of the individual with HIV disease; (b) ensure that such services will be provided in a setting that is accessible to low-income individuals with HIV disease; (c) provide outreach to low-income individuals with HIV disease to inform such individuals of the services available; (d) for continuum of health insurance coverage, submit a plan to the Secretary that demonstrates that the State has established a program that assures that (1) Such amounts will be targeted to individuals who would not otherwise be able to afford health insurance coverage; and (2) income, asset, and medical expense criteria will be established and applied by the State to identify those individuals who qualify for assistance under such program, and information concerning such criteria shall be made available to the public; (e) the State will provide for periodic independent peer review to assess that quality and appropriateness of health and support services provided by entities that receive funds from the State; (f) the State will permit and cooperate with any Federal investigations undertaken regarding programs; (g) the State will maintain HIV-related activities at a level that is equal to not less than the level of such expenditures by the State for the 1-year period preceding the fiscal year for which the State is applying to receive a grant; and (h) the State will ensure that grant funds are not utilized to make payments for any item or service to the extent that payment has been made.


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