Ryan White CARE Act of 1990

The Ryan White Comprehensive AIDS Resources Emergency Act of 1990 makes federal funding available to cities that have been especially hard hit by the AIDS epidemic. In fiscal year 1994, $326 million was distributed to 34 eligible metropolitan areas in 17 state, the District of Columbia, and Puerto Rico. GAO testified that the act's funding formulas have resulted in per case funding disparities that are, to a great extent, unrelated to service costs or to the ability of state and cities to pay for services from local sources. These funding disparities result from the fact that (1) eligible metropolitan area cases are inappropriately double counted under the act's formulas, (2) there is no indicator that reflects differences in the cost of providing services in both states and eligible metropolitan areas, and (3) formula factors inappropriately measure caseloads and funding capacity. Greater funding equity could be achieved by eliminating the inappropriate double counting of AIDS cases and by using more appropriate measures of state and city needs.