The Ryan White Comprehensive AIDS Resources Emergency Act (Ryan White CARE Act), ), was an act of the

United States Congress The United States Congress is the legislature of the federal government of the United States. It is bicameral, composed of a lower body, the House of Representatives, and an upper body, the Senate. It meets in the U.S. Capitol in Washing ...

and is the largest federally funded program in the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...

for people living with

HIV/AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...

. In exchange for States adopting harsh criminal laws regulating the conduct of HIV-positive individuals and providing for their public felony prosecution, the act made federal funding available through contingency grants to states for

low-income Poverty is the state of having few material possessions or little

income

, uninsured, and under-insured people to be treated with the chemotherapeutic drug

AZT Zidovudine (ZDV), also known as azidothymidine (AZT), is an antiretroviral medication used to prevent and treat HIV/AIDS. It is generally recommended for use in combination with other antiretrovirals. It may be used to prevent mother-to-child ...

. The act is named in honor of

Ryan White Ryan Wayne White (December 6, 1971 – April 8, 1990) was an American teenager from Kokomo, Indiana, who became a national poster child for HIV/AIDS in the United States after his school barred him from attending classes following a diagn ...

, an

Indiana Indiana () is a U.S. state in the Midwestern United States. It is the 38th-largest by area and the 17th-most populous of the 50 States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th s ...

teenager who contracted

AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...

through a tainted blood transfusion. He was diagnosed with AIDS in 1984 at age 13 and was subsequently expelled from school because of the disease. White became a well-known advocate for AIDS research and awareness until his death in 1990 at age 18. Ryan White programs are "payer of last resort" which fund treatment when no other resources are available. As AIDS has spread, the funding of the program has increased. In 1991, the first year funds were appropriated, around US$220 million were spent; by the early 2000s, this number had almost increased 10-fold. The Act was reauthorized in 1996, 2000, 2006, and 2009. The program provides some level of care for around 500,000 people a year and, in 2004, provided funds to 2,567 organizations. The Ryan White programs also fund local and state primary medical care providers, support services, healthcare provider training programs, and provide technical assistance to such organizations. In fiscal year 2005, federal funding for the Ryan White CARE Act was $2.1 billion. As of 2005, roughly one-third of this money went to the AIDS Drug Assistance Programs (ADAP) which provides drugs for 30 percent of people living with HIV. The primary activity of ADAP is providing

FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...

-approved

prescription medication A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The rea ...

. The Ryan White CARE Act mandates that EMS personnel can find out whether they were exposed to life-threatening diseases while providing care. (This notification provision was included in the original 1990 act, dropped in the 2006 reauthorization, and reinstated in the 2008 reauthorization).

2006 reauthorization

The Ryan White Care Act was due to be reauthorized at the end of 2005, but Congress could not reach agreement on changes, and the act was extended for one year under the old terms. In 2006, the act was reauthorized for three more years, ending on September 30, 2009 with a funding level of $2.1 billion. Prior to the reauthorization, the act allocated money based on the proportion of patients with AIDS in each region. The 2006 reauthorization changed this allocation mechanism to also consider the number of people living with HIV who do not have a clinical diagnosis of AIDS A significant portion of funding from the act is emergency relief for Eligible Metropolitan Areas. The 2006 reauthorization redefined EMAs as cities with a population greater than 50,000, instead of previous versions which required 500,000.

2009 reauthorization

In 2009, Congress passed the Ryan White HIV/AIDS Treatment Extension Act, which was signed by President Obama on October 30, 2009. This bill extends the Ryan White Care Act for an additional four years.

2013 expiration

In 2013, the Ryan White CARE Act expired; however the Program remains as Congress continues to appropriate funding.

Special Projects of National Significance

The Special Projects of National Significance (often abbreviated to SPNS) program is a

United States Department of Health The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto ...

program that helps to "advance knowledge and skills in the health and support services to underserved populations diagnosed with

HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...

infection." The current SPNS effort began in 1991 with several federal grants; portfolio of 72 grants currently address issues in HIV care.

References

External links

{{wikisource, Ryan White HIV/AIDS Treatment Extension Act of 2009
The Ryan White HIV/AIDS Program

Special projects of national significance
HIV/AIDS in the United States United States Department of Health and Human Services United States federal health legislation