[Federal Register Volume 59, Number 140 (Friday, July 22, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-17839]


[[Page Unknown]]

[Federal Register: July 22, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

HIV Emergency Relief Grant Program

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of grants made to eligible metropolitan areas.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces that fiscal year 1994 funds have been awarded to the 34 
eligible metropolitan areas (EMAs) that have been the most severely 
affected by the HIV epidemic. Although these funds have already been 
awarded to the EMAs, HRSA is publishing this notice to inform the 
general public of the existence of the funds. In addition, HRSA 
determined that it would be useful for the general public to be aware 
of the structure of the HIV Emergency Relief Grant Program and the 
statutory requirements governing the use of the funds.
    The purposes of these funds are to deliver or enhance HIV-related 
(1) outpatient and ambulatory health and support services, including 
case management and comprehensive treatment services, for individuals 
and families with HIV disease; and (2) inpatient case management 
services that prevent unnecessary hospitalization or that expedite 
discharge, as medically appropriate, from inpatient facilities. The HIV 
Emergency Relief Grant Program was authorized by Title I of the Ryan 
White Comprehensive AIDS Resources Emergency (CARE) Act of 1990, Public 
Law 101-381, which amended Title XXVI of the Public Health Service Act. 
Funds were appropriated under Public Law 103-112.

FOR FURTHER INFORMATION, CONTACT: Individuals interested in the Title I 
HIV Emergency Relief Grant Program should contact the Office of the CEO 
in their locality, and may obtain information on their CEO contact by 
calling Eric P. Goosby, M.D., Director, Division of HIV Services, at 
(301) 443-6745.

SUPPLEMENTARY INFORMATION:

Availability of Funds

    A total of $319,989,000 was made available for the Title I HIV 
Emergency Relief Grant Program. Of the amount available, 50 percent was 
allocated to the 34 EMAs according to a formula based on the number and 
incidence of AIDS cases reported to the Centers for Disease Control and 
Prevention (CDC) as of March 31, 1993. The other 50 percent was awarded 
competitively to the EMAs as supplemental grants. Below is a 
distribution of grants made to the 34 EMAs. 

------------------------------------------------------------------------
                           EMA                              Total Award 
------------------------------------------------------------------------
Atlanta, GA...............................................    $7,488,801
Baltimore, MD.............................................     3,923,438
Bergen-Passaic, NJ........................................     2,019,121
Boston, MA................................................     6,955,035
Chicago, IL...............................................     9,625,451
Dallas, TX................................................     6,935,644
Denver, CO................................................     3,375,884
Detroit, MI...............................................     2,849,559
Fort Lauderdale, FL.......................................     6,814,599
Houston, TX...............................................    10,133,592
Jersey City, NJ...........................................     4,140,141
Kansas City, MO...........................................     2,655,564
Los Angeles, CA...........................................    25,441,211
Miami, FL.................................................    15,258,563
Nassau-Suffolk, NY........................................     2,886,968
New Haven, CT.............................................     2,136,872
New Orleans, LA...........................................     3,243,332
New York, NY..............................................   100,054,267
Newark, NJ................................................     7,009,180
Oakland, CA...............................................     3,929,287
Orange Co., CA............................................     2,627,947
Orlando, FL...............................................     2,715,587
Philadelphia, PA..........................................     7,374,936
Phoenix, AZ...............................................     2,217,471
Ponce, PR.................................................     1,176,793
Rivrside-Sn Bern,CA.......................................     2,402,010
St Louis, MO..............................................     2,248,247
San Diego, CA.............................................     5,233,574
San Francisco, CA.........................................    39,210,400
San Juan, PR..............................................     8,456,057
Seattle, WA...............................................     3,233,903
Tmpa-St Ptrsbrg, FL.......................................     3,304,312
Washington, D.C...........................................     9,328,712
West Palm Beach, FL.......................................     3,582,542
------------------------------------------------------------------------

Eligible Grantees

    Metropolitan areas which were eligible for grant awards under Title 
I were those areas for which, as of March 31, 1993, there had been 
reported to and confirmed by the CDC a cumulative total of more than 
2,000 cases of AIDS; or, for which the per capita incidence of 
cumulative cases of AIDS was not less than 0.0025, as computed on the 
basis of the most recently available data for the population in the 
area. Included were all human immunodeficiency virus (HIV)-infected 
persons with severe immunosuppression (<200 CD4+ T-lymphocytes/
L or a CD4+ T=lymphocyte percentage of total lymphocytes of 
<14), pulmonary tuberculosis (TB), recurrent pneumonia, or invasive 
cervical cancer.
    Grants were awarded to the chief elected official (CEO) of the city 
or urban county in each EMA that administers the public health agency 
providing outpatient and ambulatory services to the greatest number of 
individuals with AIDS.
    To be eligible for assistance under Title I, the CEO was required 
to establish or designate an HIV health services planning council to: 
(1) establish priorities for the allocation of funds within the 
eligible area; (2) develop a comprehensive plan for the organization 
and delivery of health services described in the statute that is 
compatible with any State or local plan regarding the provision of 
health services to individuals with HIV disease; and (3) assess the 
efficiency of the administrative mechanism in rapidly allocating funds 
to the areas of greatest need within the eligible area. The planning 
council must include representatives of: health care providers; 
community-based and AIDS service organizations; social services 
providers; mental health services providers; local public health 
agencies; hospital planning agencies or health care planning agencies; 
affected communities, including individuals with HIV disease; non-
elected community leaders; State government; and grantees receiving 
categorical grants for early intervention services under Title III of 
the CARE Act. The allocation of funds and services within the EMA must 
be made in accordance with the priorities established by the planning 
council.
    To be eligible to receive a grant under Title I, the EMAs were 
required to submit an application containing such information as the 
Secretary required, including assurances adequate to ensure:
     That funds received would be utilized to supplement not 
supplant State funds provided for HIV-related services;
     That the political subdivisions within the EMA would 
maintain HIV-related expenditures at a level equal to that expended for 
the 1-year period preceding the first fiscal year for which the grant 
was received. Funds received under Title I may not be used in 
maintaining the required level of expenditures;
     That the EMA has an HIV health services planning council 
and has entered into intergovernmental agreements with the political 
subdivisions and has developed or will develop a comprehensive plan for 
the organization and delivery of health services, in accordance with 
the legislation;
     That entities within the EMA that receive Title I funds 
will participate in an established HIV community-based continuum of 
care if such continuum exists within the EMA;
     That Title I funds will not be utilized to make payments 
for any item or service to the extent that payment has been made, or 
can reasonably be expected to be made, with respect to that item or 
service (1) under any State compensation program, under an insurance 
policy, or under any Federal or State health benefits program, or (2) 
by an entity that provides health services on a prepaid basis; and
     To the maximum extent practicable, that HIV health care 
and support services provided with Title I assistance 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. Such services will be provided in a setting that is 
accessible to low-income individuals with HIV disease, and a program of 
outreach will be provided to inform such individuals of such services.

General Use of Grant Funds

    EMAs must use the Title I HIV Emergency Relief grants to provide 
financial assistance to public or nonprofit entities, for the purpose 
of delivering or enhancing--
     HIV-related outpatient and ambulatory health and support 
services, including case management and comprehensive treatment 
services, for individuals and families with HIV disease; and
     HIV-related inpatient case management services that 
prevent unnecessary hospitalization or that expedite discharge, as 
medically appropriate, from inpatient facilities.
    Services supported by the Title I grant funds must be accessible to 
low-income individuals and families, including women and children with 
HIV infection, minorities, the homeless, and persons affected by 
chemical dependency.

Federal Smoke-Free Compliance

    The Public Health Service strongly encourages all grant recipients 
to provide a smoke-free workplace and promote the non-use of all 
tobacco products. This is consistent with the PHS mission to protect 
and advance the physical and mental health of the American people.

Executive Order 12372

    Grants awarded for the Title I HIV Emergency Relief Grant Program 
are subject to the provisions of Executive Order 12372, as implemented 
under 45 CFR Part 100, which allows States the option of setting up a 
system for reviewing applications within their States for assistance 
under certain Federal programs. The application packages made available 
by HRSA to the EMAs contained a listing of States which have chosen to 
set up such a review system and provided a point of contact in the 
States for the review.
    The catalog of Federal Domestic Assistance Numbers are: Formula 
Grants--93.915; Supplemental Grants--93.914.

    Dated: July 18, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-17839 Filed 7-21-94; 8:45 am]
BILLING CODE 4160-15-P