[Federal Register Volume 62, Number 229 (Friday, November 28, 1997)]
[Notices]
[Pages 63357-63359]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-31210]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


HIV Emergency Relief Grant Program

AGENCY: Health Resources and Services Administration.

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 1997 funds

[[Page 63358]]

have been awarded to the 49 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, substance abuse treatment and mental health treatment, 
and comprehensive treatment services, which include treatment education 
and prophylactic treatment for opportunistic infections, 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 is authorized by 
Title I of the Ryan White Comprehensive AIDS Resources Emergency (CARE) 
Act of 1990, Public Law 101-381, as amended by the Ryan White CARE Act 
Amendments of 1996, Public Law 104-146, which amended Title XXVI of the 
Public Health Service Act. Funds were appropriated under Public Law 
104-208.

FOR FURTHER INFORMATION, CONTACT: Individuals interested in the Title I 
HIV Emergency Relief Grant Program should contact the Office of the 
Chief Elected Official (CEO) in their locality, and may obtain 
information on their CEO contact by calling Anita Eichler, M.P.H., 
Director, Division of Service Systems, at (301) 443-6745.

SUPPLEMENTARY INFORMATION:

Availability of Funds

    A total of $429,377,900 was made available for the Title I HIV 
Emergency Relief Grant Program. Below is a table showing the total 
award of grants made to the 49 EMAs.

------------------------------------------------------------------------
                         Grantee                               Award    
------------------------------------------------------------------------
Atlanta, GA.............................................     $12,632,117
Austin, TX..............................................       3,337,861
Baltimore, MD...........................................      10,033,688
Bergen-Passaic, NJ......................................       4,292,593
Boston, MA..............................................       9,033,443
Caguas, PR..............................................       1,431,210
Chicago, IL.............................................      15,741,071
Cleveland-Lorain-Elyria, OH.............................       1,877,513
Dallas, TX..............................................       8,129,583
Denver, CO..............................................       4,668,572
Detroit, MI.............................................       6,087,121
Dutchess County, NY.....................................         776,847
Ft. Lauderdale, FL......................................       8,312,185
Ft. Worth-Arlington, TX.................................       1,902,232
Hartford, CT............................................       2,661,473
Houston, TX.............................................      10,768,697
Jacksonville, FL........................................       3,762,713
Jersey City, NJ.........................................       4,600,103
Kansas City, MO.........................................       2,884,537
Los Angeles, CA.........................................      30,227,298
Miami, FL...............................................      18,863,208
Middlesex-Somerset-Hunterdon, NJ........................       1,919,076
Minneapolis-St. Paul, MN................................       1,990,700
Nassau-Suffolk, NY......................................       4,697,795
New Haven, CT...........................................       5,336,678
New Orleans, LA.........................................       4,727,682
New York, NY............................................      92,459,373
Newark, NJ..............................................      11,612,530
Oakland, CA.............................................       5,905,961
Orange County, CA.......................................       4,401,330
Orlando, FL.............................................       4,319,349
Philadelphia, PA........................................      13,465,328
Phoenix, AZ.............................................       3,380,053
Ponce, PR...............................................       2,183,463
Portland, OR............................................       3,472,480
Riverside-San Bernardino, CA............................       5,986,979
Sacramento, CA..........................................       2,038,827
St. Louis, MO...........................................       3,506,350
San Antonio, TX.........................................       3,014,191
San Diego, CA...........................................       8,198,109
San Francisco, CA.......................................      37,194,634
San Jose, CA............................................       1,992,602
San Juan, PR............................................      10,550,845
Santa Rosa-Petaluma, CA.................................       1,330,630
Seattle, WA.............................................       5,481,431
Tampa-St. Petersburg, FL................................       6,548,952
Vineland-Millville-Bridgeton, NJ........................         677,001
Washington, D.C.........................................      15,838,868
West Palm Beach, FL.....................................       5,122,618
------------------------------------------------------------------------

Eligible Grantees

    Metropolitan areas which were eligible for grant awards under Title 
I were those areas for which, as of March 31, 1996, there had been 
reported to and confirmed by the CDC a cumulative total of more than 
2,000 cases of AIDS for the previous 5 years, and there was a 
population of at least 500,000 individuals, or, for which an award had 
been made prior to fiscal year 1997.
    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 that 
reflects in its composition the demographics of the epidemic in the 
EMA, with particular consideration given to disproportionately affected 
and historically underserved groups and subpopulations. The planning 
council is 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; (3) assess the 
efficiency of the administrative mechanism in rapidly allocating funds 
to the areas of greatest need within the eligible area; (4) participate 
in the development of the statewide coordinated statement of need 
initiated by the State public health agency responsible for 
administering State grants (Part B of Title XXVI of the Public Health 
Service Act); and (5) establish methods for obtaining input on 
community needs and priorities which may include public meetings, 
conducting focus groups, and convening ad-hoc panels. The planning 
council must include representatives of: health care providers, 
including federally qualified health centers; community-based and AIDS 
service organizations; social services providers; mental health and 
substance abuse providers; local public health agencies; hospital 
planning agencies or health care planning agencies; affected 
communities, including people with HIV disease or AIDS and historically 
underserved groups and subpopulations; non-elected community leaders; 
State government, including the State Medicaid agency and the agency 
administering the program under Part B of Title XXVI of the PHS Act; 
and grantees receiving categorical grants for early intervention 
services under Part C of Title XXVI of the PHS Act; grantees under 
section 2671 of the PHS Act, or, if none are operating in the area, 
representatives of organizations with a history of serving children, 
youth, women, and families living with HIV and operating in the area; 
and grantees under other federal HIV programs. 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

[[Page 63359]]

that expended for the preceding fiscal year. 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 any required 
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 or 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.
    o That the applicant has participated, or will agree to 
participate, in the statewide coordinated statement of need process 
where it has been initiated by the State public health agency 
responsible for administering grants under part B, and ensures that the 
services provided under the comprehensive plan are consistent with the 
statewide coordinated statement of need.

General Use of Grant Funds

    EMAs must use the Title I HIV Emergency Relief grants to provide 
financial assistance to public or nonprofit entities, or private for-
profit entities if such entities are the only available provider of 
quality HIV care in the area, for the purpose of delivering or 
enhancing--
    o HIV-related outpatient and ambulatory health and support 
services, including case management, substance abuse treatment and 
mental health treatment, and comprehensive treatment services, which 
will include treatment education and prophylactic treatment for 
opportunistic infections, for individuals and families with HIV 
disease; and
    o HIV-related inpatient case management services that prevent 
unnecessary hospitalization or that expedite discharge, as medically 
appropriate, from inpatient facilities.
    In order to provide health and support services to infants, 
children, and women with HIV disease, including treatment measures to 
prevent the perinatal transmission of HIV, the EMA must use an amount 
of funding from the Title I grant not less than the percentage 
constituted by the ratio of the population in the EMA of infants, 
children, and women with AIDS to the general population of AIDS-
infected individuals in the EMA.

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. In addition, Public Law 103-277, the Pro-Children Act 
of 1994, prohibits smoking in certain facilities (or, in some cases, 
any portion of a facility) in which regular or routine education, 
library, day care, health care or early childhood development services 
are provided to children.

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: November 21, 1997.
Claude Earl Fox,
Acting Administrator.
[FR Doc. 97-31210 Filed 11-26-97; 8:45 am]
BILLING CODE 4160-15-P