California Loses HIV/AIDS Funding Because of Outdated CARE Act Allocation Formulas

The existing CARE Act allocation formulas result in California receiving millions of dollars less than its fair share of federal CARE Act funding. Your support in correcting this disparity is vital to maintaining access to life saving medical and support services for low income Californians living with HIV disease.

• This disparity can be addressed by amending the CARE Act allocation formulas to use actual living AIDS cases rather than estimated living AIDS cases as required in current law.
• Currently, the CARE Act requires the Centers for Disease Control & Prevention to estimate the number of people living with AIDS using national estimates of how long people with AIDS survive. In California, people with HIV/AIDS are living longer than the national average, in part due to our strong systems of care. Therefore, we are providing services to more people than we are given credit for in the current resource allocation formulas.
• Estimated living AIDS cases are currently used in the formulas that determine funding allocations for Title I (the cities hardest hit by the disease) and Title II (the funding that comes to the state, including the AIDS Drug Assistance Program). The use of these estimated case counts under-counts California's living AIDS cases by approximately 30 percent and disproportionately reduces the state's share of CARE Act funding by over $20.5 million in Fiscal Year (FY) 2005.
• The chart below illustrates the potential effect of this change. In FY 2005, using the current formula, California's ADAP will receive 11.79% (approximately $90 million) of the federal ADAP earmark -- an increase of only $404,800 over the previous year's award. If the formula used living AIDS cases, California's share would increase to 13.75%. That 1.97% difference could mean a projected gain of over $15.4 million in ADAP funds and a potential $5.15 million gain in Title II base funding to the State. The total increase to the State would be even greater, since Title I formula allocations are similarly affected by allocation formulas.

Hypothetical effect on Title II CARE Act funding for California FY2005

The 2005 CARE Act reauthorization cycle provides a golden opportunity for California's congressional delegation to ensure that the federal government more fairly funds California's true HIV/AIDS disease burden. The incorporation of living AIDS cases into CARE Act allocation formulas will substantially increase California's proportion of federal HIV funding and the California Congressional delegation must advocate aggressively for this change.