Organizations at Forefront of Fight Against HIV Given New Flexibility to Provide Treatment Services

HRSA Clarifies Allowable Expenses Under Current Regulation

WASHINGTON, D.C - March 12, 2015 — AIDS United welcomes the Health Resources Services Administration (HRSA) HIV/AIDS Bureau's new Policy Clarification Notice (#15-01) which revises an overly-restrictive interpretation of the Ryan White Program's 10% administrative cap.

At issue was the interpretation of federal legislation that establishes a 10% administrative cap on Ryan White-funded programs.  Such caps are critical in ensuring the greatest portion of resources possible goes to program expenses rather than administration expenses.  However, the previous interpretation of this policy placed many traditional direct program expenses within the 10% cap, thus creating a real hardship on agencies that want to help their communities, but faced unreasonable funding restrictions.  The new policy guidance resolves this issue.

The old policy interpretation treated expenses such as patient management records and rent as administrative costs, where federal-wide regulations recognize these as vital costs required to do this work, and allocable as program and not administrative costs.  As such, the prior approach challenged agencies' ability to operate Ryan White-funded programs without losing money, and placed even greater burden on programs operating in high-rent jurisdictions. 

This created undue financial hardship and threatened the long-term financial sustainability of the organizations that serve people living with HIV under the program. An estimated 536,000 uninsured or underinsured people with HIV rely on the Ryan White Program for lifesaving health and supportive services. It is critical to the domestic response to HIV/AIDS.

"The old policy interpretations created a financial hardship on many of the very organizations we rely on to help bring about the end of AIDS," said AIDS United President & CEO Michael Kaplan.  "While we know this action will not end the epidemic, we are clear that this will ensure financially stable and healthy organizations who can help us get to the end of HIV that much quicker." 

The policy clarification is a result of longstanding and widespread HIV community concerns, including those raised by the AIDS United Public Policy Committee, that resulted in a yearlong HRSA review of laws, regulations, and policies that govern the Ryan White Program.

While HRSA's announcement addresses this issue at the federal level, some states and local jurisdictions continue to place onerous funding restrictions on organizations—positioning organizations for financial ruin. For example, in Alabama implementing partners in the field get no administrative costs for most services they offer. This places a tremendous burden on HIV/AIDS programs who must find funding to cover these costs required to implement life-saving programs.

"AIDS United is grateful for HRSA's willingness to review this issue after we pointed out the challenges and implications it created on the ground. We especially thank HRSA Administrator Mary Wakefield, Associate Administrator Laura Cheever, and Senior Advisor Janet Joyce, for their leadership and the many people at HRSA who were engaged in the process," said Kaplan.

About the Public Policy Committee:

The AIDS United Public Policy Committee (PPC) is the oldest continuing federal policy coalition working to end the HIV/AIDS epidemic in the United States since 1984. It is the largest body of community-based HIV/AIDS prevention, treatment, research, education and service organizations and coalitions in the United States. The PPC has been instrumental in creating and developing important programs, including the Ryan White Program and the National HIV/AIDS Strategy. Its national membership covers jurisdictions that include more than two-thirds of people living with HIV/AIDS and advocates for the millions of people living with or affected by HIV/AIDS in the United States and the organizations that serve them. To learn more about the PPC or to become a member, go to policy.aidsunited.org

About AIDS United:

Created by a merger between the National AIDS Fund and AIDS Action in late 2010, AIDS United's mission is to end the AIDS epidemic in the United States, through strategic grant-making, capacity building, formative research and policy. AIDS United works to ensure access to life-saving HIV/AIDS care and prevention services and to advance sound HIV/AIDS-related policy for U.S. populations and communities most impacted by the epidemic. To date, our strategic grant-making initiatives have directly funded more than $85.8 million to local communities, and have leveraged more than $110 million in additional investments for programs that include, but are not limited to, HIV prevention, access to care, capacity building, harm reduction and advocacy.