Under the CARE Act, funds are made available to assist over 530,000 individuals affected by HIV/AIDS. Grantees directly provide services to individuals (clients) or arrange with service providers to do so. The Department of Health and Human Services's (HHS), Health Resources and Services Administration (HRSA), which administers CARE Act programs, is required to cancel balances of grants that are unobligated after one year and redistribute amounts to grantees in need. HRSA began to collect client-level data in 2009. Under the CARE Act, states and territories receive grants for AIDS Drug Assistance Programs (ADAP), which provide HIV/AIDS drugs. GAO was asked to examine elements of the CARE Act. In this report, we review: (1) HRSA's implementation of the unobligated balance provisions, (2) HRSA's actions to collect client-level data, and (3) the status of ADAP waiting lists. GAO reviewed reports and agency documents and interviewed federal officials, officials from 13 state and 5 local health departments chosen based on location and number of cases, and other individuals knowledgeable about HIV/AIDS.
Recommendations for Executive Action
|Department of Health and Human Services||1. To help ensure that HRSA is able to implement the unobligated balance provisions in a timely manner, and to obtain timely and accurate information on grantees' unobligated balances, the Secretary of HHS should instruct the administrator of HRSA to identify the causes of grantees' difficulties in providing a timely and accurate accounting of their unobligated balances.|
|Department of Health and Human Services||2. To help ensure that HRSA is able to implement the unobligated balance provisions in a timely manner, and to obtain timely and accurate information on grantees' unobligated balances, the Secretary of HHS should instruct the administrator of HRSA ensure that grantees adhere to deadlines for submission of their unobligated balances by developing steps to assist them in overcoming the causes of difficulties identified in accounting for unobligated balances.|