HRSA Clarifies Allowable Expenses Under Current Regulation
WASHINGTON, D.C. — AIDS United welcomes the Health Resources and 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 an overly restrictive 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 rather than administration expenses.
However, this interpretation 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. For example, it 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.
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 help ensure healthy and financially stable organizations who can get us to the end of HIV that much quicker.”
The AIDS United Public Policy Committee, the largest and longest running community-based HIV/AIDS coalition, raised the issue directly with HRSA in late 2013 and then worked over the next year and a half across multiple federal agencies and with HRSA to press for a revised policy clarification.
While HRSA’s announcement addresses this issue at the federal level, some states and local jurisdictions continue to place onerous funding restrictions on organizations. For example, in Alabama implementing partners in the field get no administrative costs for most services they offer. This places financial stress and challenges on the long-term sustainability of organizations who provide these critical services.
“AIDS United is grateful for HRSA’s willingness to review this issue and work in partnership with the community. We especially thank HRSA Administrator Mary Wakefield, Associate Administrator Laura Cheever, and Senior Advisor Janice 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.