HRSA Funding Moves Outside Epicenters

In fiscal year 1989, HRSA appropriated a total of $3.9 million in Low Prevalence Planning Grants to 22 grantees. In retrospect, this level of funding may seem small; however, the Low Prevalence Planning Grants were among the first AIDS-specific resources in some locations. And in many parts of the country, the grants set the stage for building a care continuum outside the large urban epicenters where HIV/AIDS first emerged.

Soon after AIDS emerged, it became abundantly clear that this disease would literally know no boundaries. It spread beyond the big cities to smaller cities, towns, and rural communities across the country. Moreover, many people living with HIV/AIDS moved home to these areas to seek the support and care of family and friends.

Low Prevalence Planning Grants were among the first resources offering help to States and medium-sized cities to assist in planning and building their response to the epidemic. These grants, along with the AZT Drug Reimbursement and the Home and Community-Based Care programs, laid much of the groundwork for what was to become Title II (now Part B) of the CARE Act.

The grants helped plan for community-based systems of care providing a range of services for HIV-infected people in grantee communities, including appropriate alternatives to inpatient hospital care. In return, States and cities funded under this grant program were required to

  • assess needs and estimate resources required,
  • develop plans for efficient use of healthcare resources,
  • create coalitions of State and community organizations to plan for services, and
  • develop and submit plans to HRSA to implement the desired system of services.

But the projects funded under these grants reached beyond grantee communities. In keeping with a rich tradition of knowledge sharing at HRSA, they also served as planning models for other communities with significant HIV-positive populations.