The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, enacted in 1990 and reauthorized and amended in 1996 and 2000, provides funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance.

The CARE Act is a discretionary program that relies on annual appropriations from Congress--$2 billion in 2003--to provide care for low-income, uninsured or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to redress all of the inequalities and gaps in coverage for people with HIV.

In response to a congressional mandate, an IOM committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded.

In the report, Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act, the committee proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.