The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act serves as a safety-net provider of medical treatment and support services for uninsured or underinsured individuals living with HIV disease. As part of the 2000 CARE Act reauthorization legislation, Congress directed the IOM to conduct a study examining the following issues:

• whether states' HIV surveillance systems provide adequate and reliable information on the number and demographic characteristics of HIV cases, at the state level and for specific geographic areas within states; and whether HIV case reports are sufficiently accurate for purposes of formula grants under Titles I and II of the Ryan White CARE Act;
• the existing and needed epidemiologic data and other analytic tools for resource planning and allocation decisions related to health care for HIV infected individuals, specifically for estimating a community's severity of need and the relationship of those data to the process of funding allocation; and
• the availability and utility of health outcome measures and data for HIV primary care and support services funded by RWCA, and the extent to which those measures can be used to measure quality of funded services; and other factors that are relevant to assessing a community's ability to gain and sustain access to quality HIV services.

The IOM convened a multidisciplinary study committee to address these issues. Committee members worked with IOM staff to produce a report in fulfillment of a contract with the Health Resources and Services Administration and the Centers for Disease Control and Prevention.