Congress created the Drinking Water State Revolving Fund (DWSRF) program to assist public water systems with upgrading infrastructure to ensure the continued provision of safe drinking water. The fund requires states to give priority to projects needed to protect public health and ensure compliance with the Safe Drinking Water Act (SDWA), especially in locations with great economic need and the most serious health problems. We sought to determine whether DWSRF funds are effectively used to assist communities that do not meet standards. Congress established the DWSRF program in the 1996 amendments to SDWA. The goal of the DWSRF program is to provide states with the means to establish a revolving fund to provide low-cost loans to public water systems, and other funding through set-asides, to further public health protection under SDWA. In fiscal year 2010, the U.S. Environmental Protection Agency (EPA) allotted $1.36 billion for state DWSRF programs.