Monday, June 12, 2006

HIV cases Must Be Included in Ryan White Funding Formula

The following is a press Release from Alliance of AIDS Services - Carolina and the Southern AIDS Coalition:

Southern AIDS Coalition

Contact: Kathie Hiers at (205) 835-AIDS

HIV Cases Must Be Included in Ryan White Formula

GAO Report Ignored by Urban Congressional Leaders

Birmingham – The Southern AIDS Coalition believes that HIV cases must be counted and that count incorporated into the formula to distribute dollars for treatment and care within The Ryan White HIV/AIDS Treatment Modernization Act of 2006. Low-income persons living with HIV are served by these federal funds, and they must be counted in order for the funding to follow the epidemic. During the Ryan White reauthorization process in 2000, Congress mandated that this shift in the funding formula be completed by 2007; activists in some states that have not complied with the mandate in a timely fashion or whose reporting systems are not yet judged to be adequate are asking that the formula continue to be based only on AIDS cases. A report by the Government Accountability Office in February 2006 stated the following:

Among federal efforts to address the HIV/AIDS epidemic are the CARE Act of 1990 and Housing Opportunities for Persons with AIDS program (HOPWA)…Both use formulas based upon a grantee’s number of AIDS cases, rather than HIV and AIDS cases, to distribute funds to metropolitan areas, states, and territories. HIV cases must be incorporated with AIDS cases in CARE Act formulas not later than fiscal year 2007.

The report went on to state that the lack of HIV case counts generally resulted in less funding for states in the South and in the Midwest. These are areas of the nation experiencing the highest increases in new cases of HIV and AIDS.

A June 7, 2006, letter from the Council of State and Territorial Epidemiologists states:

....Moreover, the use of AIDS data alone would also lead to an inaccurate allocation of resources not reflective of actual disease burden.

“The South and other rural areas of the country have been the losers long enough,” states HIV-positive John Paul Womble of the Alliance of AIDS Services-Carolina. “All we hear about are the losses in some of the big states if we count HIV cases. What about the people who are dying because they can’t get meds? What about the people in our southern communities who don't have access to basic, core services like primary care? What about people who struggle to find transportation to get to the doctor? Why is no one talking about parity in the distribution of this funding?”

Some advocates now believe that the lengthy work of the U.S. Senate and the U.S. House of Representatives on the Ryan White reauthorization is in jeopardy because of disagreements among committee members over the basis for an equitable funding formula. As the current legislation continues to unfold, it is hard to believe that despite the well documented rise of HIV/AIDS among people of color living in rural and southern communities that priority would be given to maintaining or widening the inequitable disparities in funding. Proposed formula fixes that favor some cities and states but punish southern states while they are struggling to serve large numbers of impoverished HIV/AIDS citizens across largely rural geographical areas are not acceptable. If legislation without an equitable funding formula is approved, then the status quo will continue to favor the urban grantees and continue to provide inadequate funding to states for the low-income, HIV-positive persons living in rural America. We must eliminate the funding inequity, or we are de facto saying that the inequity is okay and that we accept it. It is not okay; we cannot accept it; and it cannot be continued.

President Bush has added $70 million dollars to the Ryan White Act, and the Southern AIDS Coalition urges Congress to remember that the President intended for this funding to be directed at the neediest areas. If agreement on the current bill cannot be reached without full counting of HIV cases, then the Southern AIDS Coalition agrees with many organizations from both rural and urban areas in recommending that the $70 million be allocated to the Title II base in states without a Title I Eligible Metropolitan Area and to states with 50% or more of their cases outside of their Title I, which would direct the new dollars at states in crisis and states with AIDS Drug Assistance Program (ADAP) waiting lists. Additionally, all appropriation increases over the next five years must go to these under-served areas until parity in funding is achieved. While the $70 million would improve the ability of poor states to serve their emerging epidemics, the overall Ryan White appropriation is inadequate to address the crisis within ADAP, which increases in costs at a rate of about $100 million each year.

“People waiting for life-saving HIV medications in the United States of America is a national disgrace. Last year I found myself without insurance and taking medication that costs over $2500 a month. I moved to the South from NY and found it very difficult to access funding for medication with ADAP closed. I can only tell you about what it felt like after not having to take medications for 16 years, getting sick, and then not being able to pay for it. It was like receiving a death sentence, and my option because of the type of meds that I was taking was to stop taking them altogether. Since moving here I have met so many people, especially people of color, with problems accessing adequate insurance and health care. The Ryan White Act has become a political battle ground, and the victims are the minorities and low-income residents of rural America. We must be counted! ” says Deadra Lawson Smith, an African-American woman now residing in South Carolina. “I believe that leaving us (people who are HIV+) out of the data is another form of discrimination and will ultimately lead to more deaths.”

The Southern AIDS Coalition seeks parity in access to HIV/AIDS care and treatment services for all persons living with HIV/AIDS in the United States. The Ryan White legislation must be a national model that distributes funding equitably through a structure that boldly encourages a national commitment to end AIDS in this country, community by community. A top priority must be to decrease HIV/AIDS among persons of color, and appropriate funding must be directed to the rural South to accomplish this goal.

“We are deeply concerned that the Ryan White Act is being held hostage to politics, and the price that will be paid, as it has been in the past, are the lives of persons with HIV/AIDS across rural America and in the Deep South,” says Jay Adams, HIV Care Coordinator for West Virginia.

The Southern AIDS Coalition is a non-profit organization that promotes accessible and high quality systems of HIV and STD prevention, care, treatment, and housing throughout the South through a unique partnership of government, community, and business entities.




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