March 03, 2006 - AIDS funds could drop

AIDS funds could drop

Advocates fear proposed U.S. changes could cost the state $19 million a year.

News Article/Sacramento Bee

By Judy Lin -- Bee Staff Writer
Published 2:15 am PST Friday, March 3, 2006
Story appeared on Page A3 of The Bee

As Congress begins talk of renewing HIV/AIDS funding, California patients and advocacy workers are growing concerned that policy changes backed by the White House could cost the state at least $19 million a year.

Currently, AIDS cases in major metropolitan cities are counted once as part of a city count and a second time in the overall state count. To make sure federal funds are distributed equally, the U.S. Department of Health and Human Services proposes to eliminate such double counting.

But California advocates believe that if the calculations change, the state's nine designated metropolitan areas stand to lose $19 million, or 62 percent of the current $31 million awarded.

Advocates worry that the Golden State will be penalized for its high quality of care and note that communities across the nation could lose local control of federal dollars.

"What it doesn't account for is when you look at all sorts of Ryan White funding per capita, California is slightly below the national average," said Alan Lange, program manager of the Sacramento Community Services Planning Council.

Federal funding comes from the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, which provides treatment and support of last resort for people living with HIV and AIDS. The state received more than $223 million in 2005 from all CARE Act funding. There are 140,000 Californians living with AIDS and 40,500 living with HIV.

U.S. Sen. Dianne Feinstein said it makes sense to distribute more money to urban areas, which account for 70 percent of people living with HIV and AIDS.

"Funding under the Ryan White CARE Act should go, first and foremost, to where the need is," Feinstein, D-Calif., said in a statement.

California's concerns are just some of many that lawmakers will likely hear as Congress tries to update a 16-year-old act that hasn't necessarily kept up with treatments and trends in the epidemic. For example, today's HIV and AIDS patients tend to live longer with help from better drugs. The disease, meanwhile, is growing among women and minorities.

In urging Congress to renew the CARE Act, President Bush has said he wants to focus funding on medical treatment for patients, particularly among minority groups such as African Americans.

The act, which expired five months ago, is now being heard by the Senate Health Committee. Meanwhile, U.S. Sen. Tom Coburn, R-Okla., has introduced a bill to renew the act, though Randy Allgaier, co-chair of the San Francisco HIV Health Services Planning Council, said it contains many of the same issues that concern his organization.

While local advocates support renewing the act, their concern lies in proposed changes, such as with eliminating the double count.

Principles released by the Department of Health and Human Services include mandating that 75 percent of CARE funds go to core medical services, cutting provisions that protect against drastic funding cuts, and making planning councils voluntary. California advocates say such principles would mean fewer dollars at home.

A requirement to spend 75 percent of funding on core services sounds good in theory, but advocates say it would mean loss of other services like transportation and counseling - all vital to helping patients get medications.

A "hold harmless" provision currently keeps funding cuts to a minimum so services won't be disrupted. Lange said removing that protection would make it difficult for agencies to budget year to year.

HIV patient Gary Parent, 56, said he supports local planning councils because residents know what they need most. The councils were created as a way for communities to decide how they wanted to disburse their share of federal dollars. California has nine of 51 planning councils and all are required to have one-third participation by consumers.

"I personally like local control because every community has its own unique needs," Parent said.

In response, all nine of California's metropolitan HIV planning councils have signed a statement of their concerns.

The statement was used to rally legislative support for Senate Bill 699, a measure that would convert to infection reporting by name - rather than by code - to conform with Centers for Disease Control and Prevention mandates.

Currently, California prohibits identifying test subjects without their consent. However, the CDC wants to move to a name-based system to prevent duplication and errors.

Unless the state converts its reporting system, supporters say it could jeopardize up to $50 million in annual federal funding.

"Beginning October 2006, Ryan White Care Act funds will be distributed on the basis of HIV cases - not AIDS cases alone - because HIV cases offer a more accurate picture of the epidemic," said state Sen. Nell Soto, D-Pomona, in a statement.

SB 699 has passed the Senate and is expected to go before the Assembly for a vote next week. It could go to the governor for signing in two weeks.

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AIDS funds could drop

Advocates fear proposed U.S. changes could cost the state $19 million a year.
News Article/Sacramento Bee By Judy Lin -- Bee Staff Writer Published 2:15 am PST Friday, March 3, 2006 Story appeared on Page A3 of The Bee As Congress begins talk of renewing HIV/AIDS funding, California patients and advocacy workers are growing concerned that policy changes backed by the White House could cost the state at least $19 million a year. Currently, AIDS cases in major metropolitan cities are counted once as part of a city count and a second time in the overall state count. To make sure federal funds are distributed equally, the U.S. Department of Health and Human Services proposes to eliminate such double counting. But California advocates believe that if the calculations change, the state's nine designated metropolitan areas stand to lose $19 million, or 62 percent of the current $31 million awarded. Advocates worry that the Golden State will be penalized for its high quality of care and note that communities across the nation could lose local control of federal dollars. "What it doesn't account for is when you look at all sorts of Ryan White funding per capita, California is slightly below the national average," said Alan Lange, program manager of the Sacramento Community Services Planning Council. Federal funding comes from the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, which provides treatment and support of last resort for people living with HIV and AIDS. The state received more than $223 million in 2005 from all CARE Act funding. There are 140,000 Californians living with AIDS and 40,500 living with HIV. U.S. Sen. Dianne Feinstein said it makes sense to distribute more money to urban areas, which account for 70 percent of people living with HIV and AIDS. "Funding under the Ryan White CARE Act should go, first and foremost, to where the need is," Feinstein, D-Calif., said in a statement. California's concerns are just some of many that lawmakers will likely hear as Congress tries to update a 16-year-old act that hasn't necessarily kept up with treatments and trends in the epidemic. For example, today's HIV and AIDS patients tend to live longer with help from better drugs. The disease, meanwhile, is growing among women and minorities. In urging Congress to renew the CARE Act, President Bush has said he wants to focus funding on medical treatment for patients, particularly among minority groups such as African Americans. The act, which expired five months ago, is now being heard by the Senate Health Committee. Meanwhile, U.S. Sen. Tom Coburn, R-Okla., has introduced a bill to renew the act, though Randy Allgaier, co-chair of the San Francisco HIV Health Services Planning Council, said it contains many of the same issues that concern his organization. While local advocates support renewing the act, their concern lies in proposed changes, such as with eliminating the double count. Principles released by the Department of Health and Human Services include mandating that 75 percent of CARE funds go to core medical services, cutting provisions that protect against drastic funding cuts, and making planning councils voluntary. California advocates say such principles would mean fewer dollars at home. A requirement to spend 75 percent of funding on core services sounds good in theory, but advocates say it would mean loss of other services like transportation and counseling - all vital to helping patients get medications. A "hold harmless" provision currently keeps funding cuts to a minimum so services won't be disrupted. Lange said removing that protection would make it difficult for agencies to budget year to year. HIV patient Gary Parent, 56, said he supports local planning councils because residents know what they need most. The councils were created as a way for communities to decide how they wanted to disburse their share of federal dollars. California has nine of 51 planning councils and all are required to have one-third participation by consumers. "I personally like local control because every community has its own unique needs," Parent said. In response, all nine of California's metropolitan HIV planning councils have signed a statement of their concerns. The statement was used to rally legislative support for Senate Bill 699, a measure that would convert to infection reporting by name - rather than by code - to conform with Centers for Disease Control and Prevention mandates. Currently, California prohibits identifying test subjects without their consent. However, the CDC wants to move to a name-based system to prevent duplication and errors. Unless the state converts its reporting system, supporters say it could jeopardize up to $50 million in annual federal funding. "Beginning October 2006, Ryan White Care Act funds will be distributed on the basis of HIV cases - not AIDS cases alone - because HIV cases offer a more accurate picture of the epidemic," said state Sen. Nell Soto, D-Pomona, in a statement. SB 699 has passed the Senate and is expected to go before the Assembly for a vote next week. It could go to the governor for signing in two weeks.
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