Plunge in state revenue triggers AIDS funding ‘crisis’

Heather Hauck, director of the Maryland Department of Health & Mental Hygiene’s infectious disease division (DC Agenda photo by Michael Key)

The worst economic recession since the Great Depression is devastating state and local government budgets, especially HIV/AIDS budgets, a panel of AIDS experts said Thursday.

In a briefing on Capitol Hill for congressional staff members, state and local AIDS office officials from Maryland and California, along with leaders of AIDS service groups in Los Angeles and Louisville, Ky., said they were scrambling to carry out their work in the midst of unprecedented state budget cuts.

Facing a multi-billion dollar deficit, California slashed its state AIDS budget by $85 million, resulting in what two of the panelists from Los Angeles called crushing budget cuts for HIV prevention and treatment programs.

“To say that we were shocked is to put it mildly,” said Phillip Curtis, director of government affairs for AIDS Project Los Angeles.

Curtis and Mario Perez, director of the Los Angeles County Office of AIDS Programs & Policy, told about 25 Senate staffers in one of two presentations that cutbacks in HIV treatment and prevention programs could result in an increase in new HIV infections.

According to Curtis, AIDS Project Los Angeles lost $1.9 million in state funds, forcing it to lay off staff and reduce the HIV treatment and prevention services it provides to thousands of clients, including gay male and transgender clients.

Both said their respective agencies were continuing to assist a large number of clients and, in the case of Curtis’s group, fundraisers were retained to solicit more private sector funds from foundations. Their main concern now, the two said, was the possibility of more state funding cuts in the next fiscal year.

Heather Hauck, director of the Maryland Department of Health & Mental Hygiene’s infectious disease division, said her state’s HIV programs were hit with a $786,720 budget cut in fiscal year 2009 and a $702,768 cut in fiscal 2010. She noted that the cuts have resulted in some staff layoffs, furloughs and salary reductions.

Pointing to a national survey, she said state revenue shortfalls due to the recession are forcing many states to reduce their contribution to the joint state-federal AIDS Drug Assistance Program, known as ADAP.

Hauck said the cutbacks have resulted in at least nine states running out of funds to provide life-saving antiretroviral drugs to all the low-income HIV patients that need them. The funding shortfall means these and possibly other states must establish waiting lists for patients to obtain ADAP funded drugs.

Maryland, Virginia and D.C. are not among the jurisdictions forced to set up ADAP waiting lists, according to information Hauck provided. But she and the other panelists expressed concern that unless the federal government boosts its share of ADAP funding, waiting lists will surface in more states.

Carl Schmid, deputy executive director of The AIDS Institute, a Washington-based advocacy group, and moderator of the two congressional briefings, said state and local AIDS office officials are calling on the Obama administration to help offset the state budget cuts by increasing funds for the Ryan White Care Act. The Ryan White program is the federal government’s main funding source to state and local AIDS agencies.

Schmid said a coalition of AIDS organizations called the Federal AIDS Policy Partnership wants the administration to ask Congress to appropriate $3.1 billion for the Ryan White program in fiscal year 2011, representing an increase of $818 million over the fiscal year 2010 funding.

He said the coalition also wants Congress to approve an emergency supplemental budget allocation of $126 million this year for ADAP.

“We know times are tight, but there are a lot of people’s lives at stake,” Schmid said.

Bobby Edelen, president of the Kentucky HIV/AIDS Advocacy Action Group and a person living with AIDS, told the briefing that the lives of many of the people his organization assists in Louisville and other cities are being placed in jeopardy over his own state’s budget cuts.

“You’ve heard enough about numbers,” he said. “I’m here to talk about the personal side of this. I’ve been living with this disease for 20 years.”

He said an ADAP waiting list in Kentucky is likely to result in a decline in health of people with HIV that he knows personally.

“You’re going to lose some people if they can’t get the treatment and services they need,” he said. “I understand that money is tight. But we are the greatest nation on earth. We can make things possible.”

The four panelists and Schmid, who served as moderator, conducted a morning briefing at the Dirksen Senate Office Building for Senate staffers and an afternoon briefing at the Rayburn House Office Building for U.S. House staffers.