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Southern AIDS Coalition Seeks Equitable Distribution of All HIV/AIDS-Related Federal Funds

Posted on: Tuesday, 20 December 2005, 15:00 CST

The Southern AIDS Coalition (SAC) asks Congress, the Administration, and all concerned citizens for those living with HIV/AIDS to ensure equitable prevention, care, treatment, and housing accessibility across the nation. One critical element of achieving solid public health policy will be to change the Ryan White C.A.R.E. Act to ensure that funds follow the epidemic. SAC will host a national Satellite Broadcast on Friday, January 27th, 2006, from 2:00 pm - 4:00 pm CST. The purpose of the broadcast is to reengage the nation concerning the continuous growth of HIV/AIDS cases in the country, especially the disproportionate rates in the South, and the funding disparities that continue to impact regions of the nation through premature deaths and increased infections because access to care is dependent upon a fair distribution of funds. The broadcast is supported by the Alabama Department of Public Health Video Communications Division and will include national, regional, and local speakers.

"The Southern AIDS Coalition's policy recommends fair distribution of federal tax dollars based on sound HIV/AIDS data. HIV has spread to communities that are less urban and require support that matches the per-case amounts received in many urban areas. We have never recommended anything other than a same per-case dollar distribution of the funds. Today if you live in an urban setting, you receive more money than if you live outside one of the pre-determined 51 areas in the nation. This system is not fair, nor is it good public health policy. It leads to premature death and increased infections in communities of poverty and communities of color," said SAC Director, Randall Russell.

"The existing policy to distribute federal funds based on geography rather than the per-case distribution approach of Ryan White funds are a transparent attempt to distract the HIV Community, Congress and the Administration from the real issues. SAC continues to call for increases for all federal resources, including the Ryan White C.A.R.E. Act. Increased appropriations and fair distribution of federal dollars will improve access to care and prevent new infections. We only want an even chance to fight the disease and to provide reasonable and comparable services to people infected with and affected by the disease who happen to live in our states," said Kathie Hiers, SAC Community Co-Chair.

SAC released a detailed, thorough analysis that recommends changes in the distribution of Ryan White funds as well as several policy changes in issues related to federal funds for HIV/AIDS care, treatment, and prevention on August 22, 2005. To date Congress has not reauthorized the C.A.R.E. Act, which expired September 30, 2005.

"President Bush and his administration are the first to stand up and say that we should serve the neediest first," said Tony Sea, an African-American male living with HIV disease in Tennessee. "In his State of the Union address he said that '...we must focus our efforts on fellow citizens with the highest rates of new cases, African-American men and women.' We have the highest percentage of African-Americans living with HIV disease in the South, and we have the fewest resources. I am outraged at the lack of national support to provide the same resources for care and treatment in the entire country," Sea concluded.

"SAC's initial position, adopted several years ago, reiterated on the first page of our policy statement, and which remains our continuing preference, is that significant new funds be made available through the Ryan White program and that these funds be targeted to areas experiencing significant growth in the HIV/AIDS epidemic. Epidemiology of the disease demonstrates that many of these areas have been historically under funded. While this lack of parity in funding certainly includes many of the Southern States that are part of the Southern AIDS Coalition, many other states in other regions of the country are also impacted. Sadly Congress has delivered nearly flat funding (a $10 million AIDS Drug Assistance Program increase is included, the only Ryan White C.A.R.E. Act increase to date). This trend is clearly unacceptable since HIV/AIDS continues to simmer and boil as one of the most devastating public health threats in this country. The fact that some jurisdictions must lose funding in order to help address the lack of basic services in other areas is horrific," responds SAC Government Co-Chair and North Carolina AIDS Director, Evelyn Foust.

"We have to remember that the Ryan White Care Act is reviewed only every five years, and this open window allows Congress to look at us, those regions of the country that do not receive parity funding, and say 'you need more this go around: no less than your fair share.' The next time this conversation can happen is 2010, and people with HIV disease who do not have equal access to care and treatment won't wait that long; they'll be dead. The major group that consistently keeps this fact on the front burner is SAC," Foust concluded.

"Hurricane Katrina and the inadequate disaster response devastated a significant part of New Orleans. The City will experience the impact of this storm for many long, sad years to come. I would never presume to say what it's like to live in a major urban area outside of Louisiana; but I can tell you what this Hurricane taught me first hand. If you are forced from your home in one of the limited 51 Ryan White Title I funded areas and have to move outside of a Title I EMA, the care and treatment you receive is likely to decrease dramatically. This discrepancy can easily be interpreted to mean that people who live in major urban cities deserve more money and ultimately more services than those who live in rural areas. Why a policy like this one is allowed to continue is a mystery to me. I ask representatives from Title I funded cities to come to New Orleans, visit outside of the Title I area, and tell the client from Baton Rouge sitting in the waiting room with the client evacuated from New Orleans why she is eligible for $250 a quarter for medication assistance when the client from New Orleans is eligible for $1500 of assistance. I would welcome assistance with an explanation," declares Beth Scalco, Louisiana State AIDS Director.

"It is unconscionable in this day and time that we would not join hands and demand that Congress both distribute funds fairly and increase appropriations in order to ensure that no jurisdiction loses any funding," Evelyn Foust continues.

Some national and local organizations that may lose funding if flat-level appropriations are distributed have said that a regional analysis such as the Southern AIDS Coalition's approach is unfounded. National organizations, cited below, provide us with the following convincing statistics:

 --  The South gained 13.8% and the Midwest 10.5% in AIDS incidence reports     between 1999 and 2003.  During the same period, the Northeast had a     reduction in AIDS incidence of 3.6% and the West a reduction of 3.3%. (1) --  For those areas with confidential names-based HIV reporting, the 2003     data shows the South with 48%, the Northeast with 39%, the Midwest with 9%,     and the West with 4%. (2) --  Seven of the top ten metropolitan areas in terms of the incidence of     AIDS are in the South. (3) --  There are 13 States in the SAC region of the 14 that implement     Medicaid cost containment measures that restrict access to services for low-     income individuals despite ongoing advocacy from AIDS Advocacy networks     throughout the South to increase state revenue in an effort to qualify for     Medicaid increases. (4) --  SAC states represent eight out of the top ten with respect to     percentages of African-Americans with AIDS in 2003. (5) --  The South has 36% of the nation's population with 40% of AIDS     prevalence and 46% of AIDS incidence, by far, the highest percentages of     any region. (6) --  "If HIV case counts had been incorporated with AIDS cases in     allocating Ryan White Title II funding to the states in fiscal year 2004,     about half of the states would have received an increase in funding and     half of the states would have received less funding. Many of those states     receiving increased funding would have been in the South, a region that     includes seven of the ten states with the highest estimated rates of     individuals living with HIV." (7) --  As of 2003 the South has the highest estimated numbers of people     living with HIV/AIDS. (8)      

Clearly, these facts support the horrendous plight of the epidemic in the South.

The Southern AIDS Coalition's Ryan White Reauthorization Policy can be found at

http://www.southernaidscoalition.org/Policy%202005%20final.pdf

"The Southern AIDS Coalition promotes:

 --  Access to essential care and treatment for all persons living with HIV     disease without regard as to where they live; --  Equitably distributed federal resources based on the most current data     of AIDS and/or HIV/AIDS as reported by the CDC; and --  Increases in all federal, state, and local programs to foster     prevention of new HIV infections, full care for those living with HIV,     housing stability for all in need, and treatment for all low-income persons     in the United States," SAC Director Russell concluded.      

 (1) Source: Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Vol. 15, 2004 as reported to the Southern AIDS Coalition by the Kaiser Family Foundation. (2) Notes: Based on reported HIV cases. Excludes the following states that did not have confidential name-based HIV reporting as of December 2004: CA, DE, DC, HI, IL, KY, ME, MD, MA, MT, NH, OR, RI, VT, and WA. The U.S. total does not include dependencies, possessions and associated nations and excludes persons from states with confidential name-based HIV infection reporting who were residents of other states, and persons whose area of residence is unknown. FL has had confidential name-based HIV infection reporting only for new diagnoses. PA has confidential name-based HIV infection reporting only in areas outside the city of Philadelphia. CT has confidential name-based HIV infection reporting only for pediatric cases, and allows cases of HIV infection in adults and adolescents to be reported by name or code. Source: Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Vol. 15, 2004. (3) Note: Metropolitan areas with 500,000 or more population. Source: Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Vol. 15, 2004. (4) Source: Kaiser Family Foundation, The Continuing Medicaid Budget Challenge: State Medicaid Spending Growth and Cost Containment in Fiscal Years 2004 and 2005, Results from a 50-State Survey, 2004. (5) Sources: Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention-Surveillance and Epidemiology, Special Data Request, October 2004. Available at www.StateHealthFacts.org. (6) Note: Percentages may not total 100% due to rounding. Sources: U.S. Census Bureau, Annual Estimates of the Population for the United States, Regions and Divisions: April 1, 2000 to July 1, 2003; Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, Vol. 15, 2004. (7) Government Accounting Office Report: Factors that Impact HIV/AIDS funding and Client Coverage.  http://www.gao.gov/cgi-bin/getrpt?GAO-05-841T (8) IBID 

 Contact: Randall Russell, Director The Southern AIDS Coalition P.O. Box 130159 Birmingham, AL  35213 205-591-6888 Contact via http://www.marketwire.com/mw/emailprcntct?id=E7F1C1FBDD0B3F32  

SOURCE: AIDS Alabama

Source: MARKET WIRE

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