Washington Blade - September 26, 2003
Laurel Faust

The U.S. Senate earlier this month voted down $400 million in additional Ryan White Care Act funds for fiscal year 2004.

Just days later, the Whitman-Walker Clinic announced that it would implement a major restructuring to offset a $3.5 million decline in private funding.

"The case loads are just increasing every year, and the money is not keeping pace with that. So what this means is more waiting lists, longer time for people to get into care and less availability of some services, period," Hawkins said.

She said the clinic doesn't have waiting lists in primary care, but it has them in case management and housing.

"In Prince George's County, we can't put anyone on the waiting list. It's not because there's not a demand. There's a tremendous demand. There's no hope of getting them into housing," Hawkins said.

"The entire environment has dramatically shifted," said Cornelius Baker, the clinic's executive director, the same day he announced Whitman-Walker's restructuring.

"Senator Specter, who's always been a great friend of the AIDS community, actually managed the opposition against the increases," Baker said. "Even our friends are now squeezed by the government deficit in what the budget allows."

Specter and his spokesperson did not return multiple calls.

Sen. Charles Schumer (D-N.Y.) introduced the amendment to the House Labor/Health & Human Services Appropriations bill that would have added $400 million to the ailing Ryan White Care Act. It was voted down by Specter as a point of order due to budgetary concerns.

The Congressional Budget Office in August projected a budget deficit in excess of $480 billion. That was before President Bush's request for an additional $87 billion to fund security and rebuilding in Iraq and Afghanistan.

"In fiscal year budget of 2004, President Bush stated his goal to help reduce the number of HIV infections in the United States by 50 percent by 2005," Schumer told the Senate. "However, the president's budget provides no new domestic prevention funding à to meet this goal."

Funds vital to many clinics

The Ryan White legislation funds primary care and support services for people living with HIV disease who have no other health care or the financial ability to pay for their care.

David Shippee, executive director of Chase Brexton Health Services in Baltimore, said the organization is fortunate because their budget only 22 percent grant-dependent. He said the clinic also has an in-house pharmacy, which allows for the purchase of drugs at a low cost.

Schumer's amendment would have included $214.8 million for the AIDS Drug Assistance Program, a primary component of the Ryan White Care Act.

Still, Shippee said, funding difficulties could mean the difference between keeping pace on salaries and provision of services. He said Chase Brexton will try to direct clients into Medicaid, but he noted that state Medicaid programs also face budget restrictions.

He said National Institutes of Health research likely will not see cuts because the programs are funded by the pharmaceutical industry, but he was uncertain of the prospects for prevention programs at the Centers for Disease Control & Prevention.

Shippee said Maryland could also see a redirection of tobacco restitution funds - which are supposed to be used for cancer prevention - to support other budget needs.

The Director of Health & Support Services for the D.C. HIV/AIDS Administration, Felicia Lynch, said the organization plans to be more creative to meet the needs of the client.

"If we do our job, it won't affect the client," she said.

HAA serves 13,723 clients in the eligible metropolitan area, which includes D.C., Northern Virginia, and parts of Maryland and West Virginia.

Lynch said though national funding for Ryan White funds has been level for the past three years, the eligible metro area actually saw a seven percent increase in funding.

She said what is important is that the message gets out to the people about prevention.

"Some of that is not about money. It's about caring and it's about education. It's about assuming responsibility for your neighbors," Lynch said.

"At some point, there's never going to be enough money. We have to stem the tide and that's everyone's responsibility," she said.

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MORE INFO

Sen. Arlen Specter

711 Hart Building

Washington, DC 20510

202-224-4254

Sen. Charles Schumer

313 Hart Senate Building

Washington, DC 20510

202-224-6542

030926
WB030914

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