The Bay Area Reporter - Friday, April 30, 1999
Bob Roehr

Ryan White AIDS services programs will be up for a five-year reauthorization in 2000. The GAO report probably will not be completed until early next year.

The April 20 request came in a letter signed by House majority leader Dick Armey (R-Texas) and Thomas Bliley, Jr. (R-Virginia), chairman of the Committee on Commerce, which has jurisdiction over these programs.

The third member, Dr. Tom Coburn, (R-Oklahoma), is vice chair of the Subcommittee on Health and Environment. He is closely allied with James Dobson, head of the arch-conservative Focus on the Family. Coburn was the driving force behind the request.

"Congress has a moral obligation to those suffering with AIDS/HIV to ensure that the nearly $9 billion directed to federal AIDS programs is spent for purposes for which it is intended," Coburn said in a statement released by his office.

Jim Driscoll, an AIDS lobbyist with Log Cabin Republicans, said, "The idea has been bouncing around for over a year." Log Cabin tried to find a friendly sponsor to shape the audit request.

Senator Jim Jeffords (R-Vermont) is chairman of the Labor and Human Resources Committee and a strong friend of both gay and AIDS interests. But his office "was not very enthusiastic about Ryan White reauthorization," according to Driscoll.

Other potential sponsors were equally reticent. The initiative fell to Coburn as the one with "the most genuine interest in reauthorization," Driscoll said.

Coburn did not pursue suggestions to get Democratic members to join in signing a bipartisan letter. Nor did Democrats, who were aware of the proposal over its several weeks of gestation, pro-actively seek to join the process and help shape the request.

A tangential issue fueling Capitol machinations is an ongoing trial in Puerto Rico where three administrators are charged with diverting $2 million in federal AIDS funds to political purposes. The alleged beneficiary, Governor Pedro Rossello, heads up Al Gore's presidential campaign in Puerto Rico.

Reactions

"This call for an audit is nothing less than a politically motivated attempt to raise doubts about the fight against AIDS," charged Daniel Zingale, executive director of the AIDS Action Council.

It was a common response from AIDS lobbyists in Washington. "These are not men who I would put on a primary list as being big time AIDS advocates," said Gary Rose, a member of the AIDS Drug Assistance Program (ADAP) Working Group.

Only after attacking the messenger would they admit that the message of an audit could be "a useful exercise," as the Human Rights Campaign's (HRC) political director Winnie Stachelberg put it. "I think it is important to know how federal dollars are spent.

San Francisco activist Michael Petrelis was "very happy" with news of the audit request, though he was "troubled" by a question concerning use of illegal drugs in AIDS-funded housing.

Petrelis has spearheaded the Accountability Project, which gathers information on AIDS services providers. He also was in contact with Coburn's staff and helped shape the questions sent to GAO.

Representative Nancy Pelosi (D-California), a leading AIDS advocate in Congress, noted, "There are numerous oversight and review procedures in place for Ryan White CARE and other programs." But she had "no objection" to the study.

Coburn reacted to the charge of political motivation by phoning Zingale the next morning. The congressman said he was willing to consider any additional issues Zingale might have, and may write a supplemental letter to GAO.

Impact

The GAO has a fine reputation for conducting impartial studies, so there is little concern that the process will be politicized. It delivered a similar, but more limited, review of Ryan White programs in 1995 when that bill was up for its first renewal.

"I actually think that we are going to get some answers that are useful, because GAO are smart people," said Rose. The 1995 study "challenged everybody to sit down and have the discussion that everyone was putting off. This could do the same."

He believes that GAO will "find bad bookkeeping in some agencies. They are going to find a couple of examples of misappropriation of funds, it's inevitable. It happens with every kind of government program. But I've been pretty close to the ground with almost every level of AIDS services provision and I just don't see widespread abuse."

Pelosi is "convinced that any objective and thorough review of federally funded AIDS programs will find that the vast majority of programs are high quality, cost effective, and essential to the appropriate care of thousands of people with HIV."

Terje Anderson jokingly suggested, "Our motto could be something like, 'Ryan White: Not quite as bad as any other federal program.'" He is policy director with the National Association of People With AIDS (NAPWA).

Provision of care seldom has been a contentious issue. The historically divisive issues have been those of prevention activities such as needle exchange, names reporting, condom distribution, what to teach, when and where to teach it.

Anderson reminded people that "prevention operates without the kind of legislative authority that Ryan White does." That is unlikely to change, given the ideological chasm that separates Congress on those issues.

"There is great bipartisan support for the Ryan White CARE Act," which funds medical services, said Stachelberg. "It will be reauthorized."
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