Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Bay Area Reporter - May 18, 2006
Matthew S. Bajko, m.bajko@ebar.com
Only months ago city leaders feared congressional Republicans would jettison a provision of the act referred to as "hold harmless," which protects large municipalities such as San Francisco from being hit with a one-time cut in their funding. Such an all-at-once cut would devastate the city's system of care for people with HIV and AIDS.
Under the old CARE Act, which expired last fall but was funded by Congress for an additional year, San Francisco saw its funding cut by 4 percent over four years and 5 percent in the additional year. In the draft legislation to renew the CARE Act this year, San Francisco will see its funding reduced over three years.
Newsom, in an interview with the Bay Area Reporter inside his City Hall offices Tuesday, May 16, said he is hopeful the final wording of the legislation will actually phase the cuts in over four years.
"We tried to push for five years but we had no success," said Newsom. "It's still significant. We fought hard for a fourth year."
Even with the phased in drop in AIDS funding over the four years, the cut will still mean wholesale changes in what services the city offers and how it delivers those services to people living with HIV and AIDS. Currently, the city receives $20 million in Ryan White funding.
"It is a significant cut to us," said Newsom. "We have all these Republicans who have targeted San Francisco. I am not being paranoid about that."
Jimmy Loyce, director of the health department's AIDS Office, called securing part of the hold harmless provision "good news."
"Three months ago no one in the city even wanted to see reauthorization move forward because it looked like there would not be any hold harmless in the legislation," said Loyce.
Newsom added that there is some language embedded in the CARE Act legislation being proposed that would be beneficial to the city. A change in how the federal government accounts for a city's number of HIV cases would result in a 16 percent increase in San Francisco's total number of cases, which Newsom pegged at 19,600 [see story, page 17].
"San Francisco has the third highest population of people with HIV in the country. We have more people living here with HIV than some states' total populations of people living with HIV," said Newsom.
Newsom said reauthorization of the CARE Act consumed his latest lobbying trip to Washington D.C. In early May Newsom pressed Senator Ted Kennedy (D-Massachusetts) û the ranking Democrat on the Senate Committee on Health, Education, Labor and Pensions û and Congressman John D. Dingell (D-Michigan) û the ranking Democrat on the House Committee on Energy and Commerce û about the need to protect the hold harmless provision. Both committees oversee the reauthorization of the CARE Act and both men will be key in safeguarding San Francisco's interests in the legislation.
"I don't recall in my three lobbying trips as mayor being so single-focused. The only thing I talked about was the Ryan White CARE Act," said Newsom, who has also written to Congresswoman Nancy Pelosi (D-San Francisco), the House minority leader, and California Senators Dianne Feinstein (D) and Barbara Boxer (D) about the CARE Act reauthorization.
Newsom will join with seven other mayors at the annual U.S. Conference of Mayors in June to push for passage of a resolution on Ryan White. The resolution calls for Congress to carry forward the hold harmless provision, allow cities with high HIV prevalence to continue to receive extra funding from money allocated to their states, and change how the money is divvied up from being based on estimated numbers to the actual number of people living with AIDS as determined by the Centers for Disease Control and Prevention.
As for Congress actually passing the legislation this year, both Newsom and Loyce said it remains to be seen if other issues, from immigration to the war on terror to a new director of the C.I.A. take center stage and divert Congress's attention from the CARE Act.
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