Bay Windows - February 12, 2004
Ethan Jacobs, ejacobs@baywindows.com.

Governor Romney released his FY 05 budget proposal Jan. 28 calling for a $1.7 million cut in the state's AIDS Line Item and a more than 50 percent cut to the program providing free health care to poor and middle income people living with HIV.

Romney's proposal will be debated and modified in the coming months as the House and Senate craft their own budget proposals and lawmakers work out a compromise budget to go into effect for FY 05, which begins July 1. HIV/AIDS organizations are assuming that many of Romney's cuts could remain in the final FY 05 budget, and they are taking steps to brace themselves for a hit at the beginning of the coming fiscal year. At the same time, the organizations are lobbying Beacon Hill for increased funding, hoping to undo some of the cuts in Romney's proposal.

Mary Ann Hart, director of Project ABLE (AIDS Budget Legislative Effort), said that since FY 01 the state's AIDS budget has been cut by 37 percent. Romney's budget proposal would cut the budget for the fourth year in a row at a time when the rate of HIV infection in the state is on the rise. Hart said the cuts, if retained in the FY 05 budget, would lead to cuts in support services for about 8000 people with HIV, including counseling to help people adhere to HIV medications, transportation to and from doctors' appointments, meals, and other services. The cuts would also impact Hepatitis C and sexually transmitted disease (STD) screening programs as well as the mechanisms designed to evaluate the effectiveness of the state's HIV/AIDS programs.

The Department of Public Health (DPH) disputes Hart's analysis of the impact of Romney's proposal on HIV/AIDS services in the state. Roseanne Pawelec, a DPH spokesperson, told Bay Windows that Romney's budget would maintain funding for most HIV/AIDS programs and increase funding for others.

"Spending across all of the EOHHS (Executive Office of Health and Human Services) agencies on HIV/AIDS programs is actually up as proposed by the governor [for FY 05]," said Pawelec. She said that as far as the reported cuts to the DPH AIDS budget, "There are some, but they're offset by federal funding."

Pawelec said money from the Centers for Disease Control (CDC) and Health Resources and Services Administration (HRSA) would fund community-based organizations and compensate for the state cuts.

Hart called DPH's take on Romney's proposal "wishful thinking." She said the only increase in EOHHS funding is in MassHealth, the state's Medicaid program (Bay Windows confirmed this through a document obtained from EOHHS), and she said the increase is to offset the increasing cost of medical care rather than to expand capacity.

As far as federal funding, Hart said she was not aware of any funds going to HIV/AIDS organizations.

"I think that that really is a line that the Romney administration gives," said Hart.

Officials from DPH and EOHHS were unavailable to discuss the impact of Romney's proposed budget on HIV/AIDS services.

In the meantime, HIV/AIDS organizations are bracing themselves for another difficult year, and many are forming partnerships to pool their resources. Rebecca Haag, executive director of AIDS Action, said that the executive directors of organizations from around the state have been meeting for about one year to identify synergies within the different organizations.

In response to increased difficulties in fundraising during a weak economy, AIDS Action and the Boston Living Center, which provides support services to people living with HIV, have merged their development staffs to reduce the overhead costs associated with fundraising. Haag said the move did not cost either organization any jobs; AIDS Action had vacancies in their own development office, and the Living Center used its own four development staffers to fill those vacancies. Both organizations hope the move will help each organization increase fundraising capacity and reduce competition among the groups for dwindling funds.

AIDS Action is also partnering with state organizations to expand the scope of its annual AIDS charity ride. Renaming the event the Massachusetts Red Ribbon Ride, AIDS Action plans to invite between 10 and 12 other organizations to cosponsor the event and take home a share of the proceeds. So far the Living Center and Community Research Initiative (CRI), which conducts trials of HIV/AIDS medications, have signed on.

"Rather than just raise money for AIDS Action, we think that we should be raising money around the state," said Haag.

Other collaborations include a partnership between AIDS Action and the Multicultural AIDS Coalition (MAC) around faith-based programming. AIDS Action moved its sole faith-based program, the Who Touched Me Ministry, which does outreach to black churches, to MAC, which runs multiple faith-based programs, and AIDS Action continues to provide out-of-pocket funding to the Ministry.

Cathy Morales, executive director of the Living Center, said her organization is working with Justice Resource Institute (JRI) to provide a mental health counseling program to clients. The Living Center is also working with Cambridge Cares About AIDS and local hospitals to work with homeless people living with HIV.

All of these partnerships come as AIDS organizations around the state have been forced to cut staff and programming that they is crucial to halt the spread of HIV and provide services to people living with the virus.

In 2000 AIDS Action had about 100 salaried employees. That number is down to about 75. AIDS Action has been forced to cut back on its prevention efforts, especially to youth, and its counseling and testing work.

Stephen Boswell, executive director of the Fenway Community Health Center, said the center has been forced to make due with only three case managers since the early 1990s despite a threefold increase in clients.

"In the early '90s Fenway was following 400-450 patients with HIV infection. Now we're following 1,200 patients with HIV infection. We can't do that with the same number of staff," said Boswell. He said if Fenway is unable to hire another case manager they may have to begin turning people away from case management services.

Edla Brown, executive director of AIDS Project Worcester, said that her organization has been forced to rely on private funding to support their counseling and testing program, and so far they've been successful in raising the funds. Yet she said the organization lost its volunteer coordinator, and she said without that position it has been difficult to retain their volunteer base, whose work for the organization is the equivalent of about $200,000 in paid services.

Brown also said that after Feb. 29 the organization will lose funding for its adoption foster care program, which allows clients to arrange for someone to adopt their children in the event of their death. According to Brown the program keeps the children out of the state foster care system, and she said that in total AIDS Project Worcester's clients have about 600 children.

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