Important note: Information in this article was accurate in June 2004. The state of the art may have changed since the publication date.
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HIV Treatment Alerts - June 2004
The Ryan White CARE Act is the federally mandated legislation created in 1990 that provides medical care and services to people living with HIV/AIDS across the country. This act is re-authorized every 5 years and appropriated (by Congress) annually. CARE Act funding comes to Houston and the surrounding areas essentially as a $19,128,572 "pie." This pie is then sliced up to support various services needed here in the local community. This process is accomplished by a group of dedicated volunteers known as the Ryan White Planning Council. They examine the needs within our community, prioritize services, and allocate funding to meet those needs—within the confines of the "pie" that the federal government allots. The problem is the pie is getting smaller and the number of people needing a piece of it is increasing.
As the actual funded amounts for fiscal year 2004 were finally distributed, Houston and 41 other regions throughout the nation will have to try to provide services in the face of a 6.8% decrease from the previous year's funding levels.
A 6.8% decrease may not sound like much. But the problem is that we have a national campaign that encourages people to know their HIV status, to get themselves into care if they have HIV, and to improve their health outcomes and lifespan. However, in this political and economic climate, it appears that many, if not all, of the benefits for people living with HIV/AIDS may soon be derailed. To preserve the 3 most important services (Primary Medical Care, Access to Medications, and Dental Care) for Houston area clients in 2004, every other Ryan White-funded service category was cut a minimum of 14%. Programs such as food pantry and medication assistance already had shortfalls at the end 2003.
The future for HIV funding looks bleak. The proposed budget resolution that sets spending levels for all federally funded programs for the next 5 years is in front of Congress now. As part of this resolution, spending on health-related issues would be reduced 11% by 2009. Under this current resolution, services and treatment offered through The Ryan White CARE Act will decrease by 19%. Additional and substantive cuts in research and Medicaid will further compound the crisis. Also, the President's Emergency Plan for AIDS Relief transfers money to the new Global AIDS Initiative (GAI), resulting in decreased funding to other federal agencies confronting the epidemic. The GAI is poised to receive an almost 200% increase in funding, while the CARE Act will receive only a 1.7% increase. The bottom line is that unless there is radical intervention on the part of the HIV/AIDS community, only medically necessary services will be funded by The Ryan White CARE Act beyond 2005.
How can you make a difference in this situation? The Center for AIDS offers Project LEAP, the nation's finest advocacy training program for HIV+ individuals. If you want to become involved in deciding how federal resources are prioritized and allocated here in Houston, check it out at www.centerforaids.org/cfa_programs.htm#LEAP. Classes are scheduled to begin on July 14. For more information, call 713.527.8219.
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Copyright © 2004 - Research Initiative Treatment Action (RITA!). Reproduced with permission. RITA! is published by The Center for AIDS. Contact Thomas Gegeny, MS, ELS, Editor, RITA! for permission to reproduce RITA!. tom@centerforaids.org. http://www.centerforaids.org
AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, Bridgestone/Firestone Charitable Trust, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.
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