December 9, 2004

Mayor Bloomberg Announces Baselining of HIV/AIDS Funding Targeting Communities of Color

Last Wednesday, December 1st, at his annual Gracie Mansion World AIDS Day event, Mayor Bloomberg announced that he will, beginning in 2005, permanently include in his budget $5 million for HIV and AIDS prevention in NYC communities of color.

At last! Since the start of his tenure in 2002, the AIDS community and the New York City Council have been urging Mayor Bloomberg and those in his administration to make this $5 million a permanent fixture in the budget ("baseline".) This is needed so that real, long-term, measurable, community-based programming can be developed and implemented instead of the hodgepodge of one-shot items we've had over the last few years.

Housing Works contacted Jan Carl Park, Acting Associate Director for HIV/AIDS Services at the Department of Health and Mental Hygiene to congratulate the Administration. In turn, Park acknowledged the hard work of the New York City Communities of Color HIV/AIDS Coalition (NYCCOCHAC), not only in securing these funds but also in not giving up on the struggle to get them baselined.

We expressed our concern that a large portion of these desperately needed funds would not be contracted to community-based organizations through a competitive bidding process. Park assured us that a community partnership including the NYC Prevention Planning Group (PPG) and NYCCOCHAC would participate in determining the funding allocations. We hope that this is the case.

Like the Mayor at his World AIDS Day gathering, Park extolled the virtues of several Bloomberg Administration AIDS-related initiatives, including confidential and voluntary rapid testing in several men's homeless shelters and on Riker's Island, and the much-needed expansion of syringe exchange programs in the borough of Queens. Housing Works encourages the Department of Health and Mental Hygiene to continue providing resources and political will for viable, scientifically based prevention services such as these. We also strongly urge the Bloomberg Administration to apportion some of those dollars to expand the numerous AIDS care services that New Yorkers with a positive diagnosis need, including housing, healthcare, and vital support services.

Just as importantly, Housing Works calls on Mayor Bloomberg and Health Commissioner Frieden to acknowledge, as did the prior Administration, the overarching intent of these hard-won funds. Don't water down the goal of using these dollars: to start putting an end to racial disparities in AIDS funding here in NYC.

This money was not intended only to provide AIDS services within communities of color. With nearly 80% of people living with AIDS and HIV here in New York City being black, Latino/a, Asian/Pacific Islander and Native American, that's a redundant proposal. Virtually everyone's client base falls within the rubric of "communities of color." It should also go to culturally expert, local, grossly under-funded organizations of color that have a history of helping these communities.

Brief History of the City Council/NYCCOCHAC $5 million dollar HIV/AIDS Initiative
Starting in February 2001 -- when the New York City Communities of Color HIV/AIDS Coalition (NYCCOCHAC) convened and partnered with then-Councilmember and former NYC Council Health Committee Chair Victor Robles and Councilmembers Margarita Lopez (D-2) and Bill Perkins (D-9) -- the AIDS community and our council partners urged former Mayor Giuliani to permanently provide "$7 million dollars and not a penny less" for AIDS services targeting organizations of color serving communities of color.

While the amount was several million shy, the NYC Council did include an unprecedented $5 million in their budget to "...fund prevention, education, outreach, advocacy, and support services [care]", and in June 2001 Giuliani signed this budget into law.

Formed specifically to end the funding disparities have worked steadily against communities of color, NYCCOCHAC did not revel in the short-term victory and rest on its laurels. The Coalition began to put pressure on the Giuliani administration to allocate these funds to the community as the Coalition intended. (See this July 26, 2001 letter to Neal L. Cohen, M.D., Commissioner of Health, 135K PDF.)

In August of 2001, with increasing pressure from NYCCOCHAC, Giuliani and former Health Commissioner Neal Cohen, MD sent a letter to the Coalition confirming that this $5 million dollar budget amount would indeed re-occur (baseline) for at least the next three budget years. (See this August 29, 2001 letter from Cohen, 330K PDF.)

On September 10th, one day before the 9/11 tragedy, the Medical and Health Research Association of NY (MHRA) quickly released an RFP for the allocation of these dollars. Not only was this bidders' conference standing room only with over 100 organizations in attendance, but MHRA had to convene a second bidders' conference in Brooklyn for those attendees that were packed in the hallways.

This RFP was to support 19 contracts at a maximum of $255,000 per award for up to three years, for primary prevention services for HIV seropositive persons, and gay men/MSM HIV prevention services. The language for primary prevention contracts included the following:

the delivery of HIV prevention services in a manner that most effectively addresses the sexual transmission risks of seropositive persons

• HIV prevention services that address the substance use risks of seropositive persons, including injection drug use and non-injection drug use (e.g. crack.cocaine use, methamphetimine, alcohol)
• if targeting women, the delivery of HIV prevention services to seropositive women that are gender specific, i.e., that are designed to address the particular needs and challenges of women
• if targeting gay men/MSM, the delivery of HIV prevention services to seropositive gay men/MSM that are sensitive to issues of sexual identity and behavior
• HIV prevention programs that incorporate client education about sexually transmitted diseases and which provide HIV seropositive clients with linkages to STD screening and treatment
• the delivery of HIV prevention services targeted to populations that may be at risk of HIV transmission: immigrants, sex workers; and those who are socioeconomically disadvantaged, i.e. homeless persons and/or street youth.

As important, this RFP contained language that began to address not only the funding inequities that have plagued community-based organization of color but also those that tipped the scales in favor of Manhattan-based groups:

Minority Status
Organizations submitting a proposal will be asked to provide the answers to the following questions:

1. Is the Board of Directors comprised of at least 51% individuals of racial/ethnic minorities? If not, what is the percentage?
2. Are the key management, supervisory, and administrative positions (executive director, fiscal director, program director) comprised of at least 51% individuals of racial/ethnic minorities? If not, what is the percentage?
3. Are the key service provision positions (e.g. outreach workers, case managers, groups facilitators, counselors) comprised of at least 51% individuals of racial/ethnic minorities? If not, what is the percentage?

A panel composed of members from both MHRA and NYCDOH can fund a proposal out of rank order for the following reasons:

• to ensure adequate geographic distribution of services;
• to ensure adequate access to services by members of target populations and subpopulations, including targeted HIV risk behaviors;
• to promote service provision by minority community-based organizations whose board of directors and staff, including senior management and program staff, are representative of the racial/ethnic populations they serve and/or propose to reach; and
• to promote the best combination of services and price.

For both service programs, preference will be given to minority community-based organizations whose directors and staff, including senior management and program staff, are representative of the racial/ethnic populations they serve and/or propose to reach. Organizations will need to have experience providing HIV services to communities of color and underserved populations. In addition, organizations will need to list their current board members, their professional titles and their experience and qualifications in areas related to the provision of HIV services.

Final selections will be made by NYCDOH.

Service Areas
Organizations will be asked to list the zip codes of their proposed targeted service areas and list the zip codes of the service site/facilities from where services will be delivered.

Fast-forwarding to the Present
With the September 11th attack, the City plunged into a financial crisis. A new mayor was elected and began his term with a $6 billion budget hole. Funding for social and city services felt the budget ax. But with the steadfast pressure from new City Council Speaker Gifford Miller (D-M5), new Health Committee Chair Christine Quinn (D-M3), and our veteran Council partners Lopez and Perkins, and the NYCCOCHAC membership, the $5 million dollars was not only consistently and unanimously re-budgeted but in this past budget was increased by 20% to total $6 million dollars. Even more extraordinary, Councilmember Al Vann (D-Bk36), in partnership with the National Black Leadership Commission on AIDS and the Latino Commission on AIDS, managed to include in last year's city budget an additional $2.7 million dollars in one-time emergency funds.

The dollars, however, had never again been officially "baselined", nor had the money gone into the organizations and communities to provide prevention and care services as originally intended.

Housing Works just obtained the final funding list for last year's $6 million dollar HIV/AIDS in communities of color initiative and the $2.7 million dollar emergency AIDS funding. (See FY05 HIV/AIDS Communities of Color Initiative CBO contacts document, 87K PDF). Given the fact that these dollars have now been baselined, we will continue to pressure the Administration to provide more and better services to the well over 100,000 known women, men, and youths living with AIDS and HIV here in NYC -- and to the tens of thousands of others who have yet to learn that they too are infected -- and to drastically reduce the rate of new infections among our most vulnerable. We also strongly urge Mayor Bloomberg and Health Commissioner Frieden to use these resources (and more) to provide progressive and aggressive public health leadership here in NYC, to put an end to this catastrophic plague.

For more information about the NYC HIV/AIDS communities of color funding and Coalition, contact terri smith-caronia at 212-966-0466, ext. 1296 or at smith-caronia@housingworks.org.

The Housing Works AIDS Issues Update is reported, written and edited by Diana Scholl, David Thorpe, Phil Fox Rose, Christine Campbell, terri smith-caronia and Housing Works staff. Send your feedback, leads and story ideas to d.scholl@housingworks.org.

You can reach us by phone at 212-967-1500 x168, by fax at 212-868-4222, and by email at d.scholl@housingworks.org. Housing Works provides housing, advocacy and services to homeless people living with AIDS and HIV. Housing Works is the nation's largest community-based AIDS organization and the nation's largest minority-controlled AIDS organization.

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