January 26, 2007
COOL YOUR JETS
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This plane can't get HIV |
A few years ago AIDS activists nationwide rallied together to force Congress to "Save ADAP," the perpetually in jeopardy AIDS Drug Assistance Program that pays for HIV meds for thousands of people who can't afford them or have inadequate or no health insurance. But in Rhode Island, where 750 people depend on the program, ADAP is safe—it's everything else that's in jeopardy.
Since 2005, Rhode Island's AIDS community has been reeling from the discovery of fiscal mismanagement of the state's Ryan White program, as well as the sharply rising expenses of ADAP due to people with HIV living longer, healthier lives and the increasing cost of AIDS drugs. Rhode Island's health department director Dr. David Gifford was able to convince the state legislature to bail the Ryan White program out of $3 million hole in 2006 and cover a $4.2 million shortfall in total AIDS funding for fiscal year 2007. But when the state's AIDS service providers read the health department's "request for proposals" for fiscal year 2008, they got a nasty surprise: The pool of money they were competing for had shrunk from the previous year's $2.6 million to a shocking $1.5 million.
Paul Fitzgerald, CEO and executive director of AIDS Care Ocean State (ACOS) is beside himself over the gutting of the AIDS budget. "It took 15 years to develop the solid support systems for people with HIV in this state and these cuts would be absolutely devastating. It's nuts. Staying on your meds and support services are interdependent," he says. Fitzgerald adds that ACOS's assisted living program for people with HIV would probably disappear if the cuts stay in place. He also believes that six to eight programs at other agencies "would be dramatically hurt and three more would close." The health department has already acknowledged that the state's Ryan White program is in the red zone of public health priorities, which means that to diminish its services would have a "great and possibly severe impact upon health, lives, health care and prevention infrastructures."
Why is Gifford playing axe-man? Some believe that he wants to use all of Rhode Island's federal money from "Title II" of the Ryan White Care Act to shore up the state's ADAP at the expense of programs that provide non-drug-related supportive services, such as housing, mental health, substance abuse treatment, and case management. That would be a classic misunderstanding of the web of care integral to helping people with HIV stay healthy.
Gifford wasn't available to speak to the Update but his associate director, Ana Novais, unapologetically defends the disappearing dollars. Novais insists that the shrinkage has nothing to do with saving ADAP but with making the state's AIDS infrastructure more efficient. She says the quality of services won't be affected by the cuts and that savings will come from "creating efficiencies" and "restructuring" such as computerizing claims processing and prioritizing the most useful services based on surveys of people with HIV.
Julie Davids isn't convinced. Davids is executive director of the New York City/Providence, Rhode Island–based Community HIV/AIDS Mobilization Project (CHAMP), which is also the Rhode Island affiliate of the Campaign to End AIDS (C2EA). Letters and materials CHAMP has obtained from the department of health indicate the state might impose even greater cuts on HIV/AIDS services than first thought. Davids points out that the health department already seems to have eliminated funding for "supplemental drugs"—meds that aren't strictly for fighting HIV but help with side effects and related conditions—and that Gifford himself has been quoted as saying the state eventually won't be able to pay for non-ADAP services. "Maybe Gifford was being honest instead of using bureaucratic speak to justify chipping away at AIDS organizations that provide essential services," she quips. Davids also says that the health department didn't tell people with HIV when they were being surveyed that their answers could affect funding. The situation has Davids "starting to feel like the health department is treating AIDS service providers as if they're the mythical welfare queens!"
This Tuesday, January 30, Rhode Island governor Donald Carcieri will deliver his State of the State speech—then submit his overdue budget to the legislature—so Rhode Island AIDS activists—including a healthy contingent of folks from C2EA—will be out in force at a rally in the statehouse at noon. "Rhode Island likes to be a big tax shelter to corporations. If you register a jet in Rhode Island you don't have to pay sales tax on it—that costs us a million a year," Davids says. The rally's theme? "Tax private jets, not AIDS services!"
For more information on the January 30 rally visit CHAMP's website at http://www.champnetwork.org/index.php?name=ri