February 2, 2007
DON'T WAVER ON OUR WAIVER
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New York City should oversee its piece of the Ryan White pie |
"This is the greatest threat to Ryan White I've ever seen. This is a potentially devastating situation." —Darryl Ng, Director of Public Policy, Gay Men's Health Crisis (GMHC)
Some people's eyes glaze over when the Update starts talking about the nuances of Ryan White funding but hopefully the above quotation will make your eyes pop open. New York City is bracing for $17 million in potential cuts to its $120 million share of Ryan White Care Act money (the Ryan White Care Act provides more than $2 billion in federal funds for AIDS treatment and services nationwide). But that's not what has Ng so worried.
Housing Works NYC Public Policy Director terri smith-caronia says the city's Ryan White Planning Council has actually handled the prospect of the cuts proactively, prioritizing services and finding ways to shift money in order to protect our AIDS service infrastructure; what's more, the New York State Department of Health's AIDS Institute says it can cut $2.5 million from its ADAP budget to ease the burden of possible Ryan White reductions.
What truly makes this year's Ryan White budget process so "potentially devastating" as Ng says, is that the feds haven't committed to giving New York an all-important waiver regarding the definition of core services.
DOWN TO THE CORE
"In New York City," says smith-caronia, "we provide comprehensive services. We consider transportation to a doctor's office a core service." The federal government doesn't always see such services the same way; they tend to view strictly medical services as core: The doctor's appointment—but not the subway fare to get there.
New York and many other cities with a large population of people with HIV, so-called "Eligible Metropolitan Areas," or EMAs, are experiencing a cut in Ryan White money in order to shift funds to Southern states, which haven't built an infrastructure of AIDS services but are seeing increasing infection rates. Nonetheless, Sen. Hillary Clinton and other lawmakers from New York and New Jersey held up passage of last year's reauthorization of the Ryan White Care Act until they could secure a waiver that allowed EMAs greater leeway in determining what are and what aren't core services, and by extension, what they could use their Ryan White money for. "Who is to know better than the people in this area what core services are?" says Rev. Terry Troia, executive director of the Staten Island—based agency Project Hospitality. "There has to be local determination."
The only problem is that the waiver is, as smith-caronia says, "not a law, but a handshake deal." If New York doesn't get the waiver, the results could be catastrophic. "It's absolutely essential to have," Ng says. "It would drastically alter our portfolio of social services—legal services, meals, transportation—if we don't get it." Adds smith-caronia, "Services that get people into care might come off the table. You can cut programs so much that they're not worth continuing."
WHAT YOU CAN DO
Call Sen. Hillary Clinton and Sen. Charles Schumer now and tell them you support the EMA waiver that will allow New York City greater oversight of its Ryan White funds!
Dial toll-free 1-888-802-1207
OR...
Write the U.S. Dept. of Health and Human Services' Health Resources Services Administration and tell them you support waivers allowing EMAs greater oversight of their Ryan White funding!
U.S. Dept. of Health and Human Services
Attn: Health Resources and Services Administration
200 Independence Avenue SW
Washington, D.C. 20201
A LITTLE RELATED BAD NEWS WE SPARED YOU...
There is yet more drama to the Ryan White funding saga. Last week it was announced that this year's distribution of Ryan White money would be staggered. There are three kinds of Ryan White "awards," or money: Formula awards, supplemental awards, and Minority AIDS Initiative awards. Normally all the funding comes at once, but for various reasons, this year's awards will come one after another and nobody knows exactly how long that will take. "The staggered funding creates a real cash flow problem, yet we have services that need to be continued. What will happen to them?" asks Ng. Adds smith-caronia, "This could be crippling."
The feds have also created a rule that says AIDS service programs can't have more than a 2 percent budget "carryover"—i.e. they have to spend at least 98% of the money they said they would spend in a given time period—or they can't get any supplemental funding. This new restriction, again, could cause serious financial trouble. The core services waiver will be a crucial step to negotiating this year's Ryan White funding rollercoaster.