February 23, 2007
MAI MAI MAI
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Communities in the crosshairs |
Yet again, AIDS advocates are racing against time to change wrong-headed federal policies. This time, it's the Minority HIV/AIDS Initiative (MAI) — crucial federal funding initiatives to fight AIDS where the epidemic is burning the hottest.
Federal bureaucrats say they're planning to put an abrupt end to MAI funding this Wednesday, February 28. And they're not planning to restore crucial dollars until late summer or early fall. The move will diminish or destroy to small community-based groups across the country that provide lifesaving services to people of color.
The MAI matters: it adds up to about $400 million each year, it's targeted at communities of color that suffer serious disparities in HIV/AIDS and other health problems, and it funds large numbers of indigenous organizations run by and for the communities they serve.
Congress can act to protect the MAI — but it's got to happen fast. And it's only going to happen if YOU get involved.
Hitting the Hill, concentrating on the Caucuses
Housing Works national advocacy and organizing boss Christine Campbell hit Capitol Hill this week with a delegation led by state and national AIDS advocacy groups including the New York AIDS Coalition, AIDS Action, the National Minority AIDS Council and other groups.
The goal: get the newly-powerful 'Tri-Caucuses' (Congressional Black Caucus; Congressional Hispanic Caucus; and Congressional Asian-Pacific Islander Caucus) to come up with legislation that could keep the MAI alive — perhaps by stretching the transition to an RFP process until next year.
'Out with the old, in with the new' — with a big break in between
MAI dollars are scheduled to dry up next week and not resume until August or September. That's because the U.S. Department of Health and Human Services (HHS) and the Health Resources Systems Agency (HRSA) have created a new, competitive "request for proposals" (RFP) process to allocate the funds; previous distributions were done mostly by formula funding.
The new RFP process won't be completed until the fall, when grant proposals have been selected and awards will be made.
In the meantime, AIDS organizations — and states and localities — that depend on the MAI money have been told by HRSA basically to 'suck it up' and find a way to deal.
"For smaller areas, this six- to seven- month window is going to cause a problem in continuity of services," says Matthew Lesieur, director of federal affairs at the New York AIDS Coalition.
"New York City gets about $12 million in MAI," said Lesieur. "That's a lot to 'manage' if it disappears."
Organizations that run on a shoestring budget will have to absorb brutal hits to services like emergency supportive housing, treatment adherence programs, and case management.
Changing too fast?
The competitive RFP process was supposed to help. It was integrated into the Ryan White HIV/AIDS Treatment Modernization Act of 2006 because members of the Congressional Black Caucus (CBC) believed that the MAI dollars weren't getting to the most-deserving service providers.
Previously, MAI funding was determined by a formula that measured the number of minorities in each jurisdiction.
Nonetheless, "lots of advocates are opposed to the new RFP process," says Lesieur, who's been spearheading the campaign to stop the MAI gap. "The formula [system] guarantees you funding from year to year, allowing you to build up systems and programs. With the competitive RFP, there's no guarantee from year to year."
Christine Campbell of Housing Works likes the RFP process — but not the irrational timing of its implementation. "It's laudable to compete for dollars, but it doesn't make sense to not get money to the community in the meantime," she says.
HRSA has stood firm in its resistance to amending the new Congressionally-mandated process. Instead, they're suggesting that jurisdictions use unspent Ryan White money — if there is some — from the previous year's budget to fill in the oncoming gap in MAI services.
Traditionally, states and localities funnel surplus, if there is a surplus, to chronically-underfunded AIDS Drug Assistance Programs (ADAP). Federal officials are now forcing a tough — and potentially deadly choice — between ADAP and MAI.
The fix: one more year — and could we get that quick?
Advocates want Congress to quickly draft legislation that will allow the formula-funding system to carry over another year, while the competitive grants are processed.
"We're trying to get Congress to act really fast," says Lesieur. "If they give HHS the ability to use the old formula-based methodology, then we'll have a seamless transition instead of a doughnut hole."
ACTION ALERT: CALL CONGRESS TODAY TO SAVE THE MAI
Call the U.S. Capitol toll-free at 888-802-1207 and ask for the office of the Congressional Black Caucus, the Hispanic Caucus, and/or the Asian-Pacific Islander Caucus and say:
"We need Tri-Caucus legislation to save the Minority AIDS Initiative - we can't afford a funding gap this year. Keep the current system for one more year — it's a matter of life and death for communities of color."
And if your agency would like to sign on to this letter email Matthew Lesieur of the New York AIDS Coalition at mlesieur@nyaidsc.org. And one more thing — it's important to reach out to state and local officials to make sure your area has a transition plan for MAI funding shortfalls in place.