August 17, 2007
PAIN MANAGEMENT
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New York will have to live with the pain of Ryan White cuts |
The saga of Ryan White CARE Act 2007 funding is finally over (sort of). Last week, the U.S. Department of Health and Human Services announced its Minority AIDS Initiative (MAI) awards, the final installment in the dragged-out process of allocating Ryan White Title I dollars—and now the damage to New York City can truly be assessed.
The City was given $9.3 million in MAI funds, about $2.5 million less than last year. This final cut means that total Ryan White Title I funding is down from $120.4 million in 2006 to $110.2 million, a potentially devastating 8.5 percent decrease. For New York AIDS Coalition's breakdown of Title I distribution for all eligible metropolitan areas (EMAS) click here.
"This is going to dramatically impact the services we're going to provide for people living with HIV," said terri smith-caronia, Housing Works director of New York City public policy. "It's making services shaky at best."
Not that advocates didn't see it coming. New York City's Ryan White Planning Council long ago worked out a system to spread out the impending cuts and minimize their impact on services. "The process allowed us to spread the pain throughout the community while also limiting the impact upon the highest priority service categories," said Patrick J. McGovern, executive director of Harlem United. "The process was fair, sane and rational."
But the pain will nonetheless be felt. While the New York City Department of Health and Mental Hygiene(NYCDOHM) is still finalizing the exact funding amounts for the 110 New York City organizations that receive Ryan White Title I money, programs that focus on housing placement, supportive counseling and family stabilization services, home care, food and nutrition and transportation are in the greatest danger.
"I'm not sure where our clients will go"
These at-risk "noncore" services, as the bureaucratic language of the Ryan White CARE Act describes them, are essential to people living with HIV/AIDS. "The ability to serve people living with HIV is predicated on having the funding and the infrastructure to deal with incredibly complex problems," Callen Lorde Community Health Center Executive Director Jay Laudato said. "And the cuts make it hard to attract good staff and manage these essential programs."
Although Callen Lorde is more dependent on Title II Ryan White money, (click here for NASTAD's full breakdown by state and territory), the African Services Committee (ASC) isn't as lucky. ASC expects to lose $120,000 in Title I funding, which will mean scaling back case management, client advocacy and client intervention services. "That's seven percent fewer clients who are going to get services," said Kim Nichols, the group's co-executive director. "I'm not sure where they'll go because everyone got cut." Having already laid-off three employees, ASC hopes volunteers will fill the gap. ASC has already cut back on evening hours for testing, and, because one of the laid-off employees was French-speaking, it probably won't be able to serve as many French-speaking clients.
At Citizens Advice Bureau, the funding cuts will mean the loss of a case manager, as well as cuts to its harm reduction programs. The organization will make up for the loss of a housing placement assistance grant by taking funds from other areas. Nonetheless, "the cuts are a huge concern" according to Bibi Karim, the group's department director for HIV/AIDS services. "It's going to affect the quality of services."
Where's the City?
While most advocates direct their anger at the feds for failing to provide enough AIDS dollars to New York and other cities, they aren't thrilled with the lack of action by Mayor Michael Bloomberg and City Council. The City could offset the millions in lost Ryan White money. "New York City is pushing for more people to get tested and learn their status. Those people will need early intervention and supportive services, and that's exactly what got cut," Nichols said.
A spokesperson for the NYCDOHM said in a statement, "The Health Department is reviewing all possible options for 2007 MAI awards based on Ryan White Planning Council guidelines. We will make every effort to continue to fund services for people with HIV/AIDS at the highest possible level, in light of the funding cut we received." Meanwhile, the Planning Council hasn't given up. It will be requesting that New York City increase AIDS funding to account for the new need, and put a new spending plan in place.
Even if the City steps in, a long-term solution to the funding woes has to come from the feds, and the next Ryan White CARE Act reauthorization doesn't happen till 2009. "The city has done a lot of good lobbying, but the situation is really the responsibility of the federal government," Laudato said. "I'm waiting to see what the long-term strategy for Ryan White funding will be in the future."