October 3, 2008

TIME TO KEEP OUR EYE ON THE PRIZE: UNIVERSAL HEALTH CARE

By David Ernesto Munar
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Munar: Let's focus on healthcare reform and National AIDS Strategy.

Editor's note: This op-ed is responding to Housing Works National Advocacy and Organizing Vice President Christine Campbell's op-ed "DON'T WAIT UNTIL 2012 TO REAUTHORIZE RYAN WHITE." Campbell argued that we should not delay reauthorizing the Ryan White CARE Act.

As we approach another congressional deadline involving the Ryan White HIV/AIDS Treatment Act—the nation's flagship HIV/AIDS safety net program—people living with HIV/AIDS and our advocates have some difficult soul-searching to do. In order to be effective, we must pursue a path that is most likely to result in better and more accessible services for people in our communities.

Chief among the questions we must ask ourselves and others: What ails Ryan White? Reading Christine Campbell's excellent op-ed, I couldn't help but list a few of my own gripes.

First, there is not nearly enough money devoted to the program to meet the spiraling set of needs of the growing HIV-positive population in the U.S.

Second, support service access has been greatly reduced or constrained (largely related to my first point).

Third, a complex set of legal requirements and regulations make the program increasingly difficult to administer locally and nationally.

Fourth, wide variability in Ryan White eligibility criteria, service access, and quality persists across the country (not unlike health care in general). Finally, and perhaps most egregious, the program has become the ONLY SOURCE of health care for hundreds of thousands of low-income people with HIV/AIDS, a role the program was never designed or intended to address.

So how do we fix these and other problems in the program?

Some argue that Congress should legislate a set of fixes for all that ails Ryan White via authorizing legislation, which is required by law to continue the program past October 2009. I tend to disagree with this argument and believe that authorizing legislation alone cannot fix all of Ryan White's problems. There are at least three reasons why I believe achieving Ryan White improvements must go beyond the legislative work needed to address the September 30, 2009 deadline for the program to continue:

1. Larger federal appropriations could fix many identified problems, including inadequate support services access. Because appropriations are determined through a separate congressional track, more vigorous appropriations advocacy seems at least warranted to achieve many of our goals.

2. HRSA—the federal agency running Ryan White—has narrowly, and I would argue improperly, interpreted federal Ryan White law. In some instances, HRSA's interpretations are nothing short of artfully wrong (Can you say "lifetime housing cap?").

3. The need for continuous, uniform, portable, and high-quality HIV care and support services is likely better advanced through another program beyond Ryan White. Congress created the Ryan White program in 1990 to provide emergency financial assistance to communities devastated by HIV/AIDS. Now, nearly 20 years later, the framework of the program is ill-suited for the demands of the epidemic. The epidemic today is simply bigger, more complex, and of longer duration than anyone could have ever imagined in 1990. Some of these challenges are the result of powerful medications keeping us alive longer, a development we welcome and celebrate.

Unfortunately, the framework of Ryan White is struggling to accommodate the modern epidemic, and three rounds of extensive legislative changes have only served to make a complex program, ruled by a Byzantine set of local and national requirements, a colossal challenge to manage locally and nationally. We're spending too much time spinning our Ryan-White-requirement wheels and that energy could be more efficiently and cost-effectively spent serving additional people and advocating on behalf of increased services, through larger programs such as Medicaid and Medicare, and ensuring that HIV/AIDS treatment are part of national health care reform discussions.

While no one's crystal ball is very well calibrated, a groundswell of public support for wholesale changes in the nation's health care financing and delivery systems (essentially, serious health care reform) and talk of a coordinated, national plan of action-the so-called National AIDS Strategy-come to mind as potential vehicles to achieve lasting and meaningful changes around HIV/AIDS care services.

Asking Ryan White to fix our nation's fragmented and crumbling health care and support-services systems is, I believe, asking a lot of this relatively small and targeted program.

But there's one more critical and pragmatic consideration: The utter lack of time left to achieve meaningful changes in our HIV service sector.

Once Congress gets past the November election, the inauguration in the New Year, hearings on cabinet appointments, work finalizing FY09 appropriations, work beginning on FY10 funding, and hearings and legislation to address the on-going economic crisis, the war, and the new president's priorities, they will likely have no time left for Ryan White deliberations. Moreover, after a contentious two-year struggle to broker the 2006 Ryan White reauthorization, members of Congress (including many of our champions and allies) are simply tired of the fragmented and divided AIDS community. I would not be surprised if Congress mustered, at most, just one Ryan White hearing next year.

So the prevailing opinion of many advocates, which I support, is:

1. Let's make sure Ryan White continues without interruption for those who rely on it. While we can agree there are deficits in the framework of the program, too many people with HIV/AIDS rely on it every day as a lifeline and cannot tolerate even one day's gap in essential services.

2. Since we need an act of Congress to continue the program past October 2009, let's clean up the worse and unintended messes of the 2006 language but, for the sake of expediency, not try to fundamentally rewrite the authorizing framework, at least not yet.

3. Let's apply pressure to the next occupant of the White House to sensibly interpret and implement the Ryan White laws as they are written and intended. In addition, we must ramp-up appropriations advocacy and demand that Congress respond to changes in the epidemic with new funding to serve the growing HIV population in need.

4. Let's not fight over ultimately small victories, like Ryan White funding formulas and hold- harmless provisions, but rather invest our movement's robust passion and energy in the big battles that could ultimate transform the landscape for millions of people in our country: national health care reform and a national AIDS strategy.

If neither track is fruitful in the next two years, then yes, I agree that we in the AIDS movement should have a traditionall reauthorization fight and go another round of tearing each other apart over a $2.2 billion pittance in Ryan White resources.

David Ernesto Munar is Board Chair of the National Association of People with AIDS, AIDS Action Council's Policy Committee Chair, and a Vice President at the AIDS Foundation of Chicago. You can reach David at DMunar@aidschicago.org

September 18, 2008

PUERTO RICO'S OTHER HALF

Harm reduction advocates struggle to reach drug users, who account for half of PR’s yearly HIV infections
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Rodriguez provides syringe exchange programs to Puerto Ricans in the mountains

As part of Housing Works Harm Reduction month, the Update is spotlighting harm reduction efforts and advocacy in Puerto Rico. "Harm reduction" is any program or policy that promotes the reduction of harm that individuals may do to themselves or others through substance use and/or unsafe sexual practices.

In Fajardo, Puerto Rico, a small city on the east coast of Puerto Rico, a dozen people hang out in a shooting gallery behind projects. These men and women search for a vein that's not dead so they can shoot up heroin. Then along comes Gloria Gonzalez, with clean needles and lollypops. Gonzalez, a 2008 Keith D. Cylar awardee, is treated warmly by the group, most of whom are chronic drug users. "It's hard to get methadone, but I want to quit," one man explained to the Update. Another searched for a vein in his leg since he was out of veins in his arms. One place he wouldn't go was his groin. "I don't want to kill my penis," he said, chuckling.

Because of Gonzalez, a former drug user herself, these people have access to clean needles, which help prevent the spread of HIV and hepatitis C. Yet Gonzalez receives no government funding for her syringe exchange (or "punto fijo" in Spanish) and does the distribution and outreach on her own time. She is laying the groundwork for harm reduction housing and a community center where syringe access will be provided in Fajardo.

"The mayor of the City of Fajardo believes that all is needed is detox," Gonzalez said. "He thinks he has a done a great job by establishing an agreement with an agency in Philadelphia to which he ships injection drug users who are homeless. Fajardo has an equestrian park, beautiful beaches, ferries which depart for Culebra and Vieques. So, he cleans the streets. He sends them to Philadelphia."

According to estimates, 50 percent of new HIV infections in Puerto Rico are transmitted through injection drug use. Most drug users are chronic drug users, and 17 percent of chronic drug users on the island are women. The statistics are extremely unreliable, but according to the 2008 CDC report, in 2006 there were 2,371 new reported cases of HIV and AIDS.

It's not that the Puerto Rican government is openly hostile to harm reduction—a 1993 law allows people to openly carry syringes. The main problem is that the government is unlikely to put its money where its mouth is. The federal ban on syringe exchange prohibits U.S. dollars going to this and the state provides little of its own funding for syringe exchange and harm reducation programs. The majority of drug treatment programs are faith-based, abstinence-only programs which don't provide harm reduction to patients.

In addition, groups that provide harm reduction and AIDS care are dealing with a parallel crisis of the ineptitude of Puerto Rican buraucracy. Puerto Rico receives more than $53 million in Ryan White Care Act funds but activists have documented numerous cases of people living with HIV/AIDS who are unable to access medication. In December 2006, the FBI raided four San Juan Health Department offices, seizing 400 boxes of documents in a criminal investigation into possible misuse of Ryan White grants. (Look for an in-depth story in the Update in October about the government's role in the crisis).

Working with what they've got

Despite these obstacles, there are individuals and organizations trying to provide harm reduction to drug users. "If someone's using 15 baggies and then they start using five, we go 'Yay! That's great," said Priscilla López Jaime, director of clinical services for the Iniciativa Comunitaria, a San Juan-based AIDS Service organization founded in 1990. The organization provides assistance to drug addicts, sex workers, homeless people, youth at risk and persons at risk of and affected by HIV. The Initiativa Comunitaria provide detox and rehabilitation for women, and detox for men, because they don't have enough funding for both. Condoms are distributed, and they work with sex workers. "If a client doesn't want to protect themselves, we work with them to think of strategies," Jaime said.

As part of its harm reduction program, Iniciativa Comunitaria has a syringe exchange program, exchanging needles one to one, and providing education and outreach in the process. However Iniciativa Comunitaria's executive director José Vargas Vidot criticized Puerto Rico for not funding syringe exchange in rural areas. "It's hypocrisy," he said. "They keep on funding needle exchange but put different community-based organizations to compete in the same places, when there are rural areas that need to be funded."

Drug users outside of the cities have few options to remain safe. Ivette Rodriguez was hired by CitiWide Harm Reduction, which founded El Punto en la Montaña, the first needle exchange program for people in Cayey and Cidra, two towns in the mountains near San Juan. Both areas have poor public health systems where many people rarely receive medical care. There are at least three shooting galleries in the area, and Rodriguez and volunteers go door-to-door in public housing units bringing clean syringes, clothing and snacks. Most of the people Rodriguez sees are chronic drug users, but most don't have access to public health. A clinic closed in the 1990s and nothing replaced it, and buses and public transportation are horrendous. "People needing care need to travel to receiving it, but many don't." Rodriguez hopes to get more funding to be able to provide rapid testing. She receives no government funding

Despite the stigma surrounding drug use, Rodriguez said she has gotten a positive reception from the community, including the police and the families of the drug users. Rodriguez recalls one time when she arrived at the home of a man she regularly visited. His grandmother answered the door, and Rodriguez was at first unsure if she could go. But the grandmother said, "Don't go, he will be back before you leave.'" She wanted to make sure her grandson was safe.

September 12, 2008

THE LATEST ON CMS

New York pushes back in D.C. against dangerous CMS regulation
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Baucus & Co. need to get the CMS rule delayed!

Both New York AIDS advocates and New York state employees continued their fight this week to delay the Centers for Medicare & Medicaid Services (CMS) regulation that could cripple health care access for poor and disabled people—including tens of thousands living with HIV/AIDS—in 18 states who rely on outpatient Medicaid care.

The New York State Department of Health has been in regular contact with CMS; the latest from one insider is that CMS officials are receptive to New York's deep concerns about the regulation, which would reduce payment for outpatient Medicaid services to lower Medicare rates. The source speculated that there is only a "30 percent chance" that the White House's Office of Management and Budget will actually move forward on the CMS regulation.

"CMS is coming around to the fact that New York has a complicated health system and is trying to work to give New York flexibility," said one of the Governor's staff. But, that person noted, "We've been burned by the administration many times."

Grassroots pressure

Working with CMS isn't the only solution to the looming policy catastrophe. A Congressional fix would do the trick as well ( (although Bush could always veto. The CMS reg was a compromise attachment to the last Iraq appropriations bill).. New York representatives have signaled support for suspending the reg, in part because New York could stand to lose $350 million in federal funding to organizations providing outpatient care.

Legislators in other states need to join them. Despite the fact that 18 states could lose out —Alaska, California, Connecticut, Illinois, Maryland, Michigan, Missouri, New Jersey, New York, Oklahoma, Pennsylvania, South Dakota, Tennessee, Utah, Vermont, Washington and Wisconsin—most of the hardcore lobbying has come from just New York, California and various hospital associations. Some state governments in Republican-controlled governor's offices and representatives are loathe to lobby for more Medicaid dollars.

Housing Works clients and advocates went down to D.C. to speak with representatives of other states affected, including Reps. Tommy Baldwin (D-WI), Henry Waxman (D-CA), Barbara Lee (D-CA), Jesse Jackson, Jr (D-IL) and Bart Gordon (D-TN).

Housing Works Women's Health Center client Alison Richards explained to Congressional staffers how important services at the Women's Health Center were to her. Richards, chair of the client advisory board, uses the facility for dental and medical treatment, and considers it a second home. "We need to keep this place open!" she said. "I need the Women's Center."

No staffers seemed aware of the CMS issues but said they'd look into it.

The most important reps to contact are the finance bigwigs Sen. Max Baucus (D-MT) and Rep. John Dingell (D-MI). A Baucus aide told the Update that Chairman Baucus opposes the CMS rule and would look for avenues in the Senate to prevent it from taking effect

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So what can you do?

Contact the White House at 202-456-1111

Contact your reps (if you're not a New Yorker) at 800-828-0498 (Congressional switchboard).

STRATEGY SESSION

Participants at CHAMP forum united in calls for a National AIDS Strategy, but diverge on how that will happen
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Fields, Long and Collins

More than 80 people gathered at the New York City LGBT Community Center Wednesday night to discuss the movement to implement a National AIDS Strategy. Organized by the Community HIV/AIDS Mobilization Project (CHAMP), the forum highlighted both the growing momentum around the idea of a National AIDS Strategy (NAS) as well as the numerous obstacles to putting one in place. The sticking points? Who will have input into the NAS and what the NAS will actually look like.

"Do I think there should be a National AIDS Strategy? I do. Did I sit in a room during the Clinton administration for three days [working to draft one]? I did. Do I want to do it again? I don't," said panelist A. Toni Young, of the Community Education Group in Washington, D.C. Other panelists included Chris Collins, the author of Blueprint for a National AIDS Plan, C. Virginia Fields, executive director of NBLCA and Charles Long, of the New York City AIDS Housing Network.

There have been calls for a National AIDS strategy since the beginning of the epidemic, as well as plans that have since disappeared. Advocates are hoping this time will be different. Fourteen months ago, Collins wrote Improving Outcomes: Blueprint for a National AIDS Plan for the Open Society Institute detailing what an effective plan would include. Leaders from seven large AIDS organizations—AIDS Action Council, ythe AIDS Foundation of Chicago, Balm in Gilead, the Black AIDS Institute, CHAMP, Gay Men's Health Crisis, and San Francisco AIDS Foundation—came forward to start the planning, which led to resentment among groups that weren't included. The working groups to draft and promote the plan are now open to the public. (To get involved, e-mail Collins at info@nationalaidsstrategy.org)

Getting on board

Despite that initial dust-up, which has left residual wounds, more than 1,000 individuals and 300 organizations have signed on to the call for an NAS on nationalaidsstrategy.org.

After working with a group of women to write an "angry letter" to the planners, Young said "we realized we did support the concept, but we need more dialogue. And we've got to get on the train right now while it's still moving."

Barack Obama has already called for a National HIV/AIDS Strategy in his AIDS platform (though you'd be forgiven if you didn't know that—as noted at the meeting, you have to scroll the very bottom of his healthcare page to even find it). Obama reiterated his call for a National AIDS Strategy after the new CDC infection numbers were released. McCain has yet to call for a National AIDS Strategy.

Starting this weekend, the Stand Against AIDS kicks off. Mounted by the Campaign to End AIDS, the Stand is a multi-arm, multi-week advocacy road trip to the first presidential debate in Oxford, Mississippi on September 26, with the sole aim of obtaining commitments from Obama and McCain to take meaningful steps toward the creation of a National AIDS Strategy within 100 days of taking office.

Despite the new energy around the NAS, one thorny issue is what it will actually consist of. "I thought we'd come up here with an actual strategy and what the points need to be," an audience member at the CHAMP forum asked during the question and answer session.

NationalAIDSStrategy.org does not make specific demands about the creation and implementation of an NAS but its website does provide guidelines that "might" serve as blueprint.

Those guidelines are to: Those guidelines include identifying and implementing the most effective treatment coverage approaches, an accountability timeline, pilot programs to address HIV among vulnerable populations and to address racial disparities, better federal guidance for states and requiring the Secretary of Health and Human Services to report regularly on the status of progress towards the plan's targets. (Click here for the full guidelines)

Collins noted in his remarks that the government and others outside the AIDS world need to be involved in the NAS discussion. "We see this as a strategy that has to be owned by the government," he said. But Collins also said that just having a plan is a waste if it doesn't actually achieve anything, pointing out that both the Clinton White House and the Centers for Disease Control and Prevention have had national AIDS plans that were more like "wish lists" than strategies.

"It's not just about getting rid of destructive policies like the ban on needle exchange and abstinence-only education. It's not new money here or there. It has to be all of those things but more than that," Collins said. "We need to hold the government accountable and hold ourselves accountable to make that happen."

Some NAS supporters looked to the precedent of demanding national AIDS plans from countries that receive PEPFAR funding. "We find it ironic that the U.S. requires fifteen nations getting PEPFAR to make plans, but we need to have one here," Fields said.

But the PEPFAR argument isn't as persuasive when foreign countries' plans are actually dissected (some are only half a page long). Although countries are required to write a plan, U.S. money is going to community-based organizations on the ground that aren't actually following the plan.

"I don't think any of us want the National AIDS Strategy sitting on the shelves," Long said. He also said (and Fields concurred) that this conversation is a waste if it doesn't lead to actual action and results. "I will refuse this invitation in ten years if we're still talking about this. I'll be busy that day," Long said.

Confronting our own demons

Another issue on the table at the forum was the need for people living with HIV and various constituencies to be included in the NAS process.

Young said that AIDS organizations ought to confront the realities of the epidemic, including the rates of recidivism in the black community and the fact that the AIDS communities' power brokers represent the same demographics as those at the beginning of the epidemic. "One of the things that's happened in the last 10 to 15 years is that the epidemic has changed, but the power dynamic hasn't," Young said.

Long agreed that the power structure doesn't reflect those infected and affected by HIV . The only HIV-positive panelist, Long told the crowd, "Being a part of the AIDS movement does not make you a person living with AIDS. Too often, there are not people living with AIDS at the table. Or groups working with youth have no young people at the table," he said. Long then challenged the group to "confront your own demons."

Long noted, "If black and Latino communities don't confront homophobia and classism, we're not going to have a productive conversation. If the gay community doesn't confront racism and classism, we're not going to have a productive conversation. I hear how young people don't' get it, because they haven't watched their friends die. But they don't know the world without AIDS, and they might have seen their parents die."

McCain or Obama?

One thing was clear at the forum: It was a pro-Obama crowd. Robert Banks began his remarks by saying, "In light of the events of the last few weeks I have to say how good it is to be in a room of community organizers—one of the most valuable professions known to human kind," a reference to Vice Presidential nominee Sarah Palin's swipe.

"God forbid if Democrats don't win in November, we're still going to push the next administration. This is our government too. These are our dollars too. We are ready to do whatever's necessary," Fields said.

There was also an awareness that Obama wouldn't necessarily wave a a magic wand over the NAS. "I don't care if it's, McCain or Obama. It's not going to be an easy fight. We have a lot of young people saying it's a manageable disease. And if I have to be here in 10 years I will," Young said.

September 5, 2008

CHANGE FOR THE WORSE

Neither DNC nor RNC feature HIV-positive speakers; AIDS protestors MIA
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Munar, Glover and GMHC's Dr. Marjorie Hill at the DNC

HIV/AIDS should be a nonpartisan issue—but it should be a bipartisan one, too. As of Thursday, this year's Democratic and Republican National Conventions had barely touched on HIV/AIDS, and for the first time since 1992, there wasn't a single HIV-positive speaker at either convention. The Dems have had an HIV-positive speaker every year since 1992; Republicans have twice had HIV-positive AIDS advocate Mary Fischer address the its convention.

"Not to see an HIV-positive speaker in Denver was disappointing, especially with the reported rise in new infections," said David Munar, an HIV-positive Obama delegate who took a vacation from his job as vice president of policy and communications at the AIDS Foundation of Chicago to attend the Democratic convention. Munar added that "actions speak louder than words" and that he was willing to wait and see what Obama might deliver as President.

Munar's presence alone made a difference at the DNC—Munar, who is also the incoming president of the National Association for People with AIDS, was shown on CNN for 15 seconds during Michelle Obama's speech wearing a NationalAidsStrategy.org T-shirt. Afterwards he received an e-mail (via the National AIDS Strategy web site) from a newly infected person thanking him for being visible at the convention. The e-mail read, "When I saw you with your shirt a great feeling of excitement, happiness and immediate sense of a call to action came over me. I paused, rewound, and paused again finding hope printed on your chest. Thank you for bringing back to life a part of me that I'd felt was long dead."

AIDS wasn't completely absent from the discussion. In Denver Bill Clinton said Obama would, "continue the fight against AIDS, TB and malaria, including a renewal of the battle against HIV/AIDS here at home." Michelle Obama made a nod to AIDS while talking to the LGBT caucus. And B-list celeb Danny Glover joined politicians and AIDS advocates—a handful of whom were delegates—at a luncheon celebrating Congressional leadership on HIV/AIDS and calling for a National AIDS strategy.

NAPWA's Director of Federal AIDS policy Kali Lindsey gave the Dems mixed reviews. Lindsay issued a call for speakers at the convention after NAPWA realized that HIV-positive speakers were MIA from both convention agendas. "We took it for granted that it would happen at least at the Democratic convention," Lindsay said. "We did have GLBT issues spoken about and integrated into messages, which is a great step forward." Munar noted, "There were many topics discussed at the convention consistent in policy goals addressing AIDS, including national health care reform."

What do the Republicans have to say for themselves?

In St. Paul, (as of press time) AIDS was only loosely on the agenda. Unsurprisingly the focus was on the global, with Republicans touting PEPFAR and Laura Bush, mockingly stating of the increased access to antiretrovirals in Africa, "You might call that change you can really believe in."

Mainstream AIDS advocates weren't visible inside the RNC convention hall, and AIDS activists were largely absent from the protests as well. At the 2004 Republican National Convention in New York City, AIDS activists participated in a slew of protests, and in one case even got naked for the cause. But this time, further away from the center of the epidemic, although there were many protests—and activists arrested for offenses not punishable by law—none were directly focused in HIV/AIDS

NYC AIDS Housing Network co-executive director Sean Barry—a 2004 naked protester—noted that other commitments such as August's International AIDS Conference in Mexico City accounted for the lack major AIDS protests, naked or otherwise. "I wish I was confronting the RNC about the party's failure with AIDS in America despite they purport to take overseas," Barry said.

August 29, 2008

NOT SEVENTH HEAVEN

States would lose millions in federal dollars under CMS reg; contact your reps to delay harmful policy
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If seventh reg not delayed, quality of care would decrease

In June Congress enacted moratoria on six out of seven Centers for Medicare & Medicaid Services (CMS) regulations, but upheld the regulation on Medicaid Reimbursement for Outpatient Services. The regulation shifts reimbursement for outpatient services from Medicaid to the lower-paying and more restrictive Medicare rate. This political stunt would devastate poor and disabled people in 18 states who rely on outpatient Medicaid. Not only would Medicare's lower reimbursement rates jeopardize the quality of existing outpatient services, Medicare simply won't pay for outpatient services such as vision, psychiatric and dental services.

Because of the new regulation New York State could lose more than $450 million in funding for family planning, dialysis, rehabilitation, services for the developmentally disabled, AIDS care and other services. This funding catastrophe would derail the state's plans for meaningful Medicaid reform to shift patients into front line community-based care settings. "There are some family-planning facilities and Planned Parenthoods that might not be able to stay open with this new reimbursement," said Lara Kassel, advocacy coordinator for Medicaid Matters New York. Housing Works President and CEO told Gay City News that if this regulation stays in effect Housing Works won't be able to operate all of its four AIDS Adult Day Healthcare Centers. For an (in progress) spreadsheet from Paterson's office of organizations that will be affected, click here.

New York's not the only state that will suffer. In comments to Congress, California's Medicaid Director wrote, "California's emergency rooms are in crisis status and this will lead to further instability if reimbursement for the cost of care in these areas is significantly reduced." In Nevada, while the cost was not specified in the analysis, the state Medicaid director wrote, "The more restricted definition of 'outpatient services' may not only reduce hospital revenues by limiting/eliminating reimbursable services, but create major access problems as well." Illinois stands to lose $130 million in 2008. The Illinois Medicaid program is underfunded by billions of dollars. "The state is keeping Medicaid afloat by delaying payments to providers, often by six months or more. On top of that, payment rates are terribly low. This has reduced access to specialists and is making it harder for patients to find providers, and that applies to ID docs as well as specialists for HIV-related conditions," said AIDS Foundation of Chicago's John Peller. "The bottom line is that any cut in federal funds will negatively impact access for people living with HIV/AIDS."

The reason the CMS regulation on Medicaid reimbursement passed while the others were held is arbitrary political football. Bush wouldn't have signed the Iraq Appropriation bill with all the regulations in place. In order to allow him to save face, Congress eliminated kept one regulation in place. Because the rule is so complicated, many states and hospitals are still figuring out the financial impact of this new regulation.

State fights back

State Medicaid Director Deborah Bachrach said New York State is currently engaged in a "multi-pronged strategy" to fend off this harmful shift. The state's Washington, D.C. office is working with CMS staff in order to adopt more favorable interpretation of the law. The state is also working with New York's Congressional delegation to vote to delay the regulation until April 2009. The other six regulations were also delayed until then. New York Senators Charles Schumer and Hillary Clinton are currently drafting a letter to CMS, urging them to impose a moratorium on the regulation. (See below on how to do your part). Worst case scenario, the state will consider litigation.

Although Bachrach said she was "optimistic" that the CMS reg can be curtailed, a Capitol Hill insider said "things are not looking so good" and that the Bush administration has already taken steps to make the rule final. Congresspeople are currently all in Denver or en route to the Twin Cities, and nothing's going to happen until they come back from recess on September 8. Watch your inbox for action alerts to bombard your legislators then.

Contact members of Congress and tell them to delay implementation of the CMS proposed rule on hospital outpatient and community clinci services. the Congressional switchboard number is 800-828-0498. To find out who your representative is, go to house.gov.

August 22, 2008

NO AIDS LOVE AT SADDLEBACK

Despite promise, Rick Warren didn't press presidential candidates on AIDS
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A missed opportunity to chat about AIDS

AIDS advocates were excited when word came that Rev. Rick Warren would be interviewing presidential candidates John McCain and Barack Obama. While some of Warren's views are a little too religious-right for our taste, Warren (with the help of his Saddleback megachurch) has been more committed to AIDS than almost any other public figure in the U.S. And it was World AIDS Day 2006 at Saddleback when Obama "respectfully and unequivocally" denounced abstinence-only HIV prevention policies. "We cannot ignore that abstinence and fidelity may too often be the ideal and not the reality—that we are dealing with flesh and blood men and women and not abstractions—and that if condoms and potentially microbicides can prevent millions of deaths, they should be made more widely available," Obama said at the time.

But while Warren alluded to PEPFAR at last Saturday's Saddleback Civil Forum on Leadership and Compassion, (in the context of creating a similar financial committment to help orphans), AIDS, and health in general, was MIA from the agenda. At the International AIDS Conference in Mexico City two weeks ago Warren specifically told Housing Works President and CEO Charles King he would ask at least one domestic AIDS question, and even gave King his direct e-mail address and asked him to suggest a question. "I am extremely disappointed that he did not follow through with his commitment," King said. "I fear we have lost our best opportunity to get McCain, in particular, to discuss AIDS, especially domestic AIDS, before the election."

According to a spokesperson from Saddleback Church, Warren decided to go for "depth instead of breadth" in his questioning and didn't have time for all the questions he had planned for the last portion of the interview in which he would have asked the candidates their views on health issues, the environment, the Constitution and other topics.

While neither candidate has made AIDS a central part of his platform, McCain's record is particularly sparse. He didn't respond to the AIDSVote questionnaire, and most recently in response to the Centers for Disease Control and Prevention's rise in new reported infections he issued a generic statement that, "As President, I will work closely with non-profit, government, and private sector stakeholders to continue the fight against HIV/AIDS. By focusing efforts on reducing drug costs through greater market competition, promoting prevention efforts, encouraging testing, targeting communities with high infection rates, strengthening research and reducing disparities through effective public outreach, we as a nation can make great progress in fighting HIV/AIDS."

Obama's statement called for a national AIDS strategy and noted, "Combating HIV/AIDS also demands closing the gaps in opportunity that exist in our society so that we can strengthen our public health. We must also overcome the stigma that surrounds HIV/AIDS - a stigma that is too often tied to homophobia. We need to encourage folks to get tested and accelerate HIV/AIDS research toward an effective cure because we have a moral obligation to join together to meet this challenge, and to do so with the urgency this epidemic demands." Obama has issued a platform on global and domestic AIDS.

August 8, 2008

BOTTOM OF THE CLASS

IAC activists flunk the CDC; call for a national AIDS strategy
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Walt Senterfitt at the CDC demo

"Condoms, needles, housing, AIDS treatment now! The U.S. fails on AIDS!"

Hundreds of U.S. activists at the International AIDS Conference on Thursday held up "F"s as they called for a national AIDS strategy and a plan to end AIDS in the U.S. The activists marched their failing grades up to the front of the conference stage where the CDC's director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Kevin Fenton was speaking. Fenton was attempting to explain away the CDC's report released this week that showed a 40 percent increase in the annual incidence of HIV in the U.S.

Because of improved data, the annual U.S. infection rate is believed to be 56,300 a year, as opposed to the previously reported 40,000 number. Forty-five percent of new infections are among blacks, and 53 percent of new infections are among men who have sex with men, with numbers in this population increasing since 2000. Fenton said the CDC has "already begun" to work with these populations and that infections have "stabilized."

"The CDC is a failed institution at this point," said New York City AIDS Housing Network's Charles Long at a press conference about Fenton's speech. "As a black HIV-positive gay man I find it deplorable to say I'm 'stabilized.'"

ACT UP Philadelphia's Waheedah Shabazz-El agreed. "I was confused to where the urgency was," she said. "Activists have been giving solutions for a long time, and they haven't been listening." Shabazz-El called for "prevention justice," which means addressing poverty, homelessness, the prison-industrial complex and structural impediments to fighting the epidemic.

Click here for more videos and photos from the CDC action. The coalition of activists involved included CHAMP, ACT UP Philadelphia, NYCAHN, Health GAP and Housing Works.

Although Fenton said the new HIV incidence findings should be a "wake-up call," the CDC has been wide awake to this reality for a while, sitting on the new numbers since October 2007.

As AIDS Foundation of Chicago's David Munar wrote in his blog post on AIDS2008.com "An earlier release might have given the Bush administration second thoughts about requesting a $1 million decrease for CDC's domestic HIV prevention programs; spurred presidential candidates to talk more readily about HIV/AIDS in the U.S.; persuaded media pundits and debate moderators to quiz candidates on plans to end the epidemic; led Congress to pass even one of the dozen domestic HIV prevention bills languishing on Capitol Hill or motivated appropriators to finally boost HIV prevention funding or end long-held restrictions on how funding can be used. No, instead the cult of embargoes prevailed, with no account to the burgeoning public health crisis the very paper in question describes. "

While the fact that annual infection rates were up was the worst-kept secret of the year, the CDC's secrecy prevailed until this week, when activists leaked the report two days before it was to be released. The CDC canceled a press conference scheduled for the first day of the IAC, perhaps unwilling to face an informed media.

National plan gaining momentum

While the higher incidence numbers are disturbing and the CDC response disheartening, these troubling statistics, as well as the Black AIDS Institute's report "Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic have prompted more talk about addressing the AIDS epidemic in the U.S. then we've seen in a while. Fenton and Rep. Barbara Lee (D-CA) both signaled their support for a national AIDS strategy. "What we need is a domestic PEPFAR," Lee said. Although the U.S. government doesn't have a national AIDS plan, it requires countries receiving PEPFAR funding to have one.

The bad news from the CDC prompted Sen. Barack Obama to call for a national AIDS strategy. "These new figures should bring new focus to our efforts to address AIDS and HIV here at home," Obama said in a statement. John McCain did not call for a national AIDS strategy, but issued a statement saying, "By focusing efforts on reducing drug costs through greater market competition, promoting prevention efforts, encouraging testing, targeting communities with high infection rates, strengthening research and reducing disparities through effective public outreach, we as a nation can make great progress in fighting HIV/AIDS."

In September, the Campaign to End AIDS (C2EA) will organize the Stand Against AIDS, a multi-arm cross-country road trip and march to demand that the next U.S. president take significant steps toward the creation of a National AIDS Strategy within 100 days of taking office. Hundreds of people living with HIV/AIDS will travel in eight different automotive caravans from around the country and one "walking" caravan (from Jackson to Oxford) to build support for C2EA's National AIDS Strategy demand. The activists will converge in Oxford, Mississippi on September 23, 2008, for three days of action leading up to the first presidential debate between Obama and McCain on September 26.

August 1, 2008

THREADING THE NEEDLE

Time to tell Congress to nix the NEX ban; birddogging already underway
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The NEX ban belongs here
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With the ban on HIV positive travelers and immigrants to the U.S. headed for the trash can (once HHS signs off, that is), is another harmful HIV ban also about to become history? With little fanfare on Wednesday, Rep. José Serrano (D-NY) introduced legislation to lift the ban on federally funding syringe exchange and advocates think it might actually pass. That's partly because Obama is pro and McCain hasn't openly opposed it.

The Community AIDS and Hepatitis Prevention Act (H.R. 6680) would eliminate the HHS rider that prohibits federal funding for syringe exchange, allowing states and local jurisdictions to spend federal prevention dollars on syringe exchange, and also update other Congressional directives that prohibit funding for syringe exchange.

"The ban on the use of federal funds for syringe exchange programs is a relic of the War on Drugs that has become obsolete and must be done away with," Serrano said in a statement. "Scientists have proven that the programs do not increase drug use, but do reduce HIV and hepatitis infections among drug users. These are facts, not opinions. Based on them, the federal funding ban makes little sense, and, in fact is cruel as it relegates more people to suffering from these horrible diseases."

And with science trumping ideology, support for ending the ban is starting to become a bipartisan effort. Republican Rep. Ileana Ros-Lehtinen (R-FL) signed on as a cosponsor after being persuaded by her constituent National Association of People with AIDS National Community Organizer Michael Rajner. At an event Tuesday Rajner asked her, "What are the chances of your supporting this bill and signing on as a lead sponsor?," Rajner said. According to Rajner, her response was "I'm flexible and rethinking my position." The next day, thanks to Rajner's persuasion, Ros-Lehtinen proved her flexibility signed on as a co-sponsor.

Other co-sponsors include Rep. Sam Farr, Rep. Barbara Lee, Rep. Dennis Kucinich, Rep. Danny Davis, Rep. Michael Honda, Rep. Betty McCollum, Rep. Eleanor Norton, Rep. Jerrold Nadler, Rep. Yvette Clarke, Rep. Edolphus Towns, Rep. Chaka Fattah, Rep. Jim Moran, Rep. Lucille Roybal-Allard, Rep. Jim McDermott, Rep. Maurice Hinchey, Rep. Diana DeGette, Rep. Lynn Woolsey, Rep. William Delahunt, Rep. Ron Paul, Rep. Ed Pastor, Rep. Jesse Jackson, Rep. John Conyers, Rep. Henry Waxman, Rep. Ros-Lehtinen, and Rep. Wasserman-Schultz. All deserve a thank you.

If your representative is not on the list give him or her a call. Go to house.gov to find out who your U.S. congressperson is, then call the U.S. Congress switchboard at 800-828-0498 and ask to speak to his or her health staffer and urge your representative to cosponsor H.R. 6680!

More than 140 groups signed on to a letter supporting Serrano's bill.

Still work to do...

While there won't be much movement on the bill this session, advocates are still searching for a lead Senate sponsor (Hillary, now that you're not running for Prez anymore, you can make up for your former reluctance by sponsoring?).

In the 20 years since the ban was introduced, more than 200 cities and states have used their own money to fund syringe exchange. In the U.S. and in other countries, the evidence is overwhelming that syringe exchange reduces HIV and hepatitis infections without encouraging drug use. A review of data from 81 cities across Europe, Asia, and North America found that, on average, HIV prevalence increased by 5.9 percent per year in the 52 cities without syringe exchange programs and decreased by 5.8 percent per year in the 29 cities with syringe exchange programs.

Let's hope, the times, they are a changin'. During the Clinton administration there was a catastrophic uproar when HHS Secretary Donna Shalala attempted to lift the ban on federal funding for syringe exchange. But in the last ten years, the scientific evidence has mounted and the public opinion and media analysis has shifted. Last June, a bipartisan cohort of representatives voted to lift the prohibition of Washington, D.C. spending its own money on needle exchange.

July 25, 2008

SAVING THE SOUTH

"Southern Manifesto" summit highlight accomplishments, setbacks fighting AIDS in the South
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The epidemic is growing in these red states

More than 250 people gathered in Birmingham, Alabama this week at the first-ever Southern Access Summit. The summit centered around the release of the Southern States Manifesto: Update 2008. This report addresses the AIDS epidemic in the South and measures improvements since the first Southern States Manifesto was issued in 2002.

"One really positive thing since 2002 is there's more focus on the South. Eight years ago, no one thought about the South being the U.S. center of the epidemic," said Southern AIDS Coalition (SAC) community co-chair Kathie Hiers. Hiers and SAC government co-chair Evelyn Foust were honored with the Stephen G. Sherman Award at the summit for their work in addressing the AIDS epidemic in the South.

The conference was organized by SAC, founded in 2001 to fight AIDS in the South. The organization is growing and a grant from the Ford Foundation will enable it to hire an executive director this year. Conference attendees included Congresswomen Donna Christian-Cristensen (D-VI), numerous state AIDS directors, and southerners with HIV/AIDS, who made up about one-third of conference participants.

Headed South

The report noted improvements in the region, including a sharp decrease in ADAP waiting lists in North Carolina and South Carolina and increased testing initiatives in Tennessee, North Carolina and Florida. "We certainly need to get more allocations for the whole country, but I will say the $300 million shifted to us in Ryan White money helped us get rid of all the waiting lists. [A fully funded AIDS Drug Assistance Program] is something that most states take for granted," Hiers said.

But such gains were overshadowed by the continual rise of new infections and the lack of government commitment at the national, state and local levels. Although only 36 percent of all U.S. residents lived in the South in 2006, the region accounted for 52 percent of the country's estimated HIV cases that year. Blacks are particularly hard-hit, accounting for 58 percent of new AIDS cases in the South, while only accounting for 19 percent of the region's population.

"For those persons in political power both at the county and the city level, this is a document that needs to get into their hands," said Dr. Bambi Gaddist, executive director of S.C. HIV/AIDS Council. "We still have too many leaders who remain uninformed and choose to be so because they can't move past the moral issue and recognize AIDS as a public health issue."

In 2002 the Southern Manifesto made waves highlighting the HIV/AIDS problem in the South and asking for federal funding to be redistributed to reflect the South's growing HIV/AIDS epidemic. Not only is the number of new infections growing, but states haven't matched federal AIDS dollars the way New York, California and some other hard hit states have. This fight over the funding pie turned ugly during the 2005 Ryan White CARE Act reauthorization. Ryan White will be up for reauthorization once again next year. Advocates and health officials made clear at the conference that they weren't trying to undermine efforts in other regions, but rather make sure the South's epidemic is addressed.

Planning to plan

"An inherent battle occurs during reauthorization, and people view us as myopic in our agenda," Gaddist said. "But if you look at the flow of funding, we need more equity, and that involves an increasing investment at the federal, local and state perspective, as well as from the corporate community. We send millions and millions overseas and that's a good thing. But there's another part of the conversation that we have Africa right here."

One difference between the U.S. and foreign countries that receive PEPFAR dollars is that other countries must create a national strategy to address the AIDS epidemic in order to receive U.S. dollars, yet the U.S. doesn't have one. The Stand Against AIDS, a cross-country caravan trip to Oxford, Mississippi at the first presidential debate will bring together activists who want presumptive presidential nominees Sens. John McCain and Barack Obama to commit to creating a national AIDS strategy in their first 100 days in office.

"The Southern States Manifesto will prove invaluable showing what the South needs when a national AIDS strategy is conducted," said Christine Campbell, Housing Works Director of National Advocacy and Organizing.

July 18, 2008

ACTION ALERT: STRENGTHEN THE AMERICANS WITH DISABILITIES ACT!

HOPWA HURDLES

July 11, 2008

HELMS' HORRID LEGACY

July 3, 2008

TESTIFYING TO THE TRANSGENDER EXPERIENCE

June 27, 2008

UPS AND DOWNS FOR FEDERAL FUNDING

June 20, 2008

NOW OR NEVER!

YOU BETTER WORK

June 13, 2008

ACTION ALERT: DEMAND CONGRESS USE WASTEFUL ABSTINENCE-ONLY DOLLARS FOR COST-SAVING MEDICARE FIX!

May 16, 2008

DENIED

PUERTO RICO POLITICS UPDATE

ACTION ALERT: ASK CONGRESS TO SUPPORT HEP C FUNDING!

KEEPING THE "CARE" IN CAROLINA

May 2, 2008

PROTESTING PUERTO RICO'S CRISIS

PLANNING TO END AIDS

April 25, 2008

HOUSE PROTECTS MEDICAID

COLD SHOWER

April 11, 2008

THE LETTER AND THE LAW

April 4, 2008

TRACKING CHANGES

March 21, 2008

BYE-BYE BAN?

CALLING ON CONGRESS

March 14, 2008

ACTION ALERT: ASK YOUR REPS TO BOOST HOPWA FUNDING!

March 7, 2008

STUDIES SHOW...HOUSING WORKS!

IF AT FIRST YOU DON'T SUCCEED...

RELIGIOUS EXCHANGE

February 15, 2008

GOOD FORTUÑO?

February 8, 2008

LAME DUCK, LAME BUDGET

PUBLIC HEALTH RISK

February 1, 2008

PEP(FAR) TALK AND NO ACTION

ACTION ALERT! TELL CONGRESS TO VOTE FOR GREAT PEPFAR CHANGES

January 25, 2008

GOOD STEP FOR GENERICS

DEMAND SPINE ON THE STIMULUS

January 18, 2008

CALIFORNIA CUTTING

TIME FOR MICROBICIDE DEVELOPMENT

January 11, 2008

Tough as Granite

End of an Era

January 4, 2008

ANOTHER BATTLE FOR VETS

Next Stop, New Hampshire

Travel Guide

December 21, 2007

FINALLY, SOME PREVENTION JUSTICE

December 14, 2007

RUM, SODOMY AND THE BASH

ACTION ALERT! URGE CONGRESS TO PASS THE 2008 APPROPRIATIONS BILL!

December 7, 2007

PREVENTION CONVENTION

November 16, 2007

SCISSOR SISTER

DESERT DAYS

November 9, 2007

LABOR PAINS

October 26, 2007

SAN FRANCISCO FOG

October 19, 2007

THIS TIME IT'S PERSONAL

CALLING HRSA OUT

October 12, 2007

ACTION ALERT: SUPPORT TRANS-INCLUSIVE ENDA

END OF THE LINE

October 5, 2007

ENDA THE ROPE?

BIKE FOR A TYKE

September 28, 2007

KIDS HEALTH VETO SHOWDOWN

YOU WILL BE TESTED

September 21, 2007

A BETTER STRATEGERY

September 14, 2007

ICE UNDER FIRE

TOOL TIME!

ACTION ALERT: PART D MEANS DO IT!

August 31, 2007

CLEVELAND ROCKS

August 23, 2007

PLANNING WHAT WE PREACH

August 17, 2007

WAITING GAME

ACTION ALERT!: GIVE EX-PRISONERS A (SECOND) CHANCE

August 10, 2007

CAN TITLE V BE FIXED?

HEP C GOES TO WASHINGTON

August 3, 2007

ETHA TEES UP IN THE HOUSE

FEARLESS

FEISTY IN FLORIDA

AB-ONLY ACTION IN AUGUST

July 27, 2007

MORE HOPE FOR HOPWA

July 20, 2007

TASTE TEST

July 13, 2007

REACH OUT TO REPUBLICANS

CIG TAX KIDS FIX

July 6, 2007

TAKING THE TITLE

June 29, 2007

NEW YORKERS REACH OUT TO PUERTO RICANS IN CRISIS

ACTION ALERT!:TAKE TWO MINUTES TO REMIND THE SENATE TO SAVE LIVES WITH ETHA

June 22, 2007

NATIONAL HIV TESTING DAY

June 19, 2007

PACHA OUTRAGE

June 15, 2007

HOPWA HOLDS ON

BACK TO BASICS

June 8, 2007

AB-ONLY CATASTROPHE

MORE ADAP ILLS

A DISHONOR JUST TO BE NOMINATED

June 1, 2007

PEP-FAR FROM ENOUGH

May 25, 2007

TOUGH LUCK FOR SECOND CHANCE

BIG WIGS IN THE BIG EASY

May 18, 2007

DESPERATE MEASURES

A FOOT IN THE DOOR

ACT UP GOES UNIVERSAL

May 11, 2007

NOT-SO-GREAT EXPECTATIONS

TEACHIN' ETHA

EVERYTHING YOU WANTED TO KNOW ABOUT THE AIDS VACCINE BUT WERE AFRAID TO ASK

SHE HASN'T CHANGED...

May 4, 2007

ETHA ACTION

RUBBER BULL

April 20, 2007

PHONE ZAP!

AIDSWATCH RETURNS!

April 6, 2007

ROLLING OUT THE RED CARPET

March 30, 2007

ZAPPED!

SERIOUS SUMMIT

LUBE JOB

March 26, 2007

PHONE ZAP: HELP HOPWA OVER THE HUMP!

March 23, 2007

HOME OF THE BRAVE

AN ‘ETHA-OR’ SITUATION

TRIPLE SCOOP

March 16, 2007

IT’S GETTING HOT IN HERE

ETHA MAKES A COMEBACK

HAPPY ANNIVERSARY, ACT UP!

March 13, 2007

SPECIAL UPDATE ACTION ALERT: HOUSE OF REPRESENTATIVES DOUBLE WHAMMY PHONE-ZAP!

March 9, 2007

RYAN WHITE PART A AWARDS ANNOUNCED

LETTER MAN

March 2, 2007

GOOD NEWS, BAD NEWS

THE YOUNG AND THE RESTLESS

February 23, 2007

MAI MAI MAI

February 16, 2007

CRISIS AVERTED?

REALITY CHECK

ISLAND FEVER

SIGN-ON EXTRAVAGANZA

February 9, 2007

LET LEAVITT HAVE IT

BLACK AND AWARE

HEARD IT ALL BEFORE

February 2, 2007

RYAN WHITE: WHAT'S NEXT?

DON'T WAVER ON OUR WAIVER

RESOLUTION SOLUTION

January 26, 2007

COOL YOUR JETS

January 19, 2007

CALL CONGRESS TO HELP HUD HOUSING TENANTS

HRSA HOUSING HORRORS

January 12, 2007

THREE-QUARTERS OF A MILLION

SIX POINT EIGHT BILLION

January 5, 2007

BILLION-DOLLAR FIGHT

December 1, 2006

MESSAGE: 'WE CARE' - BUT WHEN?

November 10, 2006

CH-CH-CH-CHANGES

November 3, 2006

FULL FUNDING FOR RYAN WHITE

MO' RYAN WHITE, MO' MONEY PROBLEMS

SAVING SECTION 8

STAYING ALIVE

October 27, 2006

CONDOMS NOT CONTRABAND

October 20, 2006

GAO FINDS HHS MUST REQUIRE 'MEDICALLY ACCURATE' INFO ON CONDOMS

PACHA FOCUSES IN ON DC

October 13, 2006

LAST HOPE FOR A BETTER RYAN WHITE

A GLIMMER OF GOOD SENSE IN THE HOUSE

October 6, 2006

RYAN WHITE REALITY CHECK

HIV TESTING & TREATMENT: WHAT'S REALLY BROKEN?

MOMENTUM FOR CONDOMS IN PRISONS?

AIDS HOUSING SUMMIT IN BALTIMORE

September 29, 2006

LATE NIGHT WITH RYAN WHITE

US CONFERENCE ON AIDS

SEEKING STABLE HOUSING FOR PEOPLE LEAVING PRISONS

September 21, 2006

RYAN WHITE REAUTHORIZATION REACHING THE FINISH LINE

CDC GUTS CONSENT & COUNSELING

PRO-CONDOM MOVE IN WASHINGTON FOR PRISONS

September 14, 2006

READY OR NOT HERE THEY COME: CDC Testing Guidelines

A NEW PUSH IN CONGRESS FOR TESTING PRISONERS

March 2, 2006

DR. COBURN AND DR. WELDON BLOW UP WASHINGTON

January 26, 2006

A LOTT TO LEARN

MEDICAID SHOWDOWN

TO BE FRANK

PreventionWatch:
ENTER TOBIAS

January 20, 2006

Federal Update:
BIRTH-CERTIFICATE BLUES

METH BILL BOMBS

January 13, 2006

THAI TRADE TIRADE

PUSH IT REAL GOOD

IN THE MIX FOR '06

PreventionWatch:
POISONED PEMS

January 5, 2006

D.C. BEAT: NEW YEAR, NO MONEY

WHO'S BACKWARDS?

December 22, 2005

BAD SANTA

DOWN-LOW DIRECTIVE

SEE YOU IN 2006!

December 16, 2005

RYAN WHITE UPDATE

MOVING FORWARD

December 9, 2005

UN-MERRY MEDICAID PLAN

RYAN...RAPIDLY

December 1, 2005

CHANGE THE WORLD

RISKY BUSINESS

MUST-SEE TV

November 22, 2005

OF BUDGETS AND BIRDS

UNDER COVER OF DARKNESS

SISTER SOLDIERS

November 17, 2005

RYAN WHITE UPDATE

KNOCK-OUT PUNCH

BATTLE OF THE BLOGS

MOVEMENT MOMENTUM

BIRTHDAY BOY

November 11, 2005

PRAYERS! PROTESTS! PROGRESS!

November 4, 2005

JUST OVER THE HILL

BALTIMORE BUST-UP

RYAN WHITE UPDATE

BUSH WHACKING

ALITO & AIDS

October 27, 2005

ON THE MOVE

FIGHTING BACK WORKS!

MEDICAID MONSTROSITIES

TAKE TWO...

October 20, 2005

C2EA HITS THE ROAD!

BUDGET BLOODBATH

VOTER REGISTRATION THREATENED

LETTERS BETWEEN FRIENDS

WANTED: NEW LEADER

October 13, 2005

TUNNEL VISION

STOP 'N' DROP

THE LATEST ON RYAN

HURRICANE CONGRESS

SPELLING RELIEF

October 6, 2005

RALLYING FOR RYAN

HELP PASS KATRINA MEDICAID BILL

PUNISHING THE POOREST

DRINKING THE KOOL-AID

METH MADNESS

September 29, 2005

BLOCKING KATRINA RELIEF

NO TIME FOR RYAN

OPERATION AWFUL

OFFSET THIS!

September 23, 2005

NO DEFEAT, NO SURRENDER

NORTHERN HOSPITALITY

PROGRESS FOR KATRINA MEDICAID BILL

RYAN WHITE UPDATE

September 16, 2005

ACTION ALERT: CALL YOUR SENATORS TODAY TO DEMAND MEDICAID FOR KATRINA SURVIVORS

September 14, 2005

AFTER KATRINA

DEMANDING MEDICAID EXPANSION

C2EA MOVES FORWARD POST-KATRINA

ONE VOICE FOR RYAN

THE CZAR DEPARTS

September 12, 2005

CAMPAIGN TO END AIDS MOVES FORWARD THIS FALL

SIGN ON NOW TO SUPPORT DISASTER RELIEF MEDICAID FOR PEOPLE WITH AIDS HIT BY KATRINA — LETTER WILL BE SENT TO THE US SENATE MONDAY NIGHT

August 25, 2005

THE LATEST ON RYAN

CONFERENCE CALLS

August 9, 2005

MORE MAYHEM IN MISSISSIPPI

"BUPE" GETS A BOOST

PARDON OUR ABSENCE

July 29, 2005

HOUSING WORKS DENOUNCES PRESIDENT BUSH'S 2005 RYAN WHITE CARE ACT PRINCIPLES AS "INSUFFICIENT"

July 12, 2005

VERDICT: GUILTY.
SENTENCE: FUHGEDABOUDIT.

TROUBLE IN TENNESSEE

SPEAK UP FOR MEDICAID

July 7, 2005

THE NEXT WAVE

MOVEMENT IN MISSISSIPPI

SIGH OF RELIEF

HOUSE RULES

CAFTA'S MOVE FORWARD

June 29, 2005

COBURN'S QUIET COUP

FUND FOR ALL

June 21, 2005

MISSISSIPPI MELTDOWN

MEAN TO MEDICAID

RYAN'S HOPE

WHO'S YOUR DADDY?

PREVENTION POW-WOW

TRIBUTE: BRENDA PILLORS, PhD

June 15, 2005

DOIN' IT IN DIXIE

FLAT CHANCE

ACTION ALERT: TAKE A POT SHOT!

TESTING, TESTING

UNDER ONE ROOF

June 7, 2005

NO WAY TO TREAT A LADY

DON'T ORPHAN AIDS FUNDING

HOUSING HOOTENANNY

June 1, 2005

"C" AND BE SEEN

HOUSING HOOTENANNY

ENDORSE THE CAMPAIGN TO END AIDS

May 24, 2005

SENSENBRENNER'S "SNITCH" BILL

May 18, 2005

TELL TOBIAS: NO BIAS!

LEAVITT'S LOUSY LINE-UP

SOCIAL INSECURITY

HOUSING HORROR

THE CAMPAIGN TO END AIDS: MOVING FORWARD

May 10, 2005

POLITICS, PRAYER & PROTEST

MANGLING MEDICAID

May 3, 2005

LIGHTS, CAMERAS...ACTIVISM!

CALL TO ACTION

MARK SOUDER'S GOOD MOVE

A MEAN HIT ON MEDICAID

April 26, 2005

THE MYSTERIOUS LETTER

MR. SMITH GOES...BACK ON HIS WORD?!?

THE CLEAN TEAM

LIGHTS, CAMERAS...ACTIVISM!

April 19, 2005

THE CAPITOL GANG

April 12, 2005

New York House Republicans Sweeney, King, McHugh, Kuhl, and Walsh Stand Up Strong For Medicaid; Boehert On The Fence

More Medicaid: Frist Twists Arms Of Senate Medicaid Champions; Stand Up Now for Your Senator If You're in OR, MN, PA, RI, OH and ME

Just a few days until the First Keith Cylar Activist Awards Gala

April 6, 2005

Beyond HOPWA: An Achievable Legislative Vision for AIDS Housing in America

Housing Works Honors AIDS Activists at April 12 Public Forum in Washington

The Bush Administration pays abstinence-only programs to lie to kids... Now they're using the internet to lie to parents

March 30, 2005

Take Action -- The Budget Fight is NOT Over

March 24, 2005

C2EA Youth Spring Break Institute Participants Go To Washington to Sharpen Activist Skills During Week-Long Training

PWAs Lead Hill Advocacy to Save Federal AIDS Housing Program from Further Cuts

Public Forum: An Evening with Honorees of the Keith Cylar Activist Awards for Domestic and Global AIDS Activism

March 17, 2005

One More Day To Save Medicaid In The U.S. Senate: Vote On Smith-Bingaman Amendment To Block Medicaid Cuts Expected In U.S. Senate Today (Thursday) -- Call One More Time To Protect Medicaid For People With AIDS

March 16, 2005

Smith-Bingaman Amendment to Block Medicaid Cuts Expected in U.S. Senate Wednesday -- Call One More Time to Protect Medicaid for People With AIDS

March 10, 2005

Stop Medicaid Cuts In Senate Budget Resolution: Congress Moves to Consider Budget Resolution -- Deep Cuts in Medicaid Hang in the Balance

March 9, 2005

Join Reps Maloney And Lee Defending The HOPWA Program: Ask Your Rep To Sign Letter Supporting Increased Funding For Housing Programs For PLWHAs

March 1, 2005

Call Your Senator before March 7 or We May Lose Medicaid for People Living With AIDS and HIV

Student March Against AIDS Organize National Rally for Decisive Global Action

A Love Note for an Amazing Student March -- We Have Turned a Corner

Campaign to End AIDS Releases First Weekly Update: Join the Campaign and Mobilize a National Caravan and March on Washington, DC to Demand an End to AIDS

AIDS Among Blacks Doubles, While Over 200,000 Americans Who Need HIV Meds Don't Get Them: Retrovirus Conference Marked by Strong Social Science Findings

February 24, 2005

Souder Circus: Committee Head Attacks Harm Reduction and Its Advocates in Hearing, Hints At International Funding Crackdown -- Reformers Make Strong Showing During Circus-Like Proceeding

CAEAR Coalition And AIDS Action Release Joint Policy Proposals For Reauthorization; Ryan White's Mother Joins in Call for Swift Reauthorization of Strong, Effective Program

Medicaid Budget Battle in the U.S. Congress -- Next Two Weeks Are Crucial

Campaign To End AIDS Continues Western States Barnstorming Tour

February 16, 2005

From The Drug Policy Alliance: Hostile DC Legislators to Convene Harm Reduction Hearings Slamming Sterile Syringe Access, Overdose Prevention and Other Life Saving Measures

Project Inform Press Statement on the New York City Department of Health Report of a "Super" Strain of HIV

Early Treatment for HIV Act (ETHA) Introduced in U.S. Senate by Senators Smith and Clinton; Would Expand HIV Care and Cut AIDS Death Rate In Half

Fossella Health Staffer to Leave DC--Championed Funding for HIV Positive New Yorkers

Campaign to End AIDS Focuses on Reaching Out to Western State Activists

February 8, 2005

Zap New HHS Secretary Mike Leavitt: Demand Adequate Funding for People Living with AIDS and HIV in New York

Bush Budget Blasts Medicaid, HOPWA: $60 Billion in Medicaid Cuts Is Just Round One as HHS and Congressional Leaders Negotiate With Governors for More

POTUS Calls for Reauthorizing the Ryan White CARE Act in SOTU Address

Rep. Nathan Deal to Head House Subcommittee on Health, Over Ryan White CARE Act Reauthorization, Medicaid and Other Important Programs for PLWAs

Campaign to End AIDS Continues Ramp Up

February 3, 2005

Bush Privatization Plan Threatens Social Security Disability Benefits

Nationally Known Organizer Susan Birmingham to Coordinate Campaign To End AIDS

Medicare Drug Rules Don't Protect Beneficiaries with HIV/AIDS; Some Key Drugs Could Be Left Off the List

AIDS Organizations Ask Bush to Protect Medicaid for People with HIV

More Than 200 Organizations Send Letter to Congressional Leaders Urging Review Of Abstinence-Only-Until-Marriage Programs — Groups Seek Hearing To Review Harmful Curricula

January 25, 2005

HHS Secretary Nominee Mike Leavitt Senate Confirmation Hearing Further Reveals Expected Approach to Ryan White CARE Act and Medicaid Programs

National "Exchange" on Syringe Exchange Program Effectiveness

Feds OK Cocktail for HIV Exposures

Campaign to End AIDS Forging Ahead: Be a Part of History to Stop the Epidemic

January 12, 2005

AIDS Activists Get Jail Time from Arlington County Judge for October CD at Bush/Cheney HQ

Activists Convene In The Nation's Capital To Re-energize AIDS Advocacy

Bush & His "Enforcers" Want to Slash Benefits And Entitlements For Poor, Elderly and Disabled Americans

What Happened at the Summit?

Tentative Plans for the Campaign to End AIDS

Claude Allen to Join White House Team As Bush Advisor On Domestic Policy

January 4, 2005

AIDS Action Council Has A Serious Case Of Laryngitis As The National "Voice" On AIDS

AIDS Inc. or AIDS Mobilization?

The Answer? Get Yourself and Your Posse To Washington DC — Create Your Own National Voice On AIDS

Over 100 Activists Participate In AIDS March Planning And Organizing Summit In Washington, DC

Location of Washington Meeting changed

December 30, 2004

Over 100 Activists to Participate In Planning and Organizing Summit in Washington, DC for Upcoming AIDS March

December 17, 2004

Momentum Builds For AIDSMarch Planning Summit: Jan 4-5, Washington DC

Leavitt Nominated to Head HHS and Lead the Drive to End Medicaid Entitlement

December 10, 2004

"Walk a hundred miles in my shoes...": A National and International MARCH TO END AIDS * Washington, DC * May 1-2-3-4, 2005

The March to End AIDS Follows in the Footsteps of Martin Luther King's Poor Peoples' Campaign

December 9, 2004

Could Anti-Safe Sex, Anti-Gay, Anti-PWA, Anti-Choice, Former Jesse Helms Attack Dog Claude Allen Be The New HHS Secretary?

First Russian AIDS Demos!

Dr. Frist Commits Malpractice

No New Money For Abstinence-Only Programs

Waxman Study Breaks Down the Bad Science Behind Abstinence-Only Programs

Good news on the Senate Democrat block grant letter

Smith: Playing Politics With Compassion

AP: Bush Signs Legislative Package Into Law

Correction to 11/24 member items article

November 30, 2004

World AIDS Day Phone Zaps: Take Action on Domestic and Global AIDS Issues

November 24, 2004

Congress Passes Omnibus Budget & Federal FY05 AIDS Funding: Across-The-Board Cuts Pay For Tiny Increases

AIDS Service Organizations Feed On Pork Supplied By 2005 Congressional Spending Bill

DC Advocacy Office Opens with a Splash, Off 'K' Street and On Capitol Hill

Ask Your Senator To Keep the Medicaid Guarantee!

DC Office and Federal Advocacy Staff Highlighted in National Journal

Republican Governors Target Medicaid -- Will Pataki Join Them?

Kaiser on DC Opening

November 16, 2004

Bush's Second Term Priorities Leave PLWAs Behind; Attacks On Medicaid Likely

Schumer Nabs Seat on Powerful Senate Finance Committee

Congress Moves to Kill Domestic AIDS Funding By A Thousand Cuts

November 9, 2004

Only A Mass Movement Can End the AIDS Epidemic: Post-Election Commentary From Charles King, President And CEO Of Housing Works

DC Office For Federal Advocacy And Nationwide Grassroots Organizing Opens Next Week

Who Is Senator-Elect Tom Coburn?

Urge Your Senators To Sign ADAP Funding Letter

Post-Election Community Forum Is SRO -- That's Standing Room Only

November 2, 2004

Vote Today To End the Plague of HIV/AIDS

AIDSvote.org, Greater Cleveland AIDS Task Force and Ohio Legal Rights Services Win Fight To Ensure Right to Vote for Ohioans With Disabilities

HHS Attempts to Coordinate Patchwork Federal Flu Response

Election and the Epidemic community forum in NYC this Saturday

October 26, 2004

Federal, State and Local Officials Failing to Deal with Flu Vaccine Crisis: Up To 40 Million at High-Risk Could Be Denied Shots; Housing Works Sets 5-Point Plan For Action To Save Lives Of Americans Living With AIDS & HIV

Protestors Tell Senator Specter to Get A Spine and Stand Up To President Bush on ADAP Funding

Maryland Comptroller Says, 'People with AIDS are a danger and they bring it on themselves'

New ACRIA Update Highlights Ryan White Care Act Reauthorization

Washington Post: 21 Arrested in Arlington Protest of Bush Administration AIDS Policy

Election and the Epidemic community forum in NYC Saturday

NY Daily News: Pols ignore crisis among black women

October 18, 2004

Activists Demand Action On Global And Domestic AIDS Epidemic, Taking Over Bush/Cheney Campaign HQ In Arlington, VA to Highlight "Compassion Failure"

October 12, 2004

US Flu Vaccine Shortage Threatens PWA's Lives

Abre Los Ojos: El VIH No Tiene Fronteras; Open Your Eyes: HIV Has No Borders

AIDSVote.org Says Cheney Gaffe Highlights Gap In Understanding Of U.S. Epidemic Among Both Republicans And Democrats

October 6, 2004

CHENEY'S AIDS GAFFE: THE VEEP DOESN'T KNOW BLACK WOMEN ARE DYING FROM AIDS IN AMERICA (AND EDWARDS CAN'T SAY MUCH MORE): KERRY AND BUSH MUST SPEAK OUT ON AIDS IN AMERICA

DEBATE TRANSCRIPT: IFILL, CHENEY AND EDWARDS

LA TIMES STORY ON THE CHENEY-EDWARDS FAILURE

October 5, 2004

If It Quacks Like A Duck: Why We Care That The Do-Nothing Congress Do Its Job

New Spanish-Language Website Launched to Educate Voters on AIDS

Nueva página de internet informa a votantes latinos sobre el SIDA

Kaiser Releases Two New Fact Sheets On Medicaid and Medicare And HIV/AIDS

New DC Office Open House November 17th

September 28, 2004

SIGN ON THIS WEEK TO COMMENTS FOR NEW MEDICARE DRUG PROGRAM

SENATE STANDS UP FOR HOMELESS HOUSING; HOUSE STILL WANTS BIG CUTS

HOUSE EXTREMISTS MOVE TO BLOCK SCIENTISTS' TRAVEL TO INTERNATIONAL CONFERENCES

VOTE EARLY & HELP OTHERS VOTE TOO: USE AIDSVOTE ABSENTEE BALLOTS

NEW DC OFFICE OPEN HOUSE PARTY, NOVEMBER 17

September 21, 2004

HOUSE AND SENATE APPROPRIATORS FLAT FUND AIDS PROGRAMS... AGAIN

MAKE ONE TOLL-FREE CALL TODAY TO FIGHT FOR AIDS HOUSING AND THE NATIONAL HOUSING TRUST FUND

CDC “RESPONDS” TO SENATOR KENNEDY’S QUESTIONS ON HIV REPORTING

COBURN TRYING TO WIN OKLAHOMA SENATE SEAT IN A TIGHT RACE

SENATOR ENZI OF WYOMING IN LINE TO CHAIR THE POWERFUL SENATE HELP COMMITTEE

GET YOUR ABSENTEE BALLOT APPLICATION AT AIDSVOTE.ORG

September 15, 2004

CONGRESS MOVING NOW ON 2005 AIDS SPENDING BILLS: TAKE TWO ACTIONS THIS WEEK TO MAKE THEM WAKE UP!

SIGN ON TO A NATIONAL LETTER TO PROTECT PEOPLE WITH AIDS IN THE NEW MEDICARE DRUG PROGRAM

"LAME DUCK" CONGRESSIONAL SESSION LIKELY DUE TO ELECTIONS

AIDS CRIMINAL CLAUDE ALLEN STILL NOT A JUDGE

HRSA SOLICITS COMMENTS ON POLICY REGARDING THE RYAN WHITE CARE ACT AND VETERANS

September 7, 2004

20 ARRESTED IN DIRECT ACTION TO PROTEST THE BUSH/REPUBLICAN "COMPASSION FAILURE" ON HIV/AIDS

REPUBLICAN PARTY PLATFORM ON HIV/AIDS EMPHASIZES GLOBAL AIDS FUND AND ABSTINENCE: DO THEY REALIZE PEOPLE ARE DYING OF AIDS IN AMERICA?

August 31, 2004

POWERFUL STILL WE RISE MARCH ON THE RNC -- MORE PHOTOS ON HW SITE

MAJOR ABSENTEE BALLOT DRIVE BY HOUSING WORKS, AIDSVOTE.ORG, POZ MAGAZINE, NAPWA AND CHAMP

August 24, 2004

RYAN WHITE REAUTHORIZATION ADVOCACY

PRESIDENT BUSH'S ANNOUNCMENT ON GLOBAL AND DOMESTIC AIDS

CONTACT YOUR U.S. SENATORS AND REPRESENTATIVES DURING THE AUGUST RECESS

August 10, 2004

MARCH ON NY: STILL WE RISE, AUGUST 30TH, UNION SQUARE

KAISER FAMILY FOUNDATION: NEW SURVEY FINDS MAJORITY OF AFRICAN AMERICANS SAY U.S. IS LOSING GROUND ON HIV/AIDS

August 3, 2004

AT THE CONVENTION I: PERSONAL OBSERVATIONS FROM A DELEGATE

AT THE CONVENTION II: SHADES OF SONDA -- DEMS NEGLECT TRANSGENDER RIGHTS IN BOSTON PLATFORM

AT THE CONVENTION III: DENISE STOKES ADDRESS

July 27, 2004

DEMOCRATIC CONVENTION TO FEATURE HIV-POSITIVE SPEAKER DENISE STOKES; AIDSVOTE ACTIVISTS INSIDE AND OUT

HOUSE APPROPRIATIONS ENDORSES HOPWA CUTS BUT HOLDS OFF WORSE

DR. R. SCOTT HITT LOSES HIS MEDICAL LICENSE AND RESIGNS AS AAHIVM CEO

July 21, 2004

WE WON'T ACCEPT A HOPWA CUT! CALL NOW TIL THE FULL APPROPS COMMITTEE MEETS ON FRIDAY

July 20, 2004

AIDSVOTE CONFERENCE CALL THURSDAY JULY 22 4PM EST: "SAFE AND LEGAL ELECTION YEAR ADVOCACY BY NONPROFITS"

APPROPRIATIONS PUT OFF

(FINAL) DISPATCH V FROM THE INTERNATIONAL AIDS CONFERENCE

July 16, 2004

DISPATCH IV FROM THE INTERNATIONAL AIDS CONFERENCE

July 15, 2004

DISPATCH III FROM THE INTERNATIONAL AIDS CONFERENCE

July 14, 2004

VOTE EXPECTED TODAY -- CALL WASHINGTON TOLL-FREE (800-839-5276) AND DEMAND ACTION

DISPATCH II FROM THE INTERNATIONAL AIDS CONFERENCE

HOUSE APPROPRIATIONS COMMITTEE

July 13, 2004

DISPATCH FROM THE INTERNATIONAL AIDS CONFERENCE

ARE YOU GOING TO LET THEM GET AWAY WITH PUSHING US UNDER THE TABLE? CALL WASHINGTON TODAY TOLL-FREE (800-839-5276) TO DEMAND ACTION ON AIDS FUNDING

MALLABY'S WASHINGTON POST COLUMN

July 7, 2004

HOUSING WORKS HIRES ROBERT CORDERO TO LEAD FEDERAL ADVOCACY EFFORT; DC OFFICE TO OPEN THIS FALL

BULLET DODGED: CUTS TO CASE MANAGEMENT FUNDING SHELVED AFTER UNITED OBJECTION FROM DISABILITY & AIDS ADVOCATES AND SENATOR KENNEDY

DAILY ONLINE COVERAGE OF THE XV INTERNATIONAL AIDS CONFERENCE

June 29, 2004

PRESIDENT BUSH: THREATENS RYAN WHITE REVAMP, (BLUSH) ADMITS CONDOMS WORK

HOUSE R's AND D's JOIN TO DEFEAT RADICAL BUDGET MEASURE