Dr. Lamar Hasbrouck, the director of the Illinois Department of Public Health (IDPH), spoke about recent HIV/AIDS funding cuts and upcoming changes to the healthcare system under the Affordable Care Act (ACA) at a breakfast discussion Sept. 27.
The AIDS Foundation of Chicago (AFC) hosted the event, which was held three days before the Chicago AIDS Walk & Run. AFC President/CEO David Ernesto Munar and Hasbrouck discussed his background, the overall state of public health in Illinois (its ranking was 28th last year by the United Health Foundation), HIV/AIDS care and prevention, funding cuts and the transitions undergoing public health in implementing the ACA.
In June, the state House voted to cut HIV funding by $3.3 million, or 42 percent of previous levels. In a press release, the AFC projected more than 100 new HIV infections due to the funding cut. When asked about them, Hasbrouck stressed resourcefulness and made no mention of funding being restored to original levels.
"Just to be very genuine to you … we're always going to be in a situation where we're strapped for resources," he said. "The resources, in terms of dollars, is not the answer."
Hasbrouck added that instead of relying heavily on a system of non-profit health networks, and public programs like the AIDS Drug Assistance Program, more people with HIV will be eligible for insurance under the ACA, and a statewide waiver may allow Medicaid to expand its coverage before the national law goes into effect in 2014. Hasbrouck said this is where his agency must act.
"What we have to do in terms of public health is to work with out sister agencies… to make sure that we don't lose anybody," he said.
This remains the critical question for public health advocates: If public funding continues to decrease while access to healthcare insurance increases, how will these changes effect those who are in need of healthcare?
Hasbrouck admitted that this legislation leads to both excitement and anxiousness.
"It's a moving ball. The federal guidance isn't crystal-clear," he said.
He stressed that organizations need to focus on doing fewer things well, and not overlapping services or resources with other organizations.
A study put out this year by the Morten Group assessing the needs of Chicago's LGBT community identified affordable health care and services or health insurance as the number one issue its respondents felt the government should address.
The Center for Disease Control and Prevention also released a study in 2010 that showed that one in five men who has sex with men in 21 different cities, including Chicago, had HIV; moreover, half of those did not know they had it. According to the study, young Black men who have sex with men are disproportionately affected by the epidemic.
During the discussion, Hasbrouck also stated that there are specific communities with "explosive rates" of new HIV infection, and that's something the healthcare community needs to address.
He also stated he was in support of imposing statutory remedies on the provisions of the Communicable Prevention Act, which states principles and superintendents must be notified if an student tests HIV-positive.
According to the AFC, there are about 25,000 people in Chicago who are infected with HIV, and the number of people living with HIV in Chicago has increased every year.
Hasbrouck has previously worked as the director and chief of party for the Center for Disease Control (CDC) in Guyana for the Emergency Plan for AIDS Relief, and most recently was the director for the Department of Public Health and the Department of Mental Health of Ulster County, NY.