To the relief of many, the Ryan White CARE ( Comprehensive AIDS Resources Emergency ) Act is moving forward. On May 17, a U.S. Senate health committee 19-1 to approve legislation to reauthorize the act until 2011.
Sen. Hillary Clinton, D-N.Y., was the only one voting against it. She claims that New York will lose $20 million under the new formula for distributing funds.
Getting the legislation passed required a bipartisan effort. Sen. Michael Enzi, R-Wyo., the chairman of the Senate Health, Education, Labor, and Pensions ( HELP ) Committee, and Edward Kennedy, D-Mass., the top Democrat on board, worked closely with their House counterparts, Reps. Joe Barton, R-Texas, and John Dingell, D-Mich., to draft the bill.
In a statement, AIDS Foundation of Chicago ( AFC ) Executive Director Mark Ishaug praised what Enzi and Kennedy did. 'On behalf of an estimated 42,000 Illinoisans living with HIV/AIDS, we commend Senators Enzi and Kennedy for working toward a compromise bill,' he stated. However, he added that there are concerns 'that people living with HIV/AIDS in the Chicago area and around the state will be adversely affected by deep funding cuts and the corresponding loss of services.'
That outlook is shared by Ishaug's co-worker, AFC Associate Director David Munar. Munar described the measure to Windy City Times as 'a mixed bag.'
There are provisions that are beneficial,' he said. 'However, we're concerned about how funding will apportioned. We'll be paying very close attention to what happens.'
The legislation not only increases the number of cities that receive CARE Act emergency grants by 25 ( from 51 to 76 ) , but it also creates a new three-tier structure for cities that report high, medium and low numbers of HIV and AIDS cases, according to the AFC release.
Chicago and the surrounding nine counties would continue to qualify as a Title I area in the highest tier. However, based on AFC's estimates, Title I funding awarded to Chicago ( $23 million ) could be reduced by 10 percent or more next year under the bill's new provisions.
A compromise provision will allow Illinois and a dozen other states to estimate the number of HIV cases they report for funding purposes; previously, only the proportion of AIDS cases was factored. Because of said provision, Illinois will likely receive a slight Title II funding increase next year for comprehensive services and the AIDS Drug Assistance Program ( ADAP ) . 'That's a really big victory for us,' Munar said.
AFC is also concerned about a provision that requires no less than 75 percent of funding be allocated for 'core medical services,' essentially forcing services to put almost all of their eggs in one basket. 'We certainly support prioritizing,' Munar opined. 'However, there are other services, such as transportation, that are very important for those who need assistance—and they are not listed as core medical services.'
Title I of the act provides emergency assistance to eligible metropolitan areas most severely affected by the HIV/AIDS epidemic. Title II deals with health care and support services for persons with HIV/AIDS while Title III involves support to primary care providers through agencies such as local health departments and homeless programs.
Fortunately for Illinois residents, the state is well-represented in Congress. 'Congresswoman Jan Schakowsky and Congressman Bobby Rush have been extremely helpful with data and [ analyses ] ,' Munar told Windy City Times. 'Likewise, U.S. Senators Dick Durbin and Barack Obama have been quite engaged, as well as downstate [ Republican ] Representative John Shimkus. Illinois is represented strongly.'
Other organizations also had mixed reactions to the measure. Human Rights Campaign President Joe Solmonese commented in a press release that ' [ r ] eauthorization of the Ryan White CARE Act is long overdue,' but cautioned the Senate to make sure 'this vital program is strengthened, not weakened, as it moves forward.'
Likewise, the HIV Medicine Association was pleased to see the measure pass through the committee, but was concerned about a rationing of medications and the growing shortage of qualified care providers, according to Medical News Today.
Munar also voiced another concern. 'There's agreement that this may be the best thing we get, although anything could happen, such as new amendments being added,' he stated. Asked about what would happen if this version is indeed the one Illinois will have to work with, he responded that, although the city could pin its hopes on the state to help out financially, Chicago 'would have to do some restructuring—and those [ would not be ] easy decisions to make.'
