for the week ending March 24, 1996
All of the funding reduction must come out of existing programs serving people living with HIV/AIDS in the five counties of southeastern Pennsylvania and four counties in southern New Jersey.
AIDS Activities Coordinating Office director Jesse Milan said Friday that he would request an emergency meeting of the HIV/AIDS Commission, which is responsible for overseeing the allocation of federal AIDS funds.
The reduction in funding will have an immediate effect on local AIDS services, since supplemental funding contracts begin on April 3rd. Most services funded through supplemental grants are concentrated in minority-run and suburban agencies, since "formula" funds -- those awarded to the region according to a federal formula based on numbers of AIDS cases -- were early concentrated in "first-wave" AIDS organizations organized in the mid-1980s.
The supplemental funds are awarded competitively, based on an application prepared annually by the city health department. This year's application, prepared by embattled AACO planning manager Jennifer Kolker, was severely criticized by suburban county advocates who complained that it barely mentioned AIDS services in suburban areas, and by minority advocates who have complained for years about Kolker's alleged insensitivity to the concerns of communities of color.
HRSA sources told Alive & Kicking! that the funding cut for the Philadelphia area was based on a combination of the application of the new Ryan White funding formula -- which penalizes cities where new cases of AIDS are leveling off, in favor of regions experiencing faster rates of growth of the epidemic -- and a poor evaluation of the city's supplemental application.
Political sources have also said that the Republican Congress has also pressured HRSA to divert Ryan White funds to rural areas which traditionally have not competed well for federal AIDS funding because their actual caseloads are generally smaller than those in big cities which have been facing the epidemic for over a decade.
Overall, the combination of the supplemental funding cut and "level" funding in the city's formula award will result in a 19% total reduction in Ryan White CARE Act funding for existing AIDS services in the Philadelphia region, according to a letter faxed Friday by Milan to some Ryan White-funded agencies.
Ryan White funding supports virtually every kind of HIV/AIDS related service, including medical services and supplies, home care, foster care, case management, information and referral, substance abuse and mental health services, and risk reduction interventions.
"This funding cut will force us to put what money we have in the places where it will do the most good," said Joe Cronauer, executive director of We The People. "We simply can't afford any more to allocate most of our AIDS dollars to organizations with political connections and friends in high places -- it has to go to organizations who are out there in the real world where the real epidemic is today. It's tragic that what little funding is available now to PWA-led and minority-led efforts to combat AIDS is once again threatened. Because of years of favoritism and insider deals we were the last to get any money -- and now we're the first to have to face losing it.
"The HIV Commission cannot be allowed to 'spread the pain' of these cuts; all of us are not equal, and if there are cuts, those who can afford it the most are where they need to happen."
Cronauer said that he was also concerned at the high administrative costs associated with the new HIV Commission -- which has proposed a $750,000 budget -- and with high administrative allocations included in the budgets of some large AIDS service organizations receiving AIDS funds.
"'Administrative costs' are the secret profit that big AIDS service organizations sneak through in their grants," Cronauer said. "Administration is a necessary evil, but at a time of crisis, those who can't do the job cheaply simply should be asked to step aside."
We The People receives about $80,000 in Ryan White supplemental funding annually -- almost 10% of its annual budget -- which is allocated for its LifeSavers Emergency Needs Fund, for the Positive Voices Outreach Team, and for Alive & Kicking!
The thirteen, most of them members of the group Housing Works, were arrested after demanding public hearings on the Planning Council's decision to cut almost $22 million from existing AIDS services in light of an expected reduction in Ryan White CARE Act funding for the New York region.
The protesters disrupted the beginning of the Planning Council meeting after New York AIDS policy director Ronald Johnson refused to schedule public hearings in each of the city's five boroughs to discuss the cutbacks. Johnson had suggested that the protesters be allowed to speak at the council meeting, but that no formal public hearings be scheduled.
Underlying the protest was the decision of the Planning Council to retain full funding for the city's contribution to the AIDS Drug Assistance Program (ADAP) -- the equivalent of Pennsylvania's Special Pharmaceutical Benefits Program -- while implementing steep cuts in other programs serving low-income and minority people. ADAP, which pays for AIDS drugs for working PWAs in New York, serves primarily a middle-income clientele, according to Jeame Bergman, senior policy analyst at Housing Works.
Others defended the Planning Council deliberations. Gay Men's Health Crisis staffer Richard Elovich said it was a "miracle" that any consensus on cuts was developed at all. "To question the integrity of people and the integrity of the process is just not helpful," Elovich said.
Douglas Wirth, policy analyst for the Coalition of Voluntary Mental Health Agencies, said that a workgroup organized to plan cuts in mental health services was particularly conscious of protecting programs serving "hard-to-reach" populations.
However, despite their positive comments on the planning process, both Elovich and Wirth voted against the overall spending plan adopted by the Planning Council because they did not support the specific dollar allocations in the areas of health, mental health, social services, substance abuse, housing and "infrastructure."
The HIV Planning Council has until March 31st to finalize its funding plan for AIDS services contracts which begin April 3rd.
Chester Council rejects AIDS home
The Chester Zoning Hearing Board has rejected the proposal of Family and Community Service of Delaware County to build a 12-bed home for people with AIDS in downtown Chester.
The Zoning Board said that the planned facility was too close to the downtown business district in Chester and should have been planned for a residential area. Ironically, most AIDS housing projects which have faced opposition in the past have been controversial because they were planned for residential, rather than business, districts.
Zoning Board chairman John Brown was quoted in the Delaware County Daily Times as saying that the city had plans to use the property in question, at Fourth and Welsh streets, for "commercial use." He said that the lot is too close to Chester City Hall, and that there was "plenty of other vacant land in the city" which could be used for the program.
Board member Dalinda Carrero said that the Zoning Board's action should not be constructed as opposition to the AIDS facility, but only to its proposed location. "If it had been in another district, more residential, my decision may have been different," she told the Times. The basis of my decision was the location, and it was a hard decision to make. I personally feel [the project's] a wonderful idea, and [there is ] a need for it in Chester.
While the Delaware County Health Department refuses to release data on the distribution of AIDS cases in different areas of the county, the high concentration of low-income people and drug users in Chester leads many to believe that more than half of the county's HIV+ people live in or near the city.
Alan Edelstein, executive director of Family Service, said that his organization has already received over $1 million in funding to construct the facility, which is called Ralph Moses House after the longtime PWA activist (who just last week was appointed to the region HIV/AIDS Commission). He said that Moses House would provide transitional housing to low-income people with HIV/AIDS and offer shelter, food, support services and skills training for up to 18 months.
There was no community opposition to the proposal at the meeting, from either residents or business people located near the proposed site.
Edelstein said that he was hopeful that a site acceptable to the Zoning Board could be found so that the project -- now entering its third year of planning -- can proceed. "We're still very much committed to doing the project," he said.