February 28, 2006
Baltimore health officials and AIDS advocates worry that proposed changes to the state AIDS Administration (SAA) budget could eliminate 33 staff and leave Maryland's AIDS Drug Assistance Program (ADAP) short of funding.
Last year, the General Assembly asked SAA to phase out a contract with the University of Maryland and shift 74 positions -- among them surveillance, outreach, and research staff members -- onto the state payroll as full-time SAA employees. Though Gov. Robert Ehrlich Jr.'s proposed budget for the coming fiscal year will support 41 positions, 33 are left without funding, including five Baltimore surveillance positions. That is despite an increase in SAA's budget from $53.9 million in FY06 to $68.3 million for next year. The next fiscal year begins July 1.
"Baltimore will be affected because the bulk of the money goes to places with the highest need, the most concentrated numbers," said Dr. Kima J. Taylor, Baltimore's assistant commissioner for health promotion and disease prevention.
Officials with the Department of Health and Mental Hygiene (DHMH), which oversees SAA, said they are unable to retain all 33 employees but are working to keep testing and counseling services.
Another proposal would shift drug company rebates, which are used to subsidize AIDS medications for ADAP, into the state's general fund. SAA estimates it will receive $11 million in rebates. The governor proposes allocating $6 million as general funds, and $5 million as SAA surplus. However, rebates have never been guaranteed, said Health Department Secretary S. Anthony McCann. And AIDS advocates worry rebates will not be forthcoming if they are used not to buy drugs but for general purposes.
"It's impossible to underestimate the importance of this program -- it keeps people alive," said Dr. Joshua Sharfstein, Baltimore's health commissioner.