On March 1, the U.S. Department of Health and Human Services (HHS) announced the FY 2004 Ryan White CARE Act Title I awards. Forty major metropolitan areas, including some of the most AIDS-impacted urban areas in the country, received significant decreases in federal funding.
The Atlanta Eligible Metropolitan Area (EMA) award for the upcoming fiscal year is $18,339,732 -- a decrease of $441,446 from the funds available in FY 2003. The EMA application to HHS requested $21,000,000 to address the need in the metro area. As of December 31, 2002, there were an estimated 21,484 people living with HIV or AIDS in the EMA.
The Atlanta EMA covers the 20 counties that currently make up the metro Atlanta area as defined by the census bureau. The number of counties in this EMA is expected to expand in the next year or two due to changes in the census bureau definition.
Compounding the funding crisis, U.S. Senate and House leaders unveiled budget resolutions recently that would cap or cut funding for domestic HIV/AIDS and other social programs and even cap spending for Medicaid, the nation's largest single source of funding for HIV/AIDS care.
"If these budget resolutions do pass, it will only cause further strain on our system," notes Jeff Graham, Executive Director of AIDS Survival Project. "This Congressional action will force even deeper cuts to medical care and essential support services, such as nutrition, health education and transportation."
In addition to Atlanta, 39 of the 51 Title I cities received funding cuts. Among the hardest hit were San Francisco (a metro area with one of the highest AIDS caseloads in the country), Los Angeles, St. Louis, Denver and Newark, New Jersey.
"Our Congressional leaders can do better; our president can do better," remarked Patricia Bass, Chair of the Communities Advocating Emergency AIDS Relief (CAEAR) Coalition, a national group that advocates for Ryan White CARE Act funding. "In the past year, the number of people living with AIDS increased by nearly 8%, but overall federal AIDS funding to the nation's hardest-hit cities decreased by nearly $4 million. The Administration and Congress have made significant increases in global HIV/AIDS funding. It is frustrating and unacceptable that our nation's leaders continue to neglect the domestic HIV epidemic to the point where the situation could deteriorate to that of a third-world country."
AIDS Survival Project is one of the Atlanta agencies in the CAEAR Coalition, which represents more than 300 grantees under Title I and Title III of the Ryan White CARE Act, including the 51 major metropolitan areas most adversely affected by the HIV/AIDS epidemic.
Title I provides emergency assistance to these hardest-hit areas and supports comprehensive HIV health care and treatment for increasing numbers of uninsured and underinsured persons. Title I programs fund desperately needed services for persons living with HIV/AIDS, such as outpatient health care, case management, home health and hospice care, housing, nutrition services and transportation. Title I is the major safety net for thousands of low-income Americans living with HIV/AIDS who are ineligible for entitlement programs, inadequately insured and would otherwise not have access to HIV/AIDS treatment and care.
The Ryan White CARE Act and other key AIDS programs would see further cuts under the budget resolutions proposed by Congress, which are expected to be even larger than those included in President Bush's budget proposal. Defense and antiterrorism spending not included in the Bush budget (e.g., all spending in Iraq and Afghanistan) will force additional cuts in domestic programs later this year and in coming years. Health care spending would be cut by 11% or more under the new rules, according to the Center on Budget and Policy Priorities.
"We're calling on people to urge their senators and representatives to oppose these budget resolutions and block efforts to cap needed domestic and entitlement spending," Graham says. "More than half the Georgia congressional delegation represents the people living with HIV and AIDS in the Atlanta EMA. Therefore, it's important that all our elected officials in Congress get the message that as the epidemic moves deeper into more vulnerable populations, including women and communities of color, the increased need for funding for care and support services is growing."
|At a Glance|
|Atlanta EMA request for FY 2004 funding||$21,000,000|
|Atlanta EMA funding awarded for FY 2004||$18,339,732|
|Decrease in Atlanta EMA funding from 2003||$411,446|
|Estimated number of people with HIV or AIDS in Atlanta EMA (December 2002)||21,484|
Rob Nixon is Communications Manager for AIDS Survival Project.