AIDS Action Network 1997 Year-End Summary
December 5, 1997
As Congress drew to a close last month, AIDS Action focused Network attention on the final struggles involved in completing the Labor, Health and Human Services, and Education (Labor/HHS) FY 98 appropriations bill. As Congress is now out of session (until January 27, 1998), we thought we would take this opportunity to update Network members on developments in various legislative and administrative issues that have appeared in recent Network alerts.
Some of the items listed below will continue to present challenges in 1998. AIDS Action will be sending out a Network Alert in January that will provide an overview of what to expect in the coming year. Meanwhile, if you have questions regarding any of these issues, feel free to contact Kurt Schade at (202) 986-1300, extension 3060.
1. Funding for FY 98:Work on FY 98 appropriations for HIV/AIDS-related programs was completed in early November. The Labor/HHS appropriations bill was signed into law on November 13; the Veterans Affairs/Housing and Urban Development (VA/HUD) appropriations bill, which includes funding for the Housing Opportunities for People with AIDS (HOPWA) program, was signed into law on October 27.
Although final funding levels did not meet the need projected for our communities in FY 98, AIDS Action is pleased to note that nearly every HIV/AIDS-related federal program will receive more funding in FY 98 than in FY 97. The notable exception is the Substance Abuse and Mental Health Services Administration's (SAMHSA) Substance Abuse Prevention and Treatment block grant, which was "flat-funded" in FY 98 at the FY 97 level of $1,360.1 million. [For a chart of FY 98 appropriations levels, refer to the November 11 Network Alert, visit the AIDS Action website at www.aidsaction.org, or call us at (202) 986-1300.]
2. Syringe Exchange Funding:The syringe exchange provision included in the Labor/HHS FY 98 appropriations legislation permitted the secretary of health to retain her authority to release federal funds for these programs. However, it also placed a six month moratorium on her exercise of this authority. In preparation for Secretary Donna Shalala to release funds for these programs once the moratorium is ended (April 1, 1998), AIDS Action recently asked its Network members to urge her to make a determination that syringe exchange programs meet the eligibility criteria established in law. The secretary has not yet announced her determination on this issue. [For more information, including Secretary Shalala's address and phone number, refer to the November 21 Network Alert or contact AIDS Action.]
3. Federal Acquisitions Streamlining Act (FASA):As AIDS Action last reported in our October 6 Network Alert, the FASA repeal language was included in the Treasury, Postal Service, and General Government FY 98 appropriations bill, which was awaiting President Clinton's signature. President Clinton signed the bill into law on October 10. AIDS Action fought the repeal of FASA in hopes that it would permit the AIDS drug assistance program (ADAP) and other Ryan White programs to purchase HIV/AIDS drugs at the low prices listed on the federal purchasing schedule. The pharmaceutical industry led the repeal effort.
4. Food and Drug Administration (FDA) Reform:The FDA Modernization and Accountability Act of 1997 was signed by President Clinton on November 21. This Act included the reauthorization of the Prescription Drug User Fee (PDUFA) Act, which assists in speeding the approval of treatments for life-threatening conditions, and a requirement that pharmaceutical companies provide six months' notice before discontinuing manufacture of a drug. Other provisions limiting the FDA's authority to require clinical research and trials for new drugs were not as welcome. [For more information on these provisions, refer to the July 18 Network Alert or contact AIDS Action.]
5. HIV Prevention Act of 1997:AIDS Action last reported on this legislation, introduced by Rep. Tom Coburn (R-OK), in our March 17 and April 24 Network Alerts. Since then, Rep. Coburn announced that he would not pursue passage of the bill this year but would continue to do so in 1998. A companion bill was introduced by Sen. Don Nickles (R-OK), but has not progressed very far. Although there were fears that Rep. Coburn would attempt to attach provisions of the bill to FY 98 appropriations legislation, no such attempt was made.
6. Reinventing Medicaid:AIDS Action continues to work with the Clinton administration to develop a demonstration project allowing low-income individuals with HIV (not just those diagnosed with AIDS) access to Medicaid services that provide life-prolonging drugs and care. AIDS Action's Reinventing Medicaid proposal was first introduced early in 1997 and was endorsed by Vice President Al Gore at the organization's 1997 National Leadership Awards banquet last April. The administration has not yet announced an official determination on the merits of the proposal.
Meanwhile, AIDS Action is also supporting an FY 99 appropriations request for $100 million to fund a Medicaid demonstration project. This funding would be designated from a development and research account at the Health Care Financing Administration.
7. Immigration Reform and Non-Means Tested Benefits:November 14 was the deadline for community comments on the attorney general's list of unrestricted federal benefits that would continue to be made available to immigrants (see October 14 Network Alert). AIDS Action's goal is that federally funded AIDS programs would not be required to check the citizenship of potential clients before delivering services. The attorney general's office has not yet released its final list of these benefits.
8. New Development -- Supreme Court Will Consider ADA Protections for People with HIV:The Supreme Court announced this week that it will hear a case addressing the extent of protection for people with HIV offered by the Americans with Disability Act (ADA). The case involves a dentist in Maine who refused routine treatment to a client because the client was HIV positive. The initial court case was decided in favor of the client; the dentist appealed the decision. At stake is whether there are legal protections against discrimination for people with HIV whose conditions have not progressed to full-blown AIDS. The Supreme Court case is scheduled to be heard in March, but may not be decided until early summer.
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This article was provided by AIDS Action Council.