Memorandum

As you know from the fax alerts we've been sending, Congress' work on FY 1997 Appropriations for federal programs, including those which provide HIV/AIDS prevention, care, training, research, and housing is in full swing. In fact, the House is expected to complete work on appropriations bills (the FY 97 Labor-HHS Appropriations bill and the FY 97 VA-HUD Appropriations bill) which fund AIDS programs by the end of June.

Once the House has finished, the Senate will turn its attention in ernest to appropriations, but not until after the 4th of July recess. The 4th of July recess will start on June 28 and end on July 7. During this time your representatives and senators will be home in their districts and this is an ideal opportunity to meet with them, especially your senator.

Your diligent responses to our alerts and phone calls requesting your assistance in contacting your House Representatives on these issues have been extremely helpful! Now we must focus on the Senate.

This packet is designed to assist you in urging your Senators to support increases in HIV/AIDS prevention, care, training, research, and housing. The enclosed materials provide:

• A process overview and timetable for Senate action.
  
  
• Suggested steps and actions for your advocacy.
  
  
• Talking points on each of the major federal AIDS programs.
  
  
• A fact sheet reporting how much your state receives in federal AIDS funding.
  
  
• A summary chart of funding levels for these programs.

We hope you will use these materials to vigorously advocate for increases in federal AIDS programs as the Senate begins the process of setting funding levels for Fiscal Year 1997.

Process for Senate Action

As you know, funding for AIDS programs is provided through Congressional appropriations committees. They develop the bills with specific funding levels that eventually are voted on by the Congress and sent to the President who signs bills into law. In the Senate these committees are:

The Senate Labor/HHS Appropriations Subcommittee, chaired by Senator Specter (R-PA), has jurisdiction over CDC prevention, the Ryan White CARE Act (which incudes Titles I-V. Title is the AIDS Education and Training Centers and the AIDS Dental Reimbursement Program) and NIH AIDS Research. This sub-committee is expected to mark-up (set funding levels) for FY 1997 some time in mid-July. While the Senate would like to conclude action on their Labor/HHS Appropriations Bill before they begin their summer recess on August 3rd, most observers predict that the Senate will not complete action until mid-September.

The Senate VA/HUD Appropriations Subcommittee, chaired by Senator Bond (R-MO), sets funding for the Housing Opportunities for People with AIDS (HOPWA) program. The VA/HUD Subcommittee will most likely mark-up the week of July 8th and complete action on the bill prior to the August recess.

Timetable

The House is expected to complete work on FY '97 appropriations for AIDS programs by June 28. Proposed Funding levels prevention, care, research and housing to date are listed on the attached chart.

June 28 - July 7: House and Senate Independence Day Recess

July 8 - July 13: Senate VA/HUD subcommittee marks up its FY '97 appropriations bill

July 15 - July 19: Senate Labor/HHS subcommittee marks up its FY '97 appropriations bill

August 2 - September 4: Senate Summer Recess

August 3 - September 3: House Summer Recess

Time is of the essence. While the bill may stretch into September, initial decisions will be made in the next few weeks. We strongly urge you to take action NOW.

What You Can Do to Advocate for Increases

• Schedule a district visit with your Senator during the July 4th Recess.
  
  
• Invite the Senator and his/her staff to visit your agency or programs to learn more about what you do with the federal funds you receive.
  
  
• Attend a town meeting - if you are not successful in arranging a separate meeting with your Senator, attend a town meeting. Ask your Senator if they support increases in federal AIDS programs. Your Senator's office can give you information about scheduled town meetings.
  
  
• Write, call or fax your Senator, urging them to support increases in prevention, training, care, research and housing. All Senators can be reached at 202-224-3121. E-mail addresses for your Senators can be found posted in HandsNet at Resources/Congressional Contacts.

Tips to Make Sure Your Message is Heard and Most Effective

• Senators who are members of the appropriations committee have the most influence.
  
  
• If your Senator is not on the appropriations committee, urge them to write letters of support to the VA/HUD Subcommittee Chairman Bond in support of increases for HOPWA and to Labor/HHS Subcommittee Chairman Specter in support of increases for prevention, CARE and research.
  
  
• When you make calls, communicate with the staff person who handles AIDS issues for your Senator.
  
  
• If you have not done so already, you should develop a positive relationship with the Senator's staff.

Talking Points in Support of Increase for Federal AIDS Programs

(Please refer to the enclosed funding chart for specific FY 97 funding requests for AIDS programs.)

Labor/HHS Subcommittee Programs Prevention

The House of Representatives has provided an increase of $15.0 million for HIV prevention programs at the Centers for Disease Control & Prevention. A minimum of $738.5m for CDC prevention programs is needed. Senators should be urged to fund CDC prevention programs at least $33 million above FY 96 levels.

In the coming year, some 40,000 Americans will become infected with HIV, a quarter of whom will be between the ages of 13 and 25.

Current funding is not meeting the need. Over $60 million in prevention programs that target populations at greatest risk for HIV have been submitted by state and local health departments but remain unfunded. Without adequate funding, these vital community-based efforts will be doomed at the very moment when they are so urgently needed to prevent further spread of the disease.

Restrictions on the use of federal funds for prevention efforts should be removed --like needle exchange programs. Communities should be free to implement prevention programs that are responsive to local needs as long as they are effective and grounded in principles of good public health.

Care

• The House of Representatives provided an increase of $54.9 million for all titles of the Ryan White CARE Act. (See the chart for a breakdown of increases by title.) Senators should be urged to fund the CARE Act at a minimum of $125 million over FY 1996 funding.
  
  
• The CARE Act provides resources to local communities for medical treatment and support services for people living with HIV/AIDS and training for health care providers in competent and compassionate HIV/AIDS care.
  
  
• The CARE Act helps people with HIV/AIDS live longer and avoid expensive treatment in emergency rooms.
  
  
• The CARE Act has struggled to keep pace with increasing case loads since its inception.
  
  
• While CARE Act programs received a welcome increase in the FY 1996 appropriations process, growing case loads and the availability of promising yet costly treatments demand further increases in funding.

Research

The House provided an increase of 6.5% for all research at the NIH, but eliminated the consolidated budget for the Office of AIDS Research (OAR). Senators should be urged support increases for NIH and reinstate the OAR.

Increases in AIDS research should be consistent with increases for all biomedical research if scientists are to respond to the public health need and scientific opportunity.

Aggressive, targeted research has led to important new treatments and greatly increased our understanding of AIDS and other diseases. The Office of AIDS Research (OAR) coordinates, evaluates and plans AIDS research programs at NIH. The consolidated budget of the OAR enables its director to implement a unified, strategic plan for AIDS research. The consolidated appropriation is the most effective mechanism for a coordinated and strategic AIDS research program. VA/HUD Subcommittee Programs

HOPWA

The House has so far failed to provide any increase in HOPWA funding for the third year in a row. Senators should be urged to provide $250 million in funding for HOPWA to prevent the drastic cuts that states and localities are now facing.

Stable housing helps prevent the early onset of illness and maintains the quality of life for HIV-infected individuals and their families. Without stable housing, many people with HIV disease will die prematurely, because it is virtually impossible to link them to care services and life-sustaining treatments if they do not have a stable place to live.

HOPWA is the only federal housing program that provides cities and states hardest-hit by the AIDS epidemic with the resources to address the housing crisis facing people living with HIV/AIDS in their communities. The housing provided by HOPWA dollars reduces unnecessary hospitalizations and reduces the use of emergency health care services by an estimated $47,000 per person per year.

Level funding of the HOPWA program has added to the growing housing crisis communities face in battling the AIDS epidemic. Since FY '95, the number of metropolitan areas and states qualifying for HOPWA formula grants has increased by 23 percent, and the number of new AIDS cases reported by the CDC has increased by almost one-third. Yet in that same time period, HOPWA funding has remained flat at $171 million!

In FY '95 the 66 then-eligible jurisdictions experienced an 8% cut in their formula grants due to rescissions. In FY 96, 10 additional jurisdictions were added to these 66 while the HOPWA programs was flat-funded at $171 million. The same $171 million that served 66 jurisdictions in FY '95 had to be spread to serve 76 jurisdictions in FY'96.

The number of jurisdictions eligible for HOPWA funding continues increasing. Each year, 10 to 13 jurisdictions become newly-eligible for formula grants based on increases in AIDS caseloads. If HOPWA funding remains level, jurisdictions will actually see cuts in funding despite increasing need, because newly-eligible jurisdictions must be accommodated. If we fail to meet the urgent need in these areas, we will only transfer the financial burden of the epidemic to state and local governments. That failure will have enormous human and economic costs.

Without an increase in FY '97 funding for HOPWA, more and more people living with HIV/AIDS will be living -- and dying -- on the streets of your home towns.

FY 1997

Appropriations Levels for Federal AIDS Programs (increases or decreases from the FY 96 numbers are in parentheses) as of 6/14/96

Federal HIV/AIDS Program CDC-Prevention Actuals:

FY 96 Actuals (1): $584.1m FY 97 President's Budget Request 3/19/96: $616.5m (+32.5m) FY 97 Need (2): $738.5m (+154.5m) FY 97 House Action (3): $599.1m (+15.0m)

HRSA-Ryan White CARE Act:

Total FY 96 Actuals (1): $757.3m FY 97 President's Budget Request 3/19/96: $830.7m (+73.4m) FY 97 Need (2): $1,106.7m (+349.4m) FY 97 House Action (3): $812.3m (+54.9m)

Title I:

FY 96 Actuals (1): $391.7m FY 97 President's Budget Request 3/19/96: $423.9m (+32.2m) FY 97 Need (2): $521.5m (+129.8m) FY 97 House Action (3): $401.7m (+10.0m)

Title II:

FY 96 Actuals (1): $260.8m FY 97 President's Budget Request 3/19/96: $285.0m (+24.2m) FY 97 Need (2): $421.1 ($160.3m) FY 97 House Action (3): $290.8m (+30.0m)

Title IIIb:

FY 96 Actuals (1): $56.9m FY 97 President's Budget Request 3/19/96: $64.6m (+7.7m) FY 97 Need (2): $96.3m (+39.4m) FY 97 House Action (3): $61.9m (+5.0m)

Title IV:

FY 96 Actuals (1): $29.0m FY 97 President's Budget Request 3/19/96: $34.0m (+5.0m) FY 97 Need (2): $42.5 (+13.5m) FY 97 House Action (3): $34.0m (+5.0m)

Title V - AETCs:

FY 96 Actuals (1): $12.0m FY 97 President's Budget Request 3/19/96: $16.3m (+4.3m) FY 97 Need (2): $16.3m (+4.3m) FY 97 House Action (3): $16.3m (+4.3m)

Title V - Dental Reimbursement:

FY 96 Actuals (1): $6.9m FY 97 President's Budget Request 3/19/96: $6.9m (0.0m) FY 97 Need (2): $9.0m (+2.1m) FY 97 House Action (3): $7.5m (+0.6m)

NIH-Research: FY 96 Actuals (1): $1,407.8m FY 97 President's Budget Request 3/19/96: $1,431.9m (+24.1m) FY 97 Need (2): $1,565.0m (+157.2m) FY 97 House Action (3): $1499.5m (+91.5m) (4)

HUD-HOPWA:

FY 96 Actuals (1): $171.0m FY 97 President's Budget Request 3/19/96: $171.0m (+0.0m) FY 97 Need (2): $250.0m (+79.0m) FY 97 House Action (3): $171.0m (5) (+0.0m)

(1) Equivalent to FY '96 appropriations level, adjusted by the Administration to reflect amount to be spent in 1996. (2) Need figures are supported by the NORA Coalition and represent the resources needed to respond to growing case loads, unmet needs and unfunded research opportunities. (3) House Action represents 5/30/96 VA/HUD Subcommittee Mark-up for HOPWA and 6/13/96 Labor/HHS Subcommittee Mark-up for all other programs. (4) The Consolidated Budget for AIDS Research and all marks for AIDS research within the Institutes are again eliminated. The report language, however, intends that funds allocated for AIDS should be spent in a manner fully consistent with the AIDS research plan developed by the OAR, and relying on NIH's recommendations, includes a chart of AIDS funding by institute. NIH received an overall increase of 6.5% which translates into an FY '97 research funding level of $1,499.3m (+$91.5m). (5) An amendment to increase this number by $15 million may be offered when the bill is on the House floor.

For more information contact:
aidsaction@aidsaction.org
Lisa White
AIDS Action Council
1875 Connecticut Ave., NW Suite 700
Washington, DC 20009
202-986-1300