Since the appropriations bills were not passed and sent to the President for signature prior to the October 2-10th Congressional recess, a continuing resolution was passed to provide stop gap funding for programs for the next six weeks. The measure will provide spending for each program at 5% less than the average appropriation approved by the House and Senate for FY 1996. In the case of programs like the AIDS Education and Training Centers (AETCs) and the Substance Abuse Mental Health Services Administration (SAMHSA) AIDS linkage programs, where one or both legislative bodies, voted to terminate the program, the resolution will provide funding at 10% less than the FY 1995 appropriation. The effect of the resolution on AIDS programs will be modest cuts across the board for CDC Prevention, Ryan White CARE Act, NIH research and HOPWA, and restoration of funds for programs slated to be eliminated such as the AETCs and SAMHSA AIDS linkage programs.
The following is a summary of the appropriations proposals of the House and Senate versions of the bills which cover AIDS related program funding. The differences in the House and Senate bills will have to be worked out in conference following the October 2-10th recess. In the meantime, AIDS funding will continue in the new fiscal year which began on October 1, 1995 under the continuing resolution.
Both the House and Senate appropriations bills approved an increase of $23.0 million for the Ryan White CARE Act Title I program. The Senate bill approves an increase of $0.5 million for the Title IV of the CARE Act, increasing total funding to $26.5 million for this program. Under the Ryan White CARE Act Reauthorization bills of 1995, which are scheduled for conference, all four titles of the CARE Act will contribute 3% of their annual appropriation for the Special Projects of National Significance (SPNS) program. The additional $500,000 provide by the Senate bill will thus serve to minimize the impact of the 3% reduction in funding. However the currently funded programs will still experience a reduction of $295,000. the additional $500,000 for Title IV should be supported in the House/Senate conference.
AIDS Education & Training Centers (AETCs)- The House apppropriations bill provided no funding for these 15 Centers and 70 sites which provide training on HIV/AIDS infection to health care professionals in 50 states and Puerto Rico. The Senate appropriations bill restored $8.0 million for the AETCs. The FY 1995 appropriations for the AETCs was $16.3 million. The Senate version of the bill should be supported in the conference because it restores at least half of the 1995 level of funding and provides an opportunity to continue these critical training programs.
Substance Abuse Mental Health Services Administration (SAMHSA)- The House bill which provides $1.48 million for SAMHSA's AIDS Mental Health Demonstration Program should be supported in the conference. However the Senate provided no funding for this important program. The SAMHSA AIDS Linkage and Outreach programs were eliminated in both the Senate and House bills. The loss of these critical programs is a striking blow to AIDS prevention, particularly for people of color since they targeted AIDS outreach and linkage services to high risk populations including youth, women, injection drug users, and incarcerated persons. Funds should be restored for these programs which link high risk drug users and their sexual partners with substance abuse treatment and HIV prevention and health services.
In additon, the AIDS Mental Health Training and Clinical Training programs, which received support in the Senate bill, should also be funded in the FY 1996 appropriations bill.
Substance Abuse Block Grant- The House provides funding at a level of $1,234.1 billion for this program, which supports substance abuse treatment and prevention of alcohol and other substance abuse. The Senate bill proposes cuts in this block grant ( 108.3 million below the FY 1995 level and the House proposal) which will serve to create long waiting lists for treatment slots and negatively impact on the coordination of HIV prevention with drug/alcohol treatment efforts. Approximately 28% of all AIDS cases in the United States are attributed to substance abuse. Decreases in prevention and treatment services will only serve to increase the spread of HIV/AIDS among this population. While this vital program requires increased levels of funding, beyond the proposals in either bill, the House version provides the higher level of funding and should be supported in the conference.
Both the House and Senate appropriated funding for the CDC AIDS prevention programs at the FY 1995 level of $590.0 million. However, CDC's Sexually Transmitted Diseases (STD) program which is closely linked to HIV prevention was under funded in the Senate. The House version of the bill provided an increase of $5 million for a total of $110.2 million. The House funding level for STD prevention should be supported in the conference.
The National AIDS Program Office (PHS)- This office which coordinates all PHS AIDS programs and policies was eliminated. AIDS Dental Services- The House bill provides $6.9 million (level funding based on FY 1995), and requires that this program be coordinated with other HIV care services funded through the Ryan White CARE Act.
National Institutes of Health (NIH) AIDS Research- The House and Senate supported increased funding for the biomedical research at the National Institutes of Health (NIH). The NIH received an overall increase of $301 million and the Office of AIDS Research (OAR), received an increase of $53.3 million (4% in increased funding) in the Senate bill. The Senate bill provides 1.7% less than the House bill in funding for research, but includes AIDS research earmarks within the NIH and the consolidated budget for the OAR. The House bill did not include a line item for the Office of AIDS Research. The consolidated budget for the OAR is critical to maintain strong management, coordination and leadership for AIDS research within the NIH and should be supported in the conference.
- The Senate VA/HUD appropriations bill, which includes HOPWA passed by a vote of 55-45 on September 27. The effort top restore $360 million to the McKinney/Homeless Assistance Grants program was defeated by a vote of 48-52. The McKinney HAG program is an important non-AIDS specific source of funding for housing for homeless people living with HIV/AIDS. In FY 1996 the McKinney HAG funds which were formerly awarded on a competive basis will be distirbuted by a formula process. This means that the level of funding was not raised to $ 1 billion, states will lose large sums of money for housing for homeless people.
The Senate VA/HUD bill provides $171 million in funds for HOPWA for FY 1996. This is the same level of funding as the FY 1995 (after the rescissions) HOPWA appropriation. Although the Senate bill provides a lower level of funding than the House bill, it has HOPWA as a separate line item. Twelve new jurisdictions are eligible for funding in FY 1996. The level of funding provided under the Senate bill will be inadequate to cover the funding needs of current and new jurisdictions.
The House VA/HUD appropriations bill provides funding for HOPWA under a special needs account which includes the Section 202 and Section 811 (housing for the elderly and disabled respectively)programs, at a level of $1,441 billion. This means that the Secretary of HUD has the discretion to determine how much of that special needs account funding will be earmarked for HOPWA.
Conferees should be urged to adopt the line item funding for HOPWA proposed in the Senate bill with a funding level of $213 million, which is the proportion of funding HOPWA should receive under the House bill. While this level of funding is still inadequate, it will at least ensure that the currently funded HOPWA jurisdictions, as well as the 12 new eligible ones, do not experience severe cuts in funding in FY 1996.