Charles King, CEO and cofounder of the longtime New York City HIV/AIDS services provider Housing Works, laments all the progress in recent years on fighting HIV, the prevention and treatment of other sexually transmitted infections (STIs), and myriad other health services that the city may now have to reverse course on, due to public health funding cuts being proposed by New York State Governor Andrew Cuomo.
"You are talking about millions of dollars that have been contracted out from the Department of Health [DOH] to various community groups to do all sorts of things," says King, "like media campaigns targeting women and Latinos about PrEP [pre-exposure prophylaxis], subway and bus ads explaining that U equals U [being HIV undetectable also means being unable to transmit the virus], programs like the one Housing Works has to identify and engage young MSM [men who have sex with men] and trans women of color on [the option of going on] PrEP."
He goes on: "Also, expanded HIV testing in city health clinics that's linked to JumpstART, which gives people a starter kit of HIV meds once they're diagnosed, or a starter kit of PrEP, then links them to long-term care." The JumpstART program also funds emergency post-exposure prophylaxis (PEP), a short course of HIV medications to be taken 28 days after possible HIV exposure to prevent HIV infection.
And, he adds, that's not to mention funding for non-HIV services such as those for other STIs, hepatitis C, tuberculosis, and reproductive health care for teenage girls.
"These cuts are really alarming," King says. "It's clear that Governor Cuomo made them out of spite for [New York City Mayor Bill] de Blasio, notwithstanding the harm they will do to Cuomo's own initiatives, such as Ending the Epidemic and the elimination of hep C."
Budget Cuts Alarm HIV/AIDS Advocates
What King is talking about is an estimated $59 million in state funds for these New York City public health initiatives that Cuomo just slashed out of the state budget, leaving King and myriad other city health service providers and advocates fuming. They are pressuring de Blasio and the City Council to somehow restore the funds in the upcoming city budget.
If not, as a flyer put out by the New York City health department warns, the city could suffer such cuts as the loss of two of eight sexual health clinics (which, says the city heath department, could result in at least 47 people not getting an HIV diagnosis and treatment), 37,000 fewer clean syringes distributed, the end of two tuberculosis clinics (plus directly observed therapy for tuberculosis treatment), and reductions in drinking-water system surveillance, school-based health clinics, and anti-smoking programs.
In recent years, New York State has been getting closer to replicating the success San Francisco has shown in driving down its new HIV infections. All the more reason, say advocates, why the governor's budget slash is cruel and senseless.
"This is just an absolutely devastating cut across so many different areas of public health," says Reed Vreeland, Housing Works' policy director. "It's extraordinarily reckless."
Anthony Feliciano, director of the advocacy group Commission on the Public's Health System, agrees, saying that the cuts are going to negatively impact communities of color, because so much of the $59 million in question is funneled to groups in far-flung communities throughout the city that work to get non-English-speaking communities information about their health options and rights. This includes expanded options for undocumented immigrants that are part of NYC Care, a new city initiative.
"Let's say an organization is getting funding to provide clinical support services for people with HIV/AIDS or hep C to navigate the health system," Feliciano says. "That group could get a funding cut from, say, $60,000 to $20,000, where they can't meet their goal of reaching out to 500 people, or they have to let go of a staff person.
"Right now," he adds, "the federal environment around health care is so hostile, especially to immigrants and LGBT people," that it's an especially bad time for the state to "disinvest at the city level."
The slashed funding "is really rare and important," says Winn Periyasamy, M.P.H., policy analyst at FPWA, a New York City–based anti-poverty advocacy group, because the organizations it will affect are more than two dozen that "work in all five boroughs, providing workshops, doing one-on-one counseling, speaking in faith-based settings, and reaching out creatively" to locals. "Communities of color look to these groups to know what their rights and options are."
Pressure on the City
Now, as the city's budget process ramps up, health advocates are circulating a sign-on letter to the mayor pressuring the city to not only make up the funds but to urge Cuomo to restore the funds in next year's state budget.
They are also planning a rally during an executive budget health hearing on May 16, says Vreeland. And they are urging openly HIV-positive City Council Speaker (and mayoral hopeful) Corey Johnson to prioritize the restoration in the budget process.
Said a rep for Johnson via email: "Speaker Johnson and the Council are working throughout this budget process to ensure any cuts don't harm the social safety net for the most vulnerable New Yorkers, including those suffering from or at risk of contracting HIV/AIDS."
Can the damage be prevented? Ultimately, says King, "The only way this will happen is if the mayor puts the funds in his executive budget."
TheBody has yet to hear back from the mayor's office about the issue.