Transfer for ADAP Made, but With Costs to Ryan White Program
Dr. Laura Cheever, the Acting Associate Administrator of the HIV/AIDS Bureau at Health Resources Services Administration (HRSA) hosted a short conference call this week to review the $50 million 2011 World AIDS Day funding transfer that President Obama announced. First, she stated that the Ryan White Program is a very high priority for HRSA and that they were working diligently to ensure that the $50 million in funding for the AIDS Drug Assistance Program (ADAP) and Ryan White Program Part C services that started as a result of the World AIDS Day announcement was maintained.
As a quick reminder, the funding was first provided after the congressional appropriations process had been completed and therefore had to be a transfer of funds within the Department of Health and Human Services (HHS) in fiscal year (FY) 2012. The transfer consisted of $35 million for ADAP and $15 million for Ryan White Program Part C grants. The additional funds for ADAP and Part C were not reflected in the final Continuing Resolution for FY 2013 that Congress passed and the President signed, creating a continuity problem. The administration notified Congress last week to inform them that they would transfer funding to make up the $50 million loss that was not including in the FY 2013 CR. Dr. Cheever explained that some of the funding would come from other parts of HHS and some would come from within the Ryan White Program, excluding ADAP and Part C. She stated that the amounts transferred within the Ryan White Program funds are as follows:
Part A: $6.6 million
Part B (base): $4.2 million
Part D: $770,000
Part F Dental: $135,000
Part F AETCs: $345,000
This is about 1% of funding from each of these programs, the maximum amount Secretary Sebelius can transfer per program. In light of this transfer, the administration specifically exempted the Ryan White Program from a different 1% transfer of funds being assessed against all health programs to fund the Affordable Care Act implementation. The entire Ryan White Program will continue to be subject to sequestration at a 5.1% cut across the board.
Of the $15 million for Part C, $5 million will be reallocated within Part C from the Bureau of Primary Health Care (BPHC) to Part C clinics that are community health centers, just as was done in FY 12. The remaining FY '13 $10 million will come from changing the FY '13 grant period for Part C grants to 10 months (July 1, 2013 – April 30, 2014). FY '14 awards will revert to 12 month grants running from May 1, 2014, to April 30, 2015.
While fully supporting the $50 million in additional funding for ADAP and Part C programs, AIDS United is troubled that other parts of the Ryan White Program are being tapped to pay for the failure of Congress and the administration to include the additional funding in the final FY '13 CR. These cuts to the other Ryan White Program parts are in addition to the FY '13 sequester cuts. We acknowledge and commend the President for including the $50 million in his FY 2014 Budget Request. This all underscores the need for advocacy for Congress to pass a Labor/HHS appropriation bill for FY '14 that includes optimal funding for ADAP, the whole Ryan White Program, and domestic HIV programs at the Centers for Disease Control and Prevention (CDC). We must also continue to advocate for replacing sequestration with a balanced approach to deficit reduction that does not unfairly or unevenly cut spending for health care and programs that serve vulnerable populations.