PI Action alerts & updates ... 1997

California Fiscal Year 1997-98 HIV/AIDS Budget

In January, Governor Wilson released his proposed Fiscal Year (FY) 1997–98 budget. This proposal contains some significant increases in spending for HIV/AIDS programs, including the AIDS Drug Assistance Program (ADAP). Unfortunately, the plan also contains some problematic measures, including a “contribution” of $12.9 million from Title I areas.

Following is a summary of the Governor’s HIV/AIDS budget proposal. As the process moves forward, we will send Action Alerts asking TAN members to contact their state representatives. We also encourage everyone to attend this year’s California AIDS Lobby Day on Monday, June 2 in Sacramento.

Thanks to Sophia Kwong at AIDS Project Los Angeles for the information provided in this update.

AIDS Programs/Services
Governor Wilson proposes to spend $109.4 million from the state General Fund for all AIDS programs and services in FY 97-98 (July 1, 1997–June 30, 1998).

AIDS Drug Assistance Program:
The 97-98 budget anticipates an increase of $47.2 million over last year’s budget from the following sources:

$11.7 million increase from the state General Fund
$18.6 million increase in federal funding from the Ryan White CARE Act
$4.0 million from additional pharmaceutical company rebates
$12.9 million contribution from Title I areas
While the $11.7 million increase in state funding is significant, there is much concern about the proposal to have Title I areas “contribute” $12.9 million. Title I regions are cities hardest hit by the epidemic that receive funding from Title I of the Ryan White CARE Act. There are nine Title I areas in California. The state currently does not have authority to utilize Title I funding for ADAP. Therefore, the likely outcome from the state proposal would be that Title I areas would see reductions in their ADAP allocations, with San Francisco and Los Angeles experiencing the majority of the burden.

Project Inform and the AIDS Budget Coalition, which includes HIV/AIDS advocacy organizations statewide, are opposed to this plan. The $12.9 million is needed for ADAP and should come from the state general fund. In addition, Assemblywoman Carole Migden (D-San Francisco) has vowed to fight this measure as the budget process unfolds.

Viral Load Testing:
Governor Wilson is proposing $3.8 million for viral load testing, targeting the population that utilizes ADAP. These tests provide patients and physicians the tools for evaluating the efficacy of new treatments. More funding may be needed to effectively meet demand for these tests. Project Informs urges necessary flexibility in delivery to fill in gaps that currently exist.

Prevention:
Through a redirection of $1.6 million from the state Office of Family Planning and a $500,000 increase in federal funding, the Governor is proposing:

$1 million for new street outreach programs, targeting injection drug users among others
$600,000 for the purchase of five additional mobile vans to conduct counseling and testing in high risk areas
$500,000 to expand voluntary partner notification services
Research:
The Wilson Administration has obtained an agreement from the University of California’s AIDS Research Program to allocate $1 million for two new projects: (1) development of a new test that is capable of measuring how recently a person was infected, and (2) studies to test the linkage between viral load and infectiousness.

Welfare Reform
There have been several changes to California’s welfare system that will have a major impact on many people living with HIV/AIDS and other life-threatening illnesses:

SSI/SSP: Legal immigrants who received SSI/SSP and Medi-Cal as of August 22, 1996 will continue to receive Medi-Cal. Those who arrived after August 22, 1996 will only be eligible for emergency services. All legal immigrants, regardless of when they arrived in the country, will not be eligible for SSI/SSP until they become citizens or have worked for ten years.

TANF: Legal immigrants who were in the country before August 22, 1996 will continue to receive TANF (Temporary Assistance for Needy Families) and Medi-Cal. Those arriving after August 22, 1996 will only be eligible for emergency health care.

Elimination of the safety net: The Governor will be seeking state law changes to delete the requirement that counties be providers of last resort. If this passes, counties would no longer have to provide General Assistance or health care unless they wish to.

Prenatal Care: As of July 1, 1997, undocumented women will no longer be eligible to receive undocumented care.

These changes to the welfare and health care system will have a profoundly detrimental effect on the lives of many people in need. We will relay information about these changes as it becomes available.

Next Steps
Both the state Assembly and Senate will hold hearings on each of the major budget areas, probably in March. The budget is reviewed first by subcommittees and committees in the Assembly and Senate. After the full Assembly and Senate passes their respective versions, the budget is sent to a joint Assembly/Senate conference committee which irons out differences. The final budget is then voted on again by the full Assembly and Senate and sent to the Governor for his signature or veto. The state Constitution requires the budget to be signed by July 1.