PI Action alerts & updates ... 1997

AIDS Programs de-Prioritized in Budget Agreement

In a move that could have a serious effect on the future of HIV/AIDS funding, the Clinton Administration recently failed to negotiate priority funding for nearly every federal health program as part of the five year budget agreement. AIDS programs were on the priority list as late as mid-May, yet were removed during final negotiations. Programs which have priority are more likely to be protected from cuts and receive the funding they need in a climate of reduced government commitment to domestic spending.

In a meeting with some AIDS advocates on June 11, Clinton administration officials stated that the President intends to push for funding increases for some AIDS programs during negotiations with Congress on a final budget agreement. However, given the lack of official priority status of HIV/AIDS and other healthcare programs, and the lack of money to be spent at the federal level due to tax cuts and deficit reduction, grassroots advocacy is needed more than ever to ensure adequate funding. Look in future TAN Alerts and updates for more information as the Fiscal Year 1998 appropriations process moves forward.

Missed Opportunity for Emergency ADAP Increase
In late May, Representative Nancy Pelosi (D-CA) and Senator Arlen Specter (R-PA) attempted to attach an amendment to a disaster relief bill which would have secured supplemental funding for the AIDS Drug Assistance Program (ADAP). Congressional leaders stated that they would agree to the amendment if the Clinton Administration indicated its support for the increased funding. However, the Administration failed to make a formal request for the increase, stating that there is no concrete data indicating an ADAP emergency. This declaration was made after Mississippi announced that it would have to drop 640 people from its ADAP because of a budget shortfall. Advocates are encouraged to contact their federal elected officials and urge them to support a $132 million increase for ADAP in the FY 1998 appropriations bill. Be sure to always support adequate increases for all HIV/AIDS care, prevention, research, and housing programs in addition to ADAP funding.

If treatment access is a problem in your state, we urge you to communicate that to your federal elected officials, including President Clinton. Also let us know so we can track the problems.

Research and Needle Exchange
Battles Expected in Appropriations Debate
Research advocates are concerned that there may be attempts in Congress to pit diseases against each other during the FY 1998 appropriations battle, and possibly even move proposed National Institutes of Health (NIH) funding from one disease to another. This type of Congressional intervention doesn’t help anyone. We need to support a 9% overall increase in the NIH budget, and continue to communicate the need for and value of AIDS research funding. Look in future updates for more information as the process moves forward.

There is also concern that some legislators may attempt to remove the Health and Human Services Secretary’s authority to determine if needle exchange programs are effective in preventing the spread of HIV and do not encourage the use of illegal drugs. This declaration would allow federal funds to be used to support these programs. While the current HHS Secretary, Donna Shalala, has not yet made this public health determination during her tenure, it is important that this authority be preserved.

Medicaid Expansion Initiative Supported by Vice-President Gore
In April, Vice-President Al Gore called on the Health Care Financing Administration (HCFA), the federal agency that administers Medicaid, to study the feasibility of expanding Medicaid coverage to people living with HIV who don’t currently qualify under the Social Security Administration’s definition of disabled. While in concept this proposal appears promising for people living with HIV, there are some concerns about the details of the proposal and how it would be implemented at the state level. We will report in more detail in the next TAN update.

Meanwhile, on June 18, the Senate Finance Committee appears to have approved cuts in Medicaid funding over the next five years, while increasing funding for children’s health insurance by $8 million. The House is expected to begin considering the Medicaid budget on June 25. It is important to continue communicating with your federal legislators about the need to protect Medicaid funding.

Federal Standard of Care Guidelines Released
On June 19, the federal government released a published draft of the new Federal Guidelines for HIV Treatment, to be followed by a 3-day period of public commentary. The new standard of AIDS care guidelines were developed by the Panel on Clinical Practices for Treatment of HIV Infection, which included scientists and community-based HIV/AIDS treatment experts.

The guidelines recommend an aggressive standard of care for most HIV-positive individuals, one that calls for the simultaneous use of at least three antiretroviral drugs for everyone who decides to use treatment. The panel declared older two-drug therapies to be suboptimal and single drug therapy to be unacceptable, except as a tool for reducing the rate of mother-to-child transmission.

These guidelines have been supported by numerous AIDS advocates and organizations, and represent an important statement by the government about HIV disease. However, it is important to note that for these guidelines to be meaningful, the federal government must demonstrate its support for increased treatment access, including adequate funding for the AIDS Drug Assistance Program and Medicaid.

Project Inform Announces Women and HIV Program
In April, Dawn Averitt, former Executive Director of the Women’s Information Service Exchange (W.I.S.E.) in Atlanta, joined Project Inform’s Information and Advocacy Department, where she will coordinate a new advocacy program called Project WISE. As part of this program, Project Inform will expand its publications to include a new monthly newsletter, WISE Words, emphasizing treatment issues of concern to women living with HIV. The first issue of WISE Words is expected to be released in August. If you would like to be on the mailing list for this publication, please call Project Inform’s National HIV/AIDS Treatment Hotline at 800-822-7422.

Phone Conference on Drug Resistance Planned for August
A conference looking at issues around drug resistance is planned for July, to be followed by a community phone conference to be scheduled in August. More information will be available in the next TAN mailing.