about Federal Government Reductions in HIV/AIDS Services
Q: How are HIV/AIDS support services funded by the government?
A: Much of the public money that funds services (like delivered meals, client case management, substance abuse treatment, etc.) specifically for people living with HIV/AIDS is distributed to local governments by the federal government through the Ryan White CARE Act ("Ryan White"). The federal government distributes money based on a complex and changing formula of per capita HIV/AIDS rates. Then the local governments decide how to prioritize and ultimately spend the funds. In both San Francisco and Alameda County, there are CARE Councils made up of concerned citizens, HIV/AIDS patients, advocates and healthcare experts who decide how to best utilize the Ryan White money and provide the most critically needed services to the most ill clients in the local community. The CARE Councils set the allocation amounts for specific community-based services after considering the needs of HIV/AIDS clients in that community. In addition to federal funding distributed through Ryan White, the State of California funds some HIV/AIDS support services and in San Francisco, a substantial amount of additional local revenue is also dedicated to support services.
Q: How important to POH is Ryan White funding?
A: Ryan White funding is essential to POH and to the clients we serve. The purpose of the Ryan White CARE Act is to provide local communities with "core" funding for primary care (regular doctor visits and medications) and essential support services (housing, food, substance abuse treatment, etc.). At POH, primarily our private donors fund our HIV/AIDS services so we don't rely completely on Ryan White dollars. Although more than 65% of POH's funding comes from private sources, public funding is vitally important to our organization and allows us to maintain a high quality service to as many clients as possible. Without Ryan White funding, POH would not be able to provide the same level of service to the HIV/AIDS community that we currently provide.
Q: Do San Francisco and Alameda County receive adequate Ryan White funding to pay for all necessary support services?
A: No. HIV/AIDS support services were already under-funded when the federal government announced in March 2004 that San Francisco and Alameda County's allocations would be further reduced. San Francisco's Ryan White funds were reduced 12% or $4 million. In Alameda County, Ryan White funds were reduced about 6%. If those funds are not restored, vital support services will be reduced or eliminated. Home-delivered meals is one of the highest priority categories, so POH will not see a significant reduction in funding for our nutrition services this year. However, POH's clients will lose important services at other agencies that greatly enhance our clients' ability to benefit from POH's nutrition programs. Project Open Hand provides nutrition services to clients as part of an intricate network of community-based organizations and public healthcare facilities that, together, establish a comprehensive set of primary care and support services specifically for people living with HIV/AIDS. This network of care services that POH helped to create is frequently referred to as the "San Francisco Model of Care."
Q: How will POH clients be impacted by recently announced cuts to Ryan White funding for San Francisco and Alameda County?
A: The goal of POH's nutrition service model is to help people living with HIV/AIDS maintain a healthy lifestyle, thereby preventing the onset of serious illness. Maintaining a healthy lifestyle includes appropriate daily nutrition like the meals and groceries provided by POH, but also requires a full range of support services such as mental health and substance abuse treatment, dental care, coordinated primary care/case management, and transportation to and from necessary appointments. If Ryan White funds are not restored or replaced this year, the San Francisco Bay Area's safety net of services upon which POH's clients rely will begin to unravel. As our clients' overall health deteriorates, the need for proper nutrition to combat HIV/AIDS will become even more critical and, with diminished financial resources, more and more people will need POH's delivered meal and grocery services to survive.
Q: What can people do to help San Francisco and Alameda County get their fair share of HIV/AIDS funding?
A: The San Francisco/Oakland area has excellent elected leadership on HIV/AIDS issues at the local, state and federal levels, and we are fortunate to have led the nation in developing programs and funding for community-based HIV/AIDS care services. But now, our funding is in jeopardy. It is incumbent on those of us who can raise our voices to do so on behalf of our sick, homebound clients who face catastrophic illness. People who are concerned that San Francisco and Alameda County get an adequate allocation of Ryan White funds should contact your United States Senator, or your Member of Congress, and tell them to continue making HIV/AIDS support services a high priority for federal, state and local safety net spending. In addition, if the federal government will not adequately fund HIV/AIDS care services, then state and local elected officials will have to find additional funding to keep these vital services available to people who need them. You can also help by contacting your state Senator or Assemblymember, as well as your local Board of Supervisors or Mayor, and ask them to find a way to solve federal, state and local budget shortfalls without devastating the Bay Area's carefully constructed social service network.
Jim Illig has been Director of Government Relations for POH since 1994. He has over 25 years experience working with government contracts and as a healthcare advocate in San Francisco. San Francisco Mayor Gavin Newsom recently appointed Jim to the Health Commission.
