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GMHC Expresses Optimism and Caution
Toward Governor Spitzer's Budget
New York, NY – Gay Men's Health Crisis (GMHC) expresses a mixed reaction to Governor Spitzer's second budget. There are significant shortcomings to this year's executive budget; however there are also new directions and promising initiatives that seek to better the lives of people living with HIV/AIDS and those at greatest risk for infection.
GMHC is encouraged by Governor Spitzer's priorities that reflect a commitment toward improving and expanding health care in New York State and reinforcing critical drug access protections and Medicaid benefits for low income people living with chronic and life-threatening conditions—such as HIV, AIDS, and Hepatitis C. The Governor's plan to shift $160 million of state resources to reflect a greater commitment to primary and preventive care is fundamental to ensuring better health outcomes.
We applaud the Governor's commitment to affordable housing and his dedication of $400 million for the Housing Opportunity Fund. Research shows that stable housing is essential to HIV prevention and to keep people living with HIV healthy.
GMHC is pleased with the addition of $880,000 toward risk reduction efforts. We hope that such funds will be used to expand the condom distribution program throughout the state, as well as enhance syringe access programs that have proven to be overwhelmingly effective. We are further encouraged by $200,000 specifically for communities of color. HIV infection rates are highest among young gay men of color and heterosexual women of color. Funding for targeted populations is greatly needed to effectively curb the HIV/AIDS epidemic. We welcome this initial funding for communities of color and hope that such funding will continue to grow in subsequent budgets.
Among the positive elements of the Governor's budget is a cost of living adjustment for HIV/AIDS service providers that will be extended for three years. We are grateful to Governor Spitzer for this increase for his entire first term, particularly when the previous Governor only did so in two of his twelve years in office.
GMHC further applauds Governor Spitzer for the very first funding of Hepatitis C prevention ever in the state, totaling $1.6 million. Co-infection of HIV and Hepatitis C is common, and any gains made in Hepatitis C prevention will have a direct impact on the spread of HIV.
Dr. Marjorie Hill, CEO of GMHC said, "We are pleased in the direction Governor Spitzer's budget has taken. With new state funds targeting communities of color and risk reduction, the Governor has laid a framework for real change that will hopefully lead to more significant funding for people living with HIV/AIDS in the coming years. Also, having funds dedicated to the prevention of Hepatitis C for the first time in state history is groundbreaking." Dr. Hill continued, "Despite areas of progress in the budget from last year, there remain tremendous unmet needs. Cuts in the Ryan White Minority AIDS Initiative, coupled with the continued increase in HIV infections in communities of color, make it imperative that we address gaps in services."
GMHC is further encouraged by Governor Spitzer's commitment to primary and preventive care. Medicaid plays a critical role in providing comprehensive health care services and treatment for people living with HIV and AIDS, along with other chronic care needs. We commend Governor Spitzer for the following critical initiatives:
- Reforming and redistributing primary and preventive care reimbursement away from costly hospital in-patient care and towards more effective community-based clinics.
- Safeguarding the "provider prevails" provision of the Medicaid preferred drug list, thereby recognizing the need for physicians, not bureaucratic administrators, to determine adequate treatment for patients.
- Streamlining the Medicaid enrollment and renewal process by creating options for a centralized state enrollment portal for electronic and phoned-in applications.
- Eliminating the asset test for the Medicare savings program, thereby allowing more individuals to qualify for the low-income subsidiary under Medicare Part D.
- Increasing funding for facilitated enrollment in community-based organizations
- Authorizing the Commissioner of Health to explore bulk purchasing as a means of lowering drug costs for New Yorkers.
- Creating an Elderly Pharmaceutical Insurance Coverage (EPIC) discount card. However, we urge Governor Spitzer to go further and expand EPIC to chronically ill and disabled people under the age of 65. Prescription drug co-pays, even if discounted or nominal, are substantial for many people living with chronic conditions such as HIV and AIDS, who take upwards of 10 to 20 prescription drugs per day.
GMHC has made specific requests of this year's executive budget in a variety of areas of concern to people living with HIV/AIDS and those at greatest risk for infection. Unfortunately, there remain significant unmet needs. Chief among them are legal services and HIV prevention services for women and young men who have sex with men. Legal advice and representation are critical to the continuum of care for many people living with HIV/AIDS. As women and young gay men increasingly become infected at disproportionate rates, we believe additional funding for targeted programs in these communities is sorely needed.
Additionally, under the recent re-authorization of the Ryan White CARE Act in Congress, New York has experienced severe funding cuts for HIV/AIDS services beginning this year. Among those services hardest hit are programs for meals, nutrition, and workforce development. We know that proper nutrition and stable meals is not only a tool for people living with HIV/AIDS to maintain adherence to complex drug regimens, but it also serves as a prevention tool by creating stability in people's lives so they are not forced to make unhealthy decisions regarding substance use and sexual behavior. For those re-entering the workforce after a lengthy hiatus due to illness, or transitioning into the workforce for the first time, a high level of skill development is required. Employment counseling, job readiness, placement assistance and retention services are vital components to success in the workplace and ongoing financial health. Such stability helps people living with HIV/AIDS to manage their health better, delay the need for public assistance, and contribute to society in a meaningful way.
GMHC is further disappointed that Governor Spitzer has not sustained the budget increases for Community Service Providers (CSPs) and Multi-Service Agencies (MSAs), funding that sustains the basic provision of HIV/AIDS services throughout the state. HIV/AIDS community-based organizations are caring for greater numbers of people with fewer resources. Without additional funding for the state's network of HIV/AIDS care, infections will continue to go undetected and increase.
GMHC further expresses dissatisfaction with the Governor's failure to increase funding for COBRA case management. Many of the state's COBRA providers are running deficits within their case management programs. For many programs, these shortfalls are unsustainable and threaten service delivery to thousands of individuals and families throughout New York. With only two increases within the last 18 years, the most recent occurring eight years ago, an increase is sorely needed.
Gay Men's Health Crisis (GMHC) is a not-for-profit, volunteer-supported and community-based organization committed to national leadership in the fight against AIDS. Our mission is to reduce the spread of HIV disease, help people with HIV maintain and improve their health and independence, and keep the prevention, treatment and cure of HIV an urgent national and local priority. In fulfilling this mission, we will remain true to our heritage by fighting homophobia and affirming the individual dignity of all gay men and lesbians. We provide services and programs to over 15,000 men, women and families that are living with or affected by HIV/AIDS in New York City, and outreach and education to hundreds of thousands throughout the world. For more information, please visit www.gmhc.org.
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© 2008 Gay Men's Health Crisis
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