Giving Voice
Public Policy
In addition to cutting-edge prevention work and up-to-date direct
client service and care, GMHC has an extraordinary history of successfully
effecting significant change in the lives of hundreds of thousands
of HIV-positive people and those at risk of infection by advocating
and fighting for just and humane HIV and AIDS policies. This past
year, GMHC won numerous victories and made huge strides in ongoing
battles, many of which addressed the important issues surrounding
access to health care, housing, and prevention advocacy. Frequently,
many of our most successful policy endeavors involved the partnership
of other community-based and national organizations. By being a
leader in the fight against HIV and AIDS and through active coalition-building,
GMHC has and will continue to demand accountability and responsibility
from all levels of government in meeting the needs of people with
HIV and AIDS.
Legislative Action at All Levels of Government
 In
a political climate in which lawmakers aggressively sought to restrict
eligibility, services, and resources earmarked for people with HIV
and AIDS, GMHC had a remarkably successful year in both defending
existing resources and creating new ones. In coalition with other
community-based organizations, GMHC successfully opposed millions
of dollars in proposed state-wide budget cuts that would have had
a devastating effect on thousands with HIV and AIDS. This same coalition
successfully harnessed new funds specifically allocated for communities
at highest risk of HIV infection. Over $4 million was targeted towards
these populations at both the city and state level. In addition,
GMHC continues to oppose legislation at all levels of government
that threatens the civil liberties of persons with HIV and AIDS,
criminalizes HIV and AIDS, and imposes any kind of mandatory testing
for HIV.
Housing
GMHC has long been a vocal critic of New York City's lackluster
response to the dire need of people living with HIV and AIDS for
affordable housing. For many with HIV and AIDS, permanent housing
is the crucial component to having access to medication, stability,
and ultimately being able to increase their quality of life. The
rampant poverty so common in the lives of our clients continuously
jeopardizes their housing and, in turn, their health. Increasingly,
our clients have fewer and fewer options for housing. Rather than
pro-active solutions that address the specific obstacles of homeless
people with HIV and AIDS, New York City continues to deepen its
dependency on substandard solutions for an ever-escalating problem.
GMHC actively and aggressively holds the city responsible for its
policy inaction and frequent funding reallocation — diverting existing
resources for affordable housing to other ventures.
Medicaid Buy-In
Many of GMHC's clients, and thousands more across New York State,
have experienced great frustration at the "catch-22" presented
by restrictive public health care eligibility and, specifically,
at the ways in which it often prevents men and women from returning
to work. Currently, an HIV-positive person dependent upon Medicaid
for their essential health care needs whose earned income reaches
a certain level, is forced into the private health care market —
an often devastating alternative, with its prohibitive costs and/or
restrictive eligibility requirements. In addition to keeping many
people jobless — often deteriorating their health and well-being
— these restrictions have put a strain on an already taxed Medicaid
program. In January 2002, however, after more than three years of
intense political strategizing, fierce activism, and focused effort,
GMHC enjoyed an extraordinary victory with the hard-won approval
of the groundbreaking Medicaid Buy-In program. The program — spearheaded
by GMHC — allows men and women with HIV to maintain their Medicaid
eligibility and still return to work by paying a small affordable
premium. The benefits of transitioning back into employment have
been astounding for the health and morale of hundreds of our clients
and thousands more New Yorkers — increasing their independence and
quality of life and setting them on the road to fiscal stability.
Making Medicaid Coverage More Accessible
Demanding that access to Medicaid coverage be equitable and fair
is often an issue of making sure enrollment and coverage information
is readily available and easy to understand. Last year, GMHC added
to its already rich legacy of protecting the HIV-positive medical
consumer by coalescing all of the confusing — and often overwhelming
— data about evolving Medicaid coverage of HIV and AIDS into an
easy to read guidebook. Groundbreaking in its usefulness, SNiP Tips
is a veritable how-to book evaluating the pros and cons of Medicaid's
Special Needs Plans (SNiPs) for consumers and providers. The New
York State Department of Health consistently and frequently refers
to GMHC's SNiP Tips in their training, seminars, and publications.
Our clients — who find it exceedingly helpful — have all but exhausted
the first printing.
AIDS Drug Assistance Program
It is painfully evident that guaranteeing access to treatment for
HIV and AIDS is an escalating problem here at home as well as around
the world. Over the past fiscal year, GMHC has laid the groundwork
for the battle to secure adequate federal and state funding for
the AIDS Drug Assistance Program (ADAP). ADAP helps over 85,000
uninsured and under-insured men, women, and children living with
HIV and AIDS across the country, afford the essential medications
they need to survive. With the advent of more expensive combination
therapies, yearly increases in program participation (due in part
to the success of early detection efforts and the resulting increase
in the number of people who have tested positive for HIV), and the
federal government's refusal to allocate additional funds — an enormous
shortfall in prescription drug coverage is dreadfully near. Already,
many states have had to severely restrict program eligibility as
well as the kinds of medications covered. New York — which has the
most comprehensive ADAP in the country — is poised to be the next
to join them. Should this inevitable — yet avoidable — financial
shortfall continue unabated, it will mean a deadly interruption
of treatment for thousands of New Yorkers, and even more nationwide.
GMHC has led, and continues to lead, coalitions of national and
local organizations in a highly charged battle to secure this much-needed
funding at both the federal and state level.
Censoring Prevention Messages
 This
year, the federal government has jeopardized sexual health by censoring
basic information about how to prevent HIV and AIDS. The current
administration is threatening HIV prevention programs that talk
frankly about sex with audits by the Office of the Inspector General
of the Department of Health and Human Services. Federal policy is
strongly encouraging all HIV and AIDS service organizations to adopt
an abstinence-only prevention approach. Despite evidence suggesting
that such approaches actually jeopardize the health of young people
by providing misinformation and stigmatizing the safe and effective
use of condoms, the government continues to promote abstinence-only
prevention at the expense of more comprehensive solutions. This
policy shift flies in the face of recommendations made by leading
scientists and public health officials, who clearly advocate a pro-active,
respectful, and diverse approach to differing sexual practices demonstrated
by the success of agencies like GMHC who use accurate, behavioral
science-based, and inclusive prevention materials. HIV and AIDS
service organizations must not have their prevention efforts stymied
by fear of retribution. By labeling provocative prevention messages
as "obscene" a resulting chill will no doubt occur, directly
threatening the lives of thousands of young people at risk for infection.
GMHC will continue the fight it has led against the federal government's
restrictive, shortsighted, and ill-informed approach to the safety
of our nation's youth.
Treatment Issues
Our own in-house publication, Treatment Issues, provides
probing analyses of research data, up-to-date coverage of new and
experimental developments in AIDS therapies, life-saving information
for people living with HIV and AIDS, and public policy initiatives.
Often cited as a leading resource in cutting-edge treatment information,
Treatment Issues, is mailed monthly to over 13,000 clients,
donors, researchers, activists, and other HIV and AIDS professionals
around the world. Recent article titles have included: "House
of Mirrors in the Virtual ICAAC (Interscience Conference on Antimicrobial
Agents and Chemotherapy)," "Patient Care Squeezed by Soaring
Drug Prizes," and "Let Nevirapine Do What it Does Best".
A Global Presence
Staying true to GMHC's commitment to health care access around
the world, GMHC capitalized on the success of the Implementation
of Antiretroviral Therapy in the Developing World: Brazil and Beyond
conference by creating and distributing a comprehensive CD-ROM containing
the most important and relevant information culled from the conference
to key global HIV and AIDS policy makers. In November 2001, GMHC
hosted Monitoring and Diagnostic Tools for the Management of
Antiretroviral Therapy in Resource-Poor Settings, an international
conference in New York City principally funded by The Rockefeller
Foundation and The National Institutes of Health. The conference
addressed the different ways that monitoring and diagnostic technology
could be modified and adapted to best suit the needs of developing
nations. Highly regarded and well attended by over 100 researchers,
advocates, and government officials, the conference is still creating
ripples in the international AIDS community with satellite conferences
planned for the near future.
Many of GMHC's policy efforts reached a fevered and much publicized
pitch at the XIV International AIDS Conference in Barcelona this
past summer. GMHC was one of a few select nongovernmental organizations
invited to present on our work about HIV and AIDS prevention, service,
and advocacy. While there, GMHC led a coalition of national and
international organizations in a protest against the U.S. government's
failure to address, in an effective and timely manner, the issues
confronting not only New Yorkers with HIV and AIDS, but people living
with the disease around the world. GMHC's participation and leadership
of this demonstration made local, national, and international headlines.
This encounter clearly demonstrated the skill, savvy, and passion
that form the foundation of GMHC's legacy of positive change. From
grassroots organizing, vocal protestations, intense political lobbying,
and strategic legislative bargaining — GMHC has been, and continues
to be, on the front lines of HIV and AIDS policy.
Contents
© 2003 Gay Men's Health Crisis
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