| Hot Topics
A summary of pressing policy issues that affect the public.
New York City
A Municipal Report Card: Analysis of the Mayor’s Management
Report for FY03
The Mayor’s Management Report (MMR) was released last week on September
18, 2003, and like previous mayors, Bloomberg used the report to
highlight his administration’s successes. The report covered the
period July 1, 2002 through June 30, 2003 and emphasized that despite
major budget reductions, city services remained status quo and in
some cases improved. The report stressed that crime continued to
decline, city streets were cleaner, and more homeless people were
placed in permanent housing last year than the prior year. The report’s
message about the state of HIV/AIDS in the city was somewhat mixed
and ambiguous.
The Department of Health and Mental Hygiene (DOHMH) reported that
new AIDS cases are down from the previous years (6,017 cases in
FY 03 verse 6,355 cases in FY 02). Unfortunately, new syphilis cases
which are often used as an indicator of new HIV infections, are
dramatically up (456 cases in FY 03 verse 357 cases in FY 02). DOHMH
reported that 95 percent of the new syphilis cases involve men,
approximately 80 percent of these men reported having sex with other
men, and more that half reported HIV infection. By June 2003, the
number of person living with HIV/AIDS in the city soared to 80,
263 cases. There are more New Yorkers living HIV/AIDS than ever
before and this increase is attributed to the advancements in medical
care and HIV treatments.
Unfortunately during the MMR’s reporting period, the DOHMH also
reported a $13.9 million decrease in HIV services due to loss of
Federal Ryan White Title I funding. The number of people receiving
services that are Ryan White funded has decreased from 74,000 in
FY02 to 59,000 in FY03. DOHMH noted that this decreased is largely
attributed to a new Ryan White tracking system that prevents double
counting of clients. Thus, the number of people receiving Ryan White
services for FY03 should not be compared with the FY02 reported
number.
With an annual budget of $4.3 billion dollars, the Health and Hospitals
Corporation (HHC) is the largest municipal hospital system in the
nation. HHC is also a cornerstone of the City’s safety net for people
with HIV, providing the majority of services to the uninsured. In
the Mayor’s Management Report, HHC reported that research shows
that patients with HIV who are treated by doctors who are experts
in HIV care have better health outcomes than those who are not.
The proportion of HIV infected patients using dedicated HIV clinics
in the city’s hospitals increased from 96 percent in FY 02 to 98
percent during FY 2003. Also, as of June 2003, all of the city’s
acute care hospitals were certified by the State as Designated AIDS
Centers, indicating the availability of specialized and comprehensive
inpatient and outpatient HIV/AIDS services. GMHC congratulates all
11 of the city’s hospitals for achieving this certification.
The Human Resources Administration (HRA) is the city agency responsible
providing public assistance, food stamps and Medicaid. In order
to address the unique needs of persons living with HIV, HRA operates
a subdivision called HIV/AIDS Service Administration (HASA). In
the MMR, HRA reported that the number of PWAs receiving services
from HASA, such as housing, public assistance, food stamps, homecare
and case management, has increased from 30,700 in June 2002 to 31,800
cases as of June 2003. HRA asserted that it has “committed to address
past problems with its HIV/AIDS Service Administration (HASA), by
beginning to take necessary steps to better meet the needs of the
HIV/AIDS Community. Issues include improving case management provision,
housing models and partnerships between CBOs and governmental agencies.”
GMHC supports the HRA goals stated in the MMR for improving services
and welcomes HRA’s intent to realize these improvements.
However, the “past problems” are still present problems and we
do not understand what HRA is referring to when it says that it
is taking the “…necessary steps to better meet the needs of the
HIV/AIDS Community.” In fact, HASA’s recent Scattered Site Request
for Proposals (RFP) suggests that HASA’s policies are going in the
opposite direction. Numerous community-based providers report that
the RFP reflects a deconstruction of the existing scatter site housing
model. Providers are also upset that HASA did not consult with them
prior to releasing the RFP. While the RFP was released after the
MMR’s period of review, it does suggest the MMR’s optimism over
HASA improvements is premature.
© 2003 Gay Men's Health Crisis
|
home 
