| TESTIMONY PRESENTED TO
THE NEW YORK CITY COUNCIL
THE IMPACT OF THE MAYOR’S BUDGET ON NYC’S ABILITY
TO MEET THE NEEDS OF NEW YORKERS LIVING WITH HIV/AIDS
May 27th 2003
PRESENTED BY DARRYL NG DIRECTOR OF GOVERNMENT RELATIONS
GAY MEN’S HEALTH CRISIS
Good afternoon, my name is Darryl Ng and I am Director of Government
Relations for Gay Men’s Health Crisis (GMHC), the nation’s oldest
voluntary agency responding to the AIDS epidemic. We provide services
to over 14,000 clients annually and offer a wide range of services
in the continuum of HIV care. Thank you for the opportunity to
testify this afternoon.
Since the first cases were identified in New York City in 1981,
more than 133,171 New Yorkers have developed AIDS. Of the estimated
40,000 new HIV infections occurring in the US every year, one fifth
are expected to take place in New York City. Unfortunately, New
York City continues to be the epicenter of the nation’s HIV/AIDS
epidemic. We are disheartened that the Mayor’s Executive budget
indicated a deadly step backwards in the fight against AIDS. People
living with HIV/AIDS will be devastated in 3 particular areas.
GMHC finds these and other extreme cuts to the health infrastructure
unacceptable.
The first area of concern is that the $5 million Community of Color
HIV Initiative is not restored, leaving the City helpless to the
escalating HIV rates in high risk populations. Communities of color
have been disproportionally hit hard in the AIDS crisis. One of
the most devastating impacts has been on young gay men of color.
A study last year by the CDC showed that young gay black men in
NYC have an HIV infection rate as high as 30% and young gay Latino
men in NYC have an infection rate as high as15%. Not only should
this funding be reinstated, it should be baselined in order to have
maximum efficiency in its future utilization.
The second area of concern is the $1 million reduction activated
by folding the Mayor’s Office of HIV/AIDS Policy Coordination (MOAPC)
into the Department of Health and Mental Hygiene (DOHMH). This
move would seriously undermine the purpose and efficacy of MOAPC,
as the coordinator of HIV services across all city agencies, including
and not limited to DOHMH. MOAPC also plays a critical role in the
check and balance oversight of the City’s Ryan White Title I funds.
We believe that it is critical that the administration not undermine
the sprit of MOAPC’s creation and the efficacy of it fulfilling
its mission.
The third area of concern is the reduction of HASA’s budget by
$1 million, achieved by contracting out HIV/AIDS case management
for approximately 30,000 cases and reducing its workforce by 29
caseworkers. While the concept of contracting out case management
services to CBOs that can better provide the service warrants further
analysis, the City must not proceed unless it ensures that a maintenance
of effort stipulation is upheld and critical services that only
HASA can provide are strengthened.
We realize that these are financially hard times for the City and
we agree on the necessity of balancing the budget. But the truth
is that over the past several years, the City has siphoned off tens
of millions of federal AIDS funding via an accounting subterfuge
known as the HOPWA Swap and this atrocity continues today. Given
the run away HIV rates and the tremendous increase in the City’s
living AIDS cases, it is imperative that the three areas of concern
be addressed and the HOPWA Swap be reversed.
We also ask that the new city budget not compromise the very infrastructure
of New York’s public health. The proposed cuts to the DOHMH and
the city hospitals are very disconcerting. DOHMH promotes and
protects the health and quality of life for New Yorkers. It enforces
compliance of city health codes and operates a broad range of public
health services to monitor, prevent and control disease. In particular,
DOHMH’s HIV-related services focus on public health education, case
reporting, confidential counseling and testing, and direct clinic-based
medical care. The operation of these DOHMH functions should be
strengthened, or at the very least, maintained.
Another concern of the Mayor’s budget is continuing the underfunding
of the city hospitals. The Health and Hospital Corporation (HHC),
the largest healthcare provider for New Yorkers with HIV and AIDS,
provides 51% of the City’s hospital-based outpatient HIV care.
Because HHC provides HIV medical care to New Yorkers regardless
of their ability of pay, it serves as the City’s health care safety
net. We urge the City to properly compensate HHC for the care that
it provides to the City’s uninsured and underinsured residents.
The final point that I would like to make concerns the City’s aggressive
movement into managed care. As the City moves forward with Medicaid
managed care enrollment for the general public and begins implementation
of HIV Special Needs Plans, it becomes more vital for consumers
to have access to accurate/unbiased information and to know their
options and rights. The Managed Care Consumer Assistance Program
created by the Council in previous budget years has done an excellent
job helping consumers navigate through complex systems and we support
its continuation.
In closing, I would like to say that New York City's response to
the AIDS epidemic has been instrumental in achieving the notable
decline in AIDS mortality, and most New Yorkers fare better than
their counterparts in less enlightened localities. However, as the
epidemic evolves and the needs of the infected and affected change,
New York City must keep pace with new needs and find solutions that
meet today's challenges. Thank you again for the opportunity to
testify this afternoon.
© 2003 Gay Men's Health Crisis
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