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New York State Legislative Agenda
2007 – 2008
GMHC Legislative Priorities
GMHC's Legislative Priorities are a reflection of our mission
and the needs of the people we serve. As the world's first AIDS
service provider, we also recognize the importance of providing
recommendations that address the needs of the broader HIV/AIDS
community. These 20072008 public policy recommendations advocate
for change in areas where there continue to be clear and demonstrated
unmet needs, as well as pushing for new initiatives to meet emerging
concerns as the epidemic rages on. GMHC will continue to be vigilant
in advocating for the health care needs and civil rights of all people
living with HIV & AIDS. The prevention of HIV transmission, access
to affordable, quality health care, and the full realization of
civil rights for all are the cornerstones of our recommendations.
Additionally, GMHC supports the recommendations of the NYS
AIDS Advisory Council who have worked with the community to develop
broad fiscal and policy priorities.
Prevention
GMHC supports efforts to increase access to voluntary HIV
counseling and testing and to remove any barriers to getting
more people tested. These include making HIV testing and counseling
a routine component of medical care. Routine offering of HIV testing
in health care settings should include critical information and
counseling so patients can make voluntary informed decisions on
taking an HIV test. We believe strongly that testing must include
meaningful written informed consent, with information on what an
HIV test means, along with linkage to counseling, care and prevention
for both those who test positive and negative. We oppose recent
legislative efforts which remove written informed consent from
the testing process as well as eliminating vital HIV/AIDS
information (both pre and post test) for people who test
negative. Changes introduced by the New York State Department
of Health last year, which in New York City has resulted in
a nearly 50% increase in HIV testing, demonstrate that
effective streamlining of HIV testing procedures can be
accomplished within existing laws and requirements.
GMHC supports the permanent continuation of the Expanded
Syringe Access Program (ESAP). ESAP provides access to sterile
syringes for injection drug users through pharmacies and without
a subscription. This program encourages the safe disposal of
injection equipment, while also providing valuable education
materials to participants. Since the beginning of this program,
transmission of HIV through injection drug use has dropped
approximately 75% within just a few years. The success of
this program must be continued and expanded to ensure the
greater health risk of HIV infection is further deterred.
GMHC opposes mandatory HIV testing legislation.
GMHC strongly opposes legislation that seeks to mandate HIV testing for
certain criminals and juveniles who may have transmitted disease upon
allegedly committing a crime. GMHC urges the State to consider the
advice of public health experts, scientific organizations, and AIDS
organizations before considering involuntary testing legislation. Such
testing as a means of gathering ones HIV status is severely flawed and
does not properly address the health of the victim, and could in fact
put the victim's health in great danger. Due to the fact that a "window
period" exists between exposure to HIV and testing positive for HIV
and the fact that no time can be wasted before starting a crucial
Pre-Exposure Prophylaxis (PEP) treatment to prevent the victim from
contracting HIV, GMHC urges the State not give in to the false hope
that mandatory testing bills give. Mandatory testing of accused
criminals would not provide any relief for the victim or her/his
health.
GMHC supports the passage of the Healthy Teens Act.
New York State currently has no dedicated funding stream to provide
comprehensive sex education to young people. The Healthy Teens Act
would create a competitive grant program to fund age-appropriate,
medically accurate sex education in New York State and would be the
first grant program of its kind in the country. Sex education programs
that provide information about contraception and disease prevention,
and teach abstinence, do not increase sexual activity or sexual risk
behaviors. Research shows that comprehensive sex education helps to
delay the onset of sexual intercourse, increase condom and contraception
use, and decrease the number of sexual partners of program participants.
GMHC supports the Unintended Pregnancy Prevention Act.
The FDA recently approved emergency contraception (EC) as an over-the-counter
option for women over 18 years of age. EC is a safe, contraceptive used to
prevent pregnancy after unprotected sex. It is highly effective if taken
in a timely manner. Studies show that women who have ready access to
emergency contraception are no more likely to engage in unprotected
sex or abandon use of other contraception methods than women who do
not have easy access to the pills. This legislation would enable women
to obtain EC from pharmacists and nurses through collaborative agreements
with physicians. It is projected that more than 122,000 unintended
pregnancies could be prevented in New York — two-thirds of which
result in abortion — if EC was readily available to women. According
to a recent NYS Comptroller's report, this would save New York State
more than $450 million annually and give New York women a safe,
effective second chance to prevent pregnancy.
Access to Affordable, Quality Health Care
GMHC strongly supports the protection and expansion of the
health care safety net. Medicaid and Medicare are the first and second
largest single providers for people living with HIV/AIDS. This safety
net is fraying for tens of thousands of the most vulnerable New
Yorkers. Efforts to contain the cost of Medicare and Medicaid
cannot come at the expense of those most in need.
GMHC calls for the elimination of co-pays because no matter
how modest, any required co-pay puts basic health care out of
reach for many New Yorkers. Also, New York has an opportunity
to create one of the most powerful bulk purchasing tools in the
nation. We ask the State to support the pooling of various government
plans to lower the cost of prescription drugs. These measures will
make doctor's visits and the purchasing of prescription drugs more
affordable.
GMHC urges the state to abide by its promise and re-instate
the Medicaid wrap for Medicare Part D dual eligible beneficiaries.
Without the "wrap," some of the state's most at risk residents living
with HIV/AIDS would be unable to obtain the lifesaving medication
they so desperately need.
GMHC calls on the State to renegotiate the Federal-State
Health Reform Partnership (F-SHRP) waiver. Currently the waiver
effectively bars recovered Medicaid dollars from being reinvested
into the Medicaid program. Medicaid dollars recovered through F-SHRP
must be reinvested into Medicaid and in comprehensive, culturally
competent, community-based primary care.
GMHC calls on the State to demand medical treatment and care for
all residents of New York regardless of immigration status. Policies
that eliminate "ancillary" care to thousands of immigrants are unprincipled
and shortsighted. Not only would lives be saved if doctors and hospitals
simply provided primary and preventive care to the patients in front
of them, but the State would save money in the long run by having to
provide less critical care.
GMHC strongly opposes the orders of the OTDA audit of HASA
and these resulting program cuts. We recognize the crucial role
played by financial support and stable housing to the ongoing health
and well-being of people living with HIV and AIDS. The benefits provided
by HASA help clients reduce high-risk behaviors and maintain adherence
to treatment for HIV.
GMHC calls on the State to proactively move forward with improving
the HASA benefit system to better meet the financial needs of New
Yorkers living with AIDS. We commend State legislative efforts to
standardize HASA benefit calculations towards a Federal HUD policy
specifying clients pay 30% of their income towards rent. HASA
recipients with other forms of income — including SSI, SSDI,
veteran's benefits or work — should not be forced into an
unlivable monthly budget of $11 a day.
Further, the standard monthly income of HASA recipients of $330
is long past due for a significant increase. HASA recipients have
expected to live on $330 per month without increase for 20 years. The
cost of living has dramatically risen in New York City since 1986, and
HASA benefits, Public Assistance and the Emergency Shelter Grant has
been flat funded for far too long. By making regulatory changes, New
York can have a great opportunity to impact HIV transmission rates
and the health of New Yorkers facing AIDS and poverty.
GMHC supports the Family Health Care Decision Act. Under
current New York law, no one, not even a concerned family member, has the
right to make decisions about medical treatment for patients who lack
capacity, unless the patient has signed a health care proxy or left
"clear and convincing evidence" of his or her treatment wishes. Over
75% of adult New Yorkers never sign a health care proxy or leave
such evidence. As a result, some incapacitated patients are denied
appropriate treatment, while others are subjected to burdensome
treatments that violate their wishes, values, or beliefs. This
legislation enables family members and others close to the
patient (a "surrogate") to decide about treatment for incapacitated
patients who have not signed a health care proxy or left specific
oral or written treatment instructions. Most New Yorkers don't
realize they lack the ability to make decisions for their family.
Without a health care proxy or a living will, family members cannot
review the medical records of an incapacitated loved one or admit
an incapacitated loved one into a hospice program. Under this
legislation, family members or others could decide about treatment
only if the patient's attending physician and a second health care
professional determine that s/he lacks capacity to decide for
him/herself. The patient would retain the right to decide about
treatment as long as s/he has the ability to do so. Many of our
clients come from non-traditional families, making this legislation
of extreme importance to those without a spouse, parent, or children.
GMHC supports legislative efforts to require the Department
of Health to exercise oversight of HIV/AIDS and Hepatitis C care
within correctional institutions. Adequate medical care in prisons
and jails is an essential component of the public health responsibilities
of the state. New York State inmates suffer disproportionately from
serious illness, including HIV/AIDS. Of the 63,000 inmates in the
custody of the Department of Correctional Services (DOCS), more
than 5,500 are HIV-infected. Incarceration provides an opportunity
to test, treat and educate a population that has not had sufficient
access to health care, yet has high incidences of chronic diseases,
mental illness and substance abuse problems. Deficiencies in care have
persisted in part due to the fact that prison environments are insulated
from general public scrutiny and no other state agency or independent
authority has consistently reviewed the care being provided DOCS inmates.
As well, we call for correctional facility to implement STD/HIV
education and prevention programs, including the distribution of prophylactics.
Civil Rights
GMHC supports efforts to repeal the Rockefeller Drug Laws. Most
people incarcerated under the current set of laws are convicted of
low-level, nonviolent offenses, and many of whom have no prior criminal
records. Incarceration has destabilized the crucial network of community
and family support for thousands of individuals, forcing them into
high-risk environments without adequate access to HIV education or
prevention. The current system fails to adequately address the ongoing
crises of drug use and subsequent transmission of HIV in some of our
state's most impoverished communities. We support a restoration of
judicial discretion in sentencing, increased funding for drug treatment
and harm reduction programs and an end to mandatory minimum sentences.
The repeal of these laws will significantly impact a growing public
health problem.
GMHC supports the passage of the Gender Expression Non-Discrimination
Act (GENDA). All New Yorkers should be afforded fundamental basic civil
rights, and have the ability to live, work, and assemble regardless of
gender identity or expression. Passage of GENDA will ensure greater
physical and mental health for thousands of New Yorkers who are
disenfranchised and excluded from basic government protections.
GMHC supports full marriage rights for same-sex couples. All legal
rights and responsibilities, as well as all financial and contractual
benefits should be bestowed unto couples wishing to enter into such
a commitment. Having the ability to enter into such an institution
provides greater security and is likely to enhance the physical,
mental, and financial well being of its participants.
GMHC supports the passage of the Dignity for All Students Act
(DASA). This law seeks to protect all of New York's students from
abuse in school based on race, religion, ethnicity, national origin,
sex, gender (including gender identity and expression), sexual
orientation, and disability. An unsafe educational atmosphere can
push students out of school and into high-risk behavior. A safe
learning environment, however, allows students to stop focusing
on their personal safety at school and focus more on academics,
providing students with opportunities for better grades and a
chance to go college.
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About Gay Men's Health Crisis
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. GMHC serves one in every six persons confirmed diagnosed
with AIDS in New York City. As the world's oldest AIDS service provider,
GMHC helps over 15,000 men, women and children and their families each
year. GMHC offers a wide range of comprehensive client services, including
hot meals, benefits/entitlements advocacy, health care advocacy, case
management, legal assistance, HIV counseling and testing, individual
and group counseling services, prevention education, home-based support,
and mental health services.
GMHC has been on the frontlines of the AIDS epidemic since it
began, focused on the communities most threatened by HIV and expanding
our service provision as the epidemic expands. The number of GMHC clients
has increased by over 50% just since 2000. Our clients reflect the
diversity of HIV; 68% are people of color, 63% are lesbian, gay,
bisexual, 21% are women, and more than half reside outside of
Manhattan. Nearly one-third of our clients are 50 years of age
or older, while 28% of all new prevention clients are under 30. Of
our total clients served we continue to see a larger proportion
living in poverty. Approximately 72% of the clients we serve are
living an annual income of less than $10,000. Over 70% of GMHC
clients rely on Medicaid, while 15% rely on the AIDS Drug Assistance
Program, ADAP for their medical care and life-saving prescription drugs.
GAY MEN'S HEALTH CRISIS
THE TISCH BUILDING
119 WEST 24 STREET
NEW YORK, NY 10011
HIV/AIDS HOTLINE: 800.243.7692
hotline@gmhc.org
www.gmhc.org
© 2007 Gay Men's Health Crisis, Inc.
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