On Sept. 17, The Fort Lauderdale City Commission unanimously passed a resolution urging Florida’s Congressional delegations to defend and support two key HIV service programs: Housing Opportunities for People with AIDS (HOPWA) and the Ryan White Care Act. The last agreement to avoid a vote to default on U.S. debts resulted in a $1.2 million cut to HOPWA. The authorization for the Ryan White Care Act will expire along with the entire Federal Budget on Sept. 30, 2013.
The authors of the Ryan White Care Act’s last re-authorization in 2009 prevented the insertion of a “sunset” clause, which would have automatically terminated funding on Sept. 30, 2013. As the Ryan White Care Act lacks this “sunset” clause, continuing budget resolutions can fund its programs. According to Ann Lefert and Bill McColl, co-chairs of the Ryan White Work Group, “even if Congress does not take action, the Ryan White Program will remain a part of the law allowing funding to continue …”
Commissioner Dean Trantalis first introduced this resolution on Sept. 3. While no commissioner objected to this resolution, tactical disagreements exist within the HIV infected and affected communities about how to proceed. As soon as these tactical disagreements surfaced, Mayor Jack Seller asked for community input on these disagreements and rescheduled the vote for Sept. 17.
Some people and organizations, notably AIDS Healthcare Foundation (AHF) want the Ryan White Care Act reauthorized in 2013 to change the distribution of Ryan White Care funds among the states to reflect changes in the epidemic. Jason King of the AIDS Health Foundation explained, “AHF thinks it’s important to reauthorize this year because the HIV epidemic is impacting the South in ways that it is not impacting other states. Fifty percent of all new infections occur in the South. AHF wants programmatic fixes such as more money flowing to the South for testing, linkage, adherence, and retention programs to achieve increased viral suppression.”
Other organizations want to keep Ryan White Care funded under a continuing resolution due to the known political climate of budget austerity and the unknown effects of Health Care Reform, scheduled to begin January 1, 2014. Based on discussions with congressional staff, Ann Lefert and Bill McColl, co-chairs of the Ryan White Work Group reported bipartisan concern that “the austerity of the current budget environment could mean massive cuts to the Ryan White Program funding ….” Michael Ruppal of The AIDS Institute charged that it would be irresponsible to reauthorize Ryan White Care Act without knowing the effects of the implementation of health care reform.
The Sept. 6 meeting of the South Florida AIDS Network (SFAN) provided an opportunity to obtain community feedback within the time allotted by the Mayor. After much discussion, an ad-hoc subcommittee from SFAN was formed, met, and produced a report. The Commission’s votes reflected the input of this report, emphasizing the defense of HOPWA against looming cuts and the re-authorization of the Ryan White Care Act but without specifying when. According to Jason King, while AHF would have preferred “a more explicit timeframe for reauthorization,” AHF was satisfied with the result.
This tactical dispute among people in fundamental agreement should not prevent them from working together in the future. Two budget crises loom on the immediate horizon: 1) a vote to keep the government funded after Oct. 1, 2013, and 2) a vote, sometime in October or November, to raise the debt ceiling or default on the country’s debts. The HIV infected and affected communities need to be vigilant.
September 19, 2013 RWC meeting postponed
AIDS Healthcare Foundation had scheduled a meeting on the future of Ryan White Care Act on Sept. 19 at the Pride Center, but according to Jason King, AHF postponed it as a result of problems in setting up the panel.Sean McShee