June 5, 2009

California in Crisis: HIV Budget Cuts Will Have “Unthinkable” Consequences

Facing a $24 billion deficit, California’s governor has proposed slashing HIV funds—cuts that will likely have a profound effect on access to HIV prevention, testing, care and treatment. With enough activism there is still hope, but the mess in California foreshadows trouble for other states with big budget woes.

While pundits discuss a possible turnaround in the national economy, Darrel Cummings, the chief of staff at the Los Angeles Gay & Lesbian Center, says Californians haven’t begun to feel the worst pain. Facing a $24.3 billion shortfall, the state’s governor, Arnold Schwarzenegger, has proposed a new budget for the 2009–2010 fiscal year that drastically cuts or eliminates dozens of state programs.

Cummings says the cuts are brutal, especially for people living with, and at risk of, HIV infection. Schwarzenegger’s budget calls for a 12 percent reduction in funding for the state’s AIDS drug assistance program (ADAP), the complete elimination of state-funded prevention and education programs and a major draining of California’s general AIDS fund—an $80 million slash in total.

HIV services aren’t the only programs on the chopping block. The governor’s proposal would also kick nearly a million underprivileged children off the state’s health insurance program and eliminate state-funded home health care for severely ill people. He has also proposed massive cuts to the state Medicaid program. Cummings and other advocates are working with other disease group representatives wherever possible to oppose the massive cuts. But he warns that advocacy focusing on defending HIV programs also needs to take place.

The proposed cuts in AIDS services could yank California back to state funding levels not seen since the beginning of the epidemic, Cummings says. If the cuts go into effect, they would wipe out years of gains that have made California one of the best states for residents with HIV. He calls the consequences “unthinkable” and says they could literally result in life-threatening situations.

What the Cuts Could Mean

One proposal currently on the table—if ADAP loses 12 percent of its budget—would cut the maximum income limit from $50,000 per year to $30,000. This would mean turning away a significant number of the 34,000 people currently receiving ADAP assistance.

To illustrate the significant and drastic consequences of the proposed budget cuts, Cummings uses Los Angeles County as an example. Of the $8 million in HIV prevention and education grants that were recently awarded to LA-based organizations, $5 million would be eliminated if the state budget cuts go through. Experts say that there are already too few prevention programs for young gay men, so further cuts could be devastating to prevention efforts among this vulnerable population.

The proposed cuts also jeopardize California’s claim to federal money supporting HIV prevention and treatment from the Ryan White CARE Act and the U.S. Centers for Disease Control and Prevention (CDC). Anne Donnelly, the director of health care policy for the San Francisco–based HIV information and advocacy group Project Inform, explains that cash from these programs comes with a “maintenance of effort” clause, which requires the states to match federal funds with some of their own money. If California falls below its maintenance of effort—and the proposed cuts would drop funding below the limit, Donnelly explains—the federal government could withhold its considerable share of dollars, further ravaging HIV programs in the state.

What’s Being Done

While advocates are busy lobbying state lawmakers, California residents are also being urged to get involved. One initiative being developed is a rally scheduled for 1:30 P.M., Wednesday, June 10, on the steps at the state Capitol in Sacramento. People wishing to go can either visit the organizers’ web site or call their local AIDS organizations to see about traveling with others.

State Assemblyman Tom Ammiano (D–San Francisco) advises people with HIV to reach out to other groups and fight for adequate health care for all—but they must make sure their voices are heard. In addition to writing and calling their state elected officials, he says, they should also reach out to their U.S. representatives and senators and plead for federal assistance. Civil disobedience and other forms of activism, Ammiano says, might be equally necessary. He says that the situation is dire and while it may not be possible to head off all budget cuts, there is hope of minimizing the cuts to vital HIV programs.

Fourteen other states are facing multibillion dollar deficits during the next couple of years, including: Arizona, Connecticut, Florida, Georgia, Illinois, Massachusetts, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, Texas, Washington and Wisconsin. Advocates argue that coming out in force in California to preserve state funding for HIV could bode well in these other states should they come up against the same budget challenges.

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Previous Comments:

elias, seattle, 2009-06-23 08:41:52
Californians, encourage your governor and state legislator to give the pharmaceutical companies a choice -- Reduce the price of HIV meds to generic levels, or we will buy generics from India.

Channing, San Francisco, 2009-06-12 10:10:41
If I recall correctly, the whole premise behind Grey Davis' recall and Arnold's assent to power was a budget deficit and increased taxes. Now Arnold wants to balance the budget on the backs of the state's most vulnerable.What a joke he has turned out to be. Get vocal and involved folks. It is time for a little shake up in Sacramento.

Bob, Denver, 2009-06-11 01:10:09
We better hope this does not spread to the other states listed in this article. Could be a trend,....an easy target to go for. Jack up the taxes on some of the BIG corporations that pay their CEO's...millions in bonuses.. Most of them are not worth their ..salaries, let alone their,..millions in bonuses. Oh, yes hit on the HIV people then when they loose their jobs and then loose their homes, etc. Just what Calif needs,...more people generating..less revenue. REAL SMART THINKING.

Ryan, Denver, 2009-06-10 17:33:12
This is just genocide. In my opinion if you threaten 34,000. peoples lives your a terrorist. It seems they are making this a huge Hiv issue to sway the public like gay people are the problem, insane. When in fact this will threaten children and the elderly. It makes me wonder if the illegal aliens will still be getting their health care. I am appauled and very angry about this. Just Shameful Arnny

john swanson, Minneapolis, 2009-06-10 11:48:54
We're our own worst enemy! Fly in the face of the majority with this gay marriage crap, and now we want their help? Doesn't work folks.

Doug, Long Beach, CA, 2009-06-09 13:44:44
I'm a case manager at an Early Intervention Clinic for the City of Long Beach. My clients are calling me everyday asking "why does the Govenor want me dead?" We are possibly facing closure of our clinics and programs and the cuts to ADAP alone would be devastating. Currently, there is nothing to tell our clients other that wait and see. I am also poz, so this is all freaking me out as well. It seems that budgets will always be balanced on the backs of those who can least afford it.

Doug, Seattle, 2009-06-09 09:59:11
I think it's really tragic that when budget cuts come it always affects the most vulnerable and helpless, they never make cuts to people of means. Canpassionate conservatism, pishad, opprotunists is more like it.