Browsing Category: Policy/Advocacy

Overview of the President’s FY 2013 Budget Request

by Donna Crews, Director of Government Affairs

The annual federal budget and appropriation process kicked off this week with the release of the President’s FY 2013 proposed budget.  The budget request projects total spending of $3.8 trillion for the fiscal year that begins Oct. 1, 2012.  The President’s FY ’13 budget request for overall domestic HIV funding demonstrates a continued priority for implementing the National HIV/AIDS Strategy.  In a total budget that reflects the fiscal crisis that is forcing record setting cuts in total spending, the proposed budget includes moderate increases or flat funding for the majority of domestic HIV programs.  And, despite some disturbing proposed cuts as well AIDS United is pleased that most these life-saving programs remain intact during this challenging financial climate.

The Ryan White HIV/AIDS Program would receive a $74 million increase.  Most of that increase is for the AIDS Drug Assistance Program, funding for which would increase by $66.7 million.  That amount is on top of the $50 million that was added in FY 2012 following the President’s 2011 World AIDS Day remarks.  Part C would get a $15 million increase, which also is on top of the $15 million announced by the President on World AIDS Day.  The other parts of the Ryan White Program, including Part A, would be flat funded under the President’s proposed budget.  Regrettably Part D of the program would face a nearly $8 million dollar cut.

The President also proposed a $2 million dollar cut to the HOPWA (Housing Opportunities for People with AIDS) program, and a $5 million cut to tuberculosis prevention.

Domestic HIV prevention and surveillance programs would receive an increase of $40 million.  STI prevention programs are virtually flat funded under the President’s budget.

The President’s budget request includes a provision that would allow local communities to use federal funds for syringe exchange programs (SEPs). AIDS United is pleased about this provision, because the ban on the use of federal funds for SEPs was reinstated in the last bill to complete the FY 2012 spending plan.  AIDS United joined others throughout the HIV/AIDS community in calling for the President to support Congress lifting that ban.

President Obama included a $6 million increase for the Social Innovation Fund (SIF) and a $5 million decrease for the AmeriCorps program.  AIDS United has both a SIF grant and an AmeriCorps grant with a focus on HIV and AIDS that we fund throughout the United States.  The SIF grant must be matched by our organization and by the grantee on the local level thus leveraging $2 additional dollars for each $1 federal dollar invested.  Often, the AmeriCorps young people who work in the HIV arena remain involved in HIV policy, care, treatment, or research for their careers.  This is an important pipeline to new HIV workforce members as many of the HIV workforce begin to retire.

AIDS United is pleased and encouraged that many domestic HIV/AIDS programs remain intact, but remains very concerned about the cuts that have been proposed for AIDS housing, and the program for women, children, youth, and families.  Watch for continuing analysis here on the AIDS United blog.

Click here to see the White House’s Office of Management and Budget’s overview of the FY 2013 President’s budget.

Click here for a chart of the domestic HIV programs in the President’s proposed budget.

Historic Numbers of Virginia HIV/AIDS Advocates Tell General Assembly to End ADAP Wait List Now!

caressa cameronby Caressa Cameron, Regional Organizer, Mid-Atlantic Region

As the Mid-Atlantic regional organizer for AIDS United, I help to coordinate HIV/AIDS advocacy and organizing efforts throughout the region.  This week I had the pleasure of collaborating with Sue Roland of Virginia Organizations Responding to AIDS (VORA) to prepare advocates to tell their lawmakers to support Virginia’s AIDS Drug Assistance Program (ADAP).

Record numbers of HIV/AIDS advocates came to Richmond this week urging lawmakers to end the state’s waiting list and allocate $1 million to ADAP.  Thanks to the leadership of VORA, more than 60 advocates hit the halls of the General Assembly telling lawmakers to make their lives a priority by funding ADAP. By the end of the day, the diverse group of advocates—people living with HIV/AIDS, their families, friends, and healthcare providers– spoke with representatives from 130 of the 140 offices in the House and Senate.

For some advocates, the event marked the very first time they were able to share their personal stories in a political setting.  As the advocates told lawmakers stories of how ADAP saved their lives, it was clear they were making an impact. The advocates helped members of the General Assembly understand how treatment is prevention, how investing in ADAP can save Virginia money by avoiding costly hospitalizations, and how ADAP keeps people living with HIV healthy so they can provide for themselves and their families.

However, the day was not without its painful reminders that HIV stigma persists. After disclosing their statuses and telling their stories, a few advocates faced legislative aides unwilling to shake their hands. Though disappointed by such behavior, the advocates pressed on, determined to get their message out. They reported never feeling more empowered. They were excited to return home with their new knowledge and experience to educate and mobilize their communities around ADAP.

It is not too late for the voices of Virginians to be heard! Constituents have until Valentine’s Day to tell Virginia lawmakers to allocate the $1 million needed to fully fund Virginia’s ADAP and ensure that no person living with HIV has to be put on a waiting list before receiving life-saving medications. If you are a Virginia resident and are interested in joining this advocacy effort, contact your legislator today! For more knowledge on Virginia’s ADAP, how you can get involved, or to find contact information for your legislators, please visit www.voraonline.org. Sue Rowland can be reach at info@voraonline.org.

To get involved with HIV/AIDS advocacy in the Mid-Atlantic Region (District of Columbia, Maryland, Virginia, Pennsylvania and New Jersey) contact me at 202.404.4848 x.212/202.557.5904 or ccameron@aidsunited.org

The Time Is Now

photo of Ronald JohnsonAIDS United’s 2012 Policy Priorities

By Ronald Johnson, Vice President of Policy and Advocacy, AIDS United

We are less than two weeks into 2012, and it is already shaping up to be a pivotal one for HIV/AIDS. The end of 2011 saw the scientific advances that gave us a real vision for an AIDS-free generation, but also saw the deplorable reinstatement of the ban on the use of federal funds for syringe exchange programs. The International AIDS Conference will be in Washington D.C. in July, smack dab in the middle of the Presidential election season.

We are in for a bumpy ride, and AIDS United fully intends to take a leadership role in steering the course of that ride. And part of steering that course will be to maximize our core strengths of national advocacy, regional organizing and strategic grantmaking to ensure sound HIV/AIDS policy that helps people living with and affected by HIV/AIDS in the United States access the life-saving prevention, care and treatment services that they need and deserve.

Our regional and national advocacy activities are informed by each other, are driven by our strategic plan, and are aligned with our programmatic work. With a particular focus on Black men who have sex with men, women of color, and the Southern region of the United States, we have prioritized our advocacy work to target the following areas in 2012: Budget and Appropriations, Evidence-Based Prevention, Ryan White Program Reauthorization, Voter Education, and Re-envisioning HIV/AIDS. Our activities for each priority area are outlined below. You can download a PDF document, which includes
several examples of AIDS United’s policy-focused programmatic initiatives by clicking here.

The time is now. Our priorities are outlined, our actions are clear. And we need YOU! To achieve our bold mission of ending the domestic HIV epidemic, we know it will take teamwork. Teamwork to educate lawmakers. Teamwork to organize people living with and affected by HIV/AIDS. Teamwork to help give the HIV/AIDS community the increasingly louder voice it will need to end the epidemic. By joining with AIDS United, you demonstrate your commitment, provide critical insight, and, most importantly, amplify our voice as we fight the setbacks and push forward on scientific advances. As an advocate or a policy partner with AIDS United, you will help us zero in our 2012 policy priorities, and end the AIDS epidemic in the United States.

Budget and Appropriations

  • We will advocate for a balanced approach to deficit reduction in the implementation of the Budget Control Act.
  • We will ensure that the budget and appropriations process and efforts to reduce the federal deficit are responsive to the goals of the National
    HIV/AIDS Strategy (NHAS) and health care reform, and to the needs of vulnerable populations.
  • We will advocate for adequate funding for the Corporation for National and Community Service (which includes the Social Innovation
    Fund and AmeriCorps)

Evidence-Based Prevention

  • We will promote policies to reduce new HIV infections through a combination of behavioral, biomedical, and structural strategies.
  • We will advocate for lifting the ban on federal funding for syringe exchange programs.
  • We will ensure that biomedical prevention interventions that use anti-retroviral strategies (Pre-exposure prophylaxis (PrEP), vaginal and rectal microbicides, and treatment as prevention) in combination with
    primary prevention activities are researched as viable, endorsable strategies for preventing transmission of HIV among populations most at risk for acquiring the virus.

Ryan White HIV/AIDS Program Reauthorization

  • We will strengthen the Ryan White HIV/AIDS Program as a transition to full implementation of health care reform.
  • We will ensure that the Ryan White program continues as a safety net for people living with HIV who remain uninsured or underinsured.
  • We will lead the charge for community consensus on a reauthorization package for the Ryan White Program in 2013.

Voter Education

  • We will promote voter education and participation for people living with or affected by HIV/AIDS in the 2012 elections.
  • We will educate voters by developing and distributing voter toolkits and guidelines about candidate positions on issues that
    impact the response to HIV/AIDS.
  • We will have a leadership presence at the Republican and Democratic National Conventions to ensure visibility of HIV/AIDS in
    candidate platforms.

Re-envisioning HIV/AIDS

  • We will advocate for policies that reposition HIV/AIDS prevention and care in the context of prevention and management of other chronic diseases
    and co-morbidities of HIV.
  • We will ensure that states’ Essential Health Benefits packages meet the medical needs of people living with HIV/AIDS.
  • We will promote coordination with other chronic diseases and co-morbidities of HIV through the Health Care Reform Partnership Project.

Additional Policy Initiatives

We will also commit to playing a strong supportive and partnering role for other HIV/AIDS-related policies, and advocate for:

  • Full implementation of the Affordable Care Act (ACA) at the national and state levels.
  • Other policies that increase access to, and retention in, care for people who are living with HIV/AIDS (PLWHA).
  • Funding for domestic programs for structural HIV prevention interventions and HIV/AIDS research.
  • Policies that decrease HIV/AIDS-related stigma and discrimination towards PLWHAs. Particular focus on repealing and opposing laws that reinforce stigma by criminalizing HIV.
  • A more coordinated global and national response to the HIV/AIDS epidemic. Particular emphasis on:
    • Promoting visibility of the domestic HIV/AIDS epidemic at the 2012 International Conference on AIDS.
    • Ensuring policies that support and strengthen the implementation of the National HIV/AIDS Strategy, with particular focus on coordination among federal agencies, expansion of the twelve cities initiative, and improved coordination in low-prevalence areas.
    • Increasing U.S. leadership on policies and funding that address global HIV/AIDS.

    Click here for the AIDS United 2012 Policy Priorities document.

    Click here to learn more about becoming an AIDS United Policy Partner.

Preview of 2012: The Battles that will Shape the Future of HIV

by Ronald Johnson, Vice President of Policy and Advocacy

With all the achievements, as well as a few disappointments, of 2011 officially behind us, our attention now turns to 2012, which almost certainly will prove to be an historic year in the fight against HIV. Below, we preview some of the policy issues in 2012 that could turn the battle against HIV, for better or worse.

Affordable Care Act

In 2012, 10 new provisions of the Affordable Care Act are set to be implemented. The provisions take important steps toward preventing fraud and changing the way that the government pays for health care. However, the highlight of 2012 surely will be the Supreme Court’s ruling on the constitutionality of the Affordable Care Act, with a focus on the individual mandate that requires all Americans to buy health insurance by 2014 or pay a penalty. The Court is expected to hear the case in March. The ruling is due by July 2012, and will be critical to determining the extent to which the ACA can be implemented in its original form. A second major highlight in 2012 will be work to develop the Essential Health Benefits (EHB) package. The EHB is one of the key provisions of ACA. It guarantees that plans provide adequate benefits to their enrollees — benefits that will mirror the typical employer-sponsored plan.

Appropriations

The President will submit his Fiscal Year (FY) 2013 budget proposal to Congress no later than the first Monday of February. The President’s FY 2013 proposal is expected to conform with the spending cap mandated by the Budget Control act. The FY 2012 budget cut $700 million from the Departments of Health and Human Services’ budget, though some notable domestic HIV/AIDS programs essentially were able to maintain their FY 2011 funding levels, including the Centers for Disease Control and Prevention’s HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis Prevention programs; the Minority AIDS Initiative; and the Ryan White HIV/AIDS Program.

Deficit Reduction

In 2011, debts and deficits drove fiscal policy, as well as political rhetoric, and 2012 looks to be no different. Deficit reduction talks in 2012 will revolve around the Budget Control Act of 2011, the legislation that mandated Congress to develop a plan that would reduce the deficit by $1.2-$1.5 trillion over the next 10 years. Congress’ deadline for approving a plan is January 2, 2013. If Congress does not reach an agreement, $1.2 trillion will be cut automatically with 50% coming from defense programs and the other 50% coming from nondefense programs. Certain Members of Congress already have called for defense programs to be exempted from the automatic cuts. Though AIDS United does not take a position on cuts to defense programs, any attempt to shift cuts from defense programs to programs that serve people living with HIV would be unacceptable and would be met with our vigorous opposition.

The Temporary Payroll Tax Cut Continuation Act of 2011 was signed by President Obama just before the Congressional recess. The extension gave Congress until February 29 to negotiate continuing a tax cut for social security from 6.2% to 4.2%, a tax cut that is supported by the President. Also included in the extension was a postponement of cuts to Medicare reimbursements for doctors. Medicare payments to physicians were scheduled to be cut by 27% this year. A congressional conference committee has been created to extend the payroll tax cut and to come up with a long term solution for Medicare reimbursements. The committee is expected to first meet the week of January 16.

Elections

Elections in 2012 will determine the makeup of the 113th Congress, as well as the occupier of the White House. The new Congress and the winner of the presidential election will be faced with reauthorizing the Ryan White Care Act in 2013, implementing the major reforms of the Affordable Care Act, continuing the implementation of the National HIV/AIDS Strategy, and determining funding appropriations for domestic HIV/AIDS programs under the mandates of the Budget Control Act and annual fiscal year budgets. Additionally, a number of biomedical HIV interventions are being developed, and will require the financial commitment and the vocal support of all our political leaders.

Syringe Exchange

Deplorably, Congress included a ban on federal funding for syringe exchange programs (SEPs) in the final Fiscal Year 2012 appropriations omnibus. Despite the fact that SEPs have been incontrovertibly proven to reduce rates of HIV transmission in a way that is significantly cost-effective, the ban, which was originally instituted in the late 80s and overturned in 2009, was reinstated. In 2012, HIV advocates and organizations will and must work to hold Congress and the White House accountable for this reprehensible step backward in the fight against HIV.

Biomedical advances

The past couple years have seen a flurry of biomedical advances that have given many hope that science is finally starting to gain in the fight against HIV. In 2011, we saw encouraging results in trials that tested vaccines, pre-exposure prophylaxis (PrEP), and the efficacy of ARV treatment in preventing transmission among serodiscordant couples. In 2012, the Food and Drug Administration will consider an application from Gilead Sciences, that requests Truvada be labeled as an HIV PrEP in addition to its current label as an HIV treatment drug.  PrEP is the use of HIV medications to prevent an HIV infection. Gilead’s request is based on findings from a worldwide study showing that PrEP containing the HIV drug Truvada, reduced the rate HIV incidence by 44 percent. Additionally, the Follow-on African Consortium for Tenofovir Studies (FACTS)Trial is conducting a study to investigate the effectiveness of a vaginal microbicide gel containing the HIV drug, Tenofovir. The FACTS 001 study will test if a vaginal gel containing Tenofovir is effective at preventing HIV and Herpes Virus 2 transmission among women when used immediately before and after sex. Results are expected in 2013.

In recent news, researchers testing HIV vaccines in monkeys have found their most successful vaccine, which used two different strains of adenovirus that normally causes colds, to be 80 percent effective at preventing infection. “As far as animal trials go, this is a solid step in trying to track down the [biological markers] of immunity,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, which provided partial funding of the study.

National HIV/AIDS Strategy

In July of 2012, we will mark the end of the second year of the National HIV/AIDS Strategy (NHAS). The milestone will find us 2/5 of the way toward 2015 from when the Strategy was originally released in 2010. The Administration has sought to reach the goals of NHAS by collaborating and enhancing their partnership with state and local HIV authorities. NHAS has called for ambitious levels of reduction in new HIV incidence, increases in access to care and improved health outcomes for people living with HIV, and reduction in HIV-related health disparities. The Administration will be expected to show quantifiable progress that has been made toward these goals over the past two years. Reaching the goals of NHAS would be impossible without better access to healthcare for people living with HIV, therefore, the Supreme Court’s ruling on the constitutionality of the Affordable Care Act will be pivotal to determining the success of NHAS over the next three years.

International AIDS Conference

For the first time in 20 years, the International AIDS Conference (IAC) will be held in the United States. Appropriately, the conference host will be Washington DC. The timing in an election year, as well as the location of IAC will create an extraordinary opportunity for HIV activists to call for presidential and Congressional candidates to take a position on the myriad legislation and policies that impact people living with HIV.

Fiscal Year 2012 Appropriations Update: What it Means for HIV

by Donna Crews, Director of Government Affairs

The House, the Senate, and the Administration came to agreement late last night, December 15, on the final Fiscal Year 2012 (FY12) nine bill appropriations package, H.R. 2055.  This “megabus” as it has been referenced includes the majority of the domestic HIV funding portfolio.  The HOPWA program is a part of the Transportation, Housing and Urban Development, and Related Agencies bill passed last month and funded at $332.5 million, a $2 million decrease from FY 11.  This “megabus” includes the Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) appropriations bill.  The conference agreement provides the Department of Health and Human Services a total of $69.7 billion, which is nearly $700 million below FY11. The Labor-HHS section also includes a 0.189 percent across-the-board cut to all discretionary programs except for the Pell Grant program.

The Centers for Disease Control and Prevention HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis Prevention was flat-funded at FY 11 levels. The $30 million that was included in the President’s FY12 budget request in the Prevention and Public Health is not funded in the package.  There is a bipartisan, bicameral (both the House and the Senate) agreement on the allocation of the Fund that the Congress will share with the Administration at a later time.

Budget Activity Conference Amount
Domestic HIV/AIDS Prevention and Research
HIV Prevention by Health Departments $336,912,000
HIV Surveillance $117,667,000
National/Regional/Local/Community/Other $138,059,000
Enhanced HIV Testing $65,401,000
Improving Program Effectiveness $102,406,000
School Health $30,000,000
Viral Hepatitis $19,784,000
Sexually Transmitted Diseases $154,666,000
Tuberculosis $141,100,000

The Ryan White Program was flat-funded except for a $15 million increase for ADAP.  These numbers do not include the President’s announced $50 million for ADAP and Part C.  In contrast to previous reporting, this funding will not be coming from the Prevention and Public Health Fund, for which the President had called in his World AIDS Day speech. The process for securing those funds is not known at this time; the Administration will need to determine where the funds come from.

Budget Activity Conference Amount
Ryan White AIDS Programs
Part A $672, 529
Part B Care $423,141
Part B ADAP $900,000
Part C $205,564
Part D $77,313
Part F – AETC $34,607
Part F – Dental $13,511
Total $2,311,665

The bill includes $30.7 billion for the National Institutes of Health (NIH), the same amount as last year, but actually an increase of $299 million over FY11 since full funding for the U.S. contribution to the Global Fund is now included in the State, Foreign Operations appropriations bill.  The Office of AIDS Research often receives ten percent of the total NIH budget which would total approximately $3 billion.  The National Institutes of Health Office of the Director has a line item for $5,000,000 for HIV testing and treatment of individuals in the District of Columbia.

The Secretary’s fund of the Minority AIDS Initiative (MAI) remains flat as well at $53,783.  We are still determining the total amount but we believe the MAI is flat in the other agencies.

The bill also includes a reinstatement of funding for the Community-Based Abstinence Education (CBAE) program with $5 million. This restores funding to the failed abstinence only programs that have previously been found to be ineffective.  The Teen Pregnancy Prevention Initiative (TPPI), would continue to receive funding at its current level of roughly $105 million. This includes $75 million in direct funding for evidence-based programs and $25 million for innovative programs, with the remaining funds covering the cost of program evaluation and administration.

This bill is the vehicle that reinstated the federal funding ban on syringe exchange for both domestic and global programs.

The House has passed H.R. 2055, the conference agreement, by a vote of 296-121—149 Democrats and 147 Republicans supported the measure; 35 Democrats and 86 Republicans opposed it.  The bill is now being debated in the Senate and expected to get to the President for his signature before midnight tonight when the current Continuing Resolution funding the government expires.

The AmeriCorps program received $345,000 a decrease of $2,360 from FY11. The Social Innovation Fund is funded at $44.9 million, five million less than FY11. Both are funded under the Corporation for National and Community Service.

Deficit Reduction Committee Unable to Reach Agreement, but Impasse Is Not Necessarily Failure

by Ronald Johnson, Vice President of Policy and Advocacy

The Joint Select Committee on Deficit Reduction, widely known as the “super committee,” was unable to reach an agreement on a plan to reduce the federal deficit by at least $1.2 trillion over 10 years.  The 12-member committee was created by the Budget Control Act of 2011 (BCA) and charged with developing such a proposal.  The BCA mandates that if neither super committee nor Congress is able to reach an agreement, then automatic spending cuts will be enacted to meet the minimum goal of $1.2 trillion in deficit reduction.

The notion of “failure” has been bandied about heavily in the public commentary about the super committee’s impasse. AIDS United does not see the committee’s work as failure.  We commend those committee members who stood firm against accepting draconian spending cuts and against proposals that essentially would have gutted Medicaid and Medicare.  We applaud those members who insisted that an agreement needed to be fair and balanced and include meaningful revenue growth and expecting the wealthiest people in the country to share in the sacrifice needed to make a sizable reduction in the federal deficit.  We are grateful for the strong advocacy that called for protecting health care and safety net programs serving vulnerable populations.  Protecting the vast majority of people living in America, including people living with HIV/AIDS and other chronic diseases, is not “failure.”  It is what the Constitution calls promoting the “general Welfare.”

There is no question that the automatic spending cuts that will now be triggered, on top of the nearly $1 trillion in cuts already enacted under the BCA and cuts made in Fiscal Year 2011, will hurt.  The BCA itself was the result of a misguided yearlong focus on deficit reduction rather than on job growth and further efforts to stimulate the economy.  This distraction has been harmful.  It is never good to have to choose between “a rock and a hard place,” but in the closing days of the super committee’s deliberations, it became clear to many health care and social justice advocates that no deal was better than a bad deal.

The automatic cuts that will go into effect starting in January 2013 will now come under increased attention.  The law says that 50% of the cuts must be from the “national defense” area.  Even while the super committee was still trying to reach an agreement, some senators spoke about changing the law to protect military and defense spending.  Doing so would shift all deficit reduction efforts to non-defense spending, which includes spending on health care measures and the majority of spending for HIV/AIDS prevention, treatment, and research programs.  For that reason, AIDS United calls on everyone to oppose provisions that would exempt defense spending from the automatic cuts or lessen the severity of defense cuts without similar protections for non-defense spending.   AIDS United continues to call for balanced revenue measures that would reduce the need for spending cuts generally.

Again, let’s move on from the chatter about the super committee being a failure.  Let’s focus on real policy change that protects vital, life saving programs and achieves a balanced approach that shifts the focus to growing jobs and reviving the economy.  That’s the better financial approach needed to end the HIV/AIDS epidemic in America.