Summary of the 41st Presidential Advisory Council on HIV/AIDS (PACHA) Meeting

February 1, 2011 in Policy/Advocacy

By Donna Crews, Director of Government Affairs
AIDS United

The Presidential Advisory Council on HIV/AIDS (PACHA) met on January 27th & 28th in Washington, D.C.  AIDS United Board member Douglas Brooks is a PACHA member and was in attendance, and AIDS United Vice President of External Affairs Victor Barnes offered public comments on day two of the meeting.

Following opening remarks by Dr. Howard Koh, Assistant Secretary for Health at the Department of Health and Human Services (DHAS) and Jeffrey Crowley Director of the White House Office of National HIV/AIDS Policy (ONAP), Crowley provided an update on the National HIV/AIDS Strategy (NHAS) and the public release of the NHAS operational plans. Crowley also indicated that ONAP will be publishing the first NHAS annual report, which will be less a “federal report” and more a “nation’s reponse” to the domestic HIV/AIDS epidemic.  Crowley expressed ONAP’s host for positive results from the 12-city coordination model of DHHS agencies in the highest impacted jurisdictions accounting for 44% of the HIV epidemic.

Operational plan updates

Office of HIV/AIDS Housing at the Department of Housing and Urban Development (HUD)

David Vos, Director of the Office of HIV/AIDS Housing at the Department of Housing and Urban Development (HUD) explained that HUD’s operational plan focused on Housing Opportunities for People with AIDS (HOPWA) while developing ways to bring the HIV epidemic into other parts of HUDs work, especially the homeless division of the agency.  Homelessness is a known risk factor for HIV.

Veterans Affairs (VA)

Maggie Czarnogorski, Deputy Director National Clinical Public Health Program at Veterans Affairs (VA) explained that the VA is the largest single provider of HIV care in the country,  treating over 24,000 veterans.  The agency uses (electronic?) medical records and confirms that:

  • 95% of their HIV positive patients/clients are linked to care within 90 days of diagnosis
  • 91% of those eligible to be on medication are receiving HIV medication; and
  • 84% of patients/clients are virally suppressed.
  • With its detailed client level data, the VA is also able to determine that 60% of the HIV positive veterans are over 55 years old, 80 HIV positive veterans are over eighty years old.

Federal Bureau of Prisons (BOP)

Chris Bina, Director of the Pharmacy Program at Federal Bureau of Prisons (BOP), Department of Justice (DOJ) emphasized that prison health is public health.  There is a 1.6% HIV prevalence rate in the federal prison system.  HIV testing is offered to all inmates at their first physical and is mandatory for those prisoners who are “at risk”.  BOP works with the VA to evaluate inmates’ CD4 count and viral load data.  BOP is working to increase the number of re-entry coordinators to assist ex-offenders connection to care and treatment after release from prison. Released inmates are given a 30 day supply of medication.

Department of Justice (DOJ) Civl Rights Division

David Knight of  DOJ’s Civil Rights Division explained the agency’s charge to reduce stigma and eliminate discrimination involving HIV. The DOJ Civil Rights Division gives incoming HIV/AIDS discrimination a top priority, while educating the public on HIV and stigma.  HIV is explicitly protected under the Americans with Disabilities Act , and the DOJ Civil Rights Division charged with informing the public of this protection through conferences, fact sheets, and conferences.

Social Security Administration (SSA)

A representative of the Social Security Administration (SSA) explained that the SSA is working to make faster decisions on Social Security Disability designation cases.  SSA helps individuals return to the workforce and is developing ways to raise community awareness of the role of Social Security Administration.

Department of Health and Human Services (DHHS)

Dr. Ron Valdiserri presented excerpts of the Health and Human Services (HHS) operational plan, which features the most detailed description of the $16 billion HHS HIV budget that has ever been compiled, including both entitlement and discretionary funding on the HIV domestic portfolio with some global line items as well. The twelve city initiative has expanded the CDC coordination and planning grant Enhanced Comprehensive HIV Prevention Planning and Implementation for Metropolitan Statistical Areas Most Affected by HIV/AIDS (ECHPP) to include coordination with Health Resources Services Administration (HRSA) HIV/AIDS Bureau (HAB) and Bureau of Primary Health (BPH), Substance Abuse Mental Health Services Administration (SAMHSA), Indian Health Service (IHS), Center for Medicare/Medicaid Services (CMS), and National Institutes of Health (NIH).   The intent of the initiative is to share information on funding priorities in each of the twelve jurisdictions, and to  serve as a model for the country-wide coordination of the National HIV/AIDS Strategy (NHAS). This initiative may also be an opportunity to attain a common metrics for collecting HIV data.

Other HIV-related activities at HHS include:

  • An NIH study to determine the effects of stigma on access to HIV testing, and HIV care and treatment.
  • A consultation organized by ONAP at HHS with lesbian, gay, bisexual, and transgender community leaders to discuss how the United States government can be better partners in the HIV domestic epidemic.
  • An emphasis on the importance of  public/private partnerships to ensure the HIV domestic epidemic realizes the goals of NHAS.

Subcommittee Reports

Access to Care subcommittee

Andrea Weddle, Executive Director, HIV Medicine Association and Laura Hanen, Director of Government Relations, National Alliance of State and Territorial AIDS Directors presented a health care reform update with a focus on HIV.  The subcommittee also discussed the importance of increased HIV testing, increased resources for the HIV workforce, and the need to evaluate the Ryan White Program in light of healthcare reform.

HIV Incidence subcommittee

PACHA member Dr. David Holtgrave began the presentation with the statement “fully funding prevention is the least expensive way forward” in the HIV epidemic.  Subcommittee members believe a metrics for measuring the factors associated with HIV is important, but it must be a metrics that can be used by federal, state, and local governments as well as by community based organizations.  Such a metrics have not been defined yet. The subcommittee also explained the importance of discussion and knowledge of community viral load across the country.  Subcommittee members noted that treatment as prevention must be discussed in more detail by the subcommittee and PACHA as a whole.

Global Affairs subcommittee

The majority of the subcommittee report was on a resolution to scale up global AIDS funding.  The discussion led to a conversation on how PACHA wants to use its resolution resources and how and when PACHA should weigh in on the budget and appropriations conversations annually.  The resolution was pulled but PACHA decided to send a letter expressing strong support for the United States to live up to its financial commitments in PEPFAR and the global fund.

Health Disparities subcommittee

The subcommittee report explained their monitoring of three issues 1. How the Veterans Administration monitors its 8.5 million clients/patients, 2. The need to develop system to gather data on safe disclosure issues by the end of the year as detailed in the NHAS, 3. The modernization of the HOPWA formula through the HUD Secretary’s overall housing modernization congressional plan.  The subcommittee then presented two panelists, Catherine Hanssens, Executive Director of the Center for HIV Law & Policy and Alison Nichols, from the Department of Justice, Disability Rights Section, Civil Rights Division to discuss the proliferation of laws across the nation on HIV criminalization. This issue will continue to be discussed and debated to see where PACHA members fit in to the conversation.

Public Comments

Thirteen individuals made public comments at the two -day PACHA meeting. The comments were varied focusing on ADAP, prevention funding, Ryan White Program doctors concerns, and inclusion of young people in PACHA debates and membership.  Victor Barnes, Vice President of External Affairs at AIDS United addressed PACHA about the importance of inclusion of public/private partnerships as the country works on implementation of the National HIV/AIDS Strategy.  Daria Boccher-Lattimore spoke on behalf of the National AETC network to explain how they are working to meet the NHAS goals using a cost-effective and coordinated approach to educational and clinical skills.  For example, AETCS seek to reduce new HIV infections by providing front line clinicianswith the ability to turn every visit into an HIV prevention opportunity regardless of the client’s HIV status of a client.

Team NOLA on MLK Day

January 26, 2011 in Access2Care

In honor of MLK Day, Team NOLA participated in a fire safety event organized by the Southeast Louisiana chapter of the American Red Cross.

Early Saturday morning, we arrived at the Pilgrim Progress Missionary Baptist Church. There were about 50 volunteers all together, mostly from the Red Cross Clubs of local universities.

We all had some breakfast, and then a local fire chief presented a brief introduction to fire safety. He also gave us a phone number that people can call to receive a free smoke detector.

The neighborhood was divided into sectors and each group of volunteers was assigned to canvass a certain sector. A Red Cross member led each group.

We went from house to house, placing door hangers with fire safety information on door knobs and talking to people in the neighborhood. The day was beautiful, and the residents were very friendly. We hope that people will read the door hangers we left, and that the information will save lives.

Together, volunteers canvassed 1,940 houses that day.

President Seeks Unity With State of the Union Address

in Policy/Advocacy

by William McColl, Director, Political Affairs

In last night’s State of the Union address, President Obama sought to refocus the terms of the national debate away from last year’s health care reform bill onto the need for jobs.  For the first time at the State of the Union in recent memory, Republicans and Democrats sat together and wore  black and white ribbons to honor the victims of tragic shooting in Tucson, AZ and the ongoing fight for survival of Representative Gabrielle Giffords (D-AZ).

Domestic spending freeze: no cuts “on the backs of our most vulnerable citizens”

The President spoke of seeking common ground with the newly-empowered Republicans in Congress, focusing on deficit reduction and offering a five year freeze on “annual domestic spending.”  Such a freeze seems designed to exclude possible increases in spending through entitlement programs such as Medicaid and Medicare.  However he emphasized that the new health care reform bill would actually slow spending increases in those programs.  The President also sought to carve out space for his priorities noting that deficit reduction could not only come from the 12% of the federal budget devoted to social and health care spending.  Encouragingly he urged Congress not to make cuts “on the backs of our most vulnerable citizens.”

Health care reform: “let’s fix what needs fixing and move forward”

On health care, the President once again sought common ground with Republicans by agreeing to change at least one provision to eliminate bookkeeping burdens on small businesses and offered to review other possible changes.  However he also defended the new Affordable Care Act (ACA) stating that, “this law is making prescription drugs cheaper for seniors and giving uninsured students a chance to stay on their parents’ coverage.”  Finally he challenged Congress, saying “instead of re-fighting the battles of the last two years, let’s fix what needs fixing and move forward.”

Republican response

In the Republican response, Representative Paul Ryan (R-WI) reiterated the Republican message points, promising that the new House majority would find ways to cut spending.  He also claimed that the health care reform bill was “accelerating the country towards bankruptcy and would cause millions of Americans to lose health care coverage due to increased health care premiums.  This conflicts directly with Congressional Budget Office estimates that over ten years the health care reform law would slow the growth of Medicare and Medicaid spending by about $230 billion.  Nevertheless he said that Republicans would continue efforts to repeal the bill and replace it with fiscally responsible reforms.  He did not offer examples of what those reforms would be.  The House last week passed a resolution calling for four committees to develop replacement solutions.

AIDS United is advocating for continued implementation of health care reform;
Opposes repeal of Affordable Care Act

AIDS United opposes repeal of the Affordable Care Act and is concerned that efforts to do so will ultimately result in moving back towards funding HIV/AIDS treatment and care through vulnerable discretionary funding.  This funding is already stretched thin, most visibly resulting in more than 5000 people being placed on waiting lists for AIDS Drug Assistance Programs.  AIDS United continues to hear concerns from people in the field that it is harder for people living with HIV to get necessary doctor visits, dental and vision care or access to support services that help people living with HIV to gain access to good treatment.  Additionally cuts in services threaten not only the ability of people who currently need to access care, but also fail to acknowledge every two years more than 100,000 people are infected with this terrible disease,   who also will require services too.  Failure to deal with this reality, both by preventing disease and failing to treat people living with HIV will take us back to the days in which our public health system verged on collapse.  We cannot and we will not let that happen.

Spirit of Service- Team Carolina MLK Day

January 25, 2011 in AmeriCorps

Everybody can be great, because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and verb agree to serve. You only need a heart full of grace. A soul generated by love. –Rev. Dr. Martin Luther King Jr.

Team Carolina looked forward to beginning the Day of Service early by serving at the Durham Center for Senior Life. Partnered with the United Way, our team, along with about 75 other volunteers gathered together to “Make it a day on, not a day off.” It was a change of scenery to be outside of our offices and in the heart of the community. The Durham Center for Senior Life is an Adult Day Program that helps individuals age 55+ to lead healthy, active and independent lives. Activities range from Bingo to exercise, computer and cooking classes. The gorgeous and spacious facility was the perfect place for seniors to be in a relaxed environment with their peers.

As a group, all of the volunteers, most of whom did not know each other and with little instruction began working together. Our task was simple: to paint the walls of several activity rooms and bathrooms that had become dull beige over the years. We began taping the base boards, light switches and covering anything we didn’t want damaged. All types of paint brushes began stroking the walls until the place was a light mint green. When supplies were low, volunteers chipped in and brought their own from home. While some stooped low to paint base boards, others reached high on ladders in order to reach the ceiling. It was truly wonderful to see the end result of what taking time to serving others can do. That day we all embodied the spirit of Dr. King

It was amazing to see so many people come out to serve. It was even more beautiful to see how many parents brought their children, ensuring that Dr. King’s spirit of service is passed on to the next generation. It meant a lot to Team Carolina to have been apart of this group and it is our hope that the through our acts of service, the seniors who use this space daily will continue to enjoy health, wellness and personal fulfillment.

Chicago’s “Day On”: MLK Day 2011

January 21, 2011 in AmeriCorps

“Everybody can be great… because anybody can serve.  You don’t have to have a college degree to serve.  You don’t have to make your subject and verb agree to serve.  You only need a heart full of grace.  A soul generated by love.”  -Dr. Martin Luther King, Jr.

This quote, read during the service day opening ceremony at a south-side Chicago Salvation army to 1,000 volunteers, perfectly embodied our experience serving the community this past Monday.  The Chicago City Year program organized a gigantic service day that took place in three elementary schools in Chicago’s Englewood neighborhood.  We spent the day with a diverse group of volunteers including young children, current AmeriCorps and alum, families, and corporate employees.

All volunteers set out from the Salvation Army bundled in winter clothes and escorted by city police cars around 9:30am.  It was a gusty, snowy morning but spirits were high as we walked through the neighborhood we were going to serve.

As a team, we were assigned to working at Stagg Elementary school.  The school’s project theme centered around literacy.  Stairwells were painted with motivational words and hallways displayed brightly colored high frequency words that increase in difficulty when moving from the first to the third floor of the school.  We worked on making a hands-on painted alphabet for the school’s library which will help students learn their letters.

At Guggenheim Elementary school, volunteers painted fruits and vegetables on cafeteria walls and color wheels in the art room.  They also worked to reorganize and repaint the teachers lounge to make break time more enjoyable for staff.  The walls of D.S. Wentworth Elementary school were decorated with West African Andrinka symbols which volunteers painted on the walls of all three floors in the school.

We met people serving in different capacities and, while painting our letters, were able to talk to other AmeriCorps members about their programs around Chicago.  City Year did an incredible job organizing the event which included tracing over 100 murals in three schools and preparing supplies for the different projects that were going on.

We ended the day by helping clean up the project areas and attending a closing ceremony where the Principal of Stagg Elementary school thanked us for our service to the children and the community.

In truth, the school was transformed.  The brightly colored hallways and alphabet letters brought smiles to our faces and pride to our hearts.  We could only imagine the positive impact the changes we made to the school would have on the students coming back to school Tuesday morning.

World AIDS Day in Metro Detroit

January 12, 2011 in AmeriCorps

Team Detroit spent World AIDS Day at two health fairs in the metro Detroit area – four of us at the Northwest Activities Center in Detroit, and three of us at Affirmations, a prominent LGBT community center in downtown Ferndale.

A free mobile testing unit was located outside both locations. Inside the buildings, our hosted tables passed out a wealth of free HIV/STD brochures, condoms, and safe sex kits – as well as quizzing some willing participants on their HIV knowledge. Much of our day was spent taking photographs for the “Facing AIDS”  photo series. The combination of efforts resulted in close to 100 photos being posted to the Flickr account.

Our team connected with many other organizations that hosted tables, and in addition to the expected groups from the metro Detroit area, several had traveled more than fifty miles to be there.

We even found a few well-connected people who would be invaluable in assisting with our long term project! We were pleased to see how many people local turned up for the events, and were excited by a few individuals we spoke to who had heard the radio event advertisements just hours before and decided to drop in!

At the end of the day, Team Detroit felt very well rewarded for the effort we put in to the events – they were much more enjoyable than we anticipated.

-Alex Krasicky