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Bush Administration’s Principles for Ryan White CARE Act Reauthorization Jeopardize San Francisco’s System of HIV Care


SAN FRANCISCO, July 27 -- Today the San Francisco AIDS Foundation expressed grave concerns about the potential impact of the principles outlined by the Bush Administration for the reauthorization of the Ryan White CARE Act. The principles, issued today by Health and Human Services Secretary Michael Leavitt, call for a number of changes to the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act that would significantly cut federal HIV resources to San Francisco and could reduce access to HIV services to thousands of San Franciscans living with HIV/AIDS. It is estimated that approximately 11,000 San Franciscans rely on CARE dollars for their care and treatment.

“We are particularly concerned that the Administration calls for the elimination of the hold-harmless provision that protects cities from experiencing rapid declines in resources that could dismantle systems of care,” said Mark Cloutier, executive director of the San Francisco AIDS Foundation. “It is extremely disturbing that the Administration would call for changes in the legislation that would undermine the continuity of care for thousands of San Franciscans living with HIV disease. We support the Administration’s desire to supply additional resources to regions where the epidemic is growing, but don’t believe it should come at the expense of the eliminating access to life- saving services in San Francisco. The solution is to supply new federal dollars to keep pace with the epidemic.”

The hold-harmless provision in the CARE Act currently protects San Francisco from a cut of over $7 million in federal HIV funding. A reduction of this magnitude, which represents approximately 25 percent of the city’s current $28 million direct CARE Act award, would require the city to eliminate or significantly scale back a variety of HIV services that are critical to keeping people healthy and prolonging their lives.

The Administration has also called for not counting AIDS cases from metropolitan areas in determining the allocation of CARE funds to the states because metropolitan areas also receive direct federal funding. This change could result in a reduction of nearly $20 million in HIV funding to California, where the vast majority of people living with AIDS reside in metropolitan areas.

“For five years, the Bush Administration has essentially flat- funded the CARE Act despite a steadily growing population of people living with HIV disease throughout the country,” continued Cloutier. “Without additional resources, disparities in access to HIV care and services will continue to exist and people with HIV will needlessly suffer and face reduced life expectancy. In San Francisco-and throughout the country-we have yet to identify and bring into treatment all people who are eligible and in need for treatment and care and, as a result, many individuals go without needed HIV care, particularly people of color. No amount of tinkering with the CARE Act authorizing legislation is going to change this sad reality.”


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