Advocates fear spike in HIV due to CA budget cuts
by Matthew S. Bajko
The state of California has been able to keep new HIV infections in check in recent years, with cities like San Francisco even reporting slight decreases in the number of people infected with the virus.
But fears are growing that the Golden State will reverse course and see spikes in new HIV cases after Republican Governor Arnold Schwarzenegger this week further slashed the state Office of AIDS budget in order to deal with a $24 billion deficit. Using his line-item veto power, the governor blue penciled out more than $52 million in general fund support to AIDS programs, including cuts to HIV prevention and testing efforts and health services for people living with HIV and AIDS.
Added to the cuts legislators had already approved in their budget plan sent to Schwarzenegger, the AIDS office saw its budget slashed in half, dropping from more than $167.3 million down to $82.4 million for the 2009-2010 fiscal year. AIDS advocates lashed out at the governor's decision, saying the more than $85 million cut will cripple efforts to stop the spread of HIV in the state.
"My worry is if this doesn't get remedied, we are going to see a substantial increase in new HIV infections in San Francisco, particularly if they are cutting prevention activities and testing," said Mark Cloutier, CEO of the San Francisco AIDS Foundation, who estimated his agency would lose $800,000 in funding from the state. "I am optimistic this is not the final story on this, but we do need to mobilize the community to support the efforts to restore the money."
Anne Donnelly, Project Inform's director of heath care policy, said the hit to the AIDS budget is "the largest cut by far ever" California has made to its HIV and AIDS programs.
"These cuts cripple the fight against HIV and our efforts to care for folks with HIV and AIDS in California," she said.
Michelle Roland, director of the state AIDS office, echoed those concerns in an interview with the Bay Area Reporter Tuesday, July 28 after the governor signed the budget and released a list of the additional cuts he made. Asked if the cuts would lead to increased HIV infections in the state, Roland said she is "certainly concerned about that possibility."
"When you have less resources and can't figure out how to leverage new resources or use these funds more intelligently then yes, we are all concerned about that possibility," acknowledged Roland, a bisexual woman and formerly an AIDS activist and researcher from San Francisco tapped by the governor in 2007 to run the AIDS office. "One of my focuses is going to be looking for grant opportunities and making sure that we have adequate staffing to apply for grants."
Roland said she did not see her inability to protect her office's funding as a personal failure. With the state's ballooning fiscal problems, she said it became increasingly clear her budget would be drastically reduced.
"I feel these were very incredibly difficult decisions the governor and Legislature and the state Department of Finance grappled with. I was supported by the department to give the best information to decision makers on the importance of these programs," said Roland. "I don't take it personally. If you look at all the cuts contained in the budget, these are all cuts that have very real human impacts."
But lawmakers didn't hold back in attacking not only the governor but also his LGBT staffers, particularly his chief of staff, Susan Kennedy, an out lesbian.
"He is such a callow individual," said openly gay Assemblyman Tom Ammiano (D-San Francisco). "I also hold responsible his openly gay aides, like Susan Kennedy and others. Why aren't they in the trenches fighting for us? I think it is shameful."
The end result, warned Ammiano, is that "people are going to die now" unless the cuts are reversed or other sources of funding can be found. He said he plans to press the Obama administration to increase AIDS funding during a trip to Washington being planned for this September by Assembly Speaker Karen Bass (D-Los Angeles).
"We are going to go to Washington to see about getting more stimulus money and AIDS will certainly be on my agenda," said Ammiano.
Out state Senator Mark Leno (D-San Francisco) served on the budget conference committee and just this weekend was cheering the fact that lawmakers had balanced the budget without decimating social services. His tone changed dramatically Tuesday, when he blamed the governor for a lack of leadership in the budget negotiations with GOP members of the Assembly, who blocked raising taxes and other revenue generating plans from being used to balance the budget.
"The vetoes are inappropriate and outrageous in their impact," Leno told the B.A.R. "If the governor was doing his job the night we were voting by being in his office so he might have communicated with the recalcitrant Republicans in the Assembly there might not have been any need for these cuts."
In announcing his decision to cut an additional $16.1 billion from the budget lawmakers sent him, Schwarzenegger not only boasted that the document did not include any tax increases but also defended his decision to gut social services.
"This is not an easy budget, but it is a necessary budget that does not raise taxes, solves the $24 billion dollar deficit and includes long-term reforms," stated the governor. "I see the real Californians that will be affected by the decisions made within this budget and nothing guarantees revenues won't drop further, but this budget puts us on a path toward fiscal responsibility so we can focus on bringing jobs back to get California moving forward again."
Legislative leaders are reviewing whether Schwarzenegger had the authority to make the cuts he did, with Senate Pro Tem Darrell Steinberg (D-Sacramento) saying, "We question whether the majority of these vetoes are legal."
He vowed that, "We will fight to restore every dollar of additional cuts to health and human services."
Ammiano told the B.A.R. that he has been working with his colleague, out Assemblyman John Perez (D-Los Angeles) on the legality question and plans to pursue the issue in terms of the AIDS office budget.
"We got some legal opinions on what the governor has done around HIV funding are illegal and unconstitutional," said Ammiano. "So we are going to be pursuing that path."
AIDS advocates are already mobilizing to support the legislative efforts to work out some compromise with the governor to restore the funding. They will hold a rally protesting the cuts at noon Wednesday, August 5 in front of the State Building in San Francisco's Civic Center.
"The budget passed by the Legislature had cuts but it didn't destroy the ability to fight the epidemic and care for folks," said Donnelly. "We will be with them every step of the way. It is really important for people to focus on where is the leadership from the governor's office in working toward being able to enact some revenue increases? We can't continue to Ð in this horrible budget situation Ð balance the budget on the backs of the most vulnerable Californians."
Some good news for AIDS programs
Roland argued that the budget news this week was not as dire as AIDS advocates are touting, saying that the cuts are "not decimating the Office of AIDS."
She pointed to good news in terms of funding the AIDS Drug Assistance Program and ensuring California remains competitive for federal HIV dollars.
Despite a $1 million reduction in HIV and AIDS surveillance, which was part of the Legislature's budget proposal, Roland said the cut would not impair the state's ability to pursue federal AIDS dollars. And she noted that ADAP would be fully funded this year due to tapping into a special reserve fund to backfill a $25.5 reduction in general fund dollars.
But Roland said the decision to use money from a rebate program pharmaceutical companies pay into to cover ADAP this year means that the fund would not be available to help defray the program's costs in fiscal year 2010.
"In 2010 there won't be enough money to support ADAP without finding new money," she said.
The areas impacted the most due to the budget cuts are HIV testing and prevention services, Roland said, noting her office is now left with only 20 percent of the resources it had to pay for such programs.
"We are really focusing on the most essential core functions," she said.
Cloutier said the foundation's cut would impact HIV testing at Magnet, the gay men's health center in the Castro, and substance abuse services provided by the Stonewall Project. He said it was too early to tell if there would be another round of staff layoffs at the foundation, which already reduced its payroll six months ago.
As for the merger talks between the foundation and the Stop AIDS Project, which the B.A.R. first reported on last month, Cloutier did not foresee the budget cuts expediting those negotiations.
"Those conversations are going on irrespective of this state budget cut because we are really looking at how to improve reducing new HIV infections in San Francisco. Neither organization is under severe financial stress with these cuts," said Cloutier. "It is really about improving the community's health and trying to be more efficient on how administrative funds are used by creating one larger organization."