The Bush administration has unveiled a proposal that would shift billions of dollars for HIV/AIDS-related services away from hard-hit urban centers in order to expand medical care in poor and rural parts of the country, according to the AIDS Foundation of Chicago's ( AFC's ) Online Action Bulletin.
The bulletin also stated that the announcement issued by Health Secretary Michael Leavitt 'is the clearest indication yet of the administration's position to address the nation's expanding HIV/AIDS crisis without committing new discretionary federal funds.' Leavitt's recommendations will, in all likelihood, have a hand in shaping legislation related to extending the Ryan White CARE Act, the HIV/AIDS relief program created in 1990 and re-authorized by Congress in 1996 and 2000. The current authorization expires Sept. 30.
The proposal calls for the cut of overall funding to the 51 hardest-hit cities that receive Title I grants by reducing their state's Title II funds, a share of which also supports services in urban areas. ( Title I funding refers to eligible metropolitan areas hit hardest by HIV/AIDS. Title II funding involves improving the quality, availability and organization of HIV/AIDS-related healthcare and services. ) Ultimately, more resources would go to states that have not been hit as hard by the HIV/AIDS crisis.
The proposal's recommendations include legislation that would define 'a set of core medical services' and the determination ( by the U.S. Department of Health & Human Services ) of a list of 'core medications.'
Regarding rural regions, the proposal, among other things, lobbies for a new fund-distribution formula for Title II funding based only on a state's HIV/AIDS case number in non-Title I jurisdictions.
AFC expressed disappointment over the proposal. The organization declared that it 'would shift inequities from rural and poor states to the inner cities. Improving HIV care in rural America—an important goal—should not come at the expense of poor people with HIV/AIDS who live in urban centers, including Chicago.'
— Andrew Davis