By Ruojing Liu
Gov. Bruce Rauner’s proposed budget for the 2017 fiscal year cuts $7.4 million from the Illinois state general HIV/AIDS fund compared to about $25.4 million last year. The approximate 30 percent cut raised some eyebrows among local organizations that serve the HIV/AIDS community.
On February 17, Gov. Rauner proposed a budget for fiscal year 2017 that included an $18 million appropriation for the “Expenses of AIDS/HIV Education, Services, Prescription Drugs, CTRPN and Patient and Worker Notification,” a lump sum that supports HIV housing, prevention, supportive services and health care programs for people living with HIV. This funding also supports the AIDS Drug Assistance Program (ADAP), which provides life-saving medication to people living with HIV.
“I wasn’t surprised by it, though I was disappointed and angry that we’d have to lobby again just to cover basic survival needs,” said Will Wilson, a 62-year-old living with AIDS, who, with nearly 250 advocates, staged a die-in at the chambers of the Illinois House as the Governor delivered the budget address to the General Assembly.
The proposed amount is a $2 million cut to that lump sum for fighting the epidemic in Illinois from the Governor’s 2016 budget, which has not been enacted after almost nine months into this fiscal year. It is a more dramatic deduction compared to the enacted 2015 budget.
The proposed state investment in the African-American HIV/AIDS Response Fund (AAARF) — $500,000 — was only one-third of its amount in fiscal year 2015.
Gov. Rauner already planned a cut in the same amount for the AAARF in his proposed 2016 budget, and he vetoed one passed by the General Assembly, which suggested a $1.25 million allocation for that fund.
“The AIDS Foundation of Chicago (AFC) strongly opposes these proposed cuts,” said Ramon Gardenhire, AFC’s vice president of policy and advocacy. “We will vigorously work with the General Assembly, people living with HIV, service providers and community members to restore funding for these and other vital programs.”
Gardenhire said AFC, a major organization that provides HIV/AIDS services to people living in the Chicago Metro area, was never consulted about the cut from the Governor’s office before it executed.
“I think that we agree with the Governor that we are all about … utilizing tax dollars to be the most cost-effective,” Gardenhire said, “but I don’t know the state can make those decisions without consulting the providers and organizations actually … providing these services to actually determine what is best for the tax payers.”
The current problem with the African-American HIV/AIDS Response Fund is that it has been unfunded since fiscal year 2015. According to the Illinois Department of Public Health (IDPH), there was about $222,000 left in that pot after the 2014 fiscal year ended, and it has never been refilled to its enacted level of $1.5 million since then. Because of insufficient funding, that fund was never awarded in 2015, and the situation continues as the state runs without a 2016 budget because of the disagreement between the governor and the General Assembly.
According to the most recently updated HIV surveillance report produced by IDPH for December 2015, the state’s black population constitutes 50 percent of the entire new HIV diagnoses in Illinois since 2008, with a rate of about 46 cases in 100,000 people. And African Americans form about 47 percent of the total number of people living with HIV or AIDS. These numbers haven’t really changed much compared with those calculated in December 2014, meaning blacks are still disproportionally affected by the epidemic.
“We’re worried that individuals will no longer be able to have access to organizations they trust,” Gardenhire said. “They will fall through the cracks.”
In the state, about 43 percent living with HIV are virally suppressed. Gardenhire feared that there won’t be enough funding for organizations, and that the state will see more people not knowing their HIV status, and that more people who are living with HIV/AIDS will not receive adequate care. Their personal health outcomes could become worse, “which is worse for community health outcomes, because they’re more likely to pass the virus on to others,” Gardenhire said.
To explain the reasoning behind the cut for the HIV lump sum appropriation, IDPH’s public information officer, Melaney Arnold, said in an email that “around 75 percent of IDPH’s ADAP clients have migrated to expanded Medicaid or insurance through the Affordable Care Act, thus reducing the amount of money needed for ADAP.” In fiscal year 2015, ADAP received a large proportion of about $18 million of the total HIV appropriation.
In addition, Arnold said ADAP pharmaceutical rebates were also utilized to purchase additional drugs for ADAP, freeing up dollars for outreach, prevention, testing, and other services.
As the new proposed 2017 budget shows, about $13.5 million HIV money out of the entire $25.4 million were spent in fiscal year 2015. However, to Gardenhire, a lot of HIV providers are continuing services without money from the state.
“If they actually have the money, we could hopefully link more people to care, stop new infections, have more people know about PrEP, and that work can’t be done without resources,” Gardenhire said.
AFC is rallying support for more funding for the HIV lump sum in the 2017 budget that would culminate in their 2016 Springfield Advocacy Days on April 13. But too much opposition could result in no reconciliation, and there will still be no budget.
“I think how the general assembly gets there is their job; it’s our job to tell them what we need and to advocate for adequate funding for those services,” Gardenhire said. “The longer this budget impasse goes along, you have political leadership which are engaged in an ideological war, and in the middle of the crossfire, real people are being affected.”