The Pennsylvania legislature finally agreed upon a state budget earlier this month, more than 100 days after the start of the fiscal year. Although the budget impasse has created a nightmare for local social-service agencies, many of whom went months without most of their federal, state or city funding, monies for HIV/AIDS programs remained mostly level, aside from one major cut.
The state budget category known as AIDS Programs dropped from its previous level of $10 million to $7.75 million, a nearly 25-percent reduction.
This category of funding goes to support a statewide comprehensive prevention program that includes HIV-prevention community planning; HIV counseling, testing and referral services; partner services for the individual with HIV/AIDS who has a sex or needle-sharing partner; health education and risk-reduction activities; and public-information programs.
Ken McGarvey, prevention manager for the state’s Division of HIV/AIDS, explained that the state undergoes a request-approval process to determine how much each individual health department will receive in each of the funding programs and also takes into account HIV epidemiology in each area and other federal funding coming in.
Jeff Moran, spokesperson for Philadelphia’s Department of Health, said the agency was unsure at this time how much of the cut the city would see.
Jane Shull, executive director of Philadelphia FIGHT, said her organization was “certainly not happy” with the cut but, at this time, was still evaluating if and how the funding decrease would impact FIGHT.
Matt Teter, executive director of Calcutta House, said his organization also is investigating whether its funding would be impacted by this cut but said he didn’t think there would be a measurable effect.
The budget also reflected a drop in Ryan White Part B funding from approximately $28 million to $15.6 million.
Joe Pease, director of the state’s Division of HIV/AIDS, said that in fiscal year 2007, the state did not spend all of the funding allotted to it through the federal Ryan White program — which funds AIDS Drug Assistance Programs and other outlets that seek to provide care to low-income people with HIV/AIDS. The grant awards, which are dispersed to states by the Health Resources and Services Administration, are made prior to the end of the fiscal year, so the final numbers for fiscal year 2007 were not tabulated by the time the next year’s money was released, leading to the penalization for the current fiscal year.
The Department of Public Welfare, which oversees the state’s Ryan White funding, receives rebates from drug manufacturers on a monthly basis and Pease said that year had a record number of rebate dollars.
“Ryan White is the payer of last resort; we can’t get to the Ryan White dollars until we spend down all of the other money,” Pease said. “So at the end of the year we were caught short.”
Pease said the decrease will not have a negative impact on those who receive assistance from any Ryan White-funded programs and that the department has taken steps — such as including more drugs on its list of available medications and raising income levels to allow more people to qualify — to spend all of the money, which it accomplished in fiscal year 2008.
“There is no waiting list of the Drug-Assistance Program and no one is being denied any services because of this,” Pease said. “They did make some adjustments to help spend down the money so there won’t be any further penalties.”
Funding for all other initiatives either remained level or saw increases.
Administrative and operational funding for AIDS Health Education remained at last fiscal year’s level of $4.1 million, as did the general funding for the program at $1.6 million. AIDS Health Education funds prevention programs run by health departments throughout the state.
Administrative and operational funding for HIV Care also continued at the previous $3.6 million, with HIV Care general funding seeing an increase from $10.8 million to $12 million.
This funding is dispersed to health departments throughout the state who then release the monies to community-based organizations.
The state allocated about $1.4 million for HIV/AIDS Surveillance, the same amount as last year, and slightly boosted funding for Housing for People with AIDS from $1,868,000 to $1,880,000.
Kevin Burns, executive director of ActionAIDS, said he was pleased the budget cuts were not widespread, adding he’s even more satisfied that the impasse has come to an end.
“We did have some gains in some places, which is good,” Burns said. “I’m relieved, because it could’ve been cut a lot more; it seems like good news but I think the even bigger thing right now is that we finally have a budget.”
The city announced in July that it would stop paying its vendors until the state approved its budget — vendors who include local social-service agencies like HIV/AIDS nonprofits, who receive federal, state and city funding, which is often all funneled through the city. Some organizations, like Calcutta House, announced in the summer that it would have to delay payments to its own vendors until the funding was restored.
Gov. Rendell announced this week that approximately $3 billion in delayed payments had thus far been dispersed and that the state is “expediting those remaining payments.”
Teter said Calcutta House has so far received $50,000 in back payments and is still awaiting more than $100,000 from the city, which can’t disperse the money until it’s paid by the state.
Schull said FIGHT has received some federal money but as of yet has not received any back payments from the state.
“We put in invoices in June that didn’t process for seven or eight weeks, so the last time we were paid was May, and it’s now the middle of October,” she said.
Burns said he has been closely following the progress of House Bill 1952, which would authorize the legislature to continue funding nonprofit and social-service agencies at the same level as the previous fiscal year during budget negotiations. The bill is currently in the State Government Committee.
“What I’m concerned about now is preventing this from happening again,” he said. “This bill says that with the absence of a budget, the state is required to continue level-funding nonprofits and social-service agencies until the budget issues are resolved. This will be a safety net, because I don’t know what would happen if this were to happen two years in a row.”
Also included in the budget was a $1.1-million cut — 10 percent — in funding for the Pennsylvania Human Relations Commission, which investigates discrimination complaints throughout the state.
Human Relations Commission chair Steve Glassman said the decrease is not as drastic as he’d anticipated but still puts the agency in a precarious situation.
“The funding is not as low as the Senate bill projected it to be, but it is still significantly reduced from last year and the year before,” he said.
The agency has already laid off 22 employees and is currently assessing whether or not more layoffs are necessary.
Glassman noted that the fewer employees the organization has, the less likely it is to complete investigations in a timely manner, which he said could also impact its federal funding, which is predicated on the number of completed cases.