|
February
2004
On
Monday, February 9, the National Organizations Responding to AIDS
(NORA) coalition, for which AIDS Action serves as the convener,
held its monthly meeting. The focus for this month’s meeting was
“Community Perspectives on the 2005 Reauthorization of the CARE
Act.” Pat Bass, chair of the CAEAR Coalition, and Dr. Marsha Martin,
executive director of AIDS Action, were the featured speakers.
Ms. Bass opened the presentation by providing the coalition with
an overview of the current political landscape and how it relates
to the CARE Act. Given that there is a Republican White House
and a Republican-led Congress, the politics and processes of reauthorization
will be quite different from what they were in 2000. Therefore,
the community will need to commit itself to establishing new partnerships
and making reauthorization a bipartisan effort, as it did in 2000
when the White House was headed by a Democrat and the Congress
by Republicans.
In the spirit of such co-operation, Ms. Bass shared, CAEAR is
partnering with AIDS Action on a joint reauthorization effort.
The two organizations will be working collaboratively to ensure
that the CARE Act is reauthorized, and that the reauthorized CARE
Act is, as much as possible, a reflection of the real needs of
people living with HIV and the public and community organizations
that serve them.
Ms. Bass continued by laying out what CAEAR believes will be some
of the key issues for this reauthorization. They include distribution
of funding; local control and the role of the planning councils;
quality management; access to and maintenance of care; and funding
for women, infants, children, and youth. She identified some of
the key challenges for 2005 as widening gaps in the health care
system; confusion about the CARE Act’s role in the public health
system; the heightened profile of the global epidemic; and financing
and funding formulas.
Dr. Martin’s portion of the presentation echoed many of the same
themes as Ms. Bass. She too stressed the importance of community
collaboration and cooperation, adding that AIDS Action and CAEAR
are hoping to add the Human Rights Campaign (HRC) to the collaboration
on some of their reauthorization efforts. Dr. Martin then focused
her remarks on the policies of HRSA – the Health Resources and
Services Administration – and where HRSA is in terms of their
work on reauthorization. She explained that, because the CARE
Act, which is housed in the HIV/AIDS Bureau, represents $2 billion
of HRSA’s $6 billion budget, the agency is eager to keep the program
running. In terms of changes for 2005, HRSA seems to be focused
on the implementation of the amendments added to the CARE Act
in 2000 (many of whose goals have not yet been met) and the integration
of the findings of the two Institute of Medicine (IOM) studies
that were commissioned as a result of the 2000 reauthorization.
The first of these studies, which was released in late 2003, focused
on the implications of HIV surveillance for formula allocations
and local planning. The second, which is slated to be released
in the next two months, focuses on the public financing and delivery
of HIV care.
Dr. Martin also mentioned that one particular area of concern
is the implementation of the CDC’s new HIV prevention initiative,
Advancing HIV Prevention (AHP), and its implications for care
and treatment. If AHP were to be effectively implemented, there
could be a dramatic rise in the number of people seeking services
through the CARE Act, given that one of its primary goals is encouraging
individuals to know their HIV status (so that if they are HIV
positive, they can seek appropriate services). Yet there is little
indication that the Administration is committed to increasing
funding to enable HRSA to meet the needs of those whom they already
serve, let alone this new population. An increase in the number
of people seeking care would have implications across the currently
under-funded CARE Act, creating a greater need for its services,
including primary medical services, such as the AIDS Drug Assistance
Program (ADAP); case management services; housing support; mental
health and substance abuse services; and emergency financial services.
It is unclear at this time how AHP may effect reauthorization,
but it is certainly something that will need to be monitored.
|
