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May 2004 On Monday, May 10, the National Organizations Responding to AIDS (NORA) coalition, for which AIDS Action serves as the convener, held its monthly meeting. The meeting featured two presentations. The first was an update on the status of health disparities legislation from Aranthan S. Jones, Senior Health Policy Advisor to Congresswoman Donna Christian-Christiansen (D-VI) and the Congressional Black Caucus Health Braintrust. The second offered an overview of the Community Health Centers and their role in delivering care to HIV positive people by Craig Kennedy and Lisa Cox of the National Association of Community Health Centers. During his presentation Mr. Jones outlined two pieces of proposed legislation to minimize health disparities, a problem of particular concern to NORA members because HIV continues to have a disproportionate impact on communities who have traditionally been unable to access heath care services. However, he opened by providing coalition members with some historical background. According to Mr. Jones, racial and ethnic health disparities first emerged as an issue in an 1899 publication by W.E.B. DuBois. However, the emergence of “Jim Crow” (laws that mandated segregation and defined African Americans as inferior to whites) put an end to discussion about disparities until the mid-1960s. Passed in 1964, the historical Civil Rights Act brought attention to a number of inequities—including access to heath care. The passage of this monumental legislation was followed in 1965 by the creation of Medicaid and Medicare, which led to the desegregation of health care institutions. Then, in 1985, Secretary of Health and Human Services Margaret Heckler released Report of the Secretary's Task Force on Black and Minority Health, which led to the creation of the Office of Minority Health at the Department of Health and Human Services. However, Mr. Jones noted, despite this progress, racial and ethnic health disparities are still a grave problem the United States. In an attempt to address this crisis, there are currently two bills pending in Congress “The Healthcare Equality and Accountability Act” (H.R. 3459, S. 1833), which is sponsored by Congressman Elijah Cummings (D-MD) in the House and Senator Tom Daschle (D-ND) in the Senate, and “Closing the Health Care Gap Act of 2004” (S. 2217), which is sponsored by Senator Bill Frist (R-TN). While both bills look at addressing the question of health disparities, Mr. Jones believes that H.R. 3459/S.1833 does a better job of considering the varying levels of disparity that exist for different groups while it also acknowledges that health disparity is both a civil rights issue and an issue of adequate public health infrastructure. In addition, this bill contains provisions that specifically address the HIV epidemic within communities of color in the U.S. Building on the successes of the Minority HIV/AIDS Initiative, this legislation includes provisions for increased funding and capacity building assistance so that communities can continue to implement models and interventions to reduce the rates of new HIV infections and help people living with HIV access medical care. Mr. Jones was followed by Craig Kennedy and Lisa Cox of the National Association of Community Health Centers, who provided NORA members with a brief overview of the Community Health Centers (CHCs) system and the ways in which health centers are working to provide care for people living with HIV. CHCs provide primary health care services in medically under-served areas throughout the U.S. They are funded through a federal grant program authorized by Section 330 of the Public Health Service Act. CHCs currently serve 15 million individuals through 1,000 CHCs at 4,500 sites. Both Mr. Kennedy and Ms. Cox indicated that CHCs have a long history of providing much-needed medical care to many HIV positive people. In 2002 alone, CHCs provided 317,699 HIV-related medical visits and 312,000 HIV antibody tests, Ms. Cox stated. It is also worth noting that in addition to receiving funding from the Bureau of Primary Care at the Health Resources and Services Administration (HRSA), many CHCs are also funded through the Ryan White CARE Act to provide services for people living with HIV. In fact, 34% of grantees funded through Title III of the CARE Act are CHCs. In addition to the presentation by guest speakers, NORA members also got a first look at the newly available Fiscal Year 2005 HIV/AIDS Appropriations Recommendations, the coalition’s annual examination of the federally-funded HIV/AIDS portfolio and the impact of the President’s proposed funding levels for the upcoming fiscal year. NORA members were on the Hill on Wednesday, May 12, to deliver copies of the book to all Members of Congress. In the coming days, AIDS Action will provide its member organizations with a copy of this new publication. |
