Budget Cuts Affect AIDS/HIV Agencies in Philadelphia and Pennsylvania

Social services agencies in Philadelphia and Pennsylvania have had a rough 2009.

The city announced in July that it would stop paying its vendors until the state approved the Philadelphia 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 were forced to delay payments to their vendors until the funding was restored.

Meanwhile, the legislation was not only in limbo with the city budget, but the state budget as well. Only 100 days past the start of the state fiscal year, the Pennsylvania legislature finally agreed upon a budget. The budget resolution brings a wave of relief to social service agencies across the state went over 3 months without proper funding.

Sadly, while the budget was passed - some agencies may suffer a reduction in services due to the economic reality of a limited and over-taxed state budget.

The state budget category for AIDS Programs dropped from its previous level of $10 million to a little under $7.75 million, a nearly quarter drop in funds. This funding supports statewide comprehensive prevention programs that include HIV-prevention planning, HIV counseling, testing and referral services, health education, and public-information programs. State officials were concerned, but felt that this was not a doomsday scenario.

"There is less money to be passed around, yes... But, the state does a specific approval process to determine how much every individual health department will receive in each of the funding programs," said Ken McGarvey, the prevention manager for the state's division of HIV/AIDS. "Those departments with the greatest needs will still get the greatest funding. The state also takes into account HIV epidemiology in each area, and what type of federal funding is expected as well."

McGarvey acknowledged the funding decrease is "disappointing," but believed that there were alternatives.

"Hopefully by creating partnerships between the state, federal government, and private and public institutions - we can make sure that all the bases are covered."

"We are still evaluating how the new budget will affect our programs," said Jane Shull, executive director of Philadelphia FIGHT. "I think everyone in the social-service community is saddened, but I don't think there is anything that can be done about the situation."

The budget also reflected a drop in Ryan White Part B funding from approximately $28 million to $15.6 million. Part B of the Ryan White HIV/AIDS Treatment Modernization Act provides grants to all 50 States and territories. Part B grants include a base grant, the AIDS Drug Assistance Program (ADAP) award, ADAP supplemental grants and grants to States for Emerging Communities - those reporting between 500 and 999 cumulative
reported AIDS cases over the most recent 5 years. The Department of Public Welfare, which oversees the state's Ryan White funding, receives rebates from drug manufacturers on a monthly basis and last 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," said Joe Pease, director of the state's Division of HIV/AIDS. "In fiscal year 2007, the state didn't spend all of the funding allotted to it through the program. 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."

Pease said this significant decrease will not have a serious impact on Pennsylvanians who receive assistance from Ryan White-funded programs.

On the flipside, some funding remained level or saw positive increases. With administration and operational funding staying steady. Operational and administrative funding for AIDS Health Education remained at $4 million. Administrative and operational funding for HIV The state also allocated $1.4 million for HIV/AIDS Surveillance, the same amount as last year, and increased funding for Housing for People with AIDS by less than $20,000.

"I think this isn't shocking to many of us," said Shull of the budget situation. "WE will all need to work together and come up with creative and positive ways to make sure all of our community's needs are met."