Illinois State HIV/AIDS Funding – Not out of the woods yet? Get ready for over $2 million in budget cuts.

Many HIV advocates jumped for joy on July 30 when Illinois Governor Pat Quinn announced that he had restored most of the state’s HIV budget cuts.  And when I say most, I mean 97.4 percent!  In a year when lawmakers entertained budget cuts as deep as 50 percent, this was welcome news.  But budget cuts are coming, and YOU need to take action to make sure cuts are fair.

The good news spread far and wide, with news articles in Windy City Times, Chicago Free Press (link coming soon), Towleroad, Bilerco Project, Ameriqueer, and CDC’s National Prevention Information Network, among others.  It’s been a great lift for Illinois communities in desperate need of HIV prevention, care, and housing services.  The Governor’s decision also produced great national visibility for the Quinn Administration among some of the country’s most influential GLBT bloggers.

But don’t pack up your protest signs just yet.  Let’s look at the fine print and see what’s going on with the state’s HIV budget. 

Oh, and you better be prepared to pick up the phone and TAKE ACTION.  Take a second to read this post by our new hero, Phil Reese over at Bilerco.  Yes, my pretties, it really does sound like the Illinois Department of Public Health is considering cutting HIV prevention funding to the City of Chicago.

The Illinois Department of Public Health funds essential HIV services from three primary budget categories.  Here they are, with their state fiscal year (FY) 2009 and 2010 funding amounts:

When we look at all the funding lines together, the governor’s final allocation trimmed just around three percent of the state’s total HIV-related budget.  The largest funding reduction, $570,000, lowered the annual allocation for the state’s “HIV lump sum,” a critically important part of the state’s response to HIV/AIDS.  Let’s look more closely and see where the lumps really are.  

The HIV lump sum is used to support many of the state’s general HIV/AIDS funding needs, including the HIV prevention, housing, care, IDPH staffing and administration, and other essential programs.  Most importantly, it funds the AIDS Drug Assistance Program (ADAP), which provides no-cost HIV medications to low-income people living with HIV who have no other means to obtain their lifesaving HIV medications.  In FY 2009, IDPH spent $3.1 million on ADAP to supplement $27.3 million from the Feds. 

Table 2 breaks out FY 09 lump spending on ADAP, grants to community-based programs for services, and other spending (mainly IDPH administration and over $1 million that was held back for fiscal emergency). 

ADAP is projected to need an additional $1.67 million in FY 2010, a 12 percent increase.  This is in line with growth in the past several years.  IDPH has to take the money from somewhere, and the easiest target is grants for community-based HIV-related services.

The AIDS Foundation of Chicago's (AFC) budget-crunchers estimate that $11.2-$11.7 million could be available for grants next year, a cut of 13-17% ($1.7-$2.2 million).  The difference depends on how much IDPH has to hold back for reserves and its own programs and administration.  Remember, $570,000 was cut from the overall lump sum in the current year as compared to FY09. 

OK… stay with me… stand up and stretch like Richard Simmons. Budgets may be boring, but they’re important, people! 

So are community-based providers going to see a 13-17% funding cut?  What’s IDPH likely to cut?  Most importantly, what shouldn’t they cut?  Is there an alternative?

IDPH has almost complete discretion in the allocation of grant funding.  At this point, we have no idea how they are planning to use the funding, and we probably won’t know until at least late August.  Well, we have some suggestions.

1.    Cut the reserve.  Last year, IDPH held back almost 5 percent of total funding for fiscal emergencies, or over $1 million.  Well, we’re in a fiscal emergency now.  $500,000 should be sufficient to cover any unanticipated ADAP growth.  IDPH should put money on the streets for HIV services, not squirrel it away for rainy days.  ‘Cause let me tell you—it’s a monsoon out there.  Cutting the reserve would put over half a million in additional dollars back into grants.

2.    Cut IDPH’s take.  IDPH set aside $1.3 million for programs and administration.  Yes, this spending is essential – but we all have to share the pain. IDPH should share in across-the-board cuts.  (Excluding ADAP, of course)

3.    Make across-the-board-cuts (with a little tinkering).  In a down year, the fairest way to make cuts is to cut everyone evenly.  Of course, IDPH should always consider past performance in determining grant renewals to insure funded projects leverage the biggest impact for the people of Illinois.  Given its vital role helping low-income people with HIV, ADAP should be excluded from these across-the-board cuts. 

4.    Here’s the tinkering we suggest:  IDPH should continue funding to the greatest extent possible in three key areas. 

Maintain evidence-based, HIV prevention targeted to the most at-risk groups and areas: An estimated 3,000 people are infected each year with HIV in Illinois, and over two-thirds are people of color.  Two-thirds of those new HIV cases are in Chicago. 

IDPH must maintain science-based, prevention and testing programs that work and are targeted by risk group and geography.  This includes programs funded through the Regional Implementation Groups (RIGs, including direct state funding to the City of Chicago) and other science-based programs, such as harm reduction for injection drug users and HIV testing targeted to gay men of all races, who are hardest-hit by the epidemic.

Prioritize housing for people with HIV:  In the last several years, IDPH has invested several million dollars in statewide housing services for HIV-positive people who might otherwise become homeless.  We know housing is healthcare for people with HIV.  This funding should be cut as little as possible to prevent destabilizing disruptions in healthcare that will lead to costly and debilitating illnesses.

Fund direct care services: Low-income people with HIV are in great need of services, from mental health and substance abuse to transportation.  Direct care must be prioritized. 

4. Tap into unused funds:  $1.4 million from the Quality of Life lottery is sitting in the state treasury because the oversight board has not yet been appointed.  The Governor should immediately appoint that board.  Over $1 million is sitting in the African American HIV/AIDS Response Fund, tied up over allegations of misspending by an agency.  IDPH should immediately take action to release this money.  These funds, if released, could completely fill the budget hole.

Yes, IDPH has some serious decisions to make and so do we, as members of the HIV advocacy community. 

There are two long-term solutions to this mess.  First, the only solution to the long-term state budget problems is to find new revenue.  Are we going to work closely with state leaders to ensure they understand the impact of the state’s structural deficit and give serious consideration to a lasting tax reform?  Yes we can!

Secondly, we must raise our voices in support of healthcare reform, which would transform the fight against HIV/AIDS in America, making possible long-term reductions in deaths and fewer infections.  Are we going to speak out that inadequate health service options are no longer acceptable?  Yes we can!

AND HERE'S THE TAKE ACTION, courtesy of Phil Reese at Bilerco and our other hero, State Rep. Greg Harris (D-Chicago):

"Rep. Greg Harris, in conversation with me this morning, suggested that everyone with a phone or computer try to contact Dr. Damon Arnold, director of the Illinois Department of Public Health at 217-782-4977, and Governor Quinn at 217-782-6830 or 312-814-2121.

"Encourage everyone you know in Illinois to get on the phone today and tell the governor to maintain funding in the most crucial areas... Do what you can to help us pull out all of the stops on this crisis!"

When you call, leave this message: "Governor Quinn, as you make HIV funding decisions, please maintain funding for evidence-based prevention in Chicago and elsewhere, housing and direct care for people with HIV."

John Peller, AFC’s Director of Government Relations, champions sound HIV/AIDS policy and law among Illinois lawmakers at the local, state, and federal levels of government.