June is proving to be a busy month for AIDS activists across the state who are mobilizing to block what they say would be devastating cuts to California's system of care for people living with HIV and AIDS.

Due to the faltering economy, both lawmakers in Sacramento and bureaucrats at the city level are trying to balance budgets battered by ballooning deficits. Everything from housing and medical treatment to access to drugs and prevention services are on the chopping block.

"My message to people is that they must be politically engaged," said AIDS Housing Alliance founder and director Brian Basinger. "I am concerned about the impact on our most vulnerable people. I want to make sure organizations do not go under water and are put at risk. I want to make sure they are looking at budget cuts from the client level as well."

Friday, June 5, AIDS advocates and patients will be at the state Capitol appealing to the Legislature's Budget Conference Committee as the lawmakers vote on whether to accept Governor Arnold Schwarzenegger's proposed health cuts. The governor's AIDS cuts have been in flux, with the latest proposal cutting $67.8 million from state HIV programs and asking for an additional $12.3 million cut in the AIDS Drug Assistance Program.

ADAP's total budget is $362 million, with the general fund contribution from the state accounting for $96 million. But its federal allocations for ADAP are based on how much California budgets toward the program, so any reduction in state dollars would mean less money for ADAP from national revenue sources.

"As, or more, significantly the cuts could jeopardize the state's receipt of really significant amounts of federal funding," said Jeff Hall, the San Francisco AIDS Foundation's legislative affairs director. "The governor has proposed cuts in surveillance, which is how you track HIV and AIDS cases in the state. That is required for eligibility for Ryan White grants, which is both hugely significant for San Francisco and the state."

Faced with a $24 billion deficit, the governor told lawmakers during a rare joint session Tuesday that "California's day of reckoning is here" and that the "dramatic" spending cuts he is seeking "represent much more than the hard decisions necessary to balance our budget. They represent the transformation of what services Sacramento can provide and how those services are delivered."

Both the full Senate and Assembly are expected to take up the revised budget in mid-June. To pressure the lawmakers to reject the AIDS cuts, service providers and advocacy groups are holding a rally from 1:30 to 3 p.m. Wednesday, June 10 on the steps to the Capitol. Numerous San Francisco groups plan to bus people up to Sacramento that day to take part.

Anne Donnelly of Project Inform said AIDS advocates are counting on the four-person LGBT Legislative Caucus to fight the cuts to HIV programs and services.

"Now is the time for the caucus to step to the plate because this is really serious," she said. "We are counting on them to advocate on behalf of people living with HIV and AIDS."

Donnelly said the state must find ways to increase revenues and that many organizations are willing to work with lawmakers to find a solution.

"We can not be making these cuts to all the health and education programs.  We as advocates know the level of deficit the state is in is unparalleled," she said. "We realize we may have to take cuts to our programs. But let's make sure they are minimized and that we continue to deliver the essential services to those people living with HIV and those also at risk."

Sheila Kuehl, an out lesbian who served in the state Senate, said several of her former colleagues have reached out to her for advice. She urged legislators to find a compromise where 65 percent comes in cuts and the other 35 percent comes from increased or new revenues.

"It seems to me that is very reasonable but still requires horrible cuts. But less horrible is good," said Kuehl, adding that from her point of view, a solution made up of only cuts "is not the way to go. The cuts would have to be so deep that California would be reeling from them."

While the governor continues to insist on only cuts, out state Senator Mark Leno (D-San Francisco) believes there are other options the Legislature can pursue without needing a two-thirds vote to be approved.

"There are fees that could be raised by a simple majority vote," said Leno, who sits on the budget conference committee and chairs the LGBT caucus. "My hope is that through the public hearings on all the cuts proposed, it will be realized doing so would destroy the state of California."

SF budget

What the state ultimately decides to do will impact San Francisco's health care budget. Mayor Gavin Newsom released his revised $6.6 billion budget at a ceremony inside his City Hall office Monday, June 1. It now goes to the Board of Supervisors, which must pass a balanced budget by July 1.

Newsom slashed the city's general fund support to the Department of Public Health by 24 percent or close to $97 million. While a huge hit to the department's budget, it was less than the $140 million in general fund dollars the health commission had suggested be cut.

Yet in total funding from all revenue sources the city's spending on AIDS and prevention services will actually rise by 6 percent next year under Newsom's proposal, to a total near $59 million.

Newsom is also proposing that the health department's community programs create a centralized business office in order to consolidate program managers from various sections, including HIV Health Services and HIV Prevention Services, into one location. The new central office would oversee contract development, contract oversight, compliance and monitoring functions for an estimated savings of nearly $550,000.

"This is a living and working document. I recognize it is not perfect but, under the circumstances, it is as perfect as I could make it," said Newsom.

As for the health cuts, the mayor acknowledged that they are "a lot but by no means devastating. We have not destroyed our social services safety net."

Newsom told the Bay Area Reporter that his budget does not take into account the governor's proposed AIDS cuts and that his budget staff and health officials were still analyzing what the impact would be to the city. He did set aside $25 million to help defray some of the cuts the city will incur due to state lawmakers' actions.

"I will conclude with uncertainty at the state level. That will drastically change what we are talking about," Newsom said, adding that "with the state taking its action there may be catastrophic cuts."

Openly gay Supervisor David Campos, who sits on the board's budget committee, said he is especially concerned about how the budget will impact community-based organizations.

"The devil is in the details," he said. "In terms of the impacts to public health and public safety, I want to make sure their budgets are protected."

Jim Illig, the health commission's openly gay president, said he was "absolutely" pleasantly surprised by the mayor's decision.

"What we were counting on him to do was find the resources elsewhere so the cut at public health was not as bad as it was looking," said Illig as he reviewed the budget document Monday afternoon. "Still, it is a quarter from our general fund. But it is a lot less than what we thought he was going to take."

But Illig's reaction was tempered by the fact the mayor's budget was "just the first shoe to drop" and that the "next one will be the state cuts."

"Everyone is hunkering down for what is to come," said Illig, who works at Project Open Hand. "We can't allow the state to balance its budget on the backs of the vulnerable populations we serve."

In terms of the ADAP cuts, Illig was especially alarmed at the prospect of the state either cutting off people's access to the drugs they need to survive or limiting how many people can be in the program.

"Either way people are going to be in dire straits. There is no way we can let [the governor] get away with that," he said.

For those concerned about the state's AIDS cuts, letters urging state lawmakers to reject them should be sent to the chair of the budget conference committee by tomorrow morning (Friday, June 5). The address is the Honorable Noreen Evans, Chair, Conference Committee on Budget, PO Box 942849, Sacramento, CA 94249-0007.

The AIDS Housing Alliance has lined up at least two busses through Moms Pharmacy and Project Inform for the rally next week. To reserve a seat, e-mail Basinger at mailto:info@ahasf.org.

Several other local AIDS agencies plan to also rent buses to drive people to the June 10 rally but sign up info was not available at press time. Those interested in going to Sacramento should either call or check the Web sites of the San Francisco AIDS Foundation, Stop AIDS Project, and the API Wellness Center.