State’s AIDS drug program largely safe from cuts
by Seth Hemmelgarn
[Editor's note: This article was updated late Friday.]
Governor Arnold Schwarzenegger proposed slashing funds for people with mental health issues and families with children today [Friday, May 14] in his revised budget proposal.
Hoping to plug a $19.1 billion budget gap for 2010-11, the governor called for $12.4 billion in cuts.
In announcing his cuts, Schwarzenegger said there's no more "low hanging fruit" to pick. And no medium or high hanging fruit, either.
"We have to take the ladder from the tree and shake the whole tree," he said.
But Anne Donnelly, director of health care policy for Project Inform, said the cuts, especially to Medi-Cal, are "really just an attack on the poor."
"It's just pretty outrageous," Donnelly told the Bay Area Reporter shortly after the cuts were announced.
There appeared to be some relief for people worried about the AIDS Drug Assistance Program.
Donnelly said the state ADAP took a $32.7 million adjustment, but that's mostly for administrative items, from what she and other advocates have been able to determine.
"It shouldn't affect ADAP services," said Donnelly.
However, she said, that also includes elimination of support to county jail inmates.
Large cuts have also been proposed in other parts of the budget.
“We are extremely worried about the cuts to other health care programs, Courtney Mulhern-Pearson, the San Francisco AIDS Foundation's policy and legislative associate, told the B.A.R. "We're talking about extremely limited-income people. Any cost increase results in limited access."
The reductions include $523 million from Medi-Cal.
Under Medi-Cal cuts, Donnelly said utilization controls are what she and others are most worried about.
The governor's proposal includes eliminating certain over the counter drugs, such as aspirin and cold medicine.
"That could seem minor, except we're talking about people who really have no money to support them," said Donnelly.
The proposal also includes eliminating prescriptions to six per month, except for "life-saving drugs," with no clarity about which drugs are in that category, she said.
The governor also wants to limit the number of clinician or physician visits to 10 per year.
Donnelly said another serious concern includes co-payments, such as $50 co-pays for emergency room visits.
In a conference call after Schwarzenegger’s announcement Friday, Dr. Michelle Roland, chief of the state Office of AIDS, said the news on ADAP was "very, very good."
Roland also said there’s less money included in the budget proposal for the program because there’s less need for the money. She said reasons for this include national health care reform and an increase in Ryan White Part B money, which is federal money that's distributed by the state.
However, Roland also noted the state legislative process "is a long process, it is a confusing process," and "we never really know what we’re going to be left with until we have a signed and enacted budget."
Donnelly also expressed concern to the B.A.R. that "there's been absolutely no discussion" of restoring any of the funds that were "decimated" from the state AIDS office budget last year.
Last summer, Schwarzenegger used his line-item veto power to slash $52.1 million in general fund support to AIDS programs, including totally eliminating state funding for HIV prevention and testing efforts, on top of more than $30 million lawmakers had agreed to cut from the state Office of AIDS budget.
Roland said during the conference call that there had been a vote by the Assembly budget subcommittee to restore "a number of items" that the Republican governor had cut, including funding related to prevention and testing, but "the eventual outcome is unknown."
She told people on the call to consider the remarks another state health official had made, regarding "the very dire fiscal situation and all the really extreme cuts in the rest of the budget."
Other proposals include eliminating the California Work Opportunities and Responsibility to Kids (CalWORKS), a welfare program that gives cash aid and services to eligible needy California families.
Mulhern-Pearson encouraged people to “contact your legislator and let hem know these cuts are not OK. It’s important all of us."
She said the AIDS foundation is “trying to work with other low-income health advocacy groups to do a coordinated response to these cuts.">
Openly gay Assembly Speaker John A. Perez (D-Los Angeles) said in a statement about the cuts, "With the release of the May Revise, the Legislature now knows the exact scope of the deficit we must close, and while I cannot say what the exact solution will be, I can say that the process in finding that solution will be open, honest and transparent."
Perez stated the Assembly would focus on job creation and funding services the state needs to "ensure a strong and lasting economic recovery."
He also made reference to budget negotiations that have gone on for months, making the budget overdue and requiring the state to issue IOUs.
"The Assembly will not play politics with the budget – and we will specifically not engage in the politics of extraction," Perez said in his statement. "The governor's suggestions are clearly more reflective of a hyper-partisan political agenda than in finding real solutions to our problems. Putting Californians back to work is the fundamental priority for Californians, and we do not have the luxury of another bruising summer of ideological warfare."
Openly gay Assemblyman Tom Ammiano (D-San Francisco) said in a statement that the proposed cuts "reflect the absolute disconnect of the Republican Party to the reality facing most Californians."
Referring to the millions of people in the state who are unemployed, Ammiano stated, "I find it unconscionable that the Governor has chosen to eliminate CalWORKS and drastically cut in-home care for our seniors and disabled, essentially removing the few remaining pieces of the state's social safety net."
He also stated, "Cuts alone will not solve our budget crisis and it simply defies logic that the Governor and a minority of Republican legislators prefer to starve the state of cash and eliminate basic programs rather than pass responsible revenue solutions."