HIV cuts concern supes
by James Patterson
In a packed City Hall committee room, activists, caregivers, and people living with HIV, who ranged in age from 19 to 68, testified their services, health care, and lives would be endangered if $5.3 million in funding cuts for HIV services are not restored by Mayor Ed Lee.
Gay Supervisors Scott Wiener and David Campos held a Budget and Finance Committee hearing March 27 to discuss effects of reduced federal funding to the city's HIV services community for fiscal 2013-2014. Supervisors John Avalos, London Breed, Eric Mar, and Mark Farrell also attended.
In opening remarks, Wiener called reductions of an estimated $1.88 million from Centers for Disease Control prevention funds and an estimated $3.42 million in funds from the Ryan White HIV/AIDS Treatment Extension Act, "extreme and shortsighted." San Francisco's response to HIV/AIDS is a "model for the world," he added.
Campos said the city needed to act to "protect the safety net for the city's most vulnerable people." San Francisco has an obligation to restore the cuts, he said.
"If people can't get lifesaving services, it will result in greater costs to the city," Campos said. "People will die if services are not available."
Health Director Barbara Garcia testified the cuts, if not backfilled, would reduce services and programs. She expressed concern the federal cuts would set back the city's progress on reducing HIV transmissions.
Department of Public Health Chief Financial Officer Greg Wagner said that the CDC directed HIV prevention funds to other states because infections in San Francisco were down.
"The CDC cuts punish San Francisco for its success," in HIV prevention and treatment, Wiener interjected.
An additional burden to the city's HIV services community, Wagner said, would come from the sequester, an across-the-board budget reduction in federal programs due to Washington, D.C.'s failure to agree on spending cuts to reduce the federal deficit.
In previous years, the city has backfilled federal Ryan White reductions, but this year also includes sequester cuts, increasing the amount the city would need to provide.
Wagner testified DPH estimates the sequester cuts will reduce HIV services and prevention by $1.3 million per year. In current form sequester is a 10-year plan. If it is fully implemented, city HIV services and prevention could suffer a $13 million reduction, Wagner later confirmed in a phone call.
"It would be a significant reduction," Wagner said. He could not say if the city could restore a reduction of that magnitude.
Mike Smith, executive director of AIDS Emergency Fund and president of HIV/AIDS Provider Network, a coalition of health providers, said new infections were down, but he had a grim message: "Reduction of CDC funds and a reduction of the city's HIV services would result in higher infections."
"We work hard to get people safe, to know their status, to educate them on prevention and it frustrates me we will have more infections as a result of these cuts," Wiener said.
Fear of health reversals
During public comment over 50 people, some nonprofit executives and some living with HIV/AIDS, spoke passionately for the city to backfill federal cuts in HIV services.
The supervisors listened as people testified their viral loads were undetectable due to treatment services. But many expressed fear of health reversals if treatment services were reduced or eliminated.
Former hotel worker Ron Hernandez, 43 and a San Francisco resident for nearly 20 years, is a client with Asian and Pacific Islander Wellness Center. He testified after being diagnosed HIV-positive he lost his job and health insurance.
"San Francisco's safety net saved me when I lost everything and when everyone gave up on me," Hernandez said. "What will happen to me and all the people living with HIV in San Francisco if that safety net is taken away?"
Retired hair stylist David Arcel, 53, is a client of the Tenderloin Area Center for Excellence. He said he has been living with HIV since 1984 and also has depression, panic disorder, and agoraphobia.
Arcel said TACE provides him with a variety of services including health education, mental health care, medical attention, food, and a community. He said his viral load was undetectable but he worries about cuts in services.
"Stress affects my viral load and my T-cell count and thinking about trying to do all of this by myself is terrifying," he told the supervisors. "It's like a 500-pound weight pressing down on me."
Wiener and other supervisors were noticeably moved by the speakers. After comment period closed, he said he would work closely with Lee to advocate backfilling the cuts.
"It is important to keep our safety net intact," he said. Other supervisors said they also would help.
"San Francisco is a compassionate city," Avalos said. "We care for people."
In a post-hearing e-mail, Mar said, "I am supportive of doing everything we can as a city to 'backfill' the huge gaps in funding for SF's AIDS/HIV community services and health care programs. The human stories of empowerment and dignity by people living with AIDS/ HIV at the hearing were both effective and uplifting for me as a Budget Committee member."
One man, who gave his name as W. Ortega, left immediately after commenting. He told supervisors he came to San Francisco three years ago to die. He said he would not be alive today without the city's HIV services. He left them with a stark message.
"Our lives are in your hands," he said.