Mayor's budget to add $3M for SF HIV services

  • by Matthew S. Bajko, Assistant Editor
  • Thursday May 26, 2022
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San Francisco Mayor London Breed has proposed $3 million in her proposed budget for HIV/AIDS services, but advocates are seeking $10.5 million. Photo: Steven Underhill
San Francisco Mayor London Breed has proposed $3 million in her proposed budget for HIV/AIDS services, but advocates are seeking $10.5 million. Photo: Steven Underhill

San Francisco Mayor London Breed will include a $3 million increase for HIV services in her two-year budget she is set to release June 1. The funding request has the support of the city's two gay members of the Board of Supervisors, which will make its own adjustments to the budget before adopting it by July 1.

The mayor's funding proposal is far short, however, of the $10.5 million in new city funding that a coalition of HIV advocates and service providers is seeking as part of its HIV Community Budget Proposal. Part of their ask was for between $2 to $3 million to maintain current HIV prevention services in the city.

The coalition is also calling on city leaders to backfill any cuts to San Francisco's allocation in its Ryan White Federal CARE grant to fund HIV services, currently at about $15 million. The city has yet to be told if it will see a reduction in the federal HIV funds this year.

Earlier this month Ashley Groffenberger, Breed's budget director, had said at a supervisors committee hearing focused on HIV funding that her office wasn't expecting a cut in the CARE grant. Should there be one, Groffenberger said the mayor would look to backfill the cut through the annual budget process.

New HIV diagnoses in San Francisco declined 22% from 168 diagnoses in 2019 to 131 diagnoses in 2020. The city is working to reach its goal of zero new HIV infections and currently spends $28.7 million on HIV prevention.

The health department is currently in negotiations with various service providers set to receive $8 million of that funding to create health access points focused on specific patient communities, such as gay and bisexual men or transgender individuals. But a number of longstanding HIV service providers have expressed concerns about the health department's new approach and how it will severely impact their already strained budgets and ability to continue providing services.

Breed's request for the additional $3 million is aimed at addressing the loss of funding certain agencies will receive. According to the mayor's office, the health department will use the funding to allocate new resources to populations disproportionately impacted by HIV while ensuring there is stable funding for existing initiatives and services.

"San Francisco has been a national leader in our response to the HIV/AIDS epidemic and in our efforts to get to zero new infections, with a large part of that success coming from our continued investments in preventing new infections," stated Breed. "We have seen, especially during the COVID pandemic, how critical long-term investments in public health are for the well-being of our communities. This investment will allow us to keep moving in the right direction and strengthen our support for those living with HIV/AIDS."

At their May 17 meeting the supervisors adopted a resolution calling on the mayor to include the HIV advocates' funding request in her budget. District 9 Supervisor Hillary Ronen, chair of the Budget & Appropriations Committee, co-authored it with out Supervisors Rafael Mandelman (District 8) and Matt Dorsey (District 6).

"I can say this is a high priority for me, Supervisor Mandelman and Supervisor Ronen," Dorsey, who is living with HIV, told the Bay Area Reporter. "San Francisco has a storied history on HIV, AIDS that I think includes our groundbreaking public health and community-based services response, which has saved lives and slowed the rate of HIV transmission. I think it also created a model for how our city and others have handled public health challenges up to and including COVID-19."

Mandelman told the B.A.R. he "was glad" the mayor included the $3 million in her budget. He added that he thinks "there is more work for the board to do, but I think the mayor took on an important piece, which was addressing the problem around prevention dollars and the defunding of organizations doing important work."

Both Mandelman and Dorsey told the B.A.R. they expect the supervisors will be able to fund two of the other funding requests being sought by HIV service providers. One is for roughly $500,000 to cover the cost of doing business for those service providers with Ryan White funded contracts, and the other is for $3 million in housing subsidies for people living with HIV.

"There is still a lot that needs to happen, and I hope what can happen on the board side this year is the cost of business adjustments and the housing subsidies," said Mandelman.

Dorsey said he expects the supervisors to also consider the rest of the HIV budget proposal from the service providers. A $2 million allocation would be evenly split between mental health services for long-term survivors of HIV and AIDS and intensive case management services for those living with HIV.

Between $1 to $2 million would go toward safer consumption sites where drug users could access services to help them become clean and prevent them from overdosing. The city purchased a site in the Tenderloin to potentially use as a supervised drug consumption facility, but it has yet to open. A linkage center opened in the Tenderloin earlier this year to help drug users access services and get tested for HIV, STDs, and COVID and its lease was just extended for six months.

AIDS Legal Referral Panel Executive Director Bill Hirsh, who co-chairs the city's HIV/AIDS Provider Network, told the B.A.R. this week he is still hopeful of seeing the mayor's budget include the total funding request.

"I know members of the board and the mayor's office are looking at this issue, and I know it's a priority for Mandelman and Ronen and Dorsey," said Hirsh. "I am hopeful."

He added that the network's hope "is to try to get as much of this budget proposal funded in the mayor's budget because it is going to be a very heavy lift to get these things funded through the add back process. I will also note the city has a historic commitment to the safety net services for people living with, and at risk for, HIV."

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