Federal Budget

The Ryan White CARE Act – A Lifeline For People With HIV/AIDS

April 26, 2006

Dear Member of Congress:

The undersigned organizations are writing to urge your support for increased funding for the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act for Fiscal Year 2007.

The Ryan White CARE Act provides lifesaving and life enhancing care, treatment, and support services to hundreds of thousands of low-income, uninsured, and under-insured people living with HIV/AIDS around the country. It is the final safety net for Americans who have no other means of accessing these services and continues to serve as a model health care program

However, the CARE Act suffers from inadequate funding, leaving many states and localities unable to meet the needs of those who depend on these services. Except for modest, yet insufficient, increases for the AIDS Drug Assistance Program (ADAP), the CARE Act has been cut for the past three years. Title I has been cut by $15 million, Title II base by $9 million, Title III by $5 million, and Title IV by $2 million. Meanwhile, there are approximately 40,000 new HIV infections per year, increasing the number of people who need CARE Act-funded services.

The chronic underfunding of the CARE Act has resulted in significant barriers to accessing care, treatment, and support services. According to the National Alliance of State and Territorial AIDS Directors (NASTAD), as of March 2006, eighteen states have implemented restrictions to treatment access through their ADAP, including waiting lists in nine states. Ten states/territories are anticipating new or additional ADAP restrictions in the next year. Many localities and states have been forced to reduce care and support services funded by CARE Act Title I and Title II dollars.

We believe that the Fiscal Year 2007 appropriations process is an opportunity to change this situation and place the needs of people with HIV/AIDS as a priority for the nation. To that end, we urge your support for the following funding increases to the Ryan White CARE Act:

Title I: $184.1 million increase; $788.1 million total

CARE Act Title I funds health care and support services in 51 U.S. urban areas most adversely affected by the HIV/AIDS epidemic. This increase would expand access to these services and help address the disparity in outcomes, access, and utilization of care and treatment by people of color living with HIV/AIDS.

Title II base: $70 million increase; $401 million total

CARE Act Title II base funds care and support services in all 50 states, U.S. Territories, and Puerto Rico, Guam, and the U.S. Virgin Islands. This increase would help states restore services lost to cuts over the years, address increased demand for these services, as well as rising medical inflation.

Title II ADAP: $197 million increase; $986.5 million total

The AIDS Drug Assistance Program, a line item within Title II, provides access to treatment for people with HIV/AIDS. This increase would help eliminate ADAP waiting lists and other barriers to treatment access, while allowing states to provide a full range of HIV drugs to those in need.

Title III: $76.9 million increase; $270.5 million total

CARE Act Title III provides direct grants to over 360 community-based primary health clinics and public health providers in rural and urban communities. This increase would address the increasing costs of providing primary health care services to uninsured people living with HIV.

Title IV: $41.25 million increase; $113.25 million total

CARE Act Title IV funds HIV care, psychosocial, and other essential services to women, infants, children, and youth. This funding increase would help further reduce the rates of mother-to-child transmission of HIV, target care towards adolescents who are HIV-positive, and expand Title IV projects to additional communities in crisis, thus increasing access to care and treatment for women and children living with HIV/AIDS.

Part F (AIDS Education and Training Centers): $15.3 million increase; $50 million total

CARE Act Part F (AETCs) provides HIV clinical training, consultation, and technical assistance as part of the Ryan White CARE Act to improve clinical outcomes, enhance access to care, and build clinical capacity in urban, rural, and medically-underserved areas. This increase would help AETC further its legislative mandate to train health care providers, faculty, and students who care for people with HIV/AIDS outside traditional health professions education venues.

Part F (Dental Reimbursement Program and Community-based Dental Partnerships Program): $5.9 million increase; $19 million total

People with compromised immune systems, such as those living with HIV/AIDS, are more prone to oral infections such as periodontal disease and tooth decay. CARE Act Part F (Dental) provides diagnostic and preventive oral health care at academic dental institutions. This increase would insure access to quality dental care from dental practitioners trained to provide care for people with HIV/AIDS.

Special Projects of National Significance (SPNS): $25 million total

The SPNS Program advances knowledge and skills in the delivery of health and support services to underserved populations diagnosed with HIV infection. SPNS grants fund innovative models of care and support the development of effective delivery systems for HIV care and is considered the research and development arm of the Ryan White CARE Act.

In his State of the Union address, President Bush stated that "A hopeful society acts boldly to fight diseases like HIV/AIDS, which can be prevented, and treated, and defeated." We urge you to match his strong words by funding the Ryan White CARE Act at the appropriate level to provide the care, treatment, and support services needed to fight this epidemic.

Thank you for considering this request.

Sincerely,

Access Community Health Network – Chicago, IL
The ACCESS Network, Inc. – Ridgeland, SC
ACT UP Philadelphia – Philadelphia, PA
The Advocacy Project – Houston, TX
African American Health Alliance – MD
AID Atlanta – Atlanta, GA
AIDGwinnett – Duluth, GA
AIDS/HIV/HepC Nightline – San Francisco, CA
AIDS Action Baltimore – Baltimore, MD
AIDS Action Coalition/Davis Clinic – Huntsville, AL
AIDS Action Council – Washington, DC
AIDS Action Project Northwest – Hillsboro, OR
AIDS Alabama – Birmingham, AL
AIDS Alliance for Children, Youth, & Families – Washington, DC
AIDS Coalition of Southern New Jersey
AIDS Action Committee of Massachusetts, Inc. – Boston, MA
AIDS Emergency Fund – San Francisco, CA
AIDS Foundation Chicago – Chicago, IL
The AIDS Institute – Washington, DC
AIDS Legal Referral Panel – San Francisco, CA
AIDS Outreach of EAMC – Auburn, AL
AIDS Project Los Angeles – Los Angeles, CA
AIDS Project Worcester, Inc. – Worcester, MA
AIDS Legal Services, Law Foundation of Silicon Valley – San Jose, CA
AIDS Resource Center of Wisconsin – Milwaukee, WI
AIDS Response Seacoast – Portsmouth, NH
AIDS Survival Project – Atlanta, GA
AIDS Task Force – Wheeling, WV
Alaskan AIDS Assistance Association – Anchorage, AK
American Academy of HIV Medicine – Washington, DC
American Dental Education Association – Washington, DC
Americans For Safe Access/HIV-AIDS Survivors Union – Oakland, CA
amfAR, the Foundation for AIDS Research – Washington, DC
Asian and Pacific Islander American Health Forum – San Francisco, CA & Washington, DC
Aspirations – Baton Rouge, LA
Association of Nutrition Services Agencies – Washington, DC
Baker Places, Inc. – San Francisco, CA
Barnert Hospital – Paterson, NJ
Being Alive San Diego HIV/AIDS Services – San Diego, CA
Better Way of Miami, Inc. – Miami, FL
BIENESTAR – Los Angeles, CA
Birmingham AIDS Outreach – Birmingham, AL
Boston AIDS Consortium – Boston, MA
Boston Health Care for the Homeless Program – Boston, MA
Boston Living Center, Inc. – Boston, MA
Boston Public Health Commission – Boston, MA
Bronx AIDS Services – Bronx, NY
Brooklyn AIDS Task Force – Brooklyn, NY
Cambridge Cares about AIDS – Cambridge,MA
Cambridge Health Alliance – Cambridge, MA
CARE, Inc. – Jesup, GA
CARE Program - St. Mary Medical Center – Long Beach, CA
Care Resource – Miami, FL
Caring Health Center – Springfield, MA
Casa Esperanza, Inc. – Roxbury, MA
Cathedral Health Alert @ Cathedral International – Perth Amboy, NJ
Catholic Charities of the Archdiocese of Boston – Boston, MA
The Center for AIDS Information & Advocacy – Houston, TX
The Center for Positive Connections – Miami, FL
Center for Public Managment, Suffolk University – Boston, MA
The Center in Asbury Park – Asbury Park, NJ
Central City AIDS Network, Inc. – Macon, GA
Centro Latino de Chelsea, Inc. – Chelsea, MA
Chase Brexton Health Services – Baltimore, MD
Check-mate inc. – Asbury Park, NJ
Children’s AIDS Program – Boston, MA
CitiWide Harm Reduction – Bronx, NY
Codman Square Health Center – Dorchester, MA
Committee of Ten Thousand – Washington, DC
Communities Advocating Emergency AIDS Relief (CAEAR) Coalition – Washington, DC
Community Casemanagement Inc. – Miami, FL
Community Health Care – Tacoma, WA
Community Health Care Inc. – Bridgeton, NJ
Community Healthcare Network – New York, NY
Community HIV/AIDS Mobilization Project / CHAMP – New York, NY and Providence, RI
Community Service Network, Inc. – Dunn, NC
Concilio Hispano Inc. – Boston, MA
Continuum – San Francisco, CA
Corporation for Supportive Housing – Trenton, NJ
Desert AIDS Project – Palm Springs, CA
Dooley House, Inc. – Camden, NJ
Dorchester House Multi-Service Center – Dorchester, MA
DotWell – Dorchester, MA
East Bay AIDS Advocacy Foundation – Oakland, CA
Economic Opportunity Family Health Center, Inc. – Miami, FL
Elizabeth Glaser Pediatric AIDS Foundation – Washington, DC
Exponents – New York, NY
Family Health Centers of San Diego – San Diego, CA
Fenway Community Health – Boston, MA
Foundation for Research on Sexually Transmitted Diseases – New York, NY
Garden Area Health Education Center – Bridgeton, NJ
Gay Men’s Health Crisis – New York, NY
Georgia Rural Urban Summit – Decatur, GA
Grady Health System, Infectious Disease Program – Atlanta, GA
Great Brook Valley Health Center – Worcester, MA
Greater Roslindale Medical and Dental Center – Roslindale, MA
Guardian Health Association, Inc. – West Haven, CT
Harlem United Community AIDS Center – New York, NY
Harm Reduction Coalition – New York, NY
Health Awareness Services – Worcester, MA
Health Care of Southeastern Mass., Inc. – Brockton, MA
Health Services Center, Inc. – Anniston, AL
Heartland Health Outreach – Chicago, IL
Hispanic Office of Planning and Evaluation, Inc. (HOPE) – Boston, MA
HIV Dental Alliance(HIVdent) – Atlanta, GA
HIV/AIDS Services for African Americans in Alaska – Anchorage, AK
HIV Advocacy Council of OR and SW Washington – Portland, OR
HIV Health Services Planning Council (Middlesex-Somerset-Hunterdon) – NJ
HIV Medicine Association – Alexandria, VA
HIVictorious – Madison, WI
Housing Works – Brooklyn, NY and Washington, DC
Human Rights Campaign – Washington, DC
Hyacinth AIDS Foundation – New Brunswick, NJ
Immune Enhancement Project – San Francisco, CA
International Foundation for Alternative Research in AIDS – Portland, OR
Jefferson County AIDS in Minorities, Inc. – Birmingham, AL
JSAS Healthcare, Inc. – Asbury Park, NJ
Justice Resource Institute – Boston, MA
Karibu/CSSE – San Diego, CA
Latin American Health Institute – Boston, MA
Latino Commission on AIDS – New York, NY
Legacy Community Health Services, Inc. – Houston, TX
Liberation In Truth, UFC – Newark, NJ
Lifelong AIDS Alliance – Seattle, WA
Living Room, Inc. – Atlanta, GA
Long Island Association for AIDS Care (LIAAC) – Huntington Station, NY
Los Angeles Gay and Lesbian Center – Los Angeles, CA
Lutheran Social Services of Northern California – San Francisco, CA
The Macsata-Kornegay Group, Inc. – Miami, FL
McAuley Health Center – Grand Rapids, MI
Medical and Health Research Association of New York City, Inc. – New York, NY
Miami Beach Community Health Center, Inc. – Miami, FL
Miami Family Care Program – Miami, FL
Michigan HIV/AIDS Council – Lansing, MI
Montgomery AIDS Outreach, Inc. – Montgomery, AL
Multicultural AIDS Coalition, Inc. – Jamaica Plain, MA
Nashville CARES – Nashville, TN
National AIDS Housing Coalition – Washington, DC
National Alliance of State and Territorial AIDS Directors – Washington, DC
National Association of AIDS Education and Training Centers (NAAETC)
National Association of County and City Health Officials (NACCHO) – Washington, DC
National Association of People With AIDS – Silver Spring, MD
National Association of Social Workers (NASW) – Washington, DC
National Minority AIDS Council – Washington, DC
New Jersey Association on HIV Over Fifty (NJAHOF) – Summit, NJ
New Mexico POZ Coalition – Albuquerque, NM
New York AIDS Coalition – New York, NY
New York State Black Gay Network – New York, NY
NMA Comprehensive Health Center – HIV/AIDS Services – San Diego, CA
North Jersey AIDS Alliance – Newark, NJ
Northern Colorado AIDS Project – Fort Collins, CO
Northern Kentucky Health Department, Community Health Promotion – Ft. Mitchell, KY
Pierce County AIDS Foundation – Tacoma, WA
Planetpoz – New Mexico
Positive Impact, Inc. – Atlanta, GA
Positive Resource Center – San Francisco, CA
Project Inform – San Francisco, CA
Quincy Interfaith Sheltering Coalition – Quincy, MA
Regional Transit System, LLC – Bridgeton, NJ
San Diego Volunteer Lawyer Program – San Diego, CA
San Francisco AIDS Foundation – San Francisco, CA
San Francisco Community Clinic Consortium – San Francisco, CA
Santa Clara County HIV Planning Council – San Jose, CA
SAVE ADAP
Selma AIR – Selma, AL
The Sexuality Information and Education Council of the US (SIECUS) – Washington, DC
Shanti – San Francisco, CA
Someone Cares, Inc. – Atlanta, GA
South Carolina Campaign to End AIDS – Columbia, SC
South Alabama CARES – Mobile, AL
South Carolina HIV/AIDS Council – Columbia, SC
Southern NH HIV/AIDS Task Force – Nashua, NH
St. Mary's HIV Services – San Francisco, CA
Tenderloin AIDS Resource Center – San Francisco, CA
Title II Community AIDS National Network – Washington, DC
Treatment Action Group – New York, NY
University of Miami Miller School of Medicine-Comprehensive AIDS Program – Miami, FL
University Wellness Center Consumer Advisory Board – Las Vegas, NV
Upham's Corner Health Center, HIV AIDS Services – Dorchester, MA
Victory Programs Inc. – Boston, MA
The Visiting Nurse Association of Central Jersey – North Brunswick, NJ
The Well Project – Charlottesville, VA
West Alabama AIDS Outreach – Tuscaloosa, AL
WHAAM – Brooklyn, NY
Whittier Street Health Center – Roxbury, MA
WORLD – Oakland, CA