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AIDS [Acquired Immunodeficiency Syndrome] [3]
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Records of the First Lady's Office (Clinton Administration)
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HR 1289: NEWBORN INFANT HIV NOTIFICATION ACT, continued
Aids
Given the new leadership's
CDC Suspends HIV Survey
and their infants, and encourage
provision of the Ryan White
proposals for welfare reform
in Childbearing Women
the use of zidovudine (AZT) to
CARE Act or any other legisla-
under the "Contract with
On May 11, 1995 the Sub-
reduce the risk of perinatal
tion will be vehemently op-
America", it is possible that
committee on Health and Envi-
transmission of HIV."
posed. Rep. Ackerman has gar-
mandatory HIV testing of
ronment of the House Com-
Ackerman to Amend
nered much support and already
women of childbearing age
merce Committee held hearings
H.R. 1289, Calls for
has 221 Congressional co-spon-
may be introduced as a condi-
on HIV testing of women and
Mandatory HIV Testing
sors. including many members
Updale
tion for receipt of public as-
infants. During the course of her
In response to this unex-
of color and liberal Democrats.
sistance or that other related
testimony on behalf of the Ad-
pected action which would
He now wants to amend his bill
amendments may be offered
ministration. Dr. Helene Gayle
serve to undermine his pro-
to call for mandatory testing.
on mandatory newborn HIV
stated opposition to any form of
posed Newborn Infant HIV No-
Call your Representative,
NATIONAL MINORITY AIDS COUNCIL
screening. During the recent
mandatory HIV testing of
tification Act (H.R. 1289), Rep.
(Capitol Switchboard, 202-224-
House hearings on Ryan
women and infants, and an-
Ackerman announced that very
3121) and ask her/him to oppose
White CARE act reauthoriza-
nounced that CDC suspended
evening that he would amend
H.R. 1289; if already signed on
tion, Republican representa-
the HIV survey in childbearing
his bill to call for mandatory
as a co-sponsor, remove his/her
tives expressed great interest
women. "All states [will be
testing.
name from the co-sponsor list:
in HIV testing of pregnant and
asked] to immediately suspend
What You Can Do
oppose any amended form of
post-partum women. Specula-
the current survey. A panel of
Communities of color must
H.R. 1289 that calls for manda-
tion was also raised that an
outside experts will be con-
make their voices heard in op-
tory testing; and oppose any ef-
amendment may be offered on
vened to examine strategies to
position to mandatory testing of
fort to attach H.R. 1289 or any
this issue in the Senate during
promote, implement and evalu-
women and infants in any form.
HIV testing proposal as an
Republicans Take Control
action on CARE Act Reautho-
ate in all states the CDC guide-
Our communities must let Con-
amendment to any legislation
rization or in the House ver-
lines for counseling and volun-
gress know that any attempts to
including the Ryan White CARE
sion of the bill.
tary testing of pregnant women
require mandatory testing as a
Act Reauthorization.
of 104th Congress
Conservative Reforms Target the Most Vulnerable
By Miguelina Maldonado
11
HIV Notification Act
NMAC's Director of Government Relations & Policy
HR 1289: Newborn Infant
01
FDA Reform
T
he Republican victories in
as spelled out in the "Contract
"Contract with America", the
and unlimited funding for the
the 1994 midterm elections
9
Provisions
with America" includes propos-
sweeping reforms underway in
AFDC and Supplemental Secu-
Ryan White CARE Act
served to usurp over four
als to reduce federal spending by
Congress are aimed at people of
rity Income (SSI) programs for
decades of Democratic con-
$190 billion within the next five
color. the poor and the most vul-
the needy, blind. aged, or dis-
Ryan White Reauthorization 5
trol of Congress and marked the
years. The proposed reductions
nerable in America. The propos-
abled. It would also cap growth
E
FY"95 AIDS programs
beginning of a dramatic shift in
in spending coupled with a tax
als target human services pro-
in funding for these programs as
$222 Million Cut Proposed for
ideology that minimizes the role
cut will result in major cuts in
grams which have served to pro-
well as for child support en-
I
104th Congress
of government in addressing
health and social welfare pro-
vide a safety net for the poor,
forcement, child care for the
Republicans Take Control of
major health and social prob-
grams and will ultimately have
elderly and disabled. The draft
working poor, and 15 housing
lems. The Republicans suc-
a negative impact on poor
welfare reform bill, The Per-
:anss! this uj
programs.
ceeded in taking control of both
people - particularly commu-
sonal Responsibility Act. pro-
The Republican proposals
20500 DO Mashington
houses of Congress, as well as a
nities of color.
poses drastic changes in the pro-
are based on the premises that
1600 Pennsylvania Ave, NW
majority of the governorships
Human Services Targeted
gram of cash assistance to poor
(1) welfare spending is out of
The White House Office of the First Lady
and state legislatures throughout
The change in the political
families with children (AFDC)
control and must be curtailed;
the country. This historic shift in
environment and its likely ad-
including replacing important
(2) as long as the programs re-
Margaret Williams
E-MAIL [email protected]
power and ideology portends the
verse impact on communities of
nutrition programs - food
tain entitlement status, spending
adoption of more conservative
color is of major concern to the
stamps and school lunches -
cannot be controlled: and (3)
PHONE: NMAC (6622)
HIV/AIDS and social welfare
20009442 00 "NO1ONIHSVM
National Minority AIDS Coun-
with a block grant at a reduced
states should be given maximum
MN STREET, HIEL 1861
policy, on both the national and
cil. While AIDS programs are
funding level. The result would
flexibility in administering
local levels.
not specifically mentioned in the
be to end the entitlement status
health and social welfare pro-
NATIONAL MINORITY COUNCIL
On September 27, 1994, the
grams through a block grant
House Republican leadership
The sweeping reforms
structure of funding. The Re-
PAID
UPdale
released a "Contract with Amer-
underway in Congress are aimed
publican proposals include
#293 PERMIT
ica" and pledged to implement
this road map for legislative
at people of color, the poor,
capped block grants to the states
MERRIFIELD. VA
that would replace AFDC: a
change within the first 100 days
and the most vulnerable in America.
U.S. POSTAGE
separate block grant for major
FIRST CLASS
of 1995. The Republican agenda
child care, child welfare, and
Update May/June 1995
1
REPUBLICANS CONTROL
104TH CONGRESS, continued
UPdale
NMAC Opposes H.R. 1289:
May/June 1995
Newborn Infant HIV Notification Act
O
n March 22, 1995, Rep-
A recent study conducted by the
women, who had rates 28 times
If H.R. 1289 becomes law:
child nutrition programs; restric-
AIDS programs are not directly
in the city councils, state legis-
Update reports on public policy is-
resentative Gary Acker-
Health Resources and Services
higher than white women in 21
A large population of women
tions on food stamp benefit in-
affected by the welfare reform
latures and congressional dis-
sues and information on subjects in
man (D-NY) introduced
Administration and the National
states. These 21 states accounted
may be deterred from seeking
creases; eliminating SSI benefits
proposals, the cuts in SSI. cash
trict offices. We must make our
organizational management, for
H.R. 1289, the "Newborn Infant
Institute on Drug Abuse indi-
for nearly 75% of all HIV in-
prenatal care because of this bill.
for substance abusers; restrict-
assistance and food stamps, to
people in communities of color
presence felt in the halls and
HIV Notification Act" in Con-
cated that female drug abusers
fected childbearing women in
including women who are poor,
who work with issues of HIV infec-
ing SSI eligibility for children
name a few, will also affect poor
chambers of Congress through
gress. H.R. 1289 will require
received significantly fewer ser-
the United States. In these states,
tion. The newsletter is published bi-
injection drug users, undocu-
with disabilities; ending or re-
people with HIV/AIDS. In addi-
participation in organized lob-
monthly by the National Minority
states to disclose the results of
vices than their male counter-
63% of the HIV positive women
mented immigrants and those
stricting benefits for most immi-
tion, some members of Con-
bying efforts and Congressional
AIDS Council.
HIV testing of a newborn infant
parts. Of those testing positive
were African American.
who have had negative experi-
grants - documented and un-
gress have floated proposals to
hearings. The challenges posed
Executive Director
to the biological mother, if she
for the first time, only 59.6% of
While NMAC recognizes the
ences with the child welfare sys-
Paul Akio Kawata
documented; strengthening
restructure HIV/AIDS program
to the health and welfare of com-
is the legal guardian of the in-
the women as compared to
importance of identifying HIV
tem and fear the loss of their
funding into block grants.
Editors
child support enforcement; and
munities of color by the ideol-
fant. If she is not the legal
72.4% of the men stated they
infected newborns and provid-
child's custody.
Miguelina Maldonado
ogy embodied in the "Contract
guardian, then the latter or the
received help to get services.
ing them with early medical care
No adequate provision is
Director of Government Relations
Now, more than ever,
with America" is the central fo-
& Policy
appropriate state authority must
Coercive measures will not
and treatment, we oppose the
made for the delivery of medi-
cus of this year's policy confer-
be notified of the infant's HIV
advocates, service providers and
Moises Agosto
address the problem of lack of
means by which H.R. 1289
cal and social services for
ence, Our Place at the Table:
Director of Research and
status. The proposed bill re-
access to health, drug treatment
seeks to achieve this goal. The
women and infants who have a
consumers in communities of color
The National Meeting, held May
Treatment Advocacy
quires disclosure in instances
and social services and will only
proposed legislation violates the
positive HIV antibody test. Nor
Production
must organize and unite to
22-23, 1995 at the National
where a State requires that the
does the bill authorize funds for
David Barre
protect those programs which
Press Club in Washington, DC.
Communications Manager
results of HIV testing of a new-
Coercive measures will not address
the counseling it requires states
NMAC has played a critical
born infant be reported to the
to
Design
have been designed to
role in articulating the needs of
State. Reporting is also required
the problems of lack of access to
provide.
Eugenia Kim
In states where newborn HIV
Gene Kim Graphics
address the AIDS epidemic.
communities of color impacted
if the State conducts the HIV
health, drug treatment and social
screening is done anonymously
Please inquiries to Miguelina
test on the infant.
by HIV and AIDS during policy
The bill would require that
services and will only serve to deter
and for epidemiological pur-
Maldonado at the National Minor-
formulation and legislative ac-
poses, the effect of the bill
ity AIDS Council. Articles may be
repeal of the Job Opportunities
Intensified Advocacy
tion undertaken by the Clinton
the results of anonymous HIV
reprinted and distributed without
women from seeking those already
would be to mandate testing of
and Basic Skills (JOBS) program
Needed Now
Administration and the 104th
permission, credit appreciated.
screening of infants conducted
limited services.
mothers without informed con-
for AFDC families.
This new political environ-
Congress, covering such issues
This publication is made possible
by states, such as the one funded
sent; require women to learn
During periods of recession,
ment will require a shift in strat-
as the reauthorization of the
by grants from Aetna Foundation,
by CDC's HIV Survey of Child-
their HIV status; and jeopardize
the allocation of block grants
American Express Foundation,
bearing Women. to be "un-
serve to deter women from
egies in the AIDS advocacy com-
Ryan White CARE Act, FY'95
mother's right to written in-
women's legal right to confiden-
Apple, Inc., AT&T Foundation,
may ultimately place greater
munity including intensified
rescissions, HIV housing, HIV
blinded," meaning that the chil-
seeking those already limited
formed consent and pre- and
tiality regarding their HIV sta-
Burroughs Wellcome Company,
dren and mothers are identified
rather than less burden on the
services. The National Minor-
grassroots organizing. Now,
testing of newborns and preg-
post-test counseling. A viable
tus.
Equitable Life Insurance, The Ford
and the results of the test dis-
state governments. If states re-
more than ever, advocates, ser-
nant/postpartum women, re-
Foundation, George Gund Founda-
ity AIDS Council, along with
alternative would be to provide
The bill will not accomplish
ceive insufficient funds to pro-
vice providers and consumers in
structuring of prevention activi-
-tion, Judith>Peabody,-Northshore
closed to the mother or legal
other AIDS, women's and
all pregnant and post-partum
its goals of identifying and treat-
vide health and human services,
communities of color must or-
ties at CDC, FDA reform, and
Unitarian-Universalist Society, and
guardian. H.R. 1289 also re-
children's advocacy organiza-
women counseling and volun-
ing HIV infected infants and of
the Sisterfund.
they will be unable to respond
ganize and unite to protect those
welfare reform.
quires that in disclosing the HIV
tions, opposes H.R. 1289.
tary testing. Voluntary testing
preventing the transmission of
to the changing needs of their
programs which have been de-
This edition of UPDATE pro-
National Minority AIDS Council
test results. the state shall bear
Impact on People of Color
means that after a woman re-
HIV disease because:
constituents and will be forced
signed to address the AIDS epi-
vides current information on key
1931 13th Street, NW
the responsibility to ensure that
Rates of HIV infection and
ceives appropriate counseling
the tests do not accurately
to cut programs or fill the gaps
demic. These include the HIV
issues in HIV/AIDS related pub-
Washington, DC 20009-4432
appropriate counseling is pro-
AIDS among all women are in-
from her health care provider.
reflect the HIV status of most
PHONE: 202-483-NMAC (6622)
vided to the individual about
with state funds.
lic policy. Various legislative
creasing and women of color are
she is able to make an informed
programs sponsored by the Cen-
newborns. At least 75% of all
FAX: 202-483-1135
HIV.
Communities of color will be
ters for Disease Control and Pre-
initiatives presently being con-
disproportionately affected by
decision about a test for HIV.
babies born with HIV antibod-
E-MAIL: NMACI @aol.com
The effect of this bill would
HIV. African American and His-
Studies show that when her
most adversely affected by the
vention (CDC), the Ryan White
templated in the House of Rep-
ies will shed them and test nega-
welfare reform proposals be-
Care Act (CARE Act), the Office
resentatives and the Senate, as
In the next expanded issue of UPDATE.
be to tell a woman her HIV posi-
panic/Latina women account for
health care provider talks with
tive for the virus after 15-18
cause large proportions of our
of AIDS Research (OAR), the
well as Administration propos-
NMAC will analyze recent developments in
tive status but provide no ser-
21% of all U.S. women. yet they
a pregnant woman about the
months.
the debate regarding HIV testing of pregnant
populations depend on govern-
Housing Opportunities for
als are summarized with back-
vices to assist her in dealing
represent 75% of the cumulative
HIV test and what it means for
the cooperation of women is
and postpartum women and infants and ex-
ment-assisted programs. The
People with AIDS Act (HOPWA),
ground information, status, and
amine its impact on women and children of
with her condition. Many ex-
AIDS cases reported among
her and her baby, most women
essential to the treatment of their
proposals which will deny ben-
and the Americans with Dis-
impact on communities of color.
color. Other issues of importance to our com-
perts agree, that the best way to
women. In 1993 (the most re-
choose to be tested and treated
infants. The threat of mandatory
munities which will be addressed in the next
efits to immigrants will also
abilities Act (ADA).
engage HIV+ women and their
cent year for which complete
as their doctor recommends
It is critical that you, as a con-
testing will intimidate and alien-
issue of Update will include: CDC Reorga-
negatively impact on our com-
As Republicans push for
stituent, voice your opinion to
nization: Kassebaum' bill. S 142. to block
children in on-going treatment
data are available), seropreva-
NMAC supports this approach
ate mothers, causing them to
munities since a large proportion
state and local control of domes-
your Representative and Sena-
grant CDC prevention programs: the
and care is to provide health and
lence was highest among
along with the provision of ac-
avoid the health care system and
Administration's counter proposal Pre-
tor. Your voice counts. now
social services to all women,
of the immigrant population are
tic programs, the voices of com-
women of color, particularly
cess to needed treatment and
possibly refuse treatment.
vention Performance Partnerships: HIV ap-
people of color. While HIV/
munities of color must be heard
more than ever!
propriations and budget: and welfare reform.
before and during prenatal care.
among African American
care.
Continued on page 12
2
Update May/June 1995
NATIONAL MINORITY AIDS COUNCIL
NATIONAL MINORITY AIDS COUNCIL
Update May/June 1995
11
FDA
Background
While it is desirable that the
However, protection of con-
New Congress Proposes $222 Million
The Food and Drug Admin-
drug approval process be expe-
sumers should still be the first
istration (FDA) is the agency of
dited, removal of too many re-
priority.
Reform
the US Public Health Service
strictions may put individual
While the accelerated ap-
Cut for FY'95 AIDS Programs
that regulates foods and drugs
consumers in danger. Letting
proval process has been ben-
sold to consumers. The primary
market forces control whether a
eficial in the case of several
Prevention and CARE Funds Restored;
By Moises Agosto
role of the FDA is to ensure that
particular drug family will be
drugs, the primary role of the
NMAC's Director of Research
any drug or food item sold to the
used would leave many indi-
FDA is to protect consumers
HOPWA Preservation Threatened
and Treatment Advocacy
public has been thoroughly
viduals at the mercy of the drug
from unscrupulous individuals
tested for safety and efficacy.
companies. NMAC's advocacy
and corporations. The safety
0
n February 22, 1995,
state and federal sources to ad-
1995. The cuts would also im-
The FDA also regulates the la-
efforts are to preserve the nec-
and efficacy of drugs on the
over $6 billion in cuts
dress the epidemic in their geo-
pact cities that were contemplat-
beling of products to ensure that
essary regulatory elements that
market is essential. Removal
were approved by the
graphic areas. CDC statistics
ing expansion in services to
the drugs and food items fulfill
would protect consumers. At the
of restrictions on the approval
House Subcommittee on Labor/
demonstrate that 56% of new
meet increasing caseloads. In
the claims and carry all neces-
same time, NMAC's position
of new drugs should never
HHS Appropriations to fiscal
cases are in communities of
either situation, cuts would have
sary warnings.
calls for current regulations to
take away from the protection
year 1995 appropriations al-
color; yet funding has not
prevented services from being
During the 104th Congress,
be reviewed to allow for greater
of consumers.
ready in place. The proposed re-
matched the need in communi-
provided in new areas and to
proposals have been made to
speed in producing new medi-
Impact on People of
scissions' (taking back funds
ties of color. Minority CBOs
new populations. Communities
eliminate many regulatory road-
cations.
Color
allocated for the FY'95 budget)
have been forced to rely solely
of color would be adversely af-
blocks to corporate investment.
2. BUSINESS INCENTIVES
People of color will be ad-
The proposed $23
include $23 million from CDC's
on direct funding from CDC,
fected because many minority
As part of the Republican pro-
It has been argued that many
versely impacted if drugs are
million rescission
prevention activities and $13
since state sources have note
organizations - only recently
gram, Congress is considering
of the restrictions now in place
approved that do not meet all the
million from the CARE Act.
been made available. CDC's
funded under the CARE Act -
of CDC funds
eliminating the regulations over
limit the ability of businesses to
consumer protection criteria.
Subcommittee member Nancy
Community Planning Process
would be subject to reductions
drug development. It has been
make profit. With some drugs
Many in our communities have
would eliminate
Pelosi's (D-CA) amendment to
provided an opportunity for
in their level of funding. In the
observed that some of the regu-
requiring years to obtain ap-
already been duped by unscru-
restore AIDS funding that was
communities of color to have
initial phases of development of
lations in place put an undue
proval, manufacturers argue that
pulous individuals selling false
half the increases
defeated by a vote of 7-7. Frank
direct input into the needs as-
HIV care services, these organi-
burden on businesses that pro-
their profit motive is lost when
cures. Removing many of the
for the 1995
Riggs (R-CA), Henry Bonilla (R-
sessment and prevention service
zations have fragile infrastruc-
duce food and drugs. By liber-
they have to deal with many of
restrictions currently in place
TX) and John Porter (R-IL) sup-
planning process on the state
tures which would be under-
alizing the regulations over drug
the regulations currently in
would make it easier for mem-
budget - increases
ported cuts which would result
and local level. This increased
mined by any loss of funds.
development, the Republican
place. By removing many un-
bers of our community to fall
in substantial reductions in fund-
participation would ultimately
Advocates in communities of
leadership hopes to encourage
necessary regulations and accel-
prey to false claims.
intended by
ing for HIV/AIDS care and pre-
serve to increase resources
color throughout the nation have
companies to be more cost ef-
erating the approval process,
What You Can Do
Congress to fund
vention in their states.
available to underserved popu-
struggled for many years to gain
fective and invest more on de-
manufacturers will be more in-
Contact your Representative,
CDC Prevention Funding
lations and to organizations tar-
access to the decision-making
veloping drugs.
terested in investing in research
either in person or by calling
new activities
The proposed $23 million
geting people of color. Any cuts
process through the Ryan White
Issues
and development to produce
their office in Washington or
under the
rescission of CDC funds would
in funding would mean that any
planning councils. Hard-earned
1. DRUG APPROVAL
new drugs.
your Congressional District. Tell
eliminate half the increases
new prevention activities would
victories in gaining representa-
The regulations in place are
While we favor the use of
your Representative that the
HIV Prevention
passed in 1994 for the 1995 bud-
not be funded. These cuts would
tion and access to Ryan White
to ensure that all drugs submit-
market forces to encourage pri-
most important thing is that con-
get. These increases were in-
prevent new funding for CBOs
service funds would also be
ted for approval for sale are safe
vate investment, it should not
sumers be protected while at the
Community
tended by Congress to fund new
that were previously not funded
jeopardized by the proposed
to take as indicated and will ac-
detract from the need to protect
same time drugs must be easily
Planning Process.
activities under the HIV Preven-
- primarily CBOs in commu-
cuts. The restoration of the Ryan
tually produce the effect adver-
individuals. NMAC supports ef-
accessible and affordable.
tion Community Planning Pro-
nities of color. The restoration
White funds is a critical issue for
While we favor
tised on their label. Many of the
forts to collaborate with private
To contact your Representa-
cess.
of HIV prevention funds for
people living with HIV/AIDS
regulations in place accomplish
industry in finding ways to find
tive's Washington Office. call
Federal funding for preven-
FY'95 was therefore an impor-
and especially for communities
the use of market
these goals, although some are
new drugs and treatments.
the Capitol Switchboard and ask
tion is critical to communities of
tant issue for the AIDS commu-
of color which continue to be
forces to
burdensome and may take years
3. CONSUMER PROTECTION
for your Representative or Sena-
color, particularly for organiza-
nity, especially people of color.
disproportionately affected and
to fulfill. Under pressure from
The most desirable outcome
tors by name:
tions that are not able to access
Ryan White CARE Act
underserved.
encourage private
advocacy groups, the FDA has
of the reform of regulations
Capitol Switchboard
sufficient resources from local,
Funding
Advocacy Restores
investment, it
put in place a shortened version
would be that the approval pro-
(202) 224-3121
1 A rescission is cancellation of all or part
The Labor/HHS Appropria-
Proposed Cuts
of the process. This accelerated
cess would be streamlined as
Your Representative can also be
of the budget authority (or unobligated bal-
tions Committee's proposed cut
Intensive work by national
should not
ances of the budget authority) for a budget
approval process places drugs
much as possible. This should
reached by writing to him/her at
of $13 million for the CARE Act,
account. Budget authority is the legal per-
AIDS organizations including
detract from the
on the market faster and has
consist of a review of regula-
the address below:
mission for the federal government to spend
which amounted to 25% of the
NMAC and grassroots advo-
need to protect
been used for many drugs cur-
tions that currently prevent ac-
The Honorable [name]
funds. For discretionary programs. budget
increase over FY'94, would ad-
cacy from all over the country
authority IS provided appropriations:
rently used to treat persons liv-
celerated drug research, which
US House of Representatives
versely affect new Title I cities
resulted in restoration of both
thus a rescission is reduction in the appro-
individuals.
ing with HIV/AIDS.
should be changed or removed.
Washington, DC 20510
priation previously provided by Congress.
slated to receive funding in
Continued on page 4
10
Update May/June 1995
NATIONAL MINORITY COUNCIL
NATIONAL MINORITY AIDS COUNCIL
Update May/June 1995
3
$222 MILLION CUT FOR FY'95
RYAN WHITE REAUTHORIZATION. continued
AIDS PROGRAMS, continued
the proposed cuts of $13 million
HOPWA budget for FY'95 and
among women, many of whom
cuts between the two rescission
ministrative costs of grantees to
Americans. This has been pos-
Title II for tribes to apply di-
all planning bodies of the
for Ryan White programs and
seriously jeopardizing housing
have children) need HOPWA-sup-
bills. On May 11, an agreement
10% and adds a new provision
sible through funds provided
rectly to the Federal government
CARE Act and change in the
$23 million for CDC's HIV Pre-
programs for people living with
ported housing services. Because
to rescind a total of $6.3 billion
to cap administrative costs of
under the Special Projects of
for funding, giving tribes an op-
language regarding representa-
vention Community Planning
HIV/AIDS. On March 2, Repre-
of the high levels of poverty
in FY'95 funding for HUD in-
subgrantees to 12.5% of the to-
National Significance (SPNS)
portunity to address the needs of
tion on the planning councils:
Program. These FY'95 alloca-
sentative Louis Stokes (D-OH)
among people of color and par-
cluded a $30 million cut in
tal grant. NMAC advocates for
program of the CARE Act, un-
their own populations and de-
2. elimination of the single ap-
tions were restored by a vote of
led an effort to restore $100 mil-
the development of mechanisms
der Title II, which names Native
ticularly women of color, hous-
HOPWA funding, bringing total
sign necessary programs. This
propriation for Titles I and II;
37-18 on March 2 by the full
lion in HOPWA program fund-
ing is a critical issue. HOPWA
HOPWA funding down to its
to provide greater flexibility in
Americans as one of its target
requires that some formula be
3. minimize reductions in fund-
the determination of the amount
House Appropriations Commit-
ing along with other programs run
provides a vital safety net for
1994 level of $156 million.
populations. Currently, there are
devised for subtracting the
ing to existing EMAs and
tee with strong bipartisan sup-
individuals, families and chil-
While national and grassroots
of funding CBOs may spend on
12 contracts under SPNS serv-
by HUD. Presented to the full
tribe's portion of the state allo-
highly impacted states, phase
port. Rep. Pelosi offered an
House Appropriations Commit-
dren. The program must be
advocacy efforts to save
administration and program
ing Native Americans. These
cation under Title 11. Although
in changes over five years to
amendment to the House rescis-
tee, the Stokes bill unfortunately
maintained, and restored to its
HOPWA were not totally suc-
management. Variations in CBO
include case management, tra-
S. 641 does not include lan-
limit the negative impact the
sions bill to save prevention and
was defeated along party lines.
cessful, we did manage to save
size, capacity, resources and
ditional medicine, technical as-
full funding for FY'95. People
guage to that effect, the bill must
new formulas will have on ex-
with HIV/AIDS need adequate
staffing should be considered in
sistance, and infrastructure de-
CARE funds with an offset from
Since 1991, HOPWA has pro-
this housing program - so vi-
be changed to address the needs
isting service delivery systems;
the Energy Department and a
vided funding to states and lo-
and affordable housing in order
tal to people living with HIV/
making determinations on the
velopment for Native American
of Native Americans. As tribes
4. provide funds for infrastruc-
calities on a formula basis,
proportion of funds used for ad-
services.
federal building project. Four-
to prevent the early onset of ill-
AIDS - from elimination. The
begin to operate their own health
ture and capacity building in
teen Republicans, including
giving local communities the
ness. Affordable housing also
full House and Senate has yet
ministrative purposes. CBOs
The legal relationship be-
care systems, it is very impor-
underserved communities;
will be doomed to failure with-
John Porter (R-IL) who had
capability to plan and imple-
assists them in maintaining their
to vote on the conference report.
tween tribal governments and
tant that all federal health legis-
5. provide for flexible adminis-
out the investment of resources
voted to cut AIDS funds at the
ment the most appropriate hous-
the United States is directly be-
lation include their interests.
quality of life and that of their
and President Clinton has the
trative caps for subgrantees:
ing strategies and related ser-
families.
in administrative positions and
tween the tribe which is a sov-
CARE Act Reauthorization:
subcommittee level, and the
option to veto the FY'95 rescis-
6. provide for on-going funding
systems which enable the orga-
ereign nation and the United
Impact on People of Color
for Native American services
very conservative Istook (R-OK)
vices for persons living with
House and Senate
sion bill.
and Dickey (R-AR) supported
HIV/AIDS and their families.
Rescissions at Odds
What You Can Do
nization to function effectively.
States government. Sovereign
The CARE Act provides
under SPNS and the develop-
the Pelosi amendment. In addi-
HUD distributes 90% of HOPWA
Eight days later. on March
Call or write to President
This is particularly true in the
nations have no direct legal re-
funding targeted for persons liv-
ment of a mechanism for di-
tion, 23 Democrats voted to save
funds to states, with the remain-
24, the Senate Appropriations
Clinton and urge him to veto the
case of many minority CBOs,
lationship to state governments.
ing with HIV/AIDS. With over
rect application for funds
the programs.
ing 10% distributed among vari-
Committee voted to pass a $13
rescission bill. Let him
which are struggling to provide
Applications for funding must,
50% of the new cases of AIDS
from tribes to the Federal gov-
services with limited resources
HOPWA Elimination
ous projects on a national com-
billion rescissions bill leaving
know that the importance of
therefore, be submitted directly
being reported in communities
ernment under Title II.
which constrain their adminis-
to the U.S. Government not the
of color, it is essential that tar-
Threatened
petitive basis.
intact Ryan White, HIV Preven-
HOPWA cannot be underesti-
Contact your Representative
tion, and HOPWA funding. On
trative capacity.
On February 23, 1995, the
Approximately 60% of
mated, as adequate housing and
states. NMAC has joined the
geted funding for HIV/AIDS ser-
in person or call their office in
4. Programs for Native
National Native American AIDS
vices continue. It is also critical
Veterans Affairs and Housing
people living with HIV/AIDS
April 6th, the full Senate passed
support services have been
Washington or your Congres-
Americans
and Urban Development (HUD)
will need assistance with hous-
its FY'95 rescissions bill which
Prevention Center (NNAAPC)
shown to reduce the frequency
that the funding go to those ar-
sional District. Call the Capitol
Native American communi-
Subcommittee voted to rescind
ing at some point during the
did not include any cuts to
of hospital stays and their dura-
in advocating for the following
eas where there are large num-
Switchboard, 202-224-3121,
$186 million in the Housing
course of their illness. Commu-
HOPWA at all.
tion. Tell him that tax cuts for
ties are faced with unique chal-
as part of reauthorization:
bers of people of color in need
and ask for your Representative
nities of color, with a growing
Then, the House and Senate
the middle class cannot be made
lenges in obtaining services for
a. Ensure that Native Ameri-
of services.
Opportunities for People with
or Senators by name. If your
persons living with HIV/AIDS.
AIDS (HOPWA) Program, virtu-
proportion of new AIDS cases
met in conference to reconcile
on the backs of people living
cans are considered by defini-
S 641 has limited guarantees
Representative is not available,
The Indian Health Service
ally eliminating the entire
(including alarming increases
the differences in HUD funding
with HIV/AIDS.
tion a Special Project of Na-
in place for the inclusion of
speak to their legislative aide
(IHS), the Public Health Service
tional Significance. Projects
people of color. It is critical that
that works on health issues.
agency entrusted with caring for
funded under this rubric must
the language of the final bill be
These individuals are generally
Why Join NMAC?
Native Americans in reserva-
also extend beyond the current
strengthened to address the
well versed on these issues and
tions, has not provided neces-
scope of health services research
needs of people of color.
will listen to your concerns and
sary HIV/AIDS related services.
and demonstration projects. The
What You Can Do
relay them to your Representa-
The National Minority AIDS
NMAC's Treatment and Research
NMAC's ongoing publications,
For memberhip rates and additional
To date, the majority of HIV/
needs of Native Americans will
Advocacy Department advocates
information, please contact the NMAC
It is critical that you contact
tive. You can also write to your
Council is the only national AIDS
T.A. Newsletter and Update, keep
organization dedicated solely
members informed on the latest
membership department.
AIDS services have been limited
for better treatments and treatment
be met more effectively by pro-
your Representative so that lan-
Representative at: The Honor-
and specifically to minority
information in communities of color.
events, issues and information in the
to seroprevalence studies. The
viding a mechanism to ensure
guage addressing the issues de-
able [name], U.S. House of Rep-
communities.
NMAC's Honorary Board Chair
fight against AIDS.
relationships between the tribes
continuity of services to this
scribed above be included in the
resentatives, Washington, DC,
NMAC sponsors award-winning
is Grammy award-winning artist
BE A LEADER IN THE FIGHT AGAINST
NATIONAL
and the Federal government
population as well as fair and ad-
House version of the CARE Act.
20510.
conferences including the National
Patti LaBelle.
HIV/AIDS! By joining the National
MINORITY
have changed substantially in
equate inclusion in the bill.
Primary among these:
Contact both of your Sena-
Skills Building Conference, Our
NMAC has created the Women's
Minority AIDS Council, your organiza-
the recent past. Many tribes are
b. Establish a mechanism under
1. inclusion of people of color in
tors and tell them to support the
Place At the Table: The National
tion becomes part of the powerful
Project to document and address
Meeting, and the Prevention Summit.
AIDS
now opting to "compact" with
national voice of over 600 minority
CARE Act as reported by the
the needs of women and families
community based organizations fight-
the Federal government to pro-
The bill must be changed to address
Labor and Human Services
NMAC's T.A. Department pro-
of color affected by HIV/AIDS.
ing to win the war against AIDS.
COUNCIL
vide themselves the medical
the needs of Native Americans.
Committee. Call the Capitol
vides unsurpassed technical assis-
NMAC produces state-of-the-art
NMAC provides its members with
care that was entrusted to IHS in
tance and training to member CBOs.
technical assistance manuals such
representation on Capitol Hill,
As tribes begin to operate their own
Switchboard at (202) 224-3121
comprehensive technical assistance,
1931 13TH STREET, NW
the past. Since the beginning of
and ask for your Senators by
NMAC's Public Policy Depart-
as the "Strategic Planning Manual
ment protects your rights on
for AIDS Service Organizations"
a wide range of publications and a
WASHINGTON, DC 20009-4432
the epidemic the Native Ameri-
health care systems, it is very
name. You can also write to your
dedication to develop leadership
PHONE: 202-483-NMAC (6622)
can non-profit sector has devel-
and the "Finance Manual."
within communities of color to
oped systems to respond to the
important that all federal health
Senators in their office in Wash-
Capitol Hill.
FAX: 202-483-1135
E-MAIL: [email protected]
ington, U.S. Senate, Washing-
address issues of HIV/AIDS.
needs of HIV-infected Native
legislation include their interests.
ton, DC, 20515.
4
Update May/June 1995
NATIONAL MINORITY AIDS
AIDS COUNCIL
Update May/June 1995
9
Ryan White CARE Act Provisions Continued
Ryan White Reauthorization
PROPOSED CHANGES
Loss caps to states would be proportion-
Background
used to provide case management, refer-
vocacy groups, including the
ing, the face of the HIV epi-
EMAs with recent increases in
Title II
ally reduced consistent with any reduction
rals to hospitals, drug abuse, mental
The Ryan White Compre-
Four Title Coalition (which rep-
demic has changed since the
AIDS cases receive substantially
hensive AIDS Resources Emer-
health, social and support services. Com-
resents the grantees under the
CARE Act was first authorized
Allows funds to be spent on substance
in available funding.
less funding than older EMAs.
abuse services, treatment education, pro-
SPNS is taken out of Title II and moved
munity health centers and other public
gency (CARE) Act was enacted
four titles) spearheaded an effort
in 1990. Once primarily a
In addition, funding inequities
phylactic treatments, and for profit entities
to a new Title V.
into law on August 18, 1990, to
to reauthorize the CARE Act.
and non-profit private primary care pro-
coastal urban area problem, the
are greater in states where the
when they are the only available provider
viders serving a significant number of
provide federal disaster relief for
NMAC was an active participant
HIV epidemic now reaches into
majority of people with AIDS
CURRENT LAW
in these activities.
the smallest and most rural ar-
of quality care.
HIV/AIDS pediatric or pregnant patients
AIDS. Emergency assistance is
live in EMAs, since a larger pro-
Requires providers of services to chil-
Title III: Early Intervention Services
also receive support.
provided to localities that are
The efforts for early reautho-
eas of the country. As the com-
portion of their caseload is
dren, mothers and families to be part of the
Title IIIA was designed to provide grants
disproportionately affected by
rization failed due to action from
mittee considers revisions to the
counted for purposes of deter-
Title II networks.
to states to give to private organizations for
PROPOSED CHANGES
the AIDS epidemic. The CARE
Republicans, who prevented the
CARE Act, I believe it is impor-
mining Title I and Title II for-
Act is divided into four titles that
Requires the establishment of a national
counseling, HIV antibody testing, referrals
Title IV
bill from being considered by
tant that adjustments be made
mula allocation. The GAO con-
minimum AIDS drug formulary for use by
to health and support services, diagnostics
grant federal funds to cities,
the Labor and Human Resources
Requires grantees to provide or arrange
to take these changes into ac-
cluded that greater equity can be
states and to other public or pri-
Committee in the Senate. While
count."
ADAP programs.
and early intervention treatments. This Title
for coordinated HIV services for the pur-
achieved by (1) changing the
Requires state plans to include a descrip-
has never been funded.
pose of supporting or maintaining compre-
vate non-profit entities both for
there were over 60 co-sponsors
GAO Calls for Change
current structure of the two titles
tion of how the plan complies with the
Title ШВ supports outpatient early in-
hensive, community-based, culturally com-
direct delivery of medical ser-
in the Senate, the legislation did
in CARE Act Funding
to eliminate double counting of
SCSN.
petent, family or youth centered HIV CARE
vices and for the development.
not come up for consideration
Formulas
tervention services for people with AIDS
EMA cases, (2) changing the
Requires states to convene at least an-
and HIV infection. Funds are granted to
systems. Projects facilitate the voluntary
organization, coordination and
before the 103rd Congress ad-
Senator Kassebaum's call for
Title I caseload measure to bet-
nually a broad cross section of service and
community-based clinics and health provid-
participation of children, youth and women
operation of more effective ser-
journed on October 7. 1994.
adjustments in funding distribu-
ter reflect the service population,
ers to organize comprehensive HIV services
vice delivery systems for indi-
Reauthorization Efforts
community representatives to develop
in qualified research protocols.
tion were supported by testi-
and (3) changing both Title I and
viduals and families with HIV
SCSN.
on an outpatient basis. More than half of
in the 104th Congress
mony from representatives of
Title Il formulas. As a result of
Provides waiver from defunding for
disease. The funding goes to cit-
Reauthorization of the CARE
Provides new guidance for use of state
the Title II grants were awarded to migrant
non-compliance with the requirement to
the General Accounting Office
the GAO study and recommen-
administrative funds.
health centers. The other half included
establish access to research for one (1)
ies most impacted by the epi-
Act thus fell under the purview
(GAO). In a report prepared to
dations, Senator Kassebaum ex-
Requires the development of grievance
awards to health care programs for the
year if assurances are given that such
demic (Title I). states (Title II),
of the new Republican leader-
study current funding formulas
pressed support for a change in
procedures with enforcement mechanisms
homeless, local health departments, family
noncompliance will be remedied in that
community health centers (Title
ship. The Senate Labor and Hu-
for the reauthorization process,
the formulas for Title I and Title
planning providers, comprehensive hemo-
period.
IIIb), and pediatric demonstra-
man Resources Committee,
the GAO concluded that there
II of the CARE Act.
to address allegations of violations of each
part or the intent of the provisions of each
philia diagnostic and treatment centers, and
Title V
tion projects (Title IV). Special
chaired by Senator Nancy
were wide disparities in funding
The proposed formula change.
part of Title II.
non-profit organizations.
This new title is created.
Projects of National Signifi-
Landon Kassebaum (R-KS),
on a per case basis across Eli-
while promoted as a mechanism
cance are also funded with
Creates a single appropriation for Titles
Funding for SPNS will be provided un-
held hearings on February 22
gible Metropolitan Areas
to create greater equity in the
I & II for fiscal year 1996. The appropria-
PROPOSED CHANGES
der this title from a 3% set aside from each
CARE Act funding. The CARE
1995. In her opening remarks.
(EMAs) and states. The report
distribution of CARE Act funds
Act is the first comprehensive
Senator Kassebaum delineated
further concluded that the use of
tion is divided between the titles based on
Title III
of the other four titles. SPNS will continue
to new and emerging areas of the
the ratio of fiscal year 1995 appropriations:
Title III B requires that not less than 50%
federal program and represents
the goals of the hearing and her
the cumulative AIDS caseload as
to address the needs of special populations,
country impacted by HIV/AIDS,
36 % for Title II.
the largest authorization of fed-
intention to address the per-
a measure to calculate the for-
does not however take into ac-
of the funds be spent on the continuum of
assist in the development of essential com-
eral funds earmarked for HIV
primary care services.
ceived disparities and inequities
mula for Titles I & II was inap-
count the fact that 71% of all
The Secretary is authorized to develop
munity-based service infrastructure and
health and social services for
in the current distribution of
and implement a method to adjust the set
Allows for profit entities to receive ser-
ensure the availability of services to Na-
propriate because it included
AIDS cases are located in large
aside for Title I & Title II to account for
vice funding when they are the only avail-
tive American communities.
people living with HIV/AIDS.
CARE Act funding through
counts of persons who were de-
metropolitan areas. By restruc-
new Title I cities and other relevant factors
able provider of quality care.
Total funding not to exceed $25 mil-
Authorized for five years, the
changes in the funding formula:
ceased. Because of this factor,
turing the funding formulas, cit-
in FY 1997 and extending through FY 2000.
Provides $50,000 planning grants for the
lion per year.
current fiscal year is the last year
"...As we will learn this morn-
according to the GAO, newer
ies that still bear a disproportion-
estimate of liv-
development of services, with preference
Grants will be based on the need to test
for CARE funding. The CARE
ate burden of the epidemic and
ing AIDS cases weighted over a ten year
given to providers in rural and suburban
the effectiveness of a model of care; their
Act has provided over $2.5 bil-
"Once primarily a coastal urban
continue to experience increases
period modified by the cost of providing
innovative nature; or the potential for rep-
lion in federal funding for ser-
in caseloads will receive reduc-
areas.
services. 50% of the funds are allocated
Increases to 10% the amount of funds
lication. Native American communities are
vices for people living with HIV/
area problem, the HIV epidemic
tions in funding.
AIDS since 1991. In FY'95, to-
based on all cases in the states (including
allowed for administrative purposes.
targeted for support Other populations in-
Requires services to be consistent with
tal appropriations for the CARE
now reaches into the smallest and
Following the hearing, com-
mittee staff drafted S 641. On
the EMAs) and 50% are allocated based on
clude: rural communities; adolescents;
Act were $633 million. Reau-
cases in non- Title I areas alone.
the SCSN.
homeless persons and families; hemophili-
most rural areas of the country.
March 29, 1995, the Senate
thorization of the CARE Act
The funding loss a state could incur from
acs; and incarcerated individuals. Propos-
As the committee considers
Committee on Labor and Hu-
the formula changes over the five year pe-
CURRENT LAW
als must be consistent with SCSN.
must occur by September 30,
man Resources, unanimously
revisions to the CARE Act,
riod of the CARE Act is capped at 7.5%
Title IV: Pediatric AIDS Research
AIDS Education and Training Centers
1995, the end of this fiscal year,
approved the bill, the Ryan
(based on current funding levels). This cap
Demonstration Projects
(AETCs)
when the current law expires.
I believe it is important that
White CARE Act Reauthori-
Reauthorization Efforts
zation Act of 1995. The bill was
would be phased in over a five year period
Provides support for comprehensive
Establishes as a new part of the CARE
Fail in Final Days of the
adjustments be made to take
in increments of 2%, 1%, 1.5%, 1.5% &
pediatric, adolescent, and family HIV
Act funding for these clinical training pro-
cosponsored by Senator Nancy
1.5%, accumulating per year until the 7.5%
care programs and coordination of access
grams that were previously supported
103rd Congress
these changes into account."
Kassebaum (R-KS) and Senator
cap is reached.
to clinical research programs. Grants are
through a discrete appropriation.
During the second session of
the 103rd Congress, various ad-
- Senator Nancy Kassebaum (R-KS)
Edward Kennedy (D-MA).
Continued on page 7
8
Update May/June 1995
NATIONAL MINORITY AIDS COUNCIL
NATIONAL MINORITY AIDS COUNCIL
Update May/June 1995
5
RYAN WHITE REAUTHORIZATION: continued
Ryan White CARE Act Provisions
S 641 has the bipartisan support
A targeted allocation should also be
The CARE Act language cur-
CURRENT LAW
tors), with particular consideration given to
riod of the CARE Act, is capped at 7.5%
of 51 Senate co-sponsors and is
disproportionately affected and historically
(based on current funding levels). This cap
currently pending passage by
provided for the development of
rently does not specify sub-
Title I: Emergency Relief Grants to
stance abuse treatment as an eli-
Eligible Metropolitan Areas (EMAs)
underserved groups." Adds to list of PC rep-
would be phased in over a five year period
the full Senate. Advocacy ef-
infrastructure and capacity building
gible funding category. Some
Title I targets cities that are dispropor-
resentatives substance abuse providers, pe-
in increments of 2%, 1%, 1.5%, 1.5% and
forts are aimed at having the full
diatric, youth and women's service organi-
1.5%, accumulating per year until the 7.5%
among organizations operating in
Planning Councils have funded
tionately affected by HIV/AIDS with funds
Senate pass the CARE Act by
substance abuse treatment. af-
for outpatient medical care and support ser-
zations. Calls for an open process for nomi-
cap is reached.
unanimous consent (without
underserved, high need communities,
ter demonstrating the need in a
vices. Grants are made to the Chief Elected
nations of members for the PCs based on
amendments) as soon as pos-
CURRENT LAW
particularly communities of color.
particular situation. However,
Official (CEO) of the city or urban county
delineated criteria including a conflict of in-
sible.
planning councils may not per-
that provides outpatient and public health
terest standard for each nominee.
Title II: HIV CARE Grants
The House of Representa-
and bisexual men of color, in-
there is a shift in the burden of
ceive substance abuse treatment
services to the largest number of individu-
Requires PCs to establish priorities for
Provided to states to improve the qual-
tive's Committee on Com-
dividuals in recovery from drug/
cases between metropolitan,
to be an eligible service because
als with AIDS. The CEO appoints a plan-
allocation of funding based on documented
ity and availability of existing health care
merce, Subcommittee on Health
alcohol dependency, homeless
suburban or rural areas, the
it is not specified in the CARE
ning council to conduct needs assessments,
needs; cost and outcome effectiveness to the
and support services for persons with HIV/
and Environment. chaired by
persons, youth, and kinship or
CARE Act funding would not
Act. NMAC's position is that the
establish funding priorities and plan ser-
extent that data exist; priorities of the HIV
AIDS. Title II supports home and commu-
Michael Bilirakis (R-FL), held
other caregivers".
shift accordingly. This would
language in the CARE Act must
vices in municipal areas with-more-than
the of
care services, drug reimburse-
hearings on April 5. Currently
The language must also al-
prevent advocacy efforts from
be altered to clearly specify sub-
2,000 diagnosed AIDS cases, or 25 cases
other governmental resources; and the
ment, expensive pharmaceutical treatments
staff of the subcommittee are
low for participation on the
impacting on the breakdown of
stance abuse as a fundable ser-
per 100,000 people. Planning councils
Statewide Coordinated Statement of Need
and insurance continuation Title II is de-
drafting the House version of
planning council to be deter-
funding.
vice. The legislation should also
guarantee local community input in creat-
(SCSN). Gives PCs the discretion to assess
signed to establish and support a continuum
the CARE Act reauthorization
mined by other co-morbidity
We believe that the single
include substance abuse treat-
ing continuum of care services in their
the effectiveness of services in meeting
of AIDS health care, treatment and support
bill.
indicators which are closely as-
appropriation will also mean a
ment as an eligible service that
EMAs. Planning Council members must in-
identified needs. Requires PCs to participate
services.
NMAC Testifies Before
sociated with HIV. These in-
potential funding shortfall for
can be funded under Titles I and
clude representatives of health care, social
in the development of a SCSN coordinated
Title II establishes consortia which are
House Subcommittee
clude: tuberculosis and sexually
existing Title I cities, if and
II: substance abuse treatment
service, mental health service, provider or-
by the state.
associations of one or more public and one
Offers Minority Focused
transmitted disease rates. inci-
when new cities become eli-
programs as entities that should
ganizations, community-based and AIDS
Requires HRSA to give priority consid-
or more non-profit private, health care sup-
Recommendations
dence of homelessness, and
gible. Title I cities are vulner-
be on Title I planning councils;
service organizations, individuals with HIV,
eration under the Supplemental Grant ap-
port service providers and community-
At the hearings before the
substance abuse. These indica-
able to a reduction in funding
and supplemental funding pri-
non-elected community leaders and state
plications to those areas with more severe
based organizations (CBOs) operating in
House Subcommittee on Health
tors are all associated with pov-
every time new cities become
ority to Title I cities that have
government officials.
need based on the presence of sexually
those areas of the state most affected by
and Environment. Miguelina
erty and poor health. which in
eligible. If Congress does not
severe need based on rates of
In FY 1991, 16 cities were eligible. In
transmitted diseases, Tuberculosis, sub-
HIV/AIDS. HIV care consortia use funds to
Maldonado, Director of Gov-
turn, relate to the incidence of
appropriate sufficient additional
substance abuse, tuberculosis,
FY 1995, 42 cities qualified and in FY 1996,
stance abuse, severe mental illness and
develop and provide comprehensive out-
ernment Relations and Policy,
HIV in communities of color as
funds to cover increased costs,
other sexually transmitted dis-
59 cities are expected to be eligible for
homelessness. Allows funds to be spent on
patient health and support services for per-
NMAC, testified in support of
well as other communities. The
existing cities will suffer a re-
eases and homelessness.
grants. Half of the funds are distributed ac-
substance abuse services, treatment educa-
sons living with HIV/AIDS. Those states
reauthorization of the CARE Act
legislation must allow for ex-
duction in funding. The single
TECHNICAL ASSISTANCE
cording to a formula based on cumulative
tion, prophylactic treatments and for profit
that report one percent or more of all cu-
with its existing four-title struc-
panded nominations and selec-
appropriation also threatens the
ALLOCATION
AIDS caseloads and the other half is
entities when they are the only available
mulative AIDS cases in the United States
ture and advocated for inclusion
tion for membership processes
structural integrity of the CARE
The CARE Act must also al-
awarded through a competitive grant pro-
provider of quality care.
are required to use at least 50% of their
of language in the House bill to
on the planning councils based
Act, eliminating the distinct ap-
low for ongoing analysis of the
cess (supplemental application).
Amends the descriptions of costs sub-
CARE grants to establish HIV consortia in
address the needs of communi-
on locally delineated and pub-
propriation lines for Title I and
service needs in a particular
Administrative Caps: Provisions un-
ject to a 10% administrative cap for grant-
those areas with high numbers of persons
ties of color. The analysis that
licized criteria which reflects
II. Preserving the targeting of
population Planning Councils
der the CARE Act currently limit the ad-
ees and adds an administrative cap for
living with HIV/AIDS.
led to these positions focused on
the local demographics of the
funding to metropolitan areas
should be required to conduct.
ministrative costs of grantees (cities and
subgrantees (CBOs) of up to 12.5%.
Special Projects of National Signifi-
the issues that are particular to
epidemic and ensures diversity
with large concentrations of
at least on an annual basis, train-
states), but not those of subgrantees (ser-
Allows for the use of a single applica-
cance (SPNS) is designed to award direct
people of color. NMAC contin-
and representation.
people of color is essential to
ing, orientation, and program
vice providers and contractors).
tion for Title I funding (formula and supple-
grants to to public and non-profit entities
ues to spearhead efforts to in-
2. Funding Formulas
meet the expanding epidemic
review. A targeted allocation
mental). Creates a single appropriation for
including CBOs are funded through a set
clude legislative language on
The Senate bill includes a
among people of color.
should also be provided for the
PROPOSED CHANGES S. 641
Titles I and II for FY 1996. The appropria-
aside of up to 10% of the funds appropri-
the following areas:
single appropriation for Titles I
3. Program Structure
development of infrastructure
Title I
tion is divided between the titles based on
ated to Title II. Organizations proposing to
1. Minority Representation
and II. Of this single appropria-
SUBSTANCE ABUSE
and capacity building among
Changes eligibility criteria to require a
the ratio of FY 1995 appropriations: 64% is
demonstrate innovative models of deliver-
Language in the legislation
tion, 64% would go to Title I
TREATMENT
organizations operating in
Title I city to have a population of at least
designated for Title I.
ing health and support services to persons
must be changed and strength-
and 36% would go to Title II.
NMAC has long supported
underserved, high need commu-
500,000 and to have 5,000 AIDS cases over
The Secretary is authorized to develop
living with HIV/AIDS which can be repli-
ened to ensure greater represen-
The proportionate breakdown in
the programs that provide ser-
nities (particularly communities
the previous 5 years. Existing Title I cities
and implement a method to adjust the set
cated, are eligible to compete for these
tation for people of color in HIV
the Senate bill is consistent with
vices to people of color.
of color). Eligible activities for
would still be covered under the law, re-
aside for Title I and Title II to account for
funds. Target populations include substance
Planning Councils and other
the current funding for Titles I
NMAC's advocacy efforts in the
this funding would include tech-
gardless of whether they meet this criteria
new Title I cities and other relevant factors
abusers, participants in family based care
decision-making structures. The
and II. NMAC believes that the
area of program structure have
nical assistance to support grant
or not.
in FY 1997 and extending through FY 2000.
networks, the underserved hemophilia
legislation must include lan-
single appropriation would
focused on those areas that im-
and report writing, program de-
Composition of the Planning Councils
Grants are made based on an estimate of
community including minorities in rural
guage requiring the inclusion of
lock-in this specific percentage
pact people of color. According
velopment and administration,
(PCs) is amended to "reflect in its compo-
the number of individuals living with AIDS
and underserved areas, "Indians" with HIV
"historically underserved and
breakdown into the legislation
to the latest statistics, substance
evaluation techniques, and fis-
sition the characteristics of the current and
weighted over a ten-year period and the
disease and their families, rural communi-
disproportionately affected
and therefore undermine the
abuse - injecting drug use in
cal management.
projected epidemic in the eligible area in-
costs for providing services.
ties, incarcerated persons and homeless in-
communities and subpopula-
flexibility to respond to the epi-
particular - is directly respon-
ADMINISTRATIVE COSTS
volved (as evidenced in reported AIDS
The funding loss a city could incur from
dividuals and their families.
tions, including but not limited
demic supported by the current
sible for over 40% of all cases
The Senate bill limits the ad-
cases, HIV data, or other relevant indica-
the formula changes over the five-year pe-
Continued on page 8
to: women, people of color, gay
law. This would mean that if
among people of color.
Continued on page 9
6
Update May/June 1995
NATIONAL MINORDY AIDS COUNCIL
NATIONAL MINORITY AIDS COUNAL
Update May/June 1995
1
File
AIDS
THE NEW YORK TIMES,
WEDNESDAY, JULY 10, 1996
Clinton Is Criticized by His Own AIDS Panel
By DAVID W. DUNLAP
the nation's AIDS patients.
eral spending but said that Govern-
President Clinton's own AIDS
The council chairman, Dr. R. Scott
ment policy was "not consistent with
Hitt of Los Angeles, said yesterday
current knowledge regarding the im-
council has called on the White
House to show 'greater courage and
that he was also glad that the Admin-
pact of such programs on H.I.V. pre-
leadership" in taking steps to pre-
istration would grant waivers allow-
vention."
vent H.I.V. transmission and to pro-
ing foreigners infected with H.I.V. to
Steve Michael, an advocate for
tect people with the virus from dis-
enter the United States to attend the
people with AIDS who is running for
Olympics, which begin this month in
President under the banner of his
crimination.
"We commend the President's
Atlanta, and the Paralympics, which
own AIDS Cure Party, said the re-
dramatically heightened responsive-
follow the Olympics.
port "hits hard" on the Administra-
ness to the urgency of this epidem-
Since 1987, foreigners with H.I.V.
tion's prevention policies.
ic," the 30-member council said in a
have been barred from the country,
"The President could, with a
report released on Monday. "Howev-
but the Government has made ex-
stroke of the pen, lift the ban on
er, when compared with what truly
ceptions for events like the interna-
Federal funding," said Mr. Michael,
needs to be done, this Administra-
tional AIDS conference in San Fran-
40, who has H.I.V.
tion's efforts are still insufficient."
cisco in 1990, and the Gay Games in
But Ms. Fleming said, "Those ad-
Specifically, the council faulted the
New York in 1994.
vocating that Federal funds be spent
Government's failure to push for
"There is no evidence of any harm
should. turn their attention to the
needle-exchange programs, saying
that has come to anyone in the Unit-
Congress."
Federal prevention policy is "under-
ed States," Ms. Fleming said about
Mr. Clinton created the Presiden-
developed, lacks focus and is overly
past waivers. "I think it does greater
tial Advisory Council on H.I.V. and
timid.' And in the area of discrimi-
harm to keep people from coming to
AIDS last year. Unlike previous
nation, it said the Administration has
this country, greater harm to our
AIDS commissions, its purpose was
been "both notably strong and nota-
image worldwide and to individuals.
not to propose national policy but to
bly weak."
It perpetuates the stigma and dis-
identify specific steps that the Ad-
On behalf of the White House, Pa-
crimination that people with H.I.V.
ministration could take to halt the
tricia S. Fleming, the national AIDS
and AIDS face."
spread of H.I.V. and mitigate its ef-
policy director, said yesterday that
But the new report criticized Fed-
fects. The panel has issued three sets
she believed that the report was gen-
eral policy against needle-exchange
of recommendations so far.
erally "very positive."
programs, in which intravenous drug
Among them are that the Govern-
"It makes clear the President's
addicts turn in used syringes and
ment rescind mandatory H.I.V. test-
commitment, and it endorses his pro-
receive sterile ones.
ing in the Foreign Service, Peace
grams," Ms. Fleming said by tele-
The idea is to cut down the trans-
Corps, Job Corps, State Department
phone from Vancouver, where she is
mission of H.I.V. that occurs through
and armed forces, if there is no pub-
attending the 11th international
the sharing of needles. On the theory
lic-health justification.
AIDS conference.
that such programs encourage illicit
Ms. Fleming said yesterday that
And indeed, the council said it was
drug use, Congress has barred Fed-
the Job Corps policy was being
impressed by the Administration's
eral spending on them. And the Ad-
changed and that others were being
"strong commitment" to increase
ministration has said it cannot over-
examined "one by one to determine
money available through the Ryan
come the hurdles posed by that legis-
the rationale."
White Comprehensive AIDS Re-
lation.
source Emergency Act, which has
"When half the new infections in
been under attack in Congress, and
this country are by people using a
by its "vigorous resistance to the
dirty needle, we clearly need to do a
More national news
proposed dismantling" of Medicaid,
lot," Dr. Hitt said. The council did not
appears on page B8.
which pays the health costs of half
go so far as to call outright for Fed
Key Russian Legislator Accuses
THE NEW YORK TIMES,
WEDNESDAY, JULY 10, 1996
Leading Military Officers of Graft
Al
By MICHAEL R. GORDON
MOSCOW, July 9 - In an early
test of President Boris N. Yeltsin's
Continued From Page Al
Government building to a construc-
tion company in exchange for offi-
promise to root out corruption if re-
cers' apartments that were never
elected, the retired general who
Grachev and many of his top aides
delivered.
heads Parliament's defense commit-
were immune from serious legal
Mr. Rokhlin asserted that General
tee has accused some of Russia's
challenges.
Kobets's son was involved in the
highest-ranking generals of enrich-
But now that Mr. Yeltsin has dis-
company, and charged that the gen-
ing themselves from the military
missed General Grachev and ap-
eral also urged the transfer of $12
budget.
pointed Aleksander I.' Lebed, a re-
The charges, which have become
tired general, as his national security
million. worth of aircraft engines to
the company.
the talk of Moscow, have rocked the
adviser, General Grachev has sud-
denly become more vulnerable.
At a news conference today, Gen-
military establishment.
eral Kobets denied that his son had
They are also shaping, and per-
The allegations are coming from
Mr. Rokhlin, a political ally of Prime
any connection to the company and
haps are being shaped by, the strug-
Minister Viktor Chernomyrdin and
said that Mr. Rokhlin's charges were
gle to succeed the ousted Defense
also a retired general, who is well
a politically motivated attempt to
Minister, Gen. Pavel S. Grachev, who
regarded within the Russian mili-
influence the selection of the new
has himself been implicated in the
Defense Minister.
tary.
scandal.
Mr. Rokhlin charged on Friday
But much of General Kobets's ac-
"While soldiers are on a hunger
that General Grachev, his key aides
count of the tangled transactions ap-
ration, while officers wait to get a
and other high-ranking officers are
peared to raise as many questions as
flat for more than 10 years and get no
"mired in corruption."
they answered.
salaries for months, those close to
No sooner were the charges made
In another charge, Mr. Rokhlin
the Defense Minister are literally
than Parliament voted 301 to 0 to
asserted that Col. Gen. Dmitri Khar-
living it up," said Lev Rokhlin, the
demand a legal investigation.
chenko, whose daughter is married
defense committee chairman.
The charges have also created a
to General Grachev's son, pocketed
Corruption. is hardly a new phe-
sensation in the Russian mass me-
the interest from a $5 million bank
nomenon within the top ranks of the
deposit of government funds.
military. There have been persistent
In the new Russia, many ousted
reports of opulent dachas, secret
officials tend to retain their privi-
bank accounts and the sale of weap-
leges and perks. But the allegations
ons for private gain, even as Russia's
raise the possibility that former
military budget has shrunk and its
ranking officials may be prosecuted.
conscript army has been deprived of
And since corruption is believed to
basic provisions.
be widespread within the military
The problem of corruption, as well
and the Government, many are ask-
as the considerable risks in uncover-
ing how far the anti-corruption drive
ing it, were brought into stark relief
will go.
two years ago when Dmitri, Kholo-
In Russia's conspiracy-minded
dov, a 27-year-old reporter for the
capital, the timing of Mr. Rokhlin's
daily Moskovsky Komsomolets, was
report produced no shortage of spec-
blown up by a booby-trapped suit-
ulation.
case.
General Grachev, who has protest-
Mr. Kholodov had been investigat-
ed his innocence, insisted that Mr.
ing graft when Russian troops were
Rokhlin was nothing more than a
stationed in East Germany and as-
stalking horse for Mr. Lebed.
serted that two Mercedes sedans
"There is a simple reason for
were purchased for General Gra-
this," General Grachev told the
chev by selling army equipment.
newspaper Nezavisimaya Gazeta.
The newspaper took to calling the
"Lebed's supporters worked on
Defense Minister "Pasha Mer-
him."
cedes." Nevertheless, during his
Associated Press
years as Defense Minister, General
Ex-Defense Minister Pavel Gra-
Mr. Rokhlin has denied that he
chev, accused of illicit enrichment.
working on Mr. Lebed's behalf. But
Continued on Page A7, Column 1
he has endorsed Mr. Lebed's candi-
date for Defense Minister, Gen. Igor
dia, which originally disclosed some
Rodionov, and has acknowledged
of the most damning allegations.
that he wants to bar the door to
Tonight, the independent television
corrupt candidates.
network NTV broadcast a report in
For all the storm and fury, some
which a camera crew and investiga-
members of Parliament say more
tors from the prosecutor's office de-
sweeping steps must be taken to
scended on a dacha settlement. The
fight corruption.
broadcast showed army trucks car-
Aleksei Arbatov, a military expert
rying concrete and soldiers building
and member of the parliamentary
the dachas, which the network said
delegation led by the liberal reform-
were for high-ranking officers from
er Grigory Yavlinsky, said that the
the Strategic Rocket Forces and the
Yeltsin Government needed to ap-
Air Defense Forces.
point honest officials and to press the
Mr. Rokhlin's report was far more
Defense Ministry to disclose more
specific.
information about its finances.
In a litany of charges was the
"That there is unprecedented cor-
accusation that Gen. Konstantin Ko-
ruption is not news," Mr. Arbatov
bets, a chief military inspector who
said. "The system is not transparent.
is among the candidates to replace
General Grachev, was part of a plot
It is most secretive, and changing it
in which the military gave away a
is one of the conditions for fighting
corruption."
PARENTS:
THE PARENTS' GUIDE
TO
"Can you talk to your teenager about
AIDS? It's awfully hard for most parents.
To discuss AIDS, you have to discuss
three of the things we find hardest to talk
about with our own children: sex, drugs,
RISKY
and death. Teenagers aren't very eager to
bring up these topics either - at least not
with you. So you've got to break the ice."
- Beth Winship
B
e informed and break the ice. By using
RISKY TIMES and THE PARENTS'
TIMES
GUIDE together, you can:
Give your children accurate information
about this disease
A
Help your teens make smart, safe choices
about sex
Discourage them from experimenting with
Companion
drugs
Teach them that AIDS is not transmitted
to
by casual, non-sexual conduct
And encourage them to have compassion
Jeanne Blake's
for people with AIDS or HIV infection
Risky Times
Beth Winship writes "Ask Beth," the nation-
ally syndicated newspaper column for teen-
agers, and is the author of Ask Beth: You
Can't Ask Your Parents and Reaching Your
Teenager. She is the mother of four children.
© 1990 by Workman Publishing Co., Inc.
BY
ISBN: 0-89480-856-7
BETH WINSHIP
WORKMAN
Clinton Presidential Records
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