Associated Press - February 8, 2012
NEW YORK -- New York City Council members grilled policymakers at
a packed hearing Wednesday over recent changes to public
assistance policies that they worry could lead to increased
homelessness and risky behavior among vulnerable New Yorkers sick
with HIV and AIDS.
Among the most contentious changes is a requirement that clients
of the HIV/AIDS Services Administration -- set up to help
vulnerable New Yorkers suffering from the virus -- be screened for
substance abuse and accept treatment or lose eligibility for some
The city has said that no one would be denied shelter because of
the policy, but that did not assuage the fears of some lawmakers.
Councilman Jimmy Van Bramer, who sits on the City Council's
general welfare committee sponsoring Wednesday's hearing, said he
was skeptical the policy accomplished the stated goal of reducing
"I believe you're punishing people, and in some ways pushing them
away at the very moment when you should actually be bringing them
closer," he said.
HASA Deputy Commissioner Jacqueline Dudley said the policy was
about improving the health of clients.
"It's the most responsible and caring thing that we can do, I
believe, to encourage them to get into treatment," she said.
She said adherence to substance abuse treatment would be one
factor weighed in assessing clients' eligibility for services.
Since the policy went into effect last fall, about 650 HASA
clients have been referred for treatment; about half of those
complied, according to a spokeswoman for the agency.
Another member of the committee, Councilwoman Maria del Carmen
Arroyo, wondered what happened with clients who refused to comply
with substance abuse treatment.
"We want to actively try to engage them and try to work with them
to accept the treatment," Dudley said. "Clients who are not
compliant will be offered alternative housing."
She said they would be offered housing where on-site counselors
are available to work with them on substance abuse.
Dudley said such housing was at 90 percent capacity.
Advocates and researchers said they were concerned that housing
was being used as leverage by the city to increase compliance
with substance abuse treatment.
They cited major studies in recent years that showed the critical
importance of stable housing for staying on life-saving
medications, reducing risky behaviors and obtaining medical care.
"They are making drug treatment the highest priority -- above
adherence to HIV antiviral medications, above survival," said
Ginny Shubert, a public policy researcher and consultant. "It
makes no sense. It is directly at odds with the way that other
communities and that other public health approaches are going
New York City continues to be the epicenter of the AIDS epidemic
in the U.S., with more than 100,000 people in the city having the
virus or full-blown disease.
HASA serves about 32,000 people, including 4,500 family members.
Clients are assigned case managers, and services can include home
care, counseling and cash assistance.
The city's substance abuse policy first got attention in
November, when the commissioner of the agency that oversees HASA
wrote a World AIDS Day column for The Huffington Post trumpeting
In that piece, published on Nov. 30, 2011, Human Resources
Commissioner Robert Doar said HASA clients who declined to
participate in substance abuse treatment could choose between
housing with on-site substance abuse counselors or the loss of
eligibility for assistance.
"This will stay in effect until proof of substance abuse
treatment is established. Tough? Maybe. But New York City is
serious when it comes to combating substance abuse," he wrote.
HIV positive New Yorkers disagreed with the new substance abuse
"I think it's a violation of the individual," said Wanda
Hernandez, 49, who is HIV positive and board chair of the HIV
advocacy group VOCAL-NY. "I don't think it should be a mandatory
thing to corner somebody into this."