San Francisco officials are once again being urged to backfill millions of dollars in federal funding cuts to HIV and AIDS services.
Due to planned reductions in the city's share of Ryan White HIV/AIDS Treatment Modernization Act funding, the city will see a $2.1 million cut to its AIDS programs and the loss of $1.88 million in HIV prevention dollars from the Centers for Disease Control and Prevention in the fiscal budget for 2013/2014, which begins July 1.
It is hoped that the city can absorb the $4 million loss with local resources.
"I believe it is doable," said gay District 8 Supervisor Scott Wiener, who worked with his board colleagues, AIDS advocates, and Mayor Ed Lee's administration last year to restore nearly $7.5 million in federal HIV/AIDS funding cuts. "We are going to be working closely with the mayor's office to really try to make that happen. But nothing is guaranteed."
In late January Wiener called for a special hearing before the board's budget committee, which will take place the last week of March, to discuss this year's pending HIV cuts. The mayor has until May 1 to present his proposed budget to the board, with the final version due June 3. The board has until July 31 to adopt the budget.
Last year, during the two-year budget process, the city backfilled 50 percent of the federal HIV/AIDS funding cuts, or roughly $3.5 million, for the upcoming fiscal year.
A $500,000 reduction in the current fiscal year in Ryan White Part D funding for Larkin Street Youth Services' HIV program was also backfilled with half of that amount added to the 2013/2014 budget. The city is being asked to restore the remaining $250,000 in funding this year.
The full amount of the budget hit this year to the city's programs for people living with HIV and AIDS, as well as its HIV prevention programs, remains unclear due to the enactment of the federal sequestration cuts that took effect Friday, March 1.
"We all have to work very hard to build the political support for backfilling that amount," said Wiener, who sits on the extended five-person budget committee as one of two additional members during the budget negotiations.
It is estimated the total impact to the city's budget will be $25 million due to the across-the-board 5 percent sequester cut in federal programs.
"Locally, this means that fewer low-income families will receive assistance to purchase necessary food, fewer youth aging out of foster care will receive support and education, and more homeless people will be unable to access shelter," stated Mayor Ed Lee in a press release. "I urge Congress to work with the president to stop these blunt cuts to our critical services in our nation's cities."
City officials have yet to specify how that number breaks down for individual programs. In her March 5 report to the city's Health Commission, Health Director Barbara Garcia wrote that city-funded health services would see a $6.2 million reduction in federal funds this fiscal year but did not specify what the exact cuts would look like.
"At this point, we are still uncertain of the impact sequestration may have on our HIV/AIDS programs," Garcia told the Bay Area Reporter. "The Department of Public Health will work closely with the mayor's office and our community-based partners to minimize the effects of these cuts to our most vulnerable residents."
AIDS advocates expect that 5 percent of the $20 million San Francisco will receive under Ryan White, which also covers programs in Marin and San Mateo counties, will be cut under sequestration, meaning an additional $1 million would need to be backfilled.
"Certainly, from the perspective of the HIV/AIDS Providers Network, we are committed to keeping the system of care whole. To do that is going to mean support from the mayor's office and supervisors, especially if sequestration makes the situation worse," said Mike Smith, who chairs HAPN and is executive director of the AIDS Emergency Fund. "And it is about to get worse."
Because of the sequestration cuts, Wiener's office doesn't expect to know until sometime in May or June the total amount needed to backfill HIV funding this year.
"Depending on what the sequester cut is, it may raise the amount and makes it more difficult. But we don't have that information yet," said Wiener. "This is one more example of the insanity in Washington affecting real people in very real ways."
In a statement sent to reporters this week, the San Francisco AIDS Foundation said that the sequester cuts will "threaten life-saving HIV/AIDS care and prevention services" and result in "a troubling step backward in the fight against HIV/AIDS."
Some of the pending reductions AIDS advocates are bracing for nationally include 7,400 people being cut from the AIDS Drug Assistance Program and 424,000 fewer HIV tests being provided.
California is expected to see 49,300 fewer HIV tests and a $12.4 million cut to its substance-use treatment grant, resulting in 9,400 fewer treatment slots, said SFAF. Sequestration will also mean a hit to HOPWA, the Housing Opportunities for Persons with AIDS, program.
The only good news, said SFAF Director of Legislative Affairs Ernest Hopkins, is that the funding has yet to be provided so people receiving treatment will not be "pulled out of care" immediately.
"It gives us at least some time to plan for the cuts and try to advocate at the local level for additional money to make the programs whole so we don't lose anyone to care. But it is a bad time," said Hopkins.
The sequester cuts may be a one-time reduction, however, if the White House and Congressional leaders can devise a budget solution going forward, said Hopkins. If not, then the lost HIV/AIDS funding will be a problem for the next decade.
"We hope the sequestration process will be able to be managed and we will be able to get rid of sequestration in [later] years. This is a 10-year project; the first year is the most severe bite of the apple," said Hopkins. "Still, the cuts will continue to come if we don't do away with sequestration every year for 10 years."
The board's budget and finance committee hearing about the HIV cuts will take place at 1 p.m. Wednesday, March 27 in the legislative chambers, Room 250 at City Hall.