Bloomberg AIDS Budget Draws Fire

AIDS groups and elected officials are opposing the Bloomberg administration’s 2004 city budget and many of them are drawing a line in the sand over one budget proposal––privatizing jobs at the HIV/AIDS Services Administration (HASA), a city agency that serves some 31,000 people with AIDS. The $44.5 billion budget for the fiscal year beginning July 1 must close a $3.8 billion gap, and included among the reductions is a $5 million cut in HIV prevention programs targeting communities of color, eliminating 29 HASA case manager positions to save $1 million and moving the Mayor’s Office of AIDS Policy Coordination to the health department to garner another $1 million in savings. The gap-closing plan, however, relies on contributions from the state and federal government as well as state approval of some new taxes. If those funds are not approved, the Bloomberg administration has proposed even deeper cuts that could include eliminating 400 HASA jobs to save $18.8 million. The so-called “doomsday” budget would also cut AIDS housing contracts by 10 percent to save $4.8 million and end service to 4,000 clients. While the budget proposal was short on details, it appears that the Bloomberg administration wants to eventually eliminate nearly 1,300 HASA case manager jobs and contract with AIDS or community groups to handle those responsibilities for the agency’s 31,000 clients. None of the proposals are winning much support among activists or elected officials. “Those cuts and others in the area of AIDS services are included in the mayor’s executive budget and it’s going to be one of our highest priorities to restore them,” said City Councilmember Bill de Blasio, chair of the Council’s General Welfare Committee which oversees HASA. The privatization plan is drawing the strongest criticism. HASA was launched in 1985 under an executive order from Mayor Ed Koch, but in 1997 the City Council enacted Local Law 49 which formally created the agency. The law was passed to stop the Giuliani administration from closing HASA. The HASA case managers help people with AIDS obtain federal disability benefits that can include enrollment in Medicaid, rental payments, and food stamps. They also assist clients in finding housing and other services. The proposed 2004 budget had the barest outline of the privatization plan. “Quite frankly the budget isn’t 100 percent clear,” said City Councilmember Christine Quinn, an out lesbian who chairs the Council’s Health Committee. “Yet I think it’s clear that the mayor has proposed to do things that he cannot do without the City Council’s approval and without changes in Local Law 49. That is not going to happen.” Bloomberg first broached the plan in a March 13 speech when he said that Local Law 49 should be amended because it “shortchanges community-based service providers, overlooks the critical role of medical providers, and prevents funds from being used to foster creative new programs.” He said any HASA restructuring could include more services for women and greater access to job training for clients who want to return to work though these items were not in the proposed budget. While AIDS groups and the City Council have sought improvements at HASA, they have also defended the agency. “The City Council is not going to make any changes that make Local Law 49 weaker,” Quinn said. “If we are going to do anything we are going to go in and open up Local Law 49 to raise the level of care… He can’t privatize functions. He can’t transfer functions to non-profits. That’s not allowed.” As Gay City News went to press, reports surfaced that the City Council is contemplating producing its own 2004 budget. This would be only the second time in the city’s history that the Council has done so. Armen Merjian, senior staff attorney at Housing Works said that even if the law were amended, the Bloomberg administration could not outsource the HASA jobs. The AIDS group has sued the city three times seeking to improve the service to HASA clients. They have cited the local law as well as two federal statutes––the Americans with Disabilities Act and the 1973 Rehabilitation Act––when arguing that HASA services are legally required as a “reasonable accommodation” to people with AIDS who are considered disabled under federal law. “The intensive case management system is not a matter of government largesse or gratuity,” Merjian said. “It is the analog for people living with AIDS to a hearing aid, a seeing-eye dog, or a wheelchair ramp.” Merjian said that 1996 and 2001 federal court orders require the city to provide case management services to HASA clients. “A federal district court issued a [1996] decision establishing that the city was obliged to provide the case management services that they provide through HASA,” he said. A 2001 order reaffirmed that. “What the mayor is proposing is doubly illegal,” Merjian said. “It is illegal under federal law and it is illegal under local law.” Activists have not forgotten where the federal courthouse is either. “[Bloomberg] could do it without amending Local Law 49, but he’ll be sued,” said Jennifer Flynn, co-director of the New York City AIDS Housing Network. “I do think it’s illegal.” A number of AIDS groups are already organizing what they hope will be a 5,000-person protest march against the cuts over the Brooklyn Bridge to City Hall and HRA on April 30. “These proposals on reforming HASA are going to be basically the death knell for a lot of people with HIV and AIDS,” said Dennis deLeon, president of the Latino Commission on AIDS. “He wants to privatize all of the case management services… I really wonder what the motive is. Is the motive to create more hurdles so people cannot get access to HIV benefits?” Ronald Johnson, associate executive director at the Gay Men’s Health Crisis (GMHC), was open to amending Local Law 49 so long as any changes did not reduce service to HASA clients. “It should enhance the quality of case management,” he said. “Anything that would compromise the quality of services to HASA clients we would oppose.” Johnson said that AIDS groups could provide some services currently supplied by HASA, but they could not be responsible to getting benefits for clients. “We’re only referring to psycho-social case management not anything related to the turning on of benefits and entitlements,” he said. “Certainly the broad concept of moving case management to community-based organizations is a good one and we would be supportive of it. We feel that case management is more effectively done by them.” Calls to City Hall and the Human Resources Administration––HASA is an HRA unit––seeking comment on the HASA proposal were not returned. AIDS activists also objected to the other proposed reductions in the budget. “What we find very problematic is, number one, the $5 million communities of color HIV prevention initiative has not been restored,” said Darryl Ng, GMHC’s director of government relations. “Number two, an additional $1 million cut by folding the Mayor’s Office of HIV/AIDS Policy Coordination into the Department of Health. This move will seriously undermine the purpose and efficacy of the office.” At a March 18 City Council hearing, Dr. Thomas R. Frieden, the city’s health commissioner, said the $5 million was a “one-time expenditure” and its exclusion from the budget did not represent a cut. Quinn was among the City Councilmembers and AIDS activists who battled the Giuliani administration to put the $5 million in the 2002 budget. “The $5 million which has been cut out is major issue for me,” she said on March 18. “With all due respect,8 the budget that was passed and agreed to by the mayor had that $5 million in it. We can play on,semantics, but the fact is that there is $5 million less available.” Moving the Office of AIDS Policy Coordination from City Hall to the health department was seen as downgrading the power of the office. “If you put it in DOH It undermines the whole purpose,” Ng said. “You don’t have that broad spectrum anymore. It undercuts the authority of the office.” Joe Pressley, executive director of the New York AIDS Coalition, agreed that the office needs City Hall behind it. “The office needs to be independent,” he said. “It needs to have direct access to the mayor.” home