Mixed Verdict on State Budget

BY PAUL SCHINDLER | As Governor David Paterson's administration and state legislative leaders scramble to finalize the budget legally due on April 1, advocates for the LGBT community and those living with HIV or working to prevent the virus' spread offered divergent views on the impact of key decisions made in Albany.

“GMHC Denounces Cuts to New York State AIDS Institute,” was the headline of a press release issued April 1 by the Gay Men's Health Crisis, which emphasized the two-percent cut in the state agency's budget for the new fiscal year beginning July 1.

“GMHC Denounces Cuts to New York State AIDS Institute,” was the headline of a press release issued April 1 by the Gay Men's Health Crisis.

GMHC argued that the cuts would hurt community-based AIDS service providers, who, it said, offer care to tens of thousands of New Yorkers, and predicted that the pain would be felt in core HIV services, testing, and prevention education. Noting that funding for such community groups was flat during Republican Governor George Pataki's administration, GMHC clearly suggested that it had hoped for more from the new Democratic governor, who took office just last month after the sudden resignation of Democrat Eliot Spitzer, who served just over one year.

In sharp contrast to GMHC's take on the budget, however, was the way in which Housing Works, another city AIDS group, framed its analysis. “Housing Works Applauds New York State Health Care Budget Reforms” was the headline of that group's press release, issued on April 2.

Housing Works pointed to a series of reforms in the state's massive Medicaid program that will, within a few years, shift up to $300 million annually from hospitals and nursing homes to community-based service providers, primary care physicians, and lower cost hospital out-patient services. Such reform has been a key health care goal of the Spitzer-Paterson administrations and has had strong support from Housing Works since Spitzer assumed office in January 2007.

Most New Yorkers living with AIDS rely on Medicaid.

The budget also provides financial incentives for the training of primary care physicians and to encourage them to practice in underserved areas, including inner-city neighborhoods where infection rates are high.

Housing Works shared GMHC's concern about the cuts to the AIDS Institute budget, and noted that when Paterson ordered an additional two-percent reduction in all non-entitlement budgets when he took office, some constituencies, such as hospitals and nursing homes, were able to negotiate a smaller hit during the legislative wrangling, while others, such as HIV/AIDS programs, were not.

Charles King, the group's president, said that advocates will press the Assembly and the governor to make up some of the AIDS Institute's shortfall in their discretionary budgets.

In fact, Dick Gottfried, a Chelsea Democrat who chairs the Assembly Health Committee, said that his chamber had already designated $1 million from its discretionary budget to reduce the $2.1 million hit to the AIDS Institute nearly in half. He acknowledged that had the $2.1 million been restored in negotiations with the Senate, the $1 million from the Assembly would have resulted in an increase for the agency.

Gottfried echoed King's assessment of the success hospitals and nursing homes had in the budget negotiation process, terming their interests the “almost exclusive focus” of Senate Republican efforts in the health care area.

Gottfried also shared the Housing Works view on the significance of the shift in Medicaid funding policy toward smaller, community-based and primary care providers.

“In my years doing health budgets I've never seen anything like this,” he said. “It is an enormously important shift in policy.”

A spokesman for the governor's budget office declined to comment on the prospects for the executive branch supplementing the AIDS Institute budget out of its discretionary dollars, saying that no assessment on that sort of issue would be made until the budget process is complete.

On another front, the Empire State Pride Agenda, New York's primary LGBT rights lobbying group, hailed the allocation of health and human services funds for non-HIV programs targeting the LGBT community.

More than 50 groups statewide which are part of the New York State LGBT Health and Human Services Network are due to receive nearly $8 million from the new budget – just under $6 million from Paterson's executive budget and a little more than $2 million from the Assembly's discretionary budget.

The funding level from the governor's executive budget is roughly the same as last year, and the Assembly has increased its contribution by about 50 percent.

“We know that this is a difficult time for New York State fiscally and we are very pleased that Governor Paterson and the Assembly have essentially maintained the historic level of funding that our community received in last year's budget,” said Alan Van Capelle, the Pride Agenda's executive director, who noted that the Network serves more than 600,000 LGBT New Yorkers each year.

Van Capelle singled out Gottfried and Deborah Glick, an out lesbian Democrat who represents the West Village in the Assembly, for their leadership in securing the health and human services funding.