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HIV/AIDS Funding Rules Restrictions
in Question
by Barbara Dozetos
Vermont organizations that provide services to people with HIV and AIDS are in disagreement over how the Department of Health can best fund such work.
On January 20, one group of consumers asked the House Appropriations Committee to add restrictions to the budget so that only existing AIDS services organizations and peer-run AIDS organizations could receive state funding.
“Our [proposed] changes direct the funds to pay for existing programs, rather than try to fund a range of separate programs in organizations that don’t deal primarily with HIV/AIDS,” said John Hannah, who made the proposal on behalf of the newly formed HIV+ Public Policy Project of Vermont CARES.
The original budget, passed last May, made a broader stipulation: that DoH funds could be allocated to any AIDS organizations with 75 percent or more of their programs in HIV/AIDS services or prevention.
But other Vermont organizations think that even the original plan was too restrictive. Rob Larabee, the statewide consumer organizer for the Vermont People with AIDS Coalition, thinks that making the money available to other organizations would be a positive move.
“We have to find ways to get to the people who are hiding from us,” said Larabee. He said that the highest rates of HIV infections now are among intravenous drug users, who often don’t want to be seen walking into an ASO. “People who are still using don’t want to be identified,” he said.
Some ASOs themselves also believe that competition should be free, even if that meant a smaller share of funding for their own organizations.
“I think it’s healthier that any group has an opportunity write up a proposal to get part of those monies,” said Tom Moch, co-executive director of AIDS Community Resource Network in White River Junction.
“If we can’t stand that competition, we’re in the wrong business,” said Susan Bell, Brattleboro Area AIDS Project director. She said her organization’s mission is to make the HIV-positive community and those at risk of becoming infected are served. “In the most rural areas, another organization might be better suited [for the work.]” Bell said.
Hannah disagrees. “This is not the time to make a healthier market through diversity,” he said. While allowing community doctors and clinics to provide services sounds like a cost-effective way to use funds, he contends it’s not necessarily best for the consumer.
“The experience of AIDS is not something every doctor can understand. Stigmatization is very high and a very high degree of specialization is required,” said Hannah.
Virginia Renfrew, a lobbyist formerly contracted by the VPWAC, now working for the HIV+ Public Policy Project, also cautions against what may be a move to mainstream HIV care and treatment. “I predict that if the funding gets opened up, the ASOs will be gone within two years,” she said.
“If that’s what the people with HIV/AIDS truly want, then so be it. But they should certainly be aware of what’s going on,” said Renfrew.
The House Appropriations Committee is expected to finalize the changes to the budget before Town Meeting Day.
The various AIDS/HIV organizations plan to address their philosophical differences with a meeting in the near future.