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U.S. Congress Reauthorizes CARE Act

By Armand Cachero and Nick Truong

The Ryan White CARE (Comprehensive AIDS Resources Emergency) Act was reauthorized, passed by Congress, and signed by President Bush on December 6, 2006. The CARE Act funds healthcare for people living with HIV/AIDS with the intent to fill the gaps in care for people with low incomes and little or no insurance. The CARE Act is named after the Ryan White, a young man who contracted HIV as part of his treatment for hemophilia in the early eighties. As a result of his AIDS diagnosis, he was expelled from school because of the supposed health risk to other students. His situation became a controversial issue in North America with AIDS activists lobbying to have him reinstated while attempted to explain to the public that AIDS cannot be transmitted by casual contact but rather only by blood and sexual contact (Wikipedia). He died on December 8, 1990.

The reauthorization has major changes compared to its last version which includes a mandate that 75% of the service dollars must be allocated to “core medial services.” Those core medical services are defined in the legislation. Among the core medical services that affect the delivery of programs at APAIT include treatment adherence (treatment education), mental health counseling and psychotherapy, psychoscoial case management, and translation/interpretation or language services. Since funds trickle down on to local jurisdictions, the local health department and the Commission on HIV is in the midst of priority allocation.

One of the successes of this version’s legislation is the inclusion of linguistic services as part of support services. Thanks in large part to lobbying by partners like the Asian Pacific Islander American Health Forum and Bienestar Human Services, this is the first time that the need for linguistic services has been acknowledged in bill language.

The legislation would call for strengthening “hold harmless” provisions and maintaining funding levels so that states would not receive less than 95% of their 2006 funding levels; counting all HIV-positive people for funding regardless of where they live or how the data are reported; maintaining the funding pool for prescription drugs and therapeutics (AIDS Drugs Assistance Program/ ADAP); continuing the Health and Human Services Department’s development of a framework addressing HIV/AIDS in the US and a follow-up report of their progress in 2008; and maintaining a four-year transition period for states with code-based HIV reporting systems to switch to names-based reporting systems without penalty.

While local health department priority setting allocation sessions will likely be finalized by the time this is published, APAIT is committed to ensuring that there will be no service gaps and that sustaining our CARE programs, now titled “Mind, Body, Spirit and Wellness” program, remain the soul of our core program services. Over the past several years, APAIT has been successful in securing private funding dollars to sustain its CARE programs including but not limited to support from Johnson and Johnson, Entertainment Industry Foundation, Kaiser Permanente Foundation, and Queenscare Foundation.

Meanwhile, the Ryan White CARE Act will continue to provide much needed services for people living with HIV/AIDS despite the decrease of funds for urban areas like Los Angeles and New York cities. APAIT hopes that you will join in its efforts, along with other service providers, in advocating for increase in HIV treatment funding at future advocacy campaigns.