Lessons Learned (GF, RC, USCA)lapublichealth.org/ · v a n d D a as De n v e tr Du t c h e s s P Co...
63
Changes in CARE Act Title I: Lessons Learned in Los Angeles and New York Gunther Freehill Director, Public Affairs County of Los Angeles Department of Health Services Office of AIDS Programs and Policy Robert Cordero Director of Federal Advocacy Housing Works New York October 23, 2004
Transcript of Lessons Learned (GF, RC, USCA)lapublichealth.org/ · v a n d D a as De n v e tr Du t c h e s s P Co...
Changes in CARE Act Title I:Lessons Learned in Los Angeles and New York
Gunther FreehillDirector, Public AffairsCounty of Los AngelesDepartment of Health ServicesOffice of AIDS Programs and Policy
Robert CorderoDirector of Federal AdvocacyHousing WorksNew York
October 23, 2004
2
Lesson No. 1
CARE Act Programs are a Moving Target.
3
Year 14 Title I ChangesEstimated Living AIDS Cases
• EMAs with Increase 51• Overall Increase 30,794• Overall Increase 14.5%• Largest Increase 22.0%• Smallest Increase 8.6%
4
Year 13, 14 ChangesEstimated Living AIDS Cases (ELAC) by EMA
108.6%
122.0%
100.0%
105.0%
110.0%
115.0%
120.0%
125.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonioSan
Dieg
o
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
5
Year 13, 14 ChangesProportion ELAC by EMA
94.9%
106.6%
88.00%
90.00%
92.00%
94.00%
96.00%
98.00%
100.00%
102.00%
104.00%
106.00%
108.00%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonioSan
Dieg
o
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
6
Year 13, 14 ChangesFormula Award by EMA
96.7%
105.8%
92.0%
94.0%
96.0%
98.0%
100.0%
102.0%
104.0%
106.0%
108.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonioSan
Dieg
o
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
7
Year 12, 13 ChangesSupplemental Award by EMA
136.2%
67.7%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
140.0%
160.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBos
tonCag
uas
Chicag
oClev
eland
Dallas
Denve
rDetr
oit
Dutche
ss C
ounty
Fort La
uderd
aleFort
Wort
hHart
ford
Housto
n
Jack
sonv
illeJe
rsey C
ity
Kansa
s City
Las V
egas
Los A
ngele
sMiam
i
Middles
ex-S
omers
et-Hun
terdo
n
Minnea
polis
-St. P
aul
Nassa
u (Suff
olk C
ounty
)
New H
aven
New O
rlean
sNew
York
Newark
Norfolk
Oaklan
d
Orange
Cou
ntyOrla
ndo
Philad
elphia
Phoen
ixPon
cePort
land
Riversi
de / S
an Bern
ardino
Sacram
ento
San Anto
nioSan
Dieg
o
San Fran
cisco
San Jo
seSan
Juan
Santa
Rosa
Seattle
St. L
ouis
Tampa
- St P
etersb
urg
Vinelan
d-Millv
ille-B
ridge
ton
Was
hingto
n, D.C
.
West P
alm B
each
8
Year 13, 14 ChangesSupplemental Award by EMA
70.9%
160.5%
50.0%
75.0%
100.0%
125.0%
150.0%
175.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonioSan
Dieg
o
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
9
Year 13, 14 ChangesMinority AIDS Initiative by EMA
80.4%
258.4%
0.0%
50.0%
100.0%
150.0%
200.0%
250.0%
300.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonio
San D
iego
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
10
Year 13, 14 ChangesTotal Title I by EMA
86.2%
117.5%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
140.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonio
San D
iego
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
11
Year 13, 14 ChangesFunding per ELAC by EMA
87.4%
119.3%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
140.0%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonio
San D
iego
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
12
Lesson No. 2
Hold Harmless Doesn’t.
13
Allocating FundsTitle I Formula 1990• 75%: Cumulative AIDS Cases
! Cumulative AIDS Cases Each Jurisdiction / Cumulative AIDS Cases Among Jurisdictions
• 25%: Ratio of Relative Density! Density: AIDS Cases per 100,000 Population! Ratio: Density of Each Jurisdiction / Total of
Densities for All Jurisdictions
14
Allocating FundsTitle I Formula 1996• 100% Estimated Living AIDS Cases
! Ten-Year Band! Adjusted for Estimated Mortality
• “Hold Harmless”! Maximum Reduction of Formula Award! One Percent per Year of Base Year
15
Allocating FundsTitle I Formula 2000• 100% Estimated Living AIDS Cases
! Ten-Year Band! Adjusted for Mortality! Use HIV Cases as of 2004 or 2007
• “Hold Harmless”! Maximum Reduction of Formula! Minimum Two Percent per Year of Base Year! Graduated Increase for Consecutive Years of
Need (Maximum of 15%)
16
Year 13, 14 ChangesProportion Funding per ELAC by EMA
80.00%
100.00%
120.00%
140.00%
160.00%
180.00%
Atlanta
Austin
Baltim
ore
Bergen
Passa
icBosto
nCag
uasChica
goClev
eland
Dallas
Denve
rDetr
oit
Dutches
s County
Fort Lau
derdale
Fort Worth
Hartford
Houston
Jack
sonvil
le
Jerse
y City
Kansa
s City
Las Veg
as
Los Angele
sMiam
i
Middlesex
-Somers
et-Hunter
don
Minneapolis
-St. P
aul
Nassa
u (Suffo
lk County)
New H
aven
New O
rlean
sNew
YorkNew
arkNorfo
lkOak
land
Orange C
ountyOrla
ndo
Philadelp
hiaPhoen
ixPonce
Portlan
d
Riversi
de / San
Bern
ardino
Sacram
ento
San A
ntonioSan
Dieg
o
San Fran
cisco
San Jo
seSan
Juan
Santa
RosaSea
ttle
St. Louis
Tampa -
St Pete
rsburg
Vineland-M
illville
-Brid
geton
Washington, D
.C.
West P
alm B
each
Year 13 Ratio
Year 14 Ratio
17
“Hold Harmless” BeneficiariesYear 13Austin 46,749 2.27%Bergen Passaic 93,206 3.47%Denver 51,269 2.04%Dutchess County 11,420 1.77%Fort Worth 3,006 0.17%Jersey City 78,578 2.52%Kansas City 92,252 5.21%Los Angeles 505,749 2.65%Miami 311 0.00%Minneapolis 29,769 1.82%-St. Paul
Newark 52,101 0.62%Oakland 90,991 2.50%Orange County 26,915 0.99%Ponce 6,53 0.44%Sacramento 50,461 3.14%San Diego 60,011 1.15%San Francisco 7,467,493 44.67%San Jose 34,488 2.37%Santa Rosa 59,051 9.36%St. Louis 6,992 0.29% TOTAL 8,767,493 2.84%
18
0%
20%
40%
60%
80%
100%
Austin
Bergen
Pas
saic
Denve
rDutc
hess
Cou
ntyFort
Wort
hJe
rsey C
ityKan
sas C
ityLo
s Ang
eles
Miami
Minnea
polis
-St. P
aul
Newark
Oaklan
dOran
ge C
ounty
Ponce
Sacram
ento
San D
iego
San Fran
cisco
San Jo
seSan
ta Ros
aSt. L
ouis
“Hold Harmless” Benefit by EMAYear 13
“Hold Harmless”“Raw” Formula
19
“Hold Harmless” BeneficiariesYear 14Bergen Passaic 55,288 2.12%Boston 60,284 0.81%Cleveland 4,616 0.25%Denver 6,475 0.27%Jacksonville 12,825 0.51%Jersey City 58,310 1.93%Kansas City 134,485 7.84%Middlesex 8,315 0.55%Minneapolis 33,770 2.13%
- St. PaulNassau 21,212 0.67%New Haven 42.573 1.17%
Newark 10,975 0.13%Oakland 50,744 1.44%Sacramento 36,456 2.34%San Francisco 7,358,239 45.50%San Jose 12,097 0.86%San Juan 41,011 0.50%Santa Rosa 22,614 3.70%Seattle 9,844 0.33%Tampa 44,908 0.94%
– St. PetersburgWest Palm Beach 8,523 0.19%TOTAL 8,033,564 2.63%
20
0%
20%
40%
60%
80%
100%
Bergen
Pas
saic
Boston
Clevela
nd
Denve
rJa
ckso
nville
Jerse
y City
Kansa
s City
Middles
ex-S
omers
et-Hun
terdo
n
Minnea
polis-
St. Pau
l
Nassa
u (Suff
olk C
ounty
)New
Hav
en
Newark
Oaklan
dSac
ramen
toSan
Francis
coSan
Jose
San Ju
anSan
ta Ros
a
Seattle
Tampa
- St P
etersb
urgW
est P
alm B
each
“Hold Harmless” Benefit by EMAYear 14
“Hold Harmless”“Raw” Formula
21
Lesson No. 3
Appropriations Matter.
22
Appropriations by Proportion
23
Lesson No. 4
Title I Awards are not Transparent.
24
Year 14 Title I ChangesCompetitive Supplemental Application
• Application Rank and Funding IncreasesTotal Increased
! Top Third 17 3! Middle Third 17 4! Lowest Third 17 3
• Lack of Transparency in Allocation Decisions
25
Projected Ranking of Application by EMA Year 13
50.00%
55.00%
60.00%
65.00%
70.00%
75.00%
80.00%
85.00%
90.00%
95.00%
100.00%
105.00%
Housto
n
Orange
Cou
nty
San Fran
cisco
Los A
ngele
sSea
ttle
San D
iego
Newark
Dutche
ss C
ounty
St. Lou
is
Jerse
y City
West P
alm B
each
New H
aven
Fort W
orth
Boston
Phoen
ixBalt
imore
Denve
rMiam
iDall
as
Minnea
polis
-St. P
aul
Philad
elphia
Portlan
dHart
ford
Las V
egas
Atlanta
Fort La
uderd
aleDetr
oit
Nassa
u (Suff
olk C
ounty
)Aus
tin
Jack
sonv
ille
Bergen
Passa
ic
Was
hingto
n, D.C
.San
Jose
Oaklan
d
Middles
ex-S
omers
et-Hun
terdo
n
New O
rlean
s
Riversi
de / S
an Bern
ardino
Clevela
ndChic
ago
Santa
Rosa
Tampa
- St P
etersb
urgNorf
olkOrla
ndo
Kansa
s City
San A
ntonio
Ponce
Cagua
s
Sacram
ento
Vinelan
d-Millv
ille-B
ridge
tonSan
Juan
New Y
ork
Maroon: Decreased Year 13 FundingTeal: Increased Year 13 Funding
26
Projected Ranking of Application by EMA Year 14
50.00%
55.00%
60.00%
65.00%
70.00%
75.00%
80.00%
85.00%
90.00%
95.00%
Housto
nBos
ton
San D
iego
Los A
ngele
s
Fort La
uderd
ale
Wes
t Palm
Bea
chNew
York
Philad
elphia
Seattle
Orange
Cou
ntyPho
enix
Sacram
ento
Jerse
y City
Dallas
Minnea
polis-
St. Pau
lPort
land
New H
aven
San Fran
cisco
Atlanta
Chicag
oMiam
i
Dutche
ss C
ounty
Hartfor
d
Kansa
s City
Cagua
sDetr
oitAus
tin
Las V
egas
Bergen
Pas
saic
Fort W
orth
Santa
Rosa
San Jo
seDen
ver
Nassa
u (Suff
olk C
ounty
)Orla
ndo
Baltim
oreClev
eland
Newark
Jack
sonv
illeOak
land
Ponce
Tampa
- St P
etersb
urgSt. L
ouis
Was
hingto
n, D.C
.
Riversi
de / S
an B
ernard
ino
San A
ntonio
Middles
ex-S
omers
et-Hun
terdo
nSan
Juan
Vinelan
d-Millv
ille-B
ridge
tonNorf
olk
New O
rlean
s
Maroon: Decreased Year 14 FundingTeal: Increased Year 14 Funding
27
From Application to Allocation
• Step 1: Determine Formula and Supplemental Funds
• Step 2: Calculate Formula Award• Step 3: Reduce Supplemental Funds for
“Hold Harmless”
28
From Application to Allocation
• Step 4: Reduce Supplemental Funds as Needed! Minority AIDS Initiative! Evaluation Tap! Other Programs TBD
• Step 5: Score Each Application• Step 6: “Normalize” Scores
29
From Application to Allocation
• Step 7: Calculate Distribution Factor! Multiply Score by Formula Award
• Step 8: Calculate Relative Distribution Factor! Sum Distribution Factor! Divide Distribution Factor by Sum of
Distribution Factor
• Step 9: Apply Proportion of Relative Distribution Factor to Supplemental Funds
30
From Application to AllocationExample No. 1
EMA Formula Score Distribution Factor
Relative Distribution
Factor
Supple mental TOTAL
X 5,000 100 500,000 8.70% 8,696 13,696 Y 100,000 50 5,000,000 86.96% 86,957 186,957 Z 10,000 25 250,000 4.35% 4,348 14,348
TOTAL 115,000 5,750,000 100.00% 100,000 215,000
31
From Application to AllocationExample No. 2
EMA Formula Score Distribution Factor
Relative Distribution
Factor
Supple mental TOTAL
X 5,000 100 500,000 8.00% 8,000 13,000 Y 100,000 50 5,000,000 80.00% 80,000 180,000 Z 10,000 75 750,000 12.00% 12,000 22,000
TOTAL 6,250,000 100.00% 100,000 215,000
32
From Application to AllocationExample No. 3
EMA Formula Score Distribution Factor
Relative Distribution
Factor
Supple mental TOTAL
X 5,000 100 500,000 4.65% 4,651 9,651 Y 100,000 100 10,000,000 93.02% 93,023 193,023 Z 10,000 25 250,000 2.33% 2,326 12,326
TOTAL 10,750,000 100.00% 100,000 215,000
33
Lesson No. 5
Title I Awards Are Unstable.
34
Year 14 Title I Changes
EMAS with Increases in Title I Funds (Total)
Funds ELAC! Number 11 11! Average Change 6.4% 15.9%! Smallest Change .1% 8.6%! Largest Change 17.5% 22.0%
35
Year 14 Title I Changes
EMAS with Decreases in Title I Funds (Total)
Funds ELAC! Number 40 40! Average Change - 5.7% 14.2%! Smallest Change - 0.3% 9.8%! Largest Change - 15.8% 20.1%
36
Year 14 Title I ChangesFunds per Estimated Living AIDS Case
Year 13 Year 14• Overall 2,816 2,443• Minimum 2,390 2,130• Maximum 5,166 4,137
37
Lesson No. 6
Title I Has Changed Substantially.
38
Allocating FundsTitle I EMA Eligibility 1990• Criteria
! Two Thousand AIDS Cases in Five Years! Per Capita Cumulative Incidence Greater
than 2.5 per 100,000
39
Allocating FundsTitle I EMA Eligibility 1996, 2000• Criteria
! Two Thousand AIDS Cases in Five Years! (Per Capita Cumulative Incidence
Repealed)! Minimum Population 500,000! Previously Designated Remain Eligible
40
Allocating FundsTitle I EMA Eligibility
Total1990 161996 492000 51
41
Allocating FundsTitle I Supplemental 1990• Severe Need
42
Allocating FundsTitle I Supplemental 1996• Severe Need: HIV Services Impact of
! Sexually Transmitted Diseases! Substance Abuse! Tuberculosis! Severe Mental Illness! Other Co-Morbid Factors! New or Growing Subpopulations with HIV! Homelessness
43
Allocating FundsTitle I Supplemental 2000• Severe Need: Additional HIV Services
Impact of! Prevalence! Increase Need for Services, Including
Relative Rates of AIDS Cases! Unmet Need for Services
• One-third of Supplemental Score
44
Lesson No. 7
Title I Expectations Increase.
45
Community PlanningTitle I Council Duties 1990• Establish Priorities• Develop Comprehensive Plan• Assess Efficiency of Administrative
Mechanism
46
Community PlanningTitle I Council Duties 1996• Establish Priorities
! Documented Need! Cost and Outcome Effectiveness! Priorities of Affected Communities! Availability of Other Government
Resources
• Develop Comprehensive Plan
47
Community PlanningTitle I Council Duties (Cont’d) 1996• Assess Efficiency of Administrative
Mechanism! Including Effectiveness of Services
Supported• Statewide Coordinated Statement of
Need• Obtain Community Input on Needs
and Priorities
48
Community PlanningTitle I Council Duties 2000• Determine Size and Demographics of
People with HIV• Determine Needs, Emphasizing
! People with HIV Not In Care! Disparities in Access and Services
49
Community PlanningTitle I Council Duties (Cont’d) 2000•Establish Priorities
! Documented Need! Cost and Outcome Effectiveness! Priorities of Affected Communities! Availability of Other Government
Resources
50
Community PlanningTitle I Council Duties (Cont’d) 2000• Develop Comprehensive Plan,
Including! Strategies to Find People with HIV Not
In Care! Coordination with HIV Prevention! Compatibility with State or Local Plan
51
Community PlanningTitle I Council Duties (Cont’d) 2000• Assess Efficiency of Administrative
Mechanism! Including Effectiveness of Services
Supported• Statewide Coordinated Statement of
Need
52
Community PlanningTitle I Council Duties (Cont’d) 2000• Obtain Community Input on Needs &
Priorities• Coordinate with Federal Grants
53
Themes and Issues
• Increasing Guidance! Services to be Supported! Location of Services! Populations to be Served
• Underserved• Rural• Remote• Women, Children, Family and Youth
54
Themes and Issues
• Increasing Cross-Over! Early Intervention Services! Services to Women, Infants, Children
and Youth
55
Themes and Issues
• Increasing Expectations! Quality Management Programs! Data Collection! Outcome Evaluation! Coordination
56
Themes and Issues
• Persistent Questions! Structure of the Titles! Equity of Distribution! Potential Value of Block Grants! Entitlement vs. Discretionary Programs! Coordination with other Funding Sources
57
Themes and Issues
• Statutory! Amended Language! Member Request! Report Language! “Congressional Intent”! Appropriations Language
• Regulatory
58
Themes and Issues
• Not in the CARE Act…! Minority AIDS Initiative
• Programmatic• Appropriations
! HIV Prevention! HOPWA! SAMHSA! Medicaid
59
Framing Reauthorization
• National Advocacy Groups! AIDS Action! AIDS Policy Alliance! CAEAR Coalition! National Minority AIDS Council (NMAC)! National Association of People with AIDS
(NAPWA)! National Association of State and Territorial
AIDS Directors (NASTAD)
60
Framing Reauthorization (Cont’d)
• Institute of Medicine Reports! Measuring What Matters! Public Financing
• HRSA/CDC Advisory Committee• Early Treatment of HIV Act (ETHA)
61
Time Line
• Election November 2004• 109th Congress January 2005• CARE Act 2000 Expires
30 September 2005
62
Questions and Opinions
63
Contact Information
Gunther FreehillCounty of Los AngelesOffice of AIDS Programs and
Policy600 S. Commonwealth Ave.
Sixth FloorLos Angeles, CA 90005Phone: 213/351-8340Fax: 213/738-9371E-mail: [email protected]
Robert CorderoHousing Works
320 West 13th StreetNew York, NY 10014
Phone: 212/645-8111 Ext. 1Fax: 212/645-9750E-mail:
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