Thursday, September 30, 2004

Status of federal HIV/AIDS appropriations

The U.S. government is operating under a continuing resolution through November 20.

On July 15, the U.S. House passed the Labor, HHS, Education appropriation bill for FY 2005. According to a committee press release, the following appropriations were recommended by the House for medical research and health programs:

  • Centers for Disease Control funding is $4.48 billion, $101 million below last year and $15 million above the budget request.
  • Community Health Centers are expanded - fourth year of the President’s proposed expansion of health services through the Community Health Centers Program. Total funding $1.8 billion, $219 million over last year and the same as the President’s request.
  • National Institutes of Health continues our commitment to the NIH by providing $28.5 billion, $727 million more than last year.
  • International HIV/AIDS, TB and Malaria programs are funded at $ 624 million, the
    same as the President’s request.
  • Infectious disease- Enhances CDC’s resources for preventing and controlling emerging infectious disease threats, such as SARS, West Nile Virus, and Monkeypox. ($ 398 million - +$ 29 million)
  • Homeland Security/Biodefense programs are supported at $ 1.694 billion in NIH, $1.638 in CDC and $543 million in hospital preparedness.
  • Ryan White AIDS program is increased by $35 million over FY04 with total funding of $2.1 billion.
  • Children’s Graduate Medical Education (GME) is funded at $303 million, the same as the President’s request and roughly the same as last year.
  • Low Income Home Energy Assistance Program (LIHEAP) is funded at $2.2 billion, an increase of $122 over last year.
  • Faith- and Community-Based Initiatives are increased including the Compassion Capital Fund at $55 million.
  • Abstinence- Provides $110 million for the discretionary abstinence education program, an
    increase of $35 million over FY04.
  • Social Security - Provides a 6% increase to the Social Security Administration to improve service delivery of Social Security benefits and accelerate the time it takes to process disability claims.
On September 15, the Senate Appropriations Committee voted out its bill for Labor, HHS, and Education. The committee provides the following highlights of appropriations for HHS programs:

  • Community Health Centers -- $1.867 billion, which is $31 million above the request and $250 million over last year. These centers provide critical health care services to underserved and uninsured people throughout America.
  • Pediatric Graduate Medical Education -- $303 million, the same as the President’s request.
  • Health Professions – The bill includes $465 million for Health Professions programs, which restores many of these programs which were eliminated in the President’s budget.
  • National Institutes of Health -- The Senate bill includes $28.9 billion, an increase of $1.1 billion over the FY’04 appropriation and $380 million over the President’s budget request.
  • Centers for Disease Control & Prevention -- The Senate bill includes an increase of $345 million over the budget request, for a total of $4.8 billion.
  • Pandemic Flu --The bill includes $75 million in new funding to ensure that an adequate supply of vaccine would be available in the event of a severe flu outbreak.
  • Global AIDS -- The bill includes $660 million for global HIV/AIDS activities. Within this total, $149 million is included for the Global Fund for HIV/AIDS/TB, which is $50 million over the budget request and the same as last year. In addition, $118.8 million is included in CDC for global HIV/AIDS/TB activities.
  • Family Planning -- $308 million, an increase of $30 million over the budget request and $30 million over FY’04.
  • Low Income Home Energy Assistance Program (LIHEAP) -- The Senate bill includes $2 billion for LIHEAP, the same total as the budget request. Of the funds provided $99.4 million was included for the contingency emergency fund.
  • Ryan White AIDS Programs -- $2.080 billion for the Ryan White AIDS programs, $35 million more than last year's budget.
  • Family Caregivers -- The Senate bill includes $157 million for family caregivers, an increase of $4.3 million above last year.
  • Head Start -- $6.935 billion for Head Start, an increase of $160.5 million over last year.
    Abstinence Education Programs -- $138 million, an increase of $36.5 million over the FY’04 appropriation.
  • Substance Abuse & Mental Health Services -- The bill provides $3.5 billion, an increase of $133.8 million over last year. SAMHSA is responsible for supporting mental health programs and alcohol and other drug abuse prevention and treatment services throughout the country.

If I read the congressional table giving the status of appropriations correctly, the full Senate has not yet voted on this appropriations bill, so the issue has not yet gone to conference committee. It makes sense, then, point out that $35 million for the Ryan White CARE Act will not cut the mustard.

The National Organizations Responding to AIDS (NORA) recommends a $217 million increase in funding for AIDS Drug Assistance Programs (ADAPs) alone. But there are other needs for funding in the Ryan White CARE Act, including early intervention services, case management, etc. The appropriations process for FY 2005 is pretty far along to have much of an impact on the final numbers we can expect out of the conference committee (and there is no disagreement about those numbers so far between the House and the Senate anyway), but it's still worth it to let our representatives in Congress know what is being missed in this appropriation cycle.

The new federal appropriation cycle gets underway in February, 2005.

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