Monday, July 10, 2006

Appropriation victories

When we testified at the Department of State Health Services Stakeholder hearing in April, we had a lot of points to make in a very short period of time.
  • One of the points was that the Department should make a request for increased funds for HIV. The reason for making so simple a point is that, without a request, the legislature will pay less attention to HIV. The community can request additional funding, but it is harder to justify that funding when the state's agency responsible for HIV acts as if there is no need by failing to include a request in its Legislative Appropriation Request (LAR). This has happened in the past with the Department, leading to some fairly tough battles to secure funding. While the simple fact of inclusion in an LAR does not guarantee funding, it does improve the chances of getting funding. Texas AIDS Network is pleased that the Department has acted on our request (while acknowledging that staff in the HIV Program itself had a critical role to play in making this happen).
  • Another point that we made is that the Department's request should be assigned a high priority. Items in the list of Exception Item Requests may be assigned a rank or relative priority by the requesting agency. The priority assigned has some effect on appropriations. Legislators consider the relative priority as an indicator of importance and need. When funds are in short supply, only the highest priority items may be funded. Others may receive funds as they become "available," i.e., when the Comptroller certifies that there is enough money in the state's treasury to supply the request. Texas AIDS Network is gratified that all of the EIRs related to HIV/AIDS received the highest priorities. Only the gap in mental health hospital funding received such a high priority (#2).
  • A third point that we made was that funding for the Texas HIV Medication Program should be increased sufficiently to allow for expansion and improvement of the program. Typically, the Department has only made appropriation requests based on current services. That is, the Department requests funds that will allow a program to provide only the same services as are currently available to clients who meet current eligibility requirements. Such a "current services budget" does not allow for effective planning to meet actual need. The LAR for HIV Medications, regrettably, only covers current services and does not meet the need that has been identified for expansion and improvement of THMP to include medications for co-infections or to treat the side-effects of HAART. Texas AIDS Network will continue to advocate for increased funding to go beyond current services and meet the need.
  • Another point in our testimony was that the Department needed to request funds for services and prevention. The Network is pleased that the Department has risen to the challenge posed by federal funding cuts and made a modest attempt to make up for the shortfall. Again, the request made by the Department only achieves "current services," but, in the face of cuts, that represents progress.

On the whole, the DSHS LAR for 2008-2009 has responded to many of our requests. While there is work to be done to see that the Texas Legislature funds these requests and to convince them to go beyond current services to meet the need, we should all pause and savor the victory. All too often, we simply move from one stage to another in a lengthy process without appreciating what we have accomplished so far. Community members who participated in this process should take a moment to pat themselves on the back, enjoy a moment of achievement. And then get back to work, of course!

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