Copyright 2000 The Chronicle Publishing Co.
The San
Francisco Chronicle
JULY 26, 2000, WEDNESDAY, FINAL EDITION
SECTION: NEWS; Pg. A3
LENGTH: 856 words
HEADLINE:
S.F. Faces Big Cut In Federal AIDS Funds;
House to vote today on
reallocation plan
BYLINE: Carolyn Lochhead, Chronicle
Washington Bureau
DATELINE: Washington
BODY:
The House is poised today to slash San
Francisco's share of funds under a big federal AIDS program that sent
$35.2 million to the city this year.
The city could
lose as much as 25 percent of its AIDS prevention and care funding in five years
under the Ryan White Care Act, which the House of
Representatives is expected to renew today by a near unanimous vote. The bill
contains a change in the funding formula that determines where AIDS money goes.
Rep. Tom Coburn, R-Okla., who sponsored the bill, argued that if San
Francisco is no longer the epicenter of the AIDS epidemic, then the city should
no longer be the epicenter of AIDS funding.
"We're trying to make sure
the money goes where the epidemic is, and today it's not," Coburn said. "Today
it's going where the epidemic was."
Coburn, a physician who has treated
AIDS patients, said San Francisco receives twice as much federal money per
individual AIDS case as other cities where the rate of HIV infection is rising
faster, particularly among minorities and women.
Data released by the
House Commerce Committee show that under the current formula, San Francisco
receives $4,938 in Ryan White funding per AIDS case, while
Oakland receives $2,430.
The bill gradually would
change the funding formula to target HIV infections rather than full-blown AIDS
cases in an attempt to shift funds to areas where the disease is rising. The
provision most directly affecting San Francisco would allow funding levels for
any city to drop by as much as 25 percent if the number of AIDS cases declines
sharply.
The bill enjoys broad support from Democrats, including Los
Angeles Rep. Henry Waxman, a chief co-sponsor who helped write it, and many
black and Latino members whose districts receive about half of the money per
individual AIDS case as San Francisco.
"Justify why somebody in San
Francisco who is HIV positive has $5,000 spent on them and
somebody in Wyoming has $100 spent on them," Coburn said. "You
can't justify that. And you can't justify the fact that on average, everybody
else in the country has $2,500 spent on them, and somebody with
HIV in San Francisco has $5,000 spent on them."
Rep.
Nancy Pelosi, D-San Francisco, plans to vote for the overall bill, which extends
the Ryan White Care Act, but strongly objects to the changes in
the funding formulas.
Pelosi said that when the House and Senate bills
are melded together, she will push for the Senate version, which calls for a
more modest formula change that would narrow San Francisco's potential loss to
10 percent over five years and does not shift to HIV tracking.
But a big
fight is sure to ensue when the two versions are hammered together, pitting
cities that stand to lose under a formula change against those that would gain.
If the House version prevails, Pelosi said she will lobby for much
higher increases on overall AIDS funding to keep San Francisco from losing
funds.
"Our needs are not reduced," Pelosi said. "I don't want anybody
to have any illusion that we can absorb any cut in our funding on care."
If the new formula threatens such cuts, she said, "We'll have to
continue to increase that pot dramatically to compensate.
"There's a
sentiment that there are so many more communities that need to provide care, and
we want them to have it," Pelosi added. "We just don't think it's fair for them
to take money from one place to give it to another, but instead to increase the
size of the pie."
Spending on the Ryan White program has more than
doubled already -- to $1.6 billion -- over the past four years.
Coburn insisted that those trends will continue as the number of
nationwide HIV infections continues to swell, so that San Francisco will at
least stay even with its current federal funding even if its share of overall
funding declines.
If spending continues to soar, he said, San Francisco
could even wind up with more money even as it gets a smaller share of the total.
Fred Dillon, public policy director for the San Francisco AIDS
Foundation, a nonprofit group that provides services to AIDS patients and
receives Ryan White money, said such huge increases are unlikely.
Funding for the portion of Ryan White funds that San Francisco receives
would have to double over the next five years for San Francisco to stay even,
Dillon said.
"We would not be protected from those cuts unless there's
an enormous increase that is virtually unforeseeable in the next five years,"
Dillon said.
The city's AIDS care and prevention funding has fallen
since a previous formula change four years ago, Dillon said, even as other
cities have seen double-digit increases.
"We don't disagree that, as
much as possible, the formula should direct money to new pockets of the
epidemic," Dillon said. "But we firmly believe that any cuts in any area need to
be made in a reasonable manner, so that the existing system of care is not
destabilized."
Coburn praised San Francisco's AIDS services, saying he
is not trying to degrade them but to improve services elsewhere.
E-mail Carolyn Lochhead at lochheadc@sfgate.com
LOAD-DATE: July 26, 2000 
