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Ryan White CARE Act Reauthorized Until 2005

Culminating two intense years of collaboration, coalition-building, and pressure by AIDS advocates and organizations nationwide, Congress passed the final Ryan White CARE Act reauthorization bill on October 5, and President Clinton signed it into law on October 20, 2000. The legislation ensures that the CARE Act program will remain a federal priority through fiscal year 2005.

Since 1998, the AIDS Foundation of Chicago has worked actively to support CARE Act reauthorization. In addition to meeting with members of Congress from Illinois and providing them with information about the local impact of the CARE Act, AFC strategized and collaborated with local and national partners to help shape the national AIDS advocacy efforts that ultimately resulted in passage of the bill.

AFC's statewide advocacy network was an especially critical tool in reauthorization efforts. AFC issued several "action alerts" when the voices of Illinois AIDS advocates needed to be heard by Illinois members of Congress. As an example, in early October, congressional action on the CARE Act appeared stalled, following several months of heated negotiations between congressional members and community groups. AFC alerted its more than 600-member statewide advocacy network to contact House Speaker Dennis Hastert, and urge him to schedule the bill for floor consideration. Within hours, the Speaker's office was flooded with calls from Illinois AIDS advocates calling for immediate action on the CARE Act bill. This effort, and those of our advocacy partners in DC and across the country, helped move the bill to the floor of the House where it was passed unanimously.

The final legislation signed by President Clinton maintains much of the original structure of the CARE Act and creates several new funding mechanisms to support HIV/AIDS services in medium- and small-population areas. For example, within Title II grants to states, the new law will create a special program to fund jurisdictions that are ineligible for financial support from Title I of the CARE Act, which is reserved for large metropolitan areas hardest hit by the epidemic. Another small program was created to help states that meet certain requirements – and that make matching state funds available – improve the drug formularies of their AIDS Drug Assistance Programs.

In addition, the new law will require that CARE Act-funded jurisdictions create quality management programs, develop plans to encourage individuals living with HIV who have not sought care to do so, and establish linkages between support services and medical care. For the first time, Title I and II jurisdictions will be allowed to vendor early intervention and outreach services, including HIV counseling and testing. Also, HIV case data will be used as a factor in determining Title I funding distribution as of fiscal year 2005, unless the Secretary of Health and Human Service determines that such data sets are not yet sufficiently accurate and reliable.

Despite efforts by AFC and other AIDS advocacy organizations to oppose financial incentives for states to establish mandatory newborn HIV testing, the new law includes such a provision. Mandatory newborn testing policies do nothing to help HIV-positive pregnant women access prenatal care, a critically important step in reducing perinatally transmitted HIV. Rather, such policies can have the adverse effect of discouraging women at high risk from seeking medical care for fear of losing confidentiality, child custody, or other rights.

AFC thanks Action Bulletin readers who made calls, wrote letters, and sent postcards to members of Congress in support of CARE Act reauthorization. Your efforts made a difference. We also extend our heartfelt thanks to the entire Illinois congressional delegation for supporting CARE Act reauthorization, and special thanks to those members who co-sponsored the legislation in their respective chambers: Rep. Judy Biggert, Rep. Rod Blagojevich, Rep. Jerry Costello, Rep. Danny Davis, Senator Dick Durbin, Rep. Lane Evans, Rep. Luis Gutierrez, Rep. Jesse Jackson, Jr., Rep. Ray LaHood, Rep. William Lipinski, Rep. David Phelps, Rep. Bobby Rush, Rep. Jan Schakowsky, and Rep. John Shimkus.

© Copyright 2001 AIDS Foundation of Chicago. All rights reserved.