Housing Works: Housing Prevents AIDS. Housing Improves Health.

Disturbed by the lack of urgency around creating a National AIDS Strategy and fixing the Ryan White CARE Act, Housing Works declined to sign on to the Federal AIDS Policy Partnership (FAPP) cover letter to the incoming Obama administration. The cover letter accompanied dozens of proposals that various members of the AIDS community sent to the Obama transition team.

“There has been much talk about us trusting the convening group with accurately reflecting the views of the community, yet we are either discouraged or not given the time and opportunity to provide thoughtful feedback or sharing it beyond those in the room,” Campbell wrote in a letter than was sent to the FAPP listserv. (See the entire letter below):

In addition to taking issue with the FAPP consensus-building process, Housing Works strongly disagrees with two elements of FAPP’s cover letter to Obama: FAPP’s call to extend the Ryan White CARE Act without addressing its many flaws and FAPP’s timetable for the creation of a National AIDS Strategy.

How long do we have to wait?

A National AIDS Strategy is a top priority among all AIDS advocates. However, despite the fact that most of the requirements for a national blueprint have already been laid out, FAPP is only asking the Obama administration to complete a National AIDS Strategy within one year of taking office. Housing Works wants Obama to have a plan in place within 100 days.

Some FAPP advocates stood by the one-year demand. “It’s unrealistic that we can have an inclusive process and make sure people with HIV and AIDS’ voices are heard in [100 days],” said AIDS Action Executive Director Rebecca Haag. “I’m sure if you put ten people who know a lot more than me about HIV/AIDS in the room, it could happen. But it wouldn’t have Congressional support, and it wouldn’t have community support. I think 27 years into the epidemic, a year is nothing to make sure we have a solid plan.”

Housing Works President and CEO Charles King took issue with that assessment. “There really isn’t all that much dispute about what’s needed from the perspective of people living with AIDS or prevention experts. What will largely be in dispute is formulas that go to the interests of AIDS, Inc. So buy-in becomes more about buying off.”

Jesse Milan, vice president and director of Altarum’s Community Health Systems Group, whose name has been floated as a prospective Obama AIDS appointee, was diplomatic in his views about a timetable for a National AIDS Strategy. “I agree that within the first 100 days we should have the structures in place to create a plan,” Milan said. “We need to have a team of people to lead that. There might be new structures that need to be put in place, and perhaps a national commission.”

Rethinking Ryan White

The Ryan White CARE Act was supposed to be reauthorized in 2009, but, in its current form, doesn’t address the ever-changing AIDS epidemic in this country, particularly in the South. Housing Works is calling for Ryan White to be an entitlement program, addressing all those in need, as opposed to discretionary funding that often serves AIDS service organizations more than people living with AIDS.

Some federal AIDS advocates want to focus on health care reform and not spend energy on a Ryan White battle. “The discussion for health care reform is going to zap all the energy out of the room, and AIDS advocates want to make sure we’ll have a place in this discussion,” said AIDS Action Political Director Bill McColl. He added that he is also worried about several issues, including the stability of code-based states moving to HIV names reporting and other issues.

But Housing Works Vice President of National Advocacy and Organizing Christine Campbell said we can walk and chew gum at the same time. “We need to figure out how to Ryan White is going to work as we develop health care reform,” she said.

Dear FAPP,

Housing Works will not be signing on to this document. We are writing to FAPP to express our concern over the challenges we, as FAPP, are having in conducting an open process through this administration transition and the RW legislation process. Where we appreciate the attempt to present a united AIDS community recommendation and how challenging it is to be collaborative in our efforts while pushing any process forward, we are disturbed and disappointed how feedback is not welcomed, dissenting opinions are ignored and outreach is limited in this process. We are being forced to either agree in total with the opinions of a few rather than obtaining and reflecting the consensus of the broader community, keep quiet or be viewed as mutinous. There has been much talk about us trusting the convening group with accurately reflecting the views of the community, yet we are either discouraged or not given the time and opportunity to provide thoughtful feedback or sharing it beyond those in the room.

The most recent example of this it the 2-pager to the Transition Team. There are recommendations we just completely disagree with yet have been told that there is no vehicle for substantial feedback. These include:

1. There is no requirements for a National AIDS strategy in the first 100 days
2. The goal of reducing HIV incidence rather than to ending the epidemic
3. The request for a simple three year extension to the current Ryan White Modernization Act
4. The reference to only two of the transition documents that were developed rather than the many that have been presented.

We have had the pleasure of being in part of several forums throughout the country in the past 5 weeks, as I am sure many of you have as well, and repeatedly we get asked the question as to how the national organizations that represent the broader HIV/AIDS community can adequately speak for us when they have not talked to us about the specific recommendations they are putting forth.

If we, as FAPP, really want to be in the position of speaking for the broader HIV/AIDS community our process needs to be more transparent, inclusive and reflective of the diversity within the community. We are embarking on challenging times and we need to work together differently than we have in the past, building a movement that will really end this epidemic.