Living Testimony
Housing Works said its piece in Albany
On Wednesday Housing Works testified at the New York State Budget Hearings for the Department of Health in anticipation of what is expected to be a difficult budget year for poor people living with AIDS. During the hearing, in which the Health Department and Governor’s office also heard from family planning groups and community-based organizations, Housing Works made it clear that New York State can’t cut its way out of this crisis when it comes to AIDS.
“Across-the-board budget cuts, which many social service providers remember from Pataki-era budget proposals, do not address the needs of people in our state who are the most at risk in tough economic times,” read the beginning of the testimony.
Housing Works testified about potentially devastating changes to federal Medicaid policy, halting cuts to the AIDS Institute Budget, increasing the Public Assistance grant and increasing revenues in New York State in order to make sure the state’s most vulnerable aren’t hurt the most by the State’s financial crisis.
Read Housing Works’ testimony below:
Medicaid
Medicaid is New York’s single most important HIV/AIDS program, providing lifesaving health care and services for up to 100,000 HIV-positive New Yorkers and their families. People with HIV and AIDS in New York State rely on Medicaid to stay alive.
The Federal Center for Medicare and Medicaid Services’ Proposed Rule #7 will reduce the Federal Medicaid Upper Payment Limit (UPL) and will close the doors of clinics across the country. The proposed rule, “Medicaid Program; Clarification of Outpatient Clinic and Hospital Facility Services Definition and Upper Payment Limit,” will have a devastating impact on New York State’s Medicaid budget, and will disrupt the care of 400,000 New Yorkers who use these services to stay alive.
Housing Works has been working with the Governor’s office to oppose this regulation and call for a moratorium on the rule. So far this has not been successful, and the federal government plans to go through with the change in the Upper Payment Limit (UPL). Without a moratorium on this regulation, New York State alone will loose nearly $750 million statewide, and $65 million to Upstate alone, of life-sustaining out-patient care including services necessary to keep people with HIV/AIDS connected to care.
The majority of services that will be impacted are community-based – those serving the populations that live in our poorest communities and who are most at-risk and in need of more intensive care. Consistent contact with outpatient clinical settings prevents long-term hospitalizations, especially for our nation’s poor and sick. Any barrier to receiving healthcare puts a person with HIV at greater risk for progressing to full-blown AIDS.
Housing Works also thanks Governor Paterson for supporting and calling for an increase to the Federal Medical Assistance Percentage (FMAP) that would be added to the second emergency supplemental stimulus package. Federal legislation has been proposed to increase the percentage by at least 2.95%, which would help the state continue to provide consistent medical care to low-income and disabled New Yorkers and their families. Housing Works, however, wants to ensure that as we advocate for an increase in the federal match, that all of the “savings” that would result from any increase to FMAP be mandated towards health care in the state budget.
Increase in the Public Assistance Grant
Housing Works also calls on the State to finally increase the amount of the Public Assistance Grant. The last time the PA grant was increased was 1990, and the current amount is now only 50% of the federal poverty level (FPL). The reduced value of the cash grant over time has placed families receiving public assistance at greater risk of losing employment and being unable to meet their families’ needs, including medical needs. The State should increase the public assistance basic cash grant to reflect the rise in the cost of living since 1990, which would be from $291 to $492 (monthly) for a family of three.
New York State AIDS Institute Funding
At the same time as the economy has been crashing and funding to Medicaid is threatened, another grave reality has gripped our State. The Centers for Disease Control and Prevention (CDC) recently reported that the incidence for HIV is 40% higher than expected in the U.S., with over 56,300 new infections (2006). For New York, the news is even more devastating: the rate of new infections in New York is increasing at three times the rate of the rest of country.
Ironically, while the incidence rates are increasing, New York State cut funding to vital AIDS services and prevention programs through the AIDS Institute in the last budget cut in August. Services have been cut in areas that are essential to those living with HIV/AIDS, such as legal assistance, nutrition and transportation, mental health, housing, and intensive case management. In addition to services, essential prevention programs that provide access to harm reduction, HIV counseling and testing, and education and outreach have also been affected.
We cannot now give up the fight by cutting more funding from HIV/AIDS programs. Cutting more services and prevention programs will send us deeper into a crisis. Individuals living with HIV/AIDS in New York State depend on social services to survive. When services like housing, mental health care or medical access are negatively affected, this places low-income people living with HIV/AIDS further at risk for substance abuse, homelessness, and deadly progression of their HIV illness.
In addition, in times of economic hardship with less access to much-needed services and aid, people are also more likely to engage in risk behaviors associated with HIV/AIDS that place others in jeopardy, including exchanging sex for money or shelter. New York State cannot risk the cost to people’s lives, nor can we endure the fiscal implications of the continuing spread of HIV. We must act now.
Increasing Revenues in New York State
Housing Works believes that in order to truly and fairly balance the budget as we move forward, New York State must find new revenues. Cuts alone, and at the expense of the most vulnerable citizens, will not help us make it through this recession.
The State needs to explore the option of using the Tax Stabilization Reserve Fund to close the budget gap in the FY 2008-09 budget. Housing Works also calls for New York State to consider a progressive PIT increase and to provide property tax relief in relation to income in FY 2009-10, so that those who are earning more will share more of the burden.
There are other creative ways we can increase revenue, such as closing the loopholes in the Bottle Bill, placing bottle deposits in the control of the State and not the industry. Shutting down under-used juvenile detention facilities would also result in tremendous savings. It is time for us to change the way we balance the budget and protect those who are vulnerable in our state.
Posted on October 23, 2008 at 11:14 pm
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