jus« o u t V aprii 7. 1 0 0 5 ▼ 13 local news dvocates and service providers for people with HIV and AIDS in the Portland metro area are pleased. They will receive nearly all of the $1.5 million in supplementary 1995 Ryan White Comprehensive AIDS Resources Emer­ gency Title I grants they requested to help provide HIV/AIDS health and social services. “We’re delighted. I believe this happened thanks to the committed work of local and state health officials, members of the HIV and local communi­ ties, and a whole assortment of people who wanted to ensure we had the resources to provide these critical services,” says Jim Clay, the newly ap­ pointed executive director of the Portland area HIV Services Planning Council, Ryan White CARE Act, Title I. The council, which represents five Oregon counties— Multnomah, Clackamas, Washington, Columbia and Yamhill—as well as neighboring Clark County in Washington, was established fol­ lowing the 1990 passage of the Ryan White CARE Act, the first comprehensive federal program to provide substantial support to people with HIV/ AIDS. The act is divided into four titles that grant federal funds to states, cities and community- based organizations. The purpose of Title I is to provide emergency assistance to areas that have been disproportionately affected by HIV/AIDS. Title I grants are awarded to the chief elected official of the city or urban county (in this case, Multnomah County Commission Chair Beverly Stein) that provides outpatient and ambulatory public health services to the most people with HI V/ AIDS. This official in turn appoints a planning council to conduct needs assessments, allocate funds, and establish services. Council members must include representatives of health care, social and mental health service professionals, people with HIV, community leaders, and state govern­ mental officials. Planning councils are designed to assure local community input in creating a con­ tinuum of care services in their community. “We probably spent close to a year conducting this needs assessment,” says Rudy Vasquez, co­ chair of the Portland area HIV Planning Council, Title I. “We conducted several focus groups and met with all different facets of the community— people of color, women, service providers. We really wanted to get a sense of their needs.” This past December, the Portland metropolitan area received $986,510 in Ryan White CARE Act formula grants, which are awarded noncompeti- tively to metropolitan areas reporting 2,000 or more cumulative cases of AIDS. Sixteen cities qualified for grants in 1991; that number has in­ creased this year to 42 (including the Portland area) due to rapidly growing caseloads. Last month, federal Health and Human Ser­ vices Secretary Donna Shalala announced the allo­ cation of an additional $174.7 million in supple­ mental 1995 Ryan White CARE Act grants to help A Local officials delighted well as the dollar amount requested. Topping the list, which is prioritized, is housing assistance, followed by health insurance continuation, case management, medical care, and day or respite care. Other priority categories include funding for food banks and home-delivered meals for people with HIV and AIDS, transportation, drug reimburse­ ment, client advocacy, and buddy/companion ser­ Nearly all the Ryan White CARE Act funds requested vices. to provide HIV/AIDS services in Multnomah County "The fact that we got nearly all of what we requested seems like a real vote of confidence for are granted the work we’ve been doing,” says Clay. “ 1 think it indicates that the city, county, state and local communities have been really effective in working by Inga Sorensen together.” Says Vasquez, “We worked very closely with [various governmental entities] to make sure we’re not duplicating services and wasting resources.” According to Clay, the county recently re­ ceived “written and official” notice of the HRSA grant award and has sent out a request for proposals from community-based organizations and agen­ cies seeking to provide the services outlined by the council and county. Vasquez says the funds could be disbursed to selected service providers as early as May 1. Commitment to federal funding for HI V/A1DS was tested a few weeks ago when U.S. House members threatened to slash $13 million in 1995 Ryan White CARE Act funds and $23 million for prevention programs at the Centers for Disease Control. Sen. Patty Murray (D-Wash.)joined forces with Rep. Nancy Pelosi, a San Francisco Demo- | crat, to push two amendments that restored those | cuts. The amendments were adopted by the House g Appropriations Committee during an eight-hour 5 marathon session of the committee. All committee Democrats and 13 Republicans voted in favor of the amendments, giving Pelosi and Murray a 37-18 margin of victory. Jim Clay “I have seen the devastating effects of this and Services Administration, which administers epidemic,” says the 44-ycar-old Murray. “AIDS is urban areas deal with the growing costs of care for the Ryan White CARE Act funds, adds: “The the leading cause of death of Americans in my age uninsured or underinsured men, women and chil­ grants expand the number and variety of ambula­ group. That is sobering and scary. How many Cal dren with AIDS. The supplemental grants are tory medical services Andersons and Greg Louganises will it take before awarded competitively and help reduce inap­ we get serious?” based on evidence of “The Ryan White CARE Act propriate use of more Congress will decide perhaps by late spring the unmet needs of each costly in-patient and whether to reauthorize the Ryan White CARE Act, area’s residents living represents the largest emergency-room ser­ which expires Sept. 30. with HIV. governmental dollar investment “There is a large discussion in Congress about vices.” “The Ryan White Based on findings this right now and there seems to be strong bipar­ for the care o f people with HIV CARE Act represents of an exhaustive needs tisan support for the need to continue providing the largest governmen­ infection and AIDS. assessment by the area resources for HIV/AIDS services,” says Clay. tal dollar investment These grants ease suffering and planning council, the “There is, however, some debate as to whether that for the care of people M ultnomah County should be done through the Ryan White CARE Act with HIV infection and prolong the life o f thousands of Health Department, in or through a block grant to the state.” AIDS. These grants Americans ; ” conjunction with the He adds: “I definitely would like to sec Ryan ease suffering and pro­ council, applied for White refunded because an infrastructure is al­ long the life of thou­ $1.5 million in supplemental funds and was ulti­ ready in place and it works well. If we switched to sands of Americans,” says Dr. Philip Lee, HHS block grant funding, or any new system, it would mately granted $1,416,224. assistant secretary for health and director of the Among the materials submitted by local offi­ require creating a whole new infrastructure. That Public Health Service. (Title I receives by far the cials to HRSA is a chart detailing 17 service would only waste precious time and money.” largest portion of funding of the act’s four titles.) categories they plan to provide and/or expand, as Ciro Sumaya of the federal Health Resources E xperience the E xtra ­ ordinary R enaissance I n C arpetmaking . 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