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AFC on June 13, 2011 sent a letter to Illinois Governor Pat Quinn with recommendations on how to implement the state FY 2012 budget, which begins July 1. The recommendations include implementing a Medicaid expansion for people with HIV and leveraging the National HIV/AIDS Strategy, and touch on issues related to expanding accountability and transparency for state-funded HIV programs.
June 13, 2011
The Honorable Pat Quinn
Governor, State of Illinois
100 W. Randolph, Suite 16-100
Chicago, IL 60601
Dear Governor Quinn:
Thank you for your staunch support of services and funding for the states most vulnerable citizens, including people with HIV. Because of your support of the historic tax increase enacted in January, the states finances are far more secure than they otherwise would have been. However, we recognize that FY 2012 will be an exceptionally difficult budget year, and you face agonizing decisions about programs to continue or cut.
As you know, state-funded HIV services fared better than expected, but we remain extremely concerned about the potential impact on the lives and health of people with and at risk of HIV. Overall Illinois Department of Public Health () state HIV funding was cut by $1.5 million or 5% from FY 11. However, this funding reduction will be exacerbated by increased pressure on the AIDS Drug Assistance Program (ADAP).
To make long-term headway against the AIDS epidemic in the face of these budget challenges, we urge you to take immediate advantage of two new opportunities:
State HIV portfolio recommendations: Although we oppose combining all HIV-related budgetary lines in IDPH into one lump sum, as happened in the final budget, we believe this provides IDPH an opportunity to establish new collaborations to maximize available resources. The states AIDS response must consist of a comprehensive array of coordinated activities that directs services to hardest-hit communities with an array of evidence-based activities that yield maximum results. We recommend that the state:
With declining available resources, the need for heightened transparency and accountability is greater than ever to engender confidence in the strategic investments made by the state to advance the fight against HIV/AIDS.
ADAP recommendations: Earlier this year, IDPH announced that eligibility for new ADAP enrollees would be reduced from 500% of the federal poverty level to 300%. AFC remains staunchly opposed to this change but also recognizes the states fiscal challenges. Inadequate federal funding unacceptably weakens the program. We are committed to helping inform state decision-making and the community as Illinois faces these challenges.
SB 1802 will require IDPH to establish a waiting list for individuals who are unable to access ADAP services. We urge IDPH to immediately establish this wait list when FPL is reduced for new applicants above the 300% FPL threshold and release on its website weekly the number of people on the waiting list.
Thanks to a creative collaboration between the Departments of Insurance and Public Health, Illinois can leverage the Illinois Pre-existing Condition Program (IPXP) to provide comprehensive benefits to people with HIV who have been denied ADAP coverage at a significantly lower cost. While we applaud IDPH and DOI for coordinating IPXP and HIV programs, we urge the state to strongly consider setting a cap on the number of people for whom IDPH will provide assistance or providing only limited assistance. We are concerned that additional resources will be diverted from HIV prevention and care programs that assist the most vulnerable clients.
Department of Human Services Programs: Finally, AFC is deeply concerned about cuts to Department of Human Services homeless prevention (reduced by $915,000 or 38%) and emergency housing assistance funding (reduced by $4.38 million, or 52%). These programs help people stay in their homes by assisting with rent, utilities, or other expenses. Thousands of people around the state, including people with HIV, will face homelessness as a result of these budget cuts. We urge you to closely monitor and track the impact of these funding reductions.
Thank you for your long-standing commitment to health care and social services that improve the lives of low-income people. We look forward to further discussing the budget implementation issues mentioned here and others. You can reach me at firstname.lastname@example.org or (312) 334-0933.
David Ernesto Munar
CC: Mr. Jerry Stermer
Dr. Damon Arnold
Dr. Tere Garate
State Sen. Heather Steans
State Rep. Sara Feigenholtz
State Rep. Greg Harris
State Rep. Camille Lilly