‘Poor and HIV? Billionaire Mayor Doesn’t Care”; “Make Wall Street Pay, Not People with AIDS”: That’s the response from advocates to the proposed $7.6 million in budget cuts and reforms at the city HIV/AIDS Services Administration, or HASA. In classic fashion, they’ve been demonstrating not only in front of Human Resources Administration offices, but also outside the Brooklyn home of HRA Commissioner Robert Doar.
In other words, AIDS-treatment activists haven’t changed tactics since the ’80s — and are outraged that the city actually wants to adjust to today’s vastly changed landscape for AIDS treatment and survival, as well as the worst budget crisis since the 1970s. And the City Council looks like it might cave — again.
Contra the advocates, New York has always been the most magnanimous of cities for HIV/AIDS patients. HASA was the first city agency of its kind, organized in 1985, a mere four years after scientists had named the disease. Its budget is now more than $400 million a year — up 40 percent under Mayor Bloomberg.
HASA helps low-income AIDS sufferers get physical and psychiatric assistance, food stamps, SSI benefits and Medicaid; it also provides homemaking services, free transportation to doctor appointments, vocational training and counseling.
New York is just about the only US municipality to add millions of local tax dollars to federal housing funds for HIV/AIDS patients, allowing the city to provide “enhanced” and “above-enhanced” cash assistance for its about 33,000 patients and their 13,000-plus dependents.
The advocates have never been satisfied with this largesse, let alone open to any reductions just because the city’s broke. Last year, HRA proposed some savings by eliminating redundancies where assisted-housing vendors provide case workers on top of HASA’s staff; the City Council came up with $5 million to forestall the reform.
Now the Bloomberg team seeks the same change, $7.6 million this year, as well as several smaller reforms, amounting to almost $8 million, less than 2 percent of HASA’s total budget. Speaker Christine Quinn has said she won’t approve a budget with any case-worker cuts, but it’s not clear whether the council has the discretionary funds to fill the gap again. If advocates don’t get their way, they’re likely to sue — further delaying the reform.
Also rankling advocates and their friends on the council is a new HASA policy requiring drug screening (and treatment, if appropriate) for those applying for cash rental assistance.
The policy’s aimed at a serious problem: Intravenous drug use accounts for about a quarter of new HIV/AIDS cases each year in New York. And the issue isn’t just needle-sharing, but also addicts’ greater propensity for high-risk sexual activity. Advanced anti-retroviral drugs now help these patients live longer and healthier lives — but addiction still makes self-sufficiency unlikely.
HASA doesn’t even plan a drug test, just an interview — and refusal to cooperate will at worst merely reduce the level of taxpayer assistance. But the advocates’ council champions aren’t swayed. Councilman James Van Bramer claims screening is a way of “punishing people” — meaning, of course, AIDS patients, not taxpayers. Annabel Palma, who chairs the council’s General Welfare Committee, objects that HRA hasn’t done a cost-benefit analysis on the screening policy — an impossible feat in any reasonable time frame.
The realities of AIDS and of the city budget continue to change. No matter how much the activist community may prefer denial, City Council members have a duty to face reality, reject the advocates’ unreasonable demands — and embrace reform.
Kay Hymowitz is a contributing editor of City Journal.