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Michigan stands to lose millions in HIV funding due to new federal funding rules

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MahurinPointing_Thumb_2491.jpg

A new federal funding formula from the Centers for Disease Control and Prevention in Atlanta will result in a reduction of $2.1 million in federal funding for the state of Michigan for HIV testing and prevention by 2014.

Advocates and health officials warn the cuts could have a negative impact on the state’s public health.

“The prevention measures to minimize incidence of HIV also impact numerous other Public Health problems such as sexually transmitted infections, teen pregnancy, cervical cancer, infertility, low birth weight, infant mortality, substance abuse and mental health,” says Renee Canaday, deputy health director of the Ingham County Health Department. “Thus, this funding cut is likely to have far reaching effects.”

The funding cut is the result of a new formula designed to get more money into Southern states that are facing the brunt of the epidemic currently. Under the new formula, Michigan Department of Community Health, Division of Health, Wellness and Disease Control Director Amna Osman wrote in a July 6 memo to HIV prevention funded organizations in the state, the cuts will come quickly and steeply.

“Under this new formula, in FY 12 Michigan will lose up to $1.4 million (22 percent) of our total current (FY11) award for “core” HIV prevention activities. By 2014, when the funding formula is fully implemented, Michigan’s losses will total up to $2.1 million which represents a reduction of 33 percent of our current federal funding.”

“The CDC ‘core’ funding is the

primary

source of funding supporting HIV testing in local health departments, partner services, community-based HIV testing, prevention for positives, health education and risk reduction for high risk negative individuals, and community-level interventions such as Mpowerment.”

The reductions come at a time the CDC says new infections are disproportionately impacting African-American gay men — particularly youth. Detroit is currently experiencing the epidemic at what leaders have called an “emergency” level and Congressman Hansen Clarke, (D-Detroit) declared it a “public health crisis.”

None of the agencies Michigan Messenger talked to was able to pinpoint how significant their funding reductions from the state would be or exactly what program offerings would be hit the worst in the cuts.

Kelly Neibel, spokesperson for the Michigan Department of Community Health, said in an email that the state is still evaluating how the cuts will be spread around.

The CDC funding formula change certainly poses a significant challenge for us here in Michigan. The funds awarded for “core” HIV prevention activities are the main source of funding for a variety of efforts, including supporting HIV testing in local health departments, partner services, community-based HIV testing and prevention, education and risk reduction activities.

We are currently evaluating the funding reductions and the impact they will have on our prevention portfolio. We want to make sure we complete a thorough analyses – this will be the foundation for decisions we will make about how to best utilize the resources we have while minimizing the impact of the reductions on those we serve. We will also be working with our partners and stakeholders to identify strategies to help us do just that.

Bill Antsey, deputy heath officer for the Kent County Health Department, said without know what was being cut it was difficult to be sure what impacts the cuts will have. He did say that while the department will continue to offer HIV testing at the health department, funding reductions will likely reduce the department’s ability to do innovative outreach to at-risk groups. He said the department has been traveling with its rapid testing capabilities to bars and other sites for after hours testing. That, he said, cost the county in overtime and was likely one item that would be lost in the cuts.

“Any time you remove resources from the system, from public health it does make it more difficult to respond to every day issues and extremely difficult to respond to a large event — an outbreak or cluster of HIV or syphilis or food borne illness outbreak,” Antsey said.

While the county health departments, which have endured state revenue sharing cuts for a decade, say they will struggle with cuts, at least one AIDS service organization says they believe they are financially prepared to deal with the cuts.

“The current and proposed HIV prevention cuts, while very disturbing,- especially as it relates to job loss, cannot compare to the ultimate loss which will occur in lives among MSMs and other high risk groups who will not know that they are infected or that they are infecting others,” says Helen Hicks, chief executive officer of the Michigan AIDS Coalition. “For the moment, thanks to the generosity of the design community and numerous foundations, we are stable.”

Emily Dievendorf, policy director at Equality Michigan, expressed concerns about the cuts.

Michigan has recently been bombarded with sobering news related to the spread of HIV. Recent reports have clearly identified communities in Michigan that are particularly vulnerable to the epidemic. We have yet to see a report revealed that makes a case for less resources and education toward HIV prevention, detection, and treatment, and we now know where resources need to be directed – and yet an ever-diminishing response to the HIV/AIDS crisis is exactly what we are seeing from our federal and state of Michigan budgets.

Michigan is reaching a critical point in our battle against the virus and is already operating with the bare minimum of material and staff support. The Healthy Michigan Fund, a portion of the Department of Community Health Budget that funds HIV prevention programs, is still targeted for complete elimination. Michigan cannot afford to wind down our efforts as federal funds fade to the background. Michigan lawmakers must work to protect and replenish the resources the state of Michigan dedicates to combating the spread of HIV.

Republican leaders in the state government also acknowledged the coming cuts.

Geralyn Lasher, communications director for Gov. Rick Snyder, issued the following statement to Messenger related to the cuts.

As the letter clearly points out, the Division of Health, Wellness and Disease Control is doing an analysis of the impact these reductions will have on Michigan. I am certain they will be working closely with the state budget office once their analysis is complete to develop the strategies they mention in the letter to lessen the impact of these reductions. We are going to let them do their work and properly assess what this will mean to the program.

Federal funding for MDCH HIV and AIDS initiatives is crucial to the department’s efforts and we view a reduction in federal funding as a serious concern. Again, we will let the department do their work evaluating and assessing the situation and allow them to provide their recommendations for how to proceed. DCH will also be issuing a department dashboard in the near future that will outline areas they will be measuring and I would imagine HIV to be a part of that assessment.

Ari Adler, spokesperson for Speaker of the House Jase Bolger (R-Marshall) provided this email statement to Messenger:

The state of Michigan will undoubtedly be facing additional tough decisions in the next few years as cuts are made in funding provided by the federal government. Much as we have worked diligently to start putting our fiscal house in order, the Speaker believes the federal government must do the same. That does mean, of course, that previous funding levels at the state and federal level are unsustainable and we will have to look at prioritizing how our limited resources are allocated. It is not yet clear what the impact of the federal cuts could be, so we are not speculating on what those impacts will mean to the state budget yet. Because of our efforts to balance next year’s budget with real numbers while managing to put money into the state’s savings account, we are in a better position to address unexpected financial difficulties than the state has been able to previously. Nevertheless, while we don’t know the answers yet, we do know none of them will be easy.

On the other hand, Sen. Rick Jones (R-Grand Ledge) called those cuts unwise.

“It is foolish for the federal government to cut testing for HIV. One of the key ways of stopping the spread of HIV is a person having the knowledge that they have the disease. Then the person can take proper precautions and not infect someone else,” the chair of the Senate Judiciary Committee said. “I think it is possible that this could cost more in the long run. If more HIV is spread and people end up on Medicaid seeking treatment.”

Canady of the Ingham County Health Department says that fear will inevitably be true.

“People who are unaware that they are positive are more likely to infect others,” said Canady. “The funding source allows free and anonymous testing services at local health departments and community based organizations. Loss of this funding will make it more difficult for people who are seeking confidential and/or anonymous testing services to know their status.”

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