Sign On Letter

Below is a sign-on letter to Secretary Sebelius about use of the Prevention & Wellness Fund that is part of the health care reform bill. If your organization would like to sign onto the letter, please send an email to info@nmac.org to confirm. The letter will be held until noon (eastern) on Monday, May 17th. Please share this letter with your networks and colleagues. Thank you for your support. Paul

Dear Secretary Sebelius

Thank you so much for your commitment to the National HIV/AIDS Strategy (NHAS). The organizations who have signed this letter (see below) look forward to working with you to implement the Health and Human Services (HHS) components of this plan. We also appreciate all your work on health care reform. This letter is to begin a dialogue on the Prevention and Wellness Fund within the health care reform bill and the need for additional support to prevent HIV/AIDS. As you know, HIV is a leading cause of preventable death for people of color, particularly for women, transgender women, gay men and men who have sex with men. We would like you to consider the following:

1. Increase the number of community based organizations (CBOs) that receive funding from the Center for Disease Control and Prevention (CDC) for program announcement (FOA) PS10-1003
2. Make-up budget shortfalls in state HIV/AIDS prevention programs and
3. Community Transformation Grants include HIV/AIDS prevention

As we await the final NHAS, we know that full implementation will take money. Yet these are very difficult times and the prospect of significant new resources to meet the growing demands for HIV/AIDS prevention are limited. The Prevention and Wellness Fund within the health care reform bill can make the difference between a successful NHAS versus a strategy that gets left on a bookshelf due to lack of money.

Directly Funded CBO Program

In the Fall of 2009, the CDC announced funds for HIV prevention projects for minority and other community based organizations serving populations at increased risk of acquiring or transmitting HIV infection. Over 500 applications were submitted. Currently a review is underway to determine which CBOs to fund. The current funding level will allow for 150 (approximately) applications to be supported. They are slated to start July 1, 2010. We are asking HHS via the Prevention and Wellness Fund to support an additional 100 applications at $30,000,000 per year for five (5) years for program announcement (FOA) PS10-1003.

We make this request because

• These projects are shovel ready and slated to start July 1, 2010
• The applications have undergone a federal review so there will be no delay is getting funds to these qualified CBOs
• The organizations funded are expected to support the goals and objectives within the NHAS.
• Without new money, it will be very challenging to implement a comprehensive NHAS.

Budget Shortfalls In State HIV/AIDS Programs

According to the National Alliance of State and Territorial AIDS Directors (NASTAD), in FY2009 more then $170 million was cut from state HIV/AIDS budgets. 25 jurisdictions (55% of the respondents) reported cuts to their HIV prevention programs. For FY2010 there are already an additional $18.5 million in cuts to the HIV and viral hepatitis budgets. When you factor out new monies for testing initiatives that only certain states were eligible to apply, federal funding for core state HIV/AIDS cooperative agreements has also decreased by $23 million.

Once again, if we are to have a successful NHAS, we need money. We are asking for $116.5 million address state budget cuts (55% of the $170 million that was cut in FY2009 plus the $23million in federal cuts).

We make this request because

• CDC has existing state cooperative agreements that can quickly funnel money to states and territories.
• The money requested is to back fill state HIV/AIDS prevention budget/programs where cuts are having a devastating impact on our country’s HIV/AIDS prevention agenda and ability to reduce HIV incidence.
• Without new money, it will be very challenging to implement the NHAS.

Community Transformation Grants

In the near future HHS via the CDC will award Community Transformation Grants to state and local governmental agencies and community-based organizations. These grants are for the implementation, evaluation, and dissemination of proven evidence-based community preventive health activities in order to reduce chronic disease rates, address health disparities, and develop a stronger evidence-base of effective prevention programming.

We are asking that HIV/AIDS prevention providers be eligible to apply for the Community Transformation Grants. Unfortunately HIV has a disproportionate impact on communities of color. We need stronger evidence-based prevention programs, and we would suggest that HIV disease to both an infection and a chronic disease. Community Transformation Grants should be used to address fundamental/structural issues of risk and lack of health care utilization in the most affected communities – on the topic of HIV and other health issues affecting these “high impact” communities.

We are recommending the first two projects because they are shovel ready and can start this fiscal year. The third recommendation depends on your timeline, we just want HIV/AIDS prevention to be included. The first two projects not only significantly increase our country's ability to prevent the spread of HIV/AIDS, but they will also save or add much needed jobs and economic stimulus. Without this additional funding, some community based organizations will be forced to close their doors. Not only is this bad for prevention, it is also bad for the economic burden/recovery.

Thank you so much for considering this proposal. We are eager to discuss this challenge or any other HIV/AIDS issue. Please contact Paul Kawata (pkawata@nmac.org) to schedule a meeting.

Sincerely,

(List of organizations in alpha order)