AIDS groups begin to turn on ‘disingenuous’ Cuomo
A few months ago, activists in the HIV/AIDS community cheered Gov. Andrew Cuomo for what seemed to be an unprecedented commitment to ending the epidemic.
Now some of those same activists are wondering whether they've been played.
“We’ve gone from disheartened, to feeling the governor is disingenuous, to feeling the governor has outright lied,” said Jeremy Saunders, co-executive director of VOCAL-NY, a non-profit group that works with low-income New Yorkers with HIV/AIDS. “I would say there is probably far more anger out there than reported on because people are afraid to attack a governor who is notorious for being vindictive in his approach.”
Cuomo has made ending HIV/AIDS one of his signature issues, holding a rally last April in the West Village where he accepted a blueprint, written by a 63-member task force, that laid out a plan to end the epidemic in New York State.
The ambitious goal was to reduce the number of new HIV infections to 750 by the year 2020, and Cuomo declared that New York would be a model for the nation.
The blueprint called for more than $2 billion in additional spending, which would have been used to double the number of people on anti-retrovirals, expand access to pre-exposure prophylaxis and provide housing and other social services to those who are already infected.
Advocates pointed out that this would save the state billions over the long term as the number of people who needed treatment declined, and Cuomo, last April, said “we'll find the funding to make it a reality.”
When Cuomo released his budget last month, it fell short of that promise, advocates said, allocating just $10 million in new direct spending for HIV/AIDS.
“The [HIV/AIDS] community is seriously disheartened and very concerned about a lack of follow through on his blueprint that we worked so hard to complete on his timeline,” said Doug Wirth, president and CEO of Amida Care, a non-profit health care organization.
Cuomo, in November, proposed $200 million in new funding, and advocates assumed he meant all that money would be in the upcoming budget.
But when his budget book was released, it said the money would be spent over several years.
"I think we have the will from the governor, from the elected officials, but next to the will, we need to see resource allocation,” said Guillermo Chacon, president of the Latino commission on AIDS.
Several activists told POLITICO New York that they were led to believe there would be additional funding added to the budget in the governor’s 30-day amendments.
That did not happen.
“It is fair to say we were very disappointed that we didn’t see any changes reflected in the 30-day amendments,” said Charles King, president and CEO of Housing Works and one of Cuomo’s most vocal supporters.
“I fully expected to see some additional money in the Medicaid pot in the 30-day amendments.”
Saunders was more direct.
“Lie number one is the commitment to put the $200 million in the budget,” Saunders said. “Lie number two is that there would be funding in the 30-day amendments.”
Wirth described himself as “dismayed, disheartened, frustrated and angered” when there was no additional funding included in his 30-day amendments.
Benjamin Bashein, executive director of Acria, an HIV/AIDS services organization, said he was never misled by the governor's office and recalls no conversation in which new funding was promised in the 30-day amendments.
Bashein said he was grateful for Cuomo's leadership, and confident that the governor would continue to work with the community and that more funding would, at some point, become available.
"Obviously, it's not what we hoped for on the first outing," he said. "I'm positive that working with this governor we will obtain the most resources possible to end the epidemic."
King, Wirth, Chacon, Bashein and VOCAL-NY were all on the task force that produced the Ending The Epidemic blueprint.
King said he believes the governor is sincere in his desire to end the epidemic. He did not want to “quibble” over the $200 million, a figure which the governor announced on World AIDS Day to raucous applause after a laudatory introduction from King.
“What we really need is $70 million,” King said.
That would include $20 million in additional funding for the AIDS Institute, and $50 million to expand a housing services program known as HASA.
Mayor Bill de Blasio committed $26 million this year toward expanding HASA, and as much as $44 million in future years. That was in addition to $23 million in new funding for pre-exposure prophylaxis and anti-retroviral therapies that the mayor put in his budget.
"Mayor de Blasio has made an unprecedented commitment to ending the AIDS epidemic through a major expansion of prevention, health care, and support – and achieving this vital goal will require comparable commitments from all stakeholders,” Amy Spitalnick, spokeswoman for the mayor, said in a statement.
The hope from housing advocates was that the governor would provide an additional $33 million in new funding to expand HASA in New York City and $17 million to expand the program throughout the rest of the state.
“The mayor made history,” Wirth said. “It is critical that the state step up and match New York City’s commitment.”
A spokesman for the governor, Rich Azzopardi, said the state continues to make progress on its plan.
"We're on track to meet our goal of ending the AIDS epidemic in New York by the end of 2020 and to do so we're pursuing the necessary legislative changes and investing $200 million in this multiyear effort," Azzopardi said in an email. "The blueprint — which was commissioned by the Governor — is a solid plan that we've been making great progress on, and I have no explanation as to why your sources are so misinformed."
Cuomo has made efforts to implement some of the task force's recommendations through executive orders.
In October, he banned discrimination against transgender people.
In July, he announced a $3 million program to link 1,000 people to pre-exposure prophylaxis, and $600,000 for a public awareness campaign.
The governor has also promised a $2.5 million pilot program with five Medicaid managed care companies to link 6,000 HIV patients to care.
And New York State has made tangible progress over the last decade. It has now been 17 months since an HIV-baby was born in the state, an achievement that was heralded by the state's AIDS Council.
Cuomo has been celebrated with each new announcement but the funding for the big ticket items remains elusive.
Wirth said the onus now was on legislators.
“It is now the responsibility of the legislature to say, ‘Hey Governor Cuomo, you did this amazing thing and came up with a plan, and we are going to be an active partner in funding that plan," he said.
But counting on the legislature is no sure bet.
The Republican-controlled Senate failed last year to pass no-cost legislation recommended in the blueprint, and no one has mentioned additional housing services as one of their top priorities.
“I don’t think we get the $70 million unless the governor takes the initiative,” King said.
The consequences of inaction, advocates say, are dire.
“We have a great opportunity to prevent young people from acquiring HIV and having to treat that HIV for a lifetime,” Wirth said. “I think the governor needs to understand that when you start to ask people to take an HIV test and find out their status, and engage in care, and then we don’t follow through and ready the health care system for them, don’t follow through in making sure everybody who is in need of [pre-exposure prophylaxis] as an added prevention tool receives it, when we fail to follow through on those promises, the consequences are people go back into the coset. They drop out of care.”
Ending the epidemic by 2020 was always a lofty goal but most understood it was an impossible task if the funding did not materialize.
“If we’re going to achieve the goal, this is the year we need to have a significant investment,” King said. “The failure will make it very hard.”