THOMPSON: CITY PLAN TO REDUCE VITAL SERVICES WILL JEOPARDIZE HEALTH OF NEW YORKERS WITH HIV/AIDS
New York City Comptroller William C. Thompson, Jr. today criticized a Department of Health and Mental Hygiene (DOHMH) plan to cut funding for HIV/AIDS care, jeopardizing the health of New Yorkers living with HIV/AIDS and the role of community-based groups in providing prevention, care and treatment services.
"The Scattered Site II Housing Program, which allows individuals living with HIV/AIDS to lease an apartment while receiving supportive care, has been targeted for elimination in a proclaimed effort to streamline services while saving limited City resources," Thompson said. "Until all participants are assured of continued access to vital support services, it is likely that this abrupt elimination will lead to poorer health outcomes and even larger expenses as individuals seek costly emergency health care and housing placement."
In a letter to Mayor Michael Bloomberg - which can be viewed at www.comptroller.nyc.gov - Thompson requested that his office be supplied with an analysis that would support the total elimination of the program.
Thompson further criticized the City for simultaneously proposing the elimination of almost $2 million for case management staff at supportive housing programs, as well as reducing by HASA-funded HIV nutrition programs by 50 percent.
"Both these actions will further subject some of our City's most vulnerable individuals to significant added risk," he said.
Thompson also questioned DOHMH's recent Request for Proposals (RFP) to consolidate $24 million of Ryan White Funds to create a Care Coordination Program for people living with HIV/AIDS.
"This RFP established pre-qualification criteria that effectively precluded many HIV/AIDS community-based providers from acting as lead proposers in the reconfigured program," Thompson said. "This approach would also leave some of our City's most vulnerable individuals underserved and at risk."
The RFP's formula would significantly reduce or eliminate funding for community-based primary care providers' COBRA case management, AIDS day health care and/or HIV Special Needs Plans while shifting funding to hospitals and large community health centers for the providing the same services without any requirement for aggressive outreach to the hard-to-serve, geographically dispersed, niche populations currently targeted by the community based providers.
"This is both troubling and particularly ill-advised because community-based providers are often the best and most effective source of care to this population," Thompson said. "Community-based support organizations provide vital input and must be maintained as key components of our efforts to provide care to people living with HIV/AIDS. To severely curtail their voice in addressing this health crisis will reduce our ability to provide critically important services."
The RFP, which has been issued by DOHMH's contractor, Public Health Solutions, continues a pattern of contracting decisions regarding HIV/AIDS services that Thompson first questioned in 2006. In that instance, Thompson's analysis found that legal services to individuals with HIV/AIDS were awarded in a geographically disproportionate manner.
Thompson also expressed concerns that the Public Health Solutions RFP deprives proposers of the protections contained in the City's Procurement Policy Board Rules. These Rules contain a number of provisions to ensure not only a transparent and level playing field but also due process rights to bidders and proposers who feel they have not been treated fairly.
"These issues pose significant threats to individuals living with AIDS and to providers that have demonstrated an ability to provide effective and appropriate levels of care in a cost-efficient manner," Thompson said. "I therefore urge that the current RFP be withdrawn and that the City re-evaluate its approach in light of these outstanding concerns while ensuring continuity of services as these contracts expire."
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