Passage of federal act preserves AIDS funds

Maryland may still face penalties over tardiness in altering HIV reporting

December 12, 2006|By Jonathan Bor | Jonathan Bor,Sun reporter

Fears that Maryland - and the Baltimore region in particular - could lose much of its federal AIDS funding receded over the weekend as Congress reauthorized the Ryan White CARE Act.

The legislation, which President Bush has promised to sign, gives Maryland and a handful of other states four years to revamp their method of reporting newly diagnosed HIV infections without suffering a serious funding penalty.

Even so, Dr. Kima Taylor, Baltimore's assistant health commissioner for health promotion and disease prevention, said the city and six surrounding counties could face a 5 percent reduction from the $20 million they received this year.

FOR THE RECORD - An article in Tuesday's editions incorrectly reported that the reauthorized Ryan White CARE Act calls for a 5 percent reduction in the $36 million that Maryland received this year in federal HIV/AIDS funding.
Under the act, the federal government may reduce by 5 percent the number of new infections counted in Maryland. This might result in less money for Maryland during the three-year period covered by the legislation. In addition to Maryland, the penalty affects 12 states and the District of Columbia, which had not begun reporting new HIV cases by name, or were late doing so.
The Sun regrets the errors.

Maryland's total allotment of $36 million would be cut by the same degree, according to a provision in the new law. The money pays for medical, mental health and dental services, as well as medications for people with HIV/AIDS.

The cut essentially penalizes the state for failing to meet a previous deadline for reporting the names and addresses of people who test positive for HIV, the virus that causes AIDS. Taylor said the cuts might be restored in supplementary funding, but even if that doesn't happen, the region has been spared the worst.

"We're not free and clear, but we're much better off than we would have been if we had not gotten the authorization," she said.

Maryland is one of the few states that report new cases by "unique identifier" - a code that registers the case while protecting the person's identity. Once people progress to AIDS, their names are recorded in a confidential registry.

Thirty-two states currently report new HIV cases by name. The rest either use anonymous codes or are making the transition to names.

Maryland AIDS Administrator Heather Hauck said she will push for passage of legislation by the General Assembly to allow a change to name-based reporting. Meanwhile, the agency is already preparing the logistics of the conversion.

Colin Flynn, epidemiology chief at the state AIDS Administration, said the reporting of new cases should not be difficult. But converting 12 years of cases - 18,000 people in all - from codes to names will be a huge undertaking that will require the help of doctors who treat the patients. The agency has already submitted a plan to the federal Centers for Disease Control.

After congressional wrangling over an unrelated issue that threatened to hold up reauthorization of the Ryan White CARE Act, the Senate passed the legislation Wednesday; the House passed it Saturday.

Failure to reauthorize the bill would have kept in effect provisions of the 2000 legislation, which put states on a six-year timetable to convert to name-based reporting or face the potential loss of more than half their funding.

Maryland Sen. Barbara A. Mikulski, a senior member of the committee that considered the bill, fought for language allowing Maryland to make the transition without suffering a large penalty.

"The battle against HIV/AIDS must not stop with this bill," Mikulski, a Democrat, said in a printed statement. "We must be ready to respond and support our families and communities suffering from HIV/AIDS."

Maryland's code-based system was based on the theory that many people at risk for HIV or AIDS wouldn't get tested out of fear that their privacy could be violated. But Flynn said yesterday that the same safeguards governing the privacy of people with AIDS will apply to people who test positive for the virus.

He said names will be collected only to help the state track the course of the epidemic and direct services to where they are most needed.

"We keep the information on computers not connected to computer networks," Flynn said. "We carry the information around the state in locked briefcases."

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