AIDS has taken a breathtaking toll on our families and communities. It would be difficult to find any person today who has not been personally affected by HIV/AIDS – we have felt the strain and loss of illness and death, as well as the inspiration and courage of those living with and working to end this terrible pandemic.
On this World AIDS Day it is more important than ever each of us rededicate ourselves to the education and empowerment of citizens at risk for or living with HIV/AIDS in New York, across the country, and around the world. It is a day to remember we can all make a difference.
Governments, businesses, charities and grassroots groups all over the world have joined hands to fight AIDS. But this effort has not yet been adequate to the task – more than 33 million people are now living with HIV/AIDS, and millions still don't have access to lifesaving treatment, prevention and care. Here at home, New York has more AIDS cases and more HIV infections than any other state in the U.S. We need a powerful renewal of leadership to save lives and a new commitment to take the steps necessary to bring an end to the AIDS pandemic.
The Democratic Majority, led by my friend and colleague Senator Thomas Duane [9], has shown real leadership in this effort. We worked to protect funding for vital education and prevention programs during a fiscal emergency. We passed new laws to improve access to HIV testing, making it available in all health settings because regular testing is an important part of care. We made New York's nation-leading HIV prevention programs stronger. And we partnered with the Assembly to pass legislation providing shelter assistance to New Yorkers living with HIV/AIDS because a safe and affordable place to live reduces behaviors that lead to new infections.
There is no question this is a difficult topic -- many believe wishing it away is enough, while others choose to ignore it altogether. But we have a moral obligation to confront HIV/AIDS head on, and to make treatment, prevention and education a priority for government.”
MAKING EDUCATION AND PREVENTION A PRIORITY
Budget
Despite the tough budget discussions, the Senate Majority maintained their commitment to protecting vulnerable people, including those living with HIV/AIDS. The budget passed by the Senate:
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Rejected the Governor’s proposal to eliminate the enhanced rate paid to specialty pharmacies that provide enhanced services to HIV/AIDS patients;
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Rejected the proposal to eliminate the Medicaid/Medicare Part D drug wrap for dual eligible individuals for the four drug classes still covered (anti-depressants, atypical anti-psychotics, anti-retro-virals, and anti-rejections);
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Restored funding for several HCRA-funded programs, including HIV/AIDS programs and initiatives;
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Authorized the transfer of the AIDS homeless housing program from the DOH to OTDA.
Prevention Efforts
The State Senate also passed several legislative initiatives that will support efforts to reduce the incidence of HIV/AIDS, such as:
Mandating the Offer of Voluntary HIV Testing in All Health Care Settings. The State Senate passed legislation (S8227 [10]) that simplifies and streamlines HIV testing. The legislation requires the routine offering of HIV tests to individuals ages 13-64 in all health care settings, while maintaining statutory protections that require informed consent for HIV testing. By making HIV testing a routine part of care, the number of New Yorkers who know their HIV status and get the early treatment they need if they are HIV-positive will increase. Following Senate passage, the bill was passed in the Assembly and signed into law by the Governor.
Expanding Safe, Legal Access to Needle Exchange Programs. The Senate passed legislation (S7724 [11]) that will allow Expanded Syringe Access Program participants to distribute more than 10 syringes at a transaction. Lifting the 10 syringe limit will help further the goals of the ESAP program to prevent the transmission of blood-borne pathogens through the sharing or reuse of needles. Lifting this restriction is also likely to further the program’s goal of encouraging the safe disposal of used needles. This legislation will also allow pharmacies to advertise the availability of syringes, which will help to increase awareness of the program. Increased awareness will further the program's public health goals. Only pharmacies that are registered to participate in the program would be allowed to advertise the availability of syringes. The Assembly has not yet voted on the bill.
The State Senate also passed legislation (S5620A [12]) amending the penal law to make it explicit that a person is not criminally liable for possessing syringes and drug residue in or on syringes and that the person has a right to possess such syringes based on his or her participation in New York’s Expanded Syringe Access Program or Syringe Exchange Program [13]. This bill will expand protections for users of public health syringe access programs, prevent unlawful harassment and arrest of syringe exchange participants, and as a result, reduce transmission of HIV and other blood-borne pathogens. This bill has also passed the Assembly and has been sent to the Governor.
Protecting Vulnerable New Yorkers
The State Senate passed several legislative initiatives designed to provide important support to individuals living with HIV/AIDS, including:
AIDS Assisted Living Programs. The Senate passed legislation (S7829 [14]) that would allow an AIDS assisted living program to receive reimbursement for real property capital costs and property lease costs for the property required to operate an AIDS assisted living facility. Current Medicaid reimbursement methodology does not allow for the reimbursement of capital or lease costs for property, effectively limiting the available care options for persons living with HIV/AIDS who are not able to live independently.
This could lead to lower costs if patients who are currently provided care in a skilled nursing facility were able to receive care at a lower cost assisted living program. Allowing reimbursement for capital costs would effectively allow existing HIV/AIDS nursing facilities to convert skilled nursing beds to lower cost assisted living beds and allow individuals living with HIV/AIDS to receive care in a setting that is more suitable for their needs. A same as bill has not been introduced in the Assembly.
HIV Shelter Costs. The Senate passed legislation (S2664 [15]) providing that any person with clinical/symptomatic HIV or AIDS who receives shelter assistance or emergency shelter assistance and who lives in a household that receives earned and/or unearned income will not be required to pay more than 30% of the household's monthly income toward shelter costs, including rent and utilities. The remainder would be paid by public assistance, less any federal funds being used by localities to pay for housing accommodations. This legislation was vetoed by the Governor.
