Testimony for FY 2001 Budget Hearings on the Department of HealthCommittee on Human Services
March 24, 2000
Chairman Allen, Members of the Committee, and Fellow Citizens:
My name is Bob Summersgill. I am President of the Gay & Lesbian Activists Alliance of Washington (GLAA), the nation's oldest continuously active gay and lesbian rights organization.
We will be celebrating our 29th Anniversary at 7:00 p.m. on Thursday evening, April 27 at the Doyle Washington Hotel on Dupont Circle. We trust you have all received your invitations by now. We hope to see you there.
We welcome these budget hearings as a valuable opportunity to comment on the Mayor's budget and the Department of Health.
Please help us prod the Department of Health into responding to Councilmember Harold Brazil's letters of February 14 and March 9 to Dr. Walks.
Councilmember Brazil has introduced legislation at GLAA's request to reclassify Marinol as a scheduled III drug: bill 13-639, Uniform Controlled Substances Act of 2000. GLAA strongly supports the bill, which would make this important drug more easily available for cancer chemotherapy patients and people with AIDS suffering from wasting syndrome consistent with the Federal Drug Enforcement Agency's rules.
Councilmember Brazil, in his February 14 letter, requested that the Department of Health provide the precise chemical nomenclature for Marinol so that there would not be an error in the bill's reclassification.
The March 9 letter follows up on the first letter, and asks an additional question about a possible misspelled drug in the DC Code.
GLAA wrote to Mr. Ronald E. Lewis on February 2, 2000 about the inadequate anti-discrimination language in the Department's proposed regulations on substance abuse clinics and programs. The proposed regulations ignore the DC Human Rights Law and only include federally recognized protected categories. We have not yet received any response to our letter. Dr. Walks has also failed to respond in anyway to a letter and a phone call by GLAA requesting a meeting.
While the Department of Health's failure to respond to citizens is typical, Dr. Walks' failure to respond to a Councilmember is intolerable.
We might conclude that Dr. Walks has failed to respond due to a lack of staff. A number of important positions are vacant. A few months ago Mr. Lewis was promoted to Director for Health Promotion. This means he heads up the Addiction Prevention and Recovery Administration, while simultaneously remaining the Director of the Agency for HIV and AIDS. Mr. Lewis gets high marks for bringing about substantial improvements in the functioning of AHA compared to his predecessors, but no one is talented enough to run both of these chronically mismanaged agencies at the same time with any hope of improving either one.
We are gratified to finally see an increase in the budget for the Agency for HIV and AIDS from $50,700,000 to $54,008,000, an increase of $3,307,373. However, it is unlikely to be enough.
DC has the highest AIDS rate per 100,000 population in the United States a rate that is nine times the national average.
Nearly 9,000 people in the Washington metropolitan area live with AIDS. Another estimated 14,000 to 17,000 people are infected with HIV. More than half live in DC.
Treatment options in the past several years have greatly reduced the rate of death due to AIDS, and the progression of HIV into AIDS. However, there has not been a reduction of new infections. This results in an expanding caseload of people with HIV requiring expensive triple-drug therapy as a minimum of care. In the past, the caseload didn't grow as quickly as deaths kept the number of patients in check.
Without a greatly increased expenditure in prevention, the patient caseload is going to do nothing but expand geometrically. Each patient requires drug therapy costing more than $20,000 year in addition to doctor care and viral load and immune system function. Failure to significantly improve prevention will require even greater increases in the cost of treatment in the future, let alone the human costs.
Unfortunately, the Mayor's budget is far too sketchy to determine where the increases are to be spent.
It is unclear from the budget whether the Mayor plans to fund a needle exchange program. Needle exchange programs target one of the fastest growing modes of HIV transmission in a very cost-efficient and responsible way.
In Valerie Holt's FY 2001 budget transmittal letter to Mayor Williams it states under "Health and Human Services" that there will be funding for "$500,000 to establish a secure and confidential HIV tracking system."
Last August the Mayor, with strong support from the DC Council, announced that the Department of Health would create a unique identifier system for reporting HIV infections. This will allow us to better track the demographics of the disease, plan more accurately for treatment and better target prevention efforts.
At that time, community input was promised with the creation of a community board to help plan and oversee the unique identifier system. So far, we haven't seen plans for a unique identifier system or the community board to oversee it. We would like to know what happened to that idea.
Thank you for your attention, I would be glad to answer any questions you may have.