Letter to The Honorable Mike O. Leavitt Secretary of United States Department of Health and Human Services

Letter to The Honorable Mike O. Leavitt Secretary of United States Department of Health and Human Services

The Honorable Mike O. Leavitt
Secretary
United States Department of Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201

Dear Mr. Secretary:

We write to express our concern over the implementation of the recently reauthorized Ryan White CARE Act by the Health Resources and Services Administration (HRSA). Several eligible metropolitan areas (EMAs) in our jurisdictions have been notified that they will now be classified as transitional grant areas (TGAs). We believe this notification is in error.

In the recent reauthorization of the CARE Act, Sec. 101 contains the following language regarding EMA eligibility:

(b) Continued Status as Eligible Area- Notwithstanding any other provision of this section, a metropolitan area that is an eligible area for a fiscal year continues to be an eligible area until the metropolitan area fails, for three consecutive fiscal years--

(1) to meet the requirements of subsection (a); and

(2) to have a cumulative total of 3,000 or more living cases of AIDS (reported to and confirmed by the Director of the Centers for Disease Control and Prevention) as of December 31 of the most recent calendar year for which such data is available.

Title I eligibility is lost only when an area fails to meet both of these requirements. Nothing in this Act specifies that failure to meet one of these requirements in FY 2007 would result in loss of EMA status from FY 2006. Nor does anything in the Act specify that the language regarding transitional grant areas, as laid out in Sec. 107 of the reauthorized CARE Act, should be applied prior to application of this continued status clause.

This provision does not confer EMA eligibility to all areas that your department has classified as a TGA under the CARE Act. Rather, it applies only to six areas: New Haven in Connecticut; Nassau and Suffolk Counties in New York; Riverside, Oakland and Orange Counties in California; and Seattle, Washington. According to December 2005 data from the Centers for Disease Control and Prevention, each one of these areas easily meets the 3,000 living AIDS case threshold set up in this reauthorization.

As you know, recent advances in treatment have enabled many people living with HIV and AIDS to lead longer, healthier lives. The 5-year lookback period in the original CARE Act was amended to recognize the need in EMAs that have provided quality care to people living with HIV and AIDS. This new system allows for us to account for individuals who have lived more than 5 years beyond their initial diagnosis with AIDS, rather than to inadvertently penalize EMAs that have provided the essential care and support services that help people with AIDS survive.

We would urge you to immediately reexamine your implementation of this provision for FY 2007, and ensure that these six areas retain their EMA status. Thank you for your consideration.

Sincerely,

Hillary Rodham Clinton
Maria Cantwell
Joseph I. Lieberman
Charles E. Schumer
Patty Murray

http://clinton.senate.gov/news/statements/details.cfm?id=269780&&