South Florida Officials Urge Federal Funding for Local HIV/AIDS Programs to Account for Migration

HIV/AIDS officials in South Florida say that the area is being "bypassed" for millions of dollars in federal HIV/AIDS funding because the funding allocation formula does not account for the large number of people who migrate to the area after testing HIV-positive, the South Florida Sun-Sentinel reports. When determining funding levels for HIV/AIDS programs, federal officials look only at the locations where HIV infections are diagnosed, under the assumption that an equal number of HIV-positive people will migrate from an area as arrive, thus balancing out the number of people who will need services. However, officials in South Florida say that this funding structure does not adequately take into account the many HIV-positive people who migrate to the area, either permanently or for only a few months during the winter. An analysis by the AIDS surveillance unit at the Broward County Health Department found that of the 18,554 Broward County residents with HIV/AIDS, 3,253 -- or 17% -- were diagnosed with HIV elsewhere. Broward County currently receives $14.9 million in Ryan White CARE Act funding, and a 17% increase in funding would represent an additional $2.5 million. Florida as a whole "falls short" in Ryan White funding, the Sun-Sentinel reports. As of June 2001, Florida ranked third in the number of residents living with AIDS but ranked 26th in Ryan White funds per AIDS patient during 2000. "I think we're getting ripped off," Joey Wynn, associate director of community affairs for the AIDS Healthcare Foundation in Fort Lauderdale, said. Lower funding means that many South Florida HIV/AIDS programs are "overtaxed," leading them to create waiting lists for services such as housing, food banks, dental care and counseling.

Changing the Funding Structure
Broward County officials plan to request that the state lobby for changes in federal HIV/AIDS program funding, the Sun-Sentinel reports. However, federal officials who oversee the Ryan White program say that they do not foresee making any immediate changes to the funding structure. According to the Sun-Sentinel, one HIV/AIDS specialist within HHS who spoke on condition of anonymity said that "[n]o one has proven that migration among cities does not balance out," and that even if a disparity were shown, it "would be impossible" to adjust the formula to account for constant migration. Even HIV/AIDS officials in South Florida who would like to see the system changed agreed that tracking the migration of patients would be difficult. Tom Liberti, head of the HIV/AIDS bureau at the Florida Department of Health, said that migration is "not the main problem" with deciding how to allocate HIV/AIDS funding. He said that the larger problem is that funding formulas count only AIDS cases, at the same time HIV-positive people are living longer and taking a longer time to develop AIDS. The Institute of Medicine is currently studying whether HIV reporting could be standardized and "reliably added" to the Ryan White funding formula to make allocation "fairer," and a report is due by fall 2003 (LaMendola, South Florida Sun-Sentinel, 8/5).