Equal Access to Justice for NYC PLWHAS | February 2012

Courtesy of Housing Works

At a maddening New York City Ryan White planning council meeting last Friday, legal advocates demanded the New York City Department of Health address a discrepancy with HRSA policy that would expand legal services to people with AIDS in the city. DOH said they are still awaiting written guidelines from HRSA, which is expected in six to eight weeks.

During last week’s meeting, DOH staffers also continued attempts to delay a resolution that would require AIDS service organizations to seat consumers on their boards of directors, which an advisory committee (under the heavy influence of DOH staffers who sit on the board) declared “unworkable.” This resolution passed 20 to 2 in June.

During the Ryan White reauthorization process in 2009, a group of legal advocates approached HRSA to clarify Ryan White’s legal services policy, which has been interpreted by New York’s DOH to preclude funding for housing, immigration and other services. HRSA hasn’t yet issued a memo clarifying the policy, but at a legal conference, HIV Law Project Deputy Executive Director Cynthia Knox spoke to Captain Hilda Douglas, deputy director of the Division of Service Systems in HRSA’s HIV/AIDS Bureau. Douglas told Knox that there are no additional funding restrictions imposed beyond what is stated specifically. In a previous meeting with Assistant DOH Commissioner for HIV/AIDS Prevention and Control Dr. Monica Sweeney, Sweeney told Knox that the funding limitations had come directly from HRSA. A HRSA spokesperson wouldn’t confirm or deny if this is true.

The Ryan White language states, “Legal services are the provision of services to individuals with respect to powers of attorney, do-not-resuscitate orders and interventions necessary to ensure access to eligible benefits, including discrimination or breach of confidentiality litigation as it relates to services eligible for funding under the Ryan White HIV/AIDS Program. It does not include any legal services that arrange for guardianship or adoption of children after the death of their normal caregiver.” Douglas told Knox that other than criminal cases, class action lawsuits and the above orders issued in the guidelines, no other services are prohibited.

As the Update reported this month, different jurisdictions have interpreted the policy differently, with New York and San Jose having some of the strictest restrictions. In some jurisdictions, like Philadelphia, a broader interpretation was used.

Knox said HRSA is expected to issue a statement about Ryan White funding restrictions in six to eight weeks. In the meantime, Knox has asked DOH to write a letter to HRSA requesting that the New York jurisdiction be allowed to use Ryan White money to expanded legal services for people with HIV/AIDS. Hilger told Knox that the DOH wants to expand Ryan White legal services but needs clear permission from HRSA. Knox asked DOH, and Public Health Solutions which administers Ryan White funding, to be more proactive and issue a letter to legal services providers immediately expanding legal services.

“Many of us are here to ask when Public Health Solutions will be issuing a letter. HRSA will be issuing a written statement about this in six to eight weeks. But we’d like a letter tomorrow,” Knox said during the public comment period.

Consumers continue to demand a voice

The other main event at Friday’s meeting was pushback against the special taskforce’s flimsy resolution that appointing a consumer to AIDS service organizations board of directors is “unworkable.”

“I don’t understand how y’all can say it’s not workable. Why did you pass it in June if you find it unworkable?” said Ryan White Planning Council Consumer Co-chair and Housing Works peer Felicia Carroll. “Like [Ryan White grant administrator] JoAnn [Hilger] said, we can work together to make it possible. It seems to me you don’t want to make it possible. Why are we voting yes for it if we want to come back and vote no?”

Ryan White Policy committee co-chair Matt Lesieur introduced a resolution for the taskforce to re-meet, and add members of the Ryan White consumer committee and advisory group, since there was the impression that the committee wasn’t balanced. The strongest dissent to Lesieur’s resolution came from grantee co-chair and DOH staffer Jan Carl Park, who spent 20 minutes questioning Lesieur’s resolution. Nonetheless, the resolution passed by a clear majority vote. The Ryan White Advisory Group met Saturday and appointed Housing Works CEO Charles King and Gay Men’s Health Crisis client Joseph Sellman to serve as the committee’s representatives.

While DOH has questioned if the Council can enforce this resolution if it’s beyond the purview of the Planning Council, Knox noted in public comment that DOH, as the grantee could implement it.

“I don’t understand why the grantee wouldn’t want to make a resolution. I don’t understand why the grantee wouldn’t want to make a mandate. I know for our grants we have tons of mandates,” Knox said. “This is a mandate I would recognize, rather than something that adds more paperwork. At the HIV Law Project we do have consumers on our boards directors, not because we’re so fabulous, but because it’s the right thing to do.”

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