BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                    AJR 9|
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                                 THIRD READING


          Bill No:  AJR 9
          Author:   John A. Perez (D), et al
          Amended:  4/20/09 in Assembly
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  8-0, 5/20/09
          AYES:  Alquist, Strickland, Aanestad, DeSaulnier, Leno,  
            Negrete McLeod, Pavley, Wolk
          NO VOTE RECORDED:  Cedillo, Cox, Maldonado

           ASSEMBLY FLOOR  :  76-0, 4/20/09 - See last page for vote


           SUBJECT  :    Ryan White HIV/AIDS Treatment Modernization Act  

                        of 2006

           SOURCE  :     AIDS Project Los Angeles


           DIGEST  :    This resolution urges the United States Congress  
          and the President to enact legislation to extend the sunset  
          of the Ryan White HIV/AIDS Treatment Modernization Act of  
          2006 from September 30, 2009 to September 30, 2012.

           ANALYSIS  :    

          Existing federal law establishes the Ryan White HIV/AIRDS  
          Treatment Modernization Act of 2006 (Ryan White Act),  
          administered by the United States Department of Health and  
          Human Services, Health Resources and Services  
          Administration, to provide HIV/AIDS care for those who do  
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          not have sufficient health care coverage or financial  
          resources for coping with HIV disease.  The Ryan White Act  
          provides funding through states, localities, and providers  
          for primary health care, drugs, and support services.

          Existing state law requires health care providers and  
          clinical laboratories to report cases of HIV infection to  
          local health officers (LHOs) using patient names, and  
          requires LHOs to report unduplicated HIV cases by name to  
          the Department of Public Health.

          This resolution urges the United States Congress and the  
          President to enact legislation to extend the sunset of the  
          Ryan White Act from September 30, 2009 to September 30,  
          2012, including the existing formula-based funding for  
          states with maturing names-based HIV reporting systems.

          This resolution states that such an extension will protect  
          Ryan White funding for California, preserve existing  
          systems of treatment, care, and other vital services for  
          people living with HIV/AIDS, and ensure that California and  
          other states have sufficient time to mature their  
          names-based HIV case reporting systems.

           Background
          
          According to the Federal AIDS Policy Partnership Ryan White  
          Work Group (Work Group), a nationwide group of HIV policy  
          experts, the 2006 reauthorization of the Ryan White Act  
          included many significant changes, including changing the  
          distribution formulas from estimated living AIDS cases to  
          actual living HIV and AIDS cases, a core services  
          requirement, and provisions regarding funds that are not  
          obligated.  The HIV/AIDS advocacy community and others have  
          not yet been able to evaluate the effects of these changes,  
          as sufficient data are not currently available.  The Work  
          Group also states the HIV/AIDS community is engaged in the  
          development of a national AIDS strategy.  The Work Group  
          recommends a minimum three-year extension of the Ryan White  
          Act as a prudent course of action in order to maintain  
          health stability for persons living with HIV/AIDS while the  
          larger issues of our nation's health care system and a  
          national strategic plan for HIV/AIDS prevention, care and  
          treatment are developed, assessed and analyzed.  







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           FISCAL EFFECT  :    Fiscal Com.:  No

           SUPPORT  :   (Verified  5/20/09)

          AIDS Project Los Angeles (source)
          AIDS Services Foundation Orange County
          Altamed Health Services Corporation
          American Federation of State, County and Municipal  
          Employees, AFL-CIO 
          Bienestar Human Services, Inc.
          California Communities United Institute
          Center for AIDS Research, Education, and Services 
          City of Los Angeles AIDS Coordinator's Office
          GlaxoSmithKline
          Los Angeles County Board of Supervisors
          Sierra Foothills AIDS Foundation
          Sonoma County Commission on AIDS
          Southern California HIV Advocacy Coalition
          Tri-City Health Center

           OPPOSITION  :    (Verified  5/20/09)

          AIDS Healthcare Foundation

           ARGUMENTS IN SUPPORT  :    AIDS Project Los Angeles, the  
          sponsor of this bill, and a number of supporters write that  
          extending the Ryan White Act would free up time and energy  
          in Washington for developing a comprehensive national AIDS  
          strategy and health care reform, and most importantly, that  
          an extension will give California more time to mature its  
          names-based HIV case reporting system.  The County of Los  
          Angeles writes that an extension of the Ryan White Act will  
          preserve and possibly increase funding for Los Angeles  
          County, as well as allow the county to continue to develop  
          HIV data over the next three years, which would maximize  
          the County's competitiveness for Ryan White funding.  The  
          AIDS Services Foundation Orange County (ASF) writes in  
          support that, although California's names-based reporting  
          system is two years old, it has not had sufficient time to  
          fully capture and reliably report all HIV cases in  
          California.  ASF writes that since federal funding is  
          allocated using HIV/AIDS case data, additional time is  
          needed to mature California's reporting system so that  







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          funding corresponds correctly with size and scope of the  
          HIV/AIDS epidemic in California.  ASF further writes that a  
          change in the Ryan White Act, while the California HIV  
          reporting system is still ramping up, would jeopardize  
          federal funding and threaten to destabilize local systems  
          of care.

           ARGUMENTS IN OPPOSITION  :    Writing in opposition, AIDS  
          Healthcare Foundations (AHF) writes that, while they are  
          eager to see Congress delay implementation of the new  
          funding allocation until California's data has had a chance  
          to properly mature, this resolution fails to recognize that  
          there are issues of state and national importance that must  
          be addressed in a reauthorization of the Ryan White Act.  
          AHF is concerned that the Act does not go far enough to  
          normalize HIV care, make HIV screening routine and improve  
          linkages to care.  AHF states that the Act does not  
          currently provide a practical means for California and  
          other states to pursue these goals, and that Congress needs  
          to explore other issues that are less relevant to  
          California's needs but which must be addressed for the  
          health of people in other states. AHF will support this  
          resolution if its message to Congress was solely pertinent  
          to delaying the names-based funding allocation formula.


           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Brownley, Caballero, Carter, Conway, Cook, Coto, Davis,  
            De La Torre, De Leon, DeVore, Duvall, Emmerson, Eng,  
            Evans, Feuer, Fletcher, Fong, Fuentes, Fuller, Furutani,  
            Gaines, Galgiani, Garrick, Gilmore, Hagman, Harkey,  
            Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries,  
            Jones, Knight, Krekorian, Lieu, Logue, Bonnie Lowenthal,  
            Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,  
            Nielsen, John A. Perez, V. Manuel Perez, Portantino,  
            Price, Ruskin, Salas, Saldana, Silva, Skinner, Smyth,  
            Solorio, Audra Strickland, Swanson, Torlakson, Torres,  
            Torrico, Tran, Villines, Yamada, Bass
          NO VOTE RECORDED:  Buchanan, Charles Calderon, Chesbro,  
            Hall









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          CTW:do  5/21/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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