[Congressional Record (Bound Edition), Volume 151 (2005), Part 16]
[House]
[Pages 21592-21593]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        RYAN WHITE AIDS CARE ACT

  The SPEAKER pro tempore (Mr. Inglis of South Carolina). Under a 
previous order of the House, the gentlewoman from California (Ms. 
Waters) is recognized for 5 minutes.
  Ms. WATERS. Mr. Speaker, I would like to thank the gentlewoman from 
the Virgin Islands (Mrs. Christensen) for organizing this series of 
Special Orders on the reauthorization of the Ryan White CARE Act.
  The Ryan White CARE Act is essential for millions of Americans who 
are living with the AIDS virus and millions more who are at risk of 
becoming infected in the future.
  The Ryan White CARE Act was passed into law in 1990, 10 years after 
the beginning of the HIV/AIDS epidemic, to provide a comprehensive 
approach to AIDS prevention, treatment, patient care and community 
support for people affected by this dreadful disease.
  The Ryan White CARE Act provides funding for a variety of programs, 
including drug assistance, capacity building and planning grants, 
services for infected people and their families, funding for AIDS 
Education and Training Centers, and grants to metropolitan areas like 
Los Angeles that are severely affected by HIV/AIDS.
  The Ryan White CARE authorization expires this Saturday, on October 
1, 2005. If it is not reauthorized, it will remain in its current form 
until legislation is approved. The Ryan White CARE Act needs to be 
updated to address the needs of communities affected by HIV/AIDS today. 
The people affected by HIV/AIDS have changed tremendously over the 
course of the epidemic, and HIV/AIDS programs must adapt and change as 
well.
  When the HIV/AIDS epidemic first began in 1980, most Americans with 
AIDS were white. Today, over 70 percent of new AIDS cases in the United 
States are people of color. Blacks account for about half of new AIDS 
cases, and Hispanics account for 20 percent of new AIDS cases. Racial 
minorities now represent a majority of new AIDS cases, and a majority 
of Americans living with AIDS, and a majority of deaths among persons 
with AIDS.
  The Ryan White CARE Act is critical for minorities who often lack 
access to traditional health care and support services. About half of 
all Ryan White CARE Act clients are black, and that proportion is much 
higher in some care settings.
  Title IV of the Act is especially important for racial minorities. 
Title IV provides medical care, case management, child care, 
transportation, and other support services for families affected by HIV 
and AIDS. Over 80 percent of the clients at clinics funded by Title IV 
of the Act are minorities.
  The Ryan White CARE Act is severely underfunded. In the current 
fiscal year, the Ryan White CARE Act received a total of just over $2 
billion for all programs nationwide. However, it

[[Page 21593]]

has been estimated that Ryan White CARE programs should receive at 
least $3 billion in order to address adequately the needs of people 
affected by or at risk of HIV/AIDS.
  In July of this year, the Bush administration released its principles 
for the reauthorization of the Ryan White CARE Act. Unfortunately, 
these principles are pitting the most affected communities against one 
another.

                              {time}  1915

  One of the principles is a prioriti-
zation of core medical services. This principle could eliminate many of 
the support services provided under title IV, such as case management, 
child care, and transportation, which make medical care accessible to 
people in need. For most title IV clients, medical care is covered 
through Medicaid, not title IV; but support services provided under 
title IV are essential to make medical services accessible.
  Reducing HIV/AIDS support services in order to prioritize HIV medical 
services is no way to address the needs of people with HIV/AIDS. I urge 
my colleagues to reauthorize the Ryan White CARE Act in a manner that 
will ensure that HIV/AIDS programs will indeed address the needs of all 
communities in the United States that are affected by the HIV/AIDS 
epidemic, and I urge my colleagues to make certain that the Ryan White 
CARE Act programs will be fully funded in future years.
  Mr. Speaker, I mentioned the disproportionate number of African 
Americans and Hispanics that are now HIV/AIDS positive. I would like to 
share with you what we have attempted to do to address those very 
special populations.
  In 1998, while I was the Chair of the Congressional Black Caucus, I 
spearheaded the development of the Minority AIDS Initiative, which 
provides grants to health care providers for HIV/AIDS treatment and 
prevention programs serving minority communities. The Minority AIDS 
Initiative enables health care providers to expand their capacity to 
deliver culturally and linguistically appropriate care and services.
  Mr. Speaker, we will not get the increases we need, so we need to pay 
attention not only to this reauthorization but to the very special 
needs of those who have suffered the most.

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