Source: Washington Blade

To kick off the 19th International AIDS Conference — meeting in the U.S. for the first time since 1990 — two U.S. officials announced new domestic initiatives and additional funding for international HIV/AIDS programs.

During her remarks on Sunday, the conference’s first night, Health and Human Services Secretary Kathleen Sebelius laid out four new public-private initiatives to help people living with HIV/AIDS in the U.S. These new programs are in addition to $80 million in grants to ensure that low-income people living with HIV/AIDS have access to health care and medication.

Through a partnership with the MAC AIDS Fund’s Care for Life Initiative — a multi-year, $4.5 million project — Sebelius explained that Health and Human Services officials aim to launch “a mobile texting pilot program called UCARE4LIFE to help patients get important reminders and tips for managing their disease.” And the three other initiatives will focus on training and education:

With the pharmaceutical retailer Walgreens, she announced a three-year partnership with the Centers for Disease Control to explore ways in which pharmacies can help patients stay on their medications. According to a news statement, Walgreens is supplying nearly $1 million in in-kind services for this initiative.

With Medscape, a leading provider of online continuing education for U.S. clinicians, Sebelius unveiled partnership training programs with the Centers for Medicare & Medicaid to help clinicians better understand and address HIV patients’ needs. According to a news statement, three new training modules have already been created for physicians, nurses and other medical professionals.

Finally, Sebelius announced that HHS is partnering with the eight largest AIDS drug companies — Abbot Laboratories, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Genentech, Johnson & Johnson, Merck and ViiV — to create a single application form for AIDS medications offered through their patient assistance programs.

In addition to the initiatives Sebelius touted, Secretary of State Hillary Clinton said Monday that the U.S. is donating $80 million in new funding to help poor countries reach the goal of virtually eliminating HIV-infected births. Helping HIV-positive women access health care and treatment so that their babies are born HIV-free is a component of the Obama administration’s plan to fight HIV/AIDS. At the conference, Clinton said the funds will help provide medication to women who can’t always access it.

And she added that the U.S is investing additional millions to figure out the best ways to protect the highest-risk populations in countries hard hit by HIV/AIDS: gay and bisexual men, sex workers, and injecting drug users. “If we’re going to beat AIDS, we can’t afford to avoid sensitive conversations,” Clinton said.

A new report by the Kaiser Family Foundation finds that 20 state prison systems have delegated all or part of their health care operations to private companies, leading to serious neglect and in some cases abuse in an effort to cut costs.

Maryland, Arizona, New Mexico, and Illinois are just a few of the states arguing that outsourcing prison health care is more cost effective than employing state workers, partly because private companies free the state from providing benefits and pensions to government employees. But the quality of care under these corporations frequently has been lacking.

In one example, a March report examined Idaho’s “inhumane” privatized prison health care system run by Corizon, one of the largest vendors in the U.S.:

Terminal and long-term inmates sometimes went unfed, nursing mistakes or failure likely resulted in some deaths, and one inmate wasn’t told for seven months that he likely had cancer. [...] Inmates who were terminal or required long-term care and who were unable to move on their own were sometimes left in soiled linens, given inadequate pain medication and went periods without food and water.

Also in March, Arizona inmates sued over abysmal conditions, which in one case led to the death of a prisoner whose lung cancer spread through his body after repeated requests for treatment went ignored. The lawsuit claims prison medical staff told the inmate to drink energy shakes to cure his symptoms. According to the lawsuit, “Critically ill prisoners have begged prison officials for medical treatment…only to be told to ‘be patient,’ that ‘it’s all in your head,’ or that they should ‘pray’ to be cured.”

The new Kaiser report notes that state-run prison health care is not pristine either. For the past six years, California’s prison health care has been supervised by a federal court after a judge found that the state failed to provide inmates with adequate medical treatment. In May, a federal judge denied California department of corrections the right to resume control, stating that the department must first demonstrate its ability to provide adequate medical treatment.

But privatizing health care has hardly proven to be the solution. On a technical level, coordination and communication breakdowns can occur more easily when the state manages the prisons and a separate firm handles health care. And, as Kerry Korpi of the American Federation of State, County and Municipal Employees said, “Private correctional health care companies have a track record of cost cutting that put both inmates and staff at risk. These companies’ goal is profit, not public safety.”

Our guest blogger is Susan Mottet, senior policy specialist and legal analyst at Progressive States Network.

A recent report by the State Budget Crisis Task Force chaired by former Federal Reserve Chairman Paul Volcker and former New York Lt. Gov. Richard Ravitch (D) outlined six threats to fiscal sustainability in the states. Cue the calls for more austerity! However, as other recent reports have shown, fiscal austerity at the state level harms middle class and low-income families, drives job losses, and continues to severely hinder the economic recovery.

Progressive state lawmakers have been advancing smart, effective policies to take on what the authors of the State Budget Crisis Task Force report accurately describe as the structural problems facing states in the coming years. Here are five solutions that your state can advance to help avert fiscal crisis while promoting economic growth, fairness, and equality:

1) Redesign and Strengthen Medicaid : The first problem the State Budget Crisis Task Force report identifies is that the cost of Medicaid is growing faster than inflation. This is a result of the fact that health care costs are growing faster than inflation and that more families are temporarily relying on Medicaid due to the economic downturn.

North Carolina addressed the growing cost of Medicaid over a decade ago by implementing a coordinated care model called Primary Care Medical Homes. In this model, regional networks of physicians, nurses, pharmacists, hospitals, health departments, and community organizations work together to provide cooperate, coordinated care to patients. Each patient is matched with a primary care physician who leads the health care team to ensure that the patient’s health needs are effectively addressed. By reducing hospitalizations and emergency department visits and better managing chronic illnesses, the model has saved North Carolina hundreds of millions of dollars every year. North Carolina State Representative Verla Insko explains, “not only has it saved our state $1.5 billion over three years, it has improved the health outcomes of the families that rely on this program. This is about our core values. We refused to choose between saving money and quality of care.”

Other states can follow North Carolina’s lead. Recently, Oregon adopted a law to do just that at the urging of Governor Kitzhaber, a former emergency department doctor.

2) Require Online Retailers to Collect Sales Taxes : Faced with federal budget deficits caused in part by massive tax breaks for the wealthy, Congress is reducing spending. Instead of letting the tax cuts for the wealthiest 2 percent of Americans expire, Congress passed the buck by cutting state funding, creating fiscal crises at the state level.

State reliance on federal funding has intensified as state revenue collections have declined. A major reason for that decline has been the prevalence of online shopping. Current law prohibits states from collecting sales tax for online purchases unless the vendor has a physical presence in the state. But why don’t you pay sales tax on barnesandnoble.com when Barnes and Noble has several brick-and-mortar stores in your state? To avoid sales tax collection, online versions of stores have incorporated separately.

As a result of online shopping and corporate tax avoidance strategies, state sales tax collection has declined drastically. Congress can and should fix this by authorizing states to collect sales tax from all online purchases. In the meantime, states have been taking the lead in requiring companies with physical presences in the state to collect state sales taxes. As California State Sen. Loni Hancock put it last year as a compromise was passed in that state that required Amazon to begin collecting sales taxes starting this September, what is at stake is whether online retailers care about “the people whose lives are affected by whether or not we have enough money for schools and roads and to keep the libraries and parks open.”
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