President Bush speaking Wednesday in Philadelphia suggested that the Administration needs more power to decide where and how federal Ryan White CARE Act funds are distributed and spent, The Washington Post reports. The program currently "takes too little account of the most urgent needs," Bush said, suggesting he would direct more of the funds to medical care and less to social services. Bush and Health and Human Services secretary Tommy Thompson, who accompanied the president on a campaign and fund-raising trip to Philadelphia, say they plan to ask Congress to give HHS more discretion in determining how the $2 billion Ryan White program funds are used. Funds are currently allocated regionally according to a complex funding formula and then are disbursed by local health officials and AIDS experts to local groups they determine best meet the needs of area HIV and AIDS patients.
Bush and Thompson also say they want to implement a stronger system to evaluate whether recipients of Ryan White funds are using the money effectively and to increase the proportion of the funds that go to faith-based organizations that provide AIDS services. Although Bush called for Congress to renew the Ryan White Act, which must be reapproved by lawmakers in 2005, he didn't say whether he would pledge more federal money to domestic AIDS programs. Previous reports have indicated he plans to flat-fund the program at fiscal 2004 levels.
AIDS activists sharply criticized Bush's call for more Administration control of Ryan White funds. Marsha Martin, executive director of AIDS Action, an umbrella group representing dozens of AIDS service organizations, says local communities should have more--not less--flexibility in how to allocate the federal AIDS funds. Terje Anderson, executive director of the National Association of People With AIDS, says Bush's proposal to cut money from nonmedical services will hinder the ability of many HIV-positive people to seek medical care by limiting the transportation and child care services they need.