Dozens of people living with HIV across southcentral Pennsylvania could soon lose aid for housing and prescription costs after Gov. Josh Shapiro’s administration ordered a mid-year budget cut to the commonwealth’s regional HIV service providers.
If left unrestored, the cuts could lead to nearly 100 people diagnosed with HIV becoming homeless in southcentral Pennsylvania counties — including Cumberland, Dauphin, Lancaster and York — according to a memo circulated among lawmakers by the Family Health Council of Central Pennsylvania Inc. and obtained by WITF.
“The loss of funding to support safe and stable housing for people with HIV in (the Family Health Council’s) region could result in not only poorer health outcomes for individuals, but potentially also in an increase in HIV infections in the region,” the Family Health Council’s memo reads.
The Family Health Council, central Pennsylvania’s nonprofit regional HIV grantee providing aid to individuals who test positive, warned that it may also need to cut services, including case management, transportation for medical appointments and food support.
Leaders at the Family Council referred comment on this story to the state Department of Health.
On Sept. 18, the Department of Health gave providers less than two weeks’ notice that it would cut their HIV services budget by 25% beginning Oct. 1.
Moira Foster, director of the Division of HIV Health at the Department of Health, also wrote in the department’s letter that it would reduce the income limit for its Special Pharmaceutical Benefits Program from 500% of the federal poverty level to 350% — or from $78,250 to $54,775 — for an individual.
“A host of factors are impacting the program, including the current federal funding climate, the increasing costs of services, especially prescription drug costs, and rising enrollment in the Special Pharmaceutical Benefits Program,” Foster said in the letter.
Combating the HIV epidemic
With 921 Pennsylvanians being diagnosed with HIV in 2023, according to the U.S. Department of Health, the rate of HIV diagnosis in the state is roughly 8.3 people per 100,000.
Historically, compared to other states, Pennsylvania has been on the better end of patients with HIV receiving medical care within one month of diagnosis. Of the 921 new diagnoses in 2023, about 803 received care within one month.
In total, about 36,680 Pennsylvanians knew they were living with HIV in 2023, according to the U.S. Department of Health, up from 34,916 in 2017.
Combating the HIV epidemic
With 921 Pennsylvanians being diagnosed with HIV in 2023, according to the U.S. Department of Health, the rate of HIV diagnosis in the state is roughly 8.3 people per 100,000.
Historically, compared to other states, Pennsylvania has been on the better end of patients with HIV receiving medical care within one month of diagnosis. Of the 921 new diagnoses in 2023, about 803 received care within one month.
In total, about 36,680 Pennsylvanians knew they were living with HIV in 2023, according to the U.S. Department of Health, up from 34,916 in 2017.
Slashed funds
Through Part B of the Ryan White HIV and AIDS Program — named after the Indiana teenager who became a national symbol of the epidemic when his school refused to let him return to class — the federal government provides funding to states, which then distribute the money to organizations that offer HIV-related services.
“No explanation beyond the need to cut costs was given,” the Family Council wrote in its memo. “These cuts will result in client homelessness, reduced access to services, and poorer health outcomes for people with HIV.”
Barry Ciccocioppo, communications director for the Department of Health, said in a statement that “federal funding available for this program has not kept pace with increases in program enrollment, medication prices, and costs to the entire HIV care program across the state.” A spike in enrollees for the benefits program and a rise in drug costs, he said, have “made changes to the eligibility requirements of the program necessary.”
Ciccocioppo noted about 8,200 people were enrolled in the benefits program during any given week in the last year. That’s an all-time high, he said, with a total cost of more than $139 million.
“This is a $67 million increase in the cost of medications to SPBP in a two-year period,” he said, “during a time when the core Ryan White federal funding has remained steady or slightly decreased and state funding has remained level.”
Nationwide, the rate of new HIV infections has steadily decreased in the past few decades, according to San Francisco-based health research nonprofit KFF. The group also found that people of color are disproportionately affected by HIV.
Ciccocioppo said the Health Department continues to advocate for additional federal resources to combat HIV, but the agency must prioritize “the most essential and impactful services to ensure we can reach as many people as possible.”
The Department of Health did not provide documents showing whether it had evaluated the on-the-ground impact budget cuts would have in each of the regional grantees’ coverage areas.
Legislature’s response
House Health Committee Chair Dan Frankel, D-Allegheny, blamed the “chaotic and shifting situation” coming from President Donald Trump and congressional Republicans in Washington for the “federally driven disruptions.” He said the state Department of Health told his office the “mixed and conflicting information from federal agencies” has forced “rapid decisions.”
“Our social safety net has been shredded, rewritten, and litigated at breakneck speed, with inconsistent federal directives affecting Ryan White funding, SNAP requirements, Medicaid work rules and more,” Frankel said in a statement.
Senate Health & Human Services Committee Chair Michele Brooks, R-Mercer, did not respond to a request for comment.