After weeks of not promising to do so, San Francisco Mayor London Breed on Friday committed to backfilling roughly $200,000 in cuts to one source of its federal HIV/AIDS funding. The city is still awaiting word on the exact amount of an even larger reduction in what it receives from a different federal program funding its efforts to prevent HIV.
This week the city received its notification of funding regarding its allocation from the federal Ryan White CARE Act. San Francisco, San Mateo, and Marin counties comprise the Eligible Metropolitan Area. San Francisco's reduction is $197,850, the mayor's office stated. It is that money that will be backfilled by the city, Victor Ruiz-Cornejo, a gay man who advises Breed on LGBTQ issues, informed the Bay Area Reporter.
San Francisco, San Mateo, and Marin counties will receive a total of $14,985,007 in Ryan White Part A funds, with about 84% of that money going to the city. The total reduction for all three counties is $228,000, according to the notification of funding.
Tyler TerMeer, Ph.D., a gay man who's CEO of the San Francisco AIDS Foundation, thanked Breed for backfilling the city's share of reduced Ryan White funding.
"SFAF appreciates the mayor filling the federal cuts to HIV health services," he stated. "San Francisco Eligible Metropolitan Area (EMA) received a cut of $228,000 in our annual Ryan White Part A award. This funding is essential to providing people living with HIV access to health care and support services, and we are grateful for the mayor's commitment to continuing these services in San Francisco."
Still uncertain for San Francisco is a much larger expected reduction in federal funds from the Centers for Disease Control and Prevention for HIV prevention services. That could range between $578,000 and $806,000, said Laura Thomas, who's director of harm reduction policy at the San Francisco AIDS Foundation and co-chair of the HIV/AIDS Provider Network. As the B.A.R. previously noted, the CDC had informed the city it would be receiving less money this year.
The San Francisco Department of Public Health needs to receive its cooperative agreement with the CDC to learn the exact amount of money awarded to the city. On May 31, a DPH spokesperson responded that the department has not received the cooperative agreement and expects to be notified of the amount it will be awarded in July.
Gay District 8 Supervisor Rafael Mandelman stated that it was "great news" that Breed has committed to backfilling the Ryan White cut.
"The city has been able to backfill cuts in prior years, this has been a priority for me," he wrote in a text message. "I am glad and grateful that the mayor has apparently found the funds to continue to make good on the Ryan White commitment even in a tough budget year."
He added, "I would hope and expect that the city will do the same for any other potential cuts for federal HIV prevention funding."
Typically, the city has backfilled cuts in HIV funding from the federal government; for example, in 2013, then-mayor Ed Lee and the Board of Supervisors unanimously approved backfilling $3 million.
Budget unveiled
The mayor's office posted the budget for Fiscal Years 2024-25 and 2025-26 online May 31. The budget now goes to the Board of Supervisors, which will hold hearings in June. The deadline for the mayor to sign the fully approved spending plan is August 1.
It received a chilly reception from the board's budget chair, District 1 Supervisor Connie Chan. She said her priority will be passing a budget prioritizing "safe and clean streets" and "protecting our most vulnerable residents."
"However, that is not the type of budgeting we have seen from this administration. I am extremely concerned by the wasteful spending and inefficiencies we have seen, particularly in the past few months, in our city contract and departmental spending," stated Chan, who is facing a tough reelection race this November. "My task is clear — we must comb through the Mayor's proposed budget and advance a budget that prioritizes all San Franciscans — not just the demands of the wealthy few. It is not enough to simply announce spending and closing the budget deficit in press releases — with the crisis that San Francisco faces, we must deliver results. The Board of Supervisors budget process will evaluate the proposed spending and whether it fulfills the Administration's promises."
According to a news release from the mayor, the budget is $15.9 billion for FY 2024-25, and $15.5 billion for FY 2025-26.
On May 30, Breed outlined her priorities for public safety, stating that such services will not be reduced in the budget.
The city is facing a deficit of $789 million over the next two fiscal years, according to the mayor's office. In her release, Breed stated that closing the deficit involved multiple factors, including reducing contract spending. The budget reduces expenses, increases uses from alternative revenue sources, and eliminates outstanding balances in non-critical or completed projects, the release stated.
The news about the city backfilling the nearly $200,000 in AIDS funds came after Breed said at a recent mayoral forum held by the progressive Harvey Milk LGBTQ Democratic Club that she could not commit to filling the gap created by federal reductions but that it was her goal to do so. Prior to that, her office said it was "too early to tell" if the city would be able to backfill any federal cuts.
Jeffrey Kwong, a gay man who is president of the Milk club, did not immediately respond to a request for comment.
The federal government's Ryan White notification letter comes a couple of weeks after Congressmember Nancy Pelosi (D-San Francisco) announced $1.6 million in new federal funding for San Francisco from the Ryan White HIV/AIDS Program to reduce infections. But, as the B.A.R. noted, Breed's office was already expecting the money Pelosi secured.
HIV group's budget proposal
The AIDS foundation's HIV Advocacy Network — a group of HIV and LGBTQ activists in the Bay Area — has a detailed budget proposal for San Francisco for 2024-2025: $509,000 to preserve existing services in the HIV care safety net, $500,000 to support HIV care organizations (including a small increase to account for some of the inflation of recent years), and $3.6 million for 200 additional housing subsidies for people living with HIV.
The network's proposal also includes $1 million for additional mental health services for long-term survivors, $500,000 for intensive case management, $500,000 for PrEP and PEP for Black and Latino communities, and $1-$2 million to open and fund supervised injection sites. City officials have recently been reluctant to fund the sites, which are a form of harm reduction that allow people to use their own drugs under the supervision of trained staff. That's mostly due to federal legal obstacles and, if such a site were to open, a nonprofit would have to house and operate it.
As the B.A.R. previously reported, last year's budget included $1.25 million for housing subsidies for people living with HIV for 2023-24 and $500,000 for 2024-25. The budget also included $500,000 to help HIV/AIDS nonprofits with rising costs. The funding was far short of the $7 million requested by HIV advocates.
Updated, 6/3/24: This article has been updated to include information from the Department of Public Health.
Support California's largest LGBTQ newsroom. Your one-time, monthly, or annual contribution advocates for LGBTQ communities. Amplify a trusted voice providing news, information, and cultural coverage to all members of our community, regardless of their ability to pay -- Donate today!