Marking 20 years
of bold journalism,
reader supported.
News
Health
Rights + Justice
Politics

Budget Hits Will 'Basically Gut' AIDS Vancouver

Lower Mainland HIV service groups say government funding cuts will end up costing public more.

Tom Sandborn 21 Dec 2009TheTyee.ca

Tom Sandborn covers labour and health policy beats for The Tyee. He welcomes story tips and feedback at [email protected].

image atom
Dr. Mark Tyndall: Infections will go up.

The Vancouver Coastal Region Health Authority chose World Aids Day to announce it was cutting funding for community services to people with the HIV virus and AIDS.

Three weeks later, B.C.'s minister of health has declined to discuss the cuts with The Tyee, and health authority spokespeople say only administration costs will be trimmed without any impact on direct service delivery.

But local front line workers and experts in the HIV/AIDS field say that the cuts will slam clinical services, leading to more disease and less effective treatment, and end up costing taxpayers more down the road.

The head of AIDS Vancouver, the province's longest running service provider to HIV positive people, said the cuts would 'basically gut' his organization.

The provincial government has directed the Vancouver Coastal Health Authority to eliminate a projected $90 million deficit in its nearly $3 billion budget for this fiscal year. The cuts to Vancouver-area community-based HIV/AIDS groups announced Dec. 1 will account for approximately a million dollars of the hoped for savings in 2009-2010.

The groups whose funding has been reduced include Aids Vancouver, the Dr. Peter Centre, Youthco, and the Positive Outlook Program at Vancouver Native Health Society.

Last Friday, the newly created Cancel the Cuts group staged a rally on the steps of the Vancouver Art Gallery to protest the budget reductions. The public event was part of a campaign that includes a Facebook page, Twitter feed and protest emails directed to Premier Campbell.

The group's website about says the funding reductions to Lower Mainland AIDS groups are "a miniscule dent to their $90 million deficit. But these cuts have a devastating and long lasting impact to Community Based Health Organizations."

Dr. Mark Tyndall, program director, epidemiology, B.C. Centre for Excellence in HIV/AIDS and head of the division of infectious diseases, Providence Health Care, agrees.

Province should triple funding: Tyndall

"Fewer HIV/AIDS programs will absolutely result in increased infection rates. Yet, currently, there are no apparent provisions within the province's budget to deal with the extreme financial burden of new infections on the ministry of health," Tyndall told The Tyee.

"The estimated lifetime cost of one new positive infection to B.C.'s healthcare system is $250,000. In 2007, the last year for which we have data, 395 British Columbians were newly diagnosed. For the government to think that they will be saving money by cutting HIV/AIDS programs is ludicrous. The province should triple funding for HIV/AIDS community-based health organizations rather than make cuts."

Just as worrisome as the prospect of new infections, Tyndall told The Tyee, is the danger that cuts to community groups will reduce the quality of care that already infected patients receive. He says the cuts, although billed as only affecting administration costs, will absolutely have an impact on quality of service. Money allocated on paper as administrative cost, he said, often goes to recruit and supervise volunteers, who multiply the effect of community groups in their work against HIV/AIDS.

"With reduced administration, well-organized and supervised service delivery will suffer," he said.

'Cutting in the wrong places'

Even though his group, the B.C. Persons with AIDS Society, has not yet been informed of cuts to its own funding, long-serving PWA board member Glyn Townson is very concerned about the cuts to AIDS Vancouver and other service groups.

"I'm sure cuts for us will come soon enough," Townson told The Tyee, "but the existing cuts are a problem. If you don't have people from the street level involved, you'll get bad decisions. I'm all for reducing waste, but the government is cutting in the wrong places. Look at all the expensive offices for Vancouver Coastal Health. You could cover all the money being cut from community based groups just by eliminating a few highly paid middle managers in those offices."

Townson said that his organization partners with AIDS Vancouver on many projects. When funding for AIDS Vancouver is cut, his group is hurt as well, he said.

$263,000 hit for AIDS Vancouver

Public health services in B.C. are delivered through five regionally based health authorities, one province-wide authority and one First Nations-based authority among the Nisga'a people in the north. The most significant cuts to community-based HIV/AIDS services are being made in the Lower Mainland's Vancouver Coastal Health Authority, where AIDS Vancouver, Canada's oldest AIDS service organization, has been cut back by $43,000 for the current fiscal year and will lose at least $263,000 in the fiscal year beginning April 2010.

Meanwhile, the Dr. Peter Centre's 24-hour residence program for HIV/AIDS patients will lose $34,000 on this year's budget and $70,000 in 2010-2011.

Youthco, a service for HIV/AIDS impacted young people, managed to negotiate an initially proposed eight per cent cut in this year's budget down to a minimal $200 loss, according to executive director Stephanie Grant.

RainCity Housing and Support Society's director of support services Sean Speer told The Tyee he worries that his organization's funding for harm reduction needle exchange programs and other contracts for delivering services to AIDS patients would be "reduced significantly."

Cuts lighter outside Lower Mainland

In other health authorities across the province, fewer AIDS-related services exist, and few if any cuts seem to be planned, based on phone conversations with media spokespeople for the provincial, northern and interior health regions.

However, Moira McLean, who speaks for Vancouver Island Health, told The Tyee that all community-based contractors for her region will be asked to find 5 per cent in savings in their funding in the upcoming fiscal year.

At the Vancouver Native Health Society's Positive Outlook Program, where nurse practitioner Doreen Littlejohn and her staff and volunteers deliver services to more than 1,500 patients with HIV/AIDS, the health authority has cut $6,000 from her administration budget. Littlejohn says that her understanding is that there will be two more rounds of cuts announced before April, and she is bracing for more bad news.

It's up to Vancouver Coastal Health: Minister Falcon

The Tyee asked B.C. Health Minister Kevin Falcon's office to set up an opportunity to discuss the AIDS service cuts and community response with the minister, but he declined to speak with us, suggesting we take our questions up with Vancouver Coastal Health.

Falcon's office referred us to a document on the ministry website where some provincial investments in HIV/AIDS programs are detailed, including $90 million a year for Highly Active Antiretroviral Therapy (HAART) for all B.C. residents who qualify for this HIV treatment.

Anna Marie D'Angelo, who speaks for Vancouver Coastal Health, where HIV/AIDS services for the province are concentrated and where the impending cuts are most significant, told The Tyee the cuts being required of community contractors are simply a matter of eliminating administrative fat.

Her own authority, she said, keeps its administrative costs below 10 per cent of budget, and VCH was simply requiring similar cost control of its contractors.

D'Angelo said she was unaware of the two further rounds of cuts that several sources within community service groups told The Tyee were being planned before April 1 of 2010.

D'Angelo also said all cost-cutting review work was being done in-house by Vancouver Coastal staff, at no extra cost to the taxpayer.

Debating the room for savings

"We reviewed 255 contracts across the region and 60 per cent of them have administrative costs of 15 per cent or less. We think it is reasonable to expect that groups like AIDS Vancouver, which had administrative costs this year of 26 per cent, should find efficiencies to match what we and other contractors have done," D'Angelo said.

David Swan, AIDS Vancouver executive director, doesn't agree.

"We could have managed a three to four per cent cut in admin expenditure," Swann told The Tyee, "but the size of these cuts threaten to basically gut the agency."

Swan argued that VCH is ignoring the role that volunteers play in extending the service delivery of community based groups like AIDS Vancouver, where volunteers are providing nearly 16,000 hours of contributed time, worth nearly $300,000 this year.

Administrative time and effort is required to recruit, train and supervise these volunteers, he said, and the cuts to administrative expenses demanded by the health authority will threaten effective use of volunteer energies.

At the Downtown Eastside-based Positive Outlook Program, Doreen Littlejohn has similar concerns. Her program is supported by more than 35,000 hours of volunteer time a year, and cuts to her administrative budget will make it harder to provide the leadership and supervision that maximize the usefulness of all that volunteer time.

"These cuts are unconscionable," Littlejohn said. "When I think of how marginalized we are, how marginalized people down here are, why would the government cut services to those most vulnerable, and most impacted by AIDS, Hep C, mental illness, racism, addictions and poverty? Where's the conscience in taking services away from these people?"

[Editor's note: the comment section is close for the holidays and will re-open Jan. 4th. Thanks for all your thoughtful commentary this year. Looking forward to more of the same in the next!]  [Tyee]

  • Share:

Facts matter. Get The Tyee's in-depth journalism delivered to your inbox for free

LATEST STORIES

The Barometer

Do You Think Trudeau Will Survive the Next Election?

Take this week's poll