LANSING — A bill submitted by state Rep. Dave Agema, R-Grandville, that would eliminate state funding for HIV prevention and other important health initiatives is raising alarms in the public health community.
Agema has proposed eliminating the Michigan Health Fund Initiative, which is a special Michigan Department of Community Health fund created by law by diverting a small percentage of sales tax revenues into the fund.
“This is almost like double-dipping,” Agema said, because the program funded by the MHFI was funded in other areas of the Michigan Department of Community Health budget.
The fund currently has about $9 million used to fund HIV prevention, testing and care programs in the state, as well as funding prevention programming for chronic disease such as heart disease and diabetes.
The funds are distributed to various county health departments, hospitals, churches and other private agencies, including the Michigan Public Health Institute.
Agema said he is recommending the shift of money to the Michigan Aeronautics Fund because that will help pay for maintenance and expansion projects at Michigan airports.
“This is so we don’t have to raise the fuel tax on our airplanes,” said Agema, a former airline pilot.
He said the federal government will give the state $9.50 for every one dollar it puts up for airports.
“There’s not a better job creator,” Agema said.
The Michigan Aeronautics Fund was created in the 1950s and has not been changed since its passage. The fund is paid for by a registration fee on airplanes of one cent per pound of the plane weight and with a dedicated three cent tax per gallon of airplane fuel.
The fund included a tax refund which returns 1.5 cents per gallon of fuel purchased by airlines which are based in another state, which effectively gives airlines incentives to not be based in Michigan.
Rick Hammond, administrator for the Airports Division of the Michigan Department of Transportation, said the Michigan Aeronautic Fund currently has a balance of $22 million. But $15 million is dedicated to current projects.
Hammond says the state will refund about $2.5 million to airlines this year in fuel taxes.
Agema also questions the spending of the MHFI fund, which shows nearly $5.7 million in administration costs. A spokesperson for the MDCH was not available by press time to comment on the administration costs for the program.
Bill Anstey, deputy health officer at the Kent County Health Department, said the funds from the MHFI are used to pay the salaries of the employees of the health department who conduct HIV tests. Those people not only do the tests, but they provide essential risk reduction education and counseling to clients, which helps reduce the risk of infection, Anstey said. Those employees also assist those who test positive in notifying sexual and needle sharing partners that they have been exposed to HIV.
The elimination of the funding would lead to the elimination of the positions, making the free and confidential HIV testing less likely to happen. That, he said, could have a huge impact on the epidemic’s growth. The department performs about 3,300 free confidential or anonymous HIV tests a year.
“(I)f people don’t know they have this disease … it will continue to be passed person to person,” Anstey said. “(A)ny time the county has a reduction in the money it receives it makes it more difficult to protect the public health.”
That kind of impact has those living with HIV raising the alarm.
“(C)utting the (MHIF) is short-sighted. The only way to save lives, keep people healthy, and reduce new infections — thus keeping health care costs down — is to invest in the kinds of prevention work and research that the Michigan Health Initiative Fund makes possible,” said Laurel Sprague, who is with the Global Network of People Living with HIV, North America and a member of Michigan Positive Action Coalition.
With the state already reporting 14,371 cases of HIV in Michigan, the costs to the state for health care for this group are staggering.
A report released by the federal government in 2006 found that the lifetime cost of living with HIV was $618,900 over the course of an average life expectancy of 24.2 years. 73 percent of the cost is antiretroviral medications, 13 percent inpatient care, 9 percent outpatient care, and 5 percent other HIV-related medications and laboratory costs. Most people with HIV in Michigan qualify for Medicaid coverage or the AIDS Drug Assistance Program.
In short, if there are no new HIV infections in Michigan, the state will likely spend nearly $8.9 billion over the life spans of the already infected and identified 14,371 HIV-positive people in the state.
A spokesperson from Gov. Rick Snyder’s office tells Michigan Messenger the Republican governor has not had a chance to review the specific language, and thus cannot say whether or not he will support the proposal.
“It’s too early in the budget priority setting process to make a decision/determination and we haven’t yet seen any of the specifics in this bill,” said Geralyn Lasher, Snyder’s director of communications. “Preventing the spread of HIV and ensuring Michigan draws down its fair share of federal dollars are both important priorities for the State.”
Originally published in Michigan Messenger