Local
Will health reform make AIDS groups obsolete?
HIV clinics face new competition as clients obtain insurance by 2014
‘Health care reform has been a real motivator around us improving the quality of what we do because we know we’re going to have to get better,’ said Don Blanchon, executive director of Whitman-Walker Clinic. (Washington Blade photo by Michael Key)
When the AIDS epidemic burst on the scene in the 1980s, a cadre of volunteers –many from the LGBT community — emerged to provide compassionate and dedicated care for the sick and dying, services that government agencies and existing charitable groups were not providing.
Since that time, the mostly volunteer-driven, community-based AIDS clinics and advocacy groups created back then have evolved into professionally run facilities receiving millions of dollars in state and federal funds. Like the Whitman-Walker Clinic in D.C., many of the clinics and advocacy groups provide a vast array of services for people with HIV and AIDS, most of whom can’t afford private health insurance.
But in March, Congress approved and President Obama signed into law a sweeping health care reform measure called the Patient Protection and Affordable Care Act. Obama administration officials say it will result in more than 94 percent of all Americans being covered by some form of private or public health insurance by 2014.
Although most AIDS activists and officials with local and national AIDS organizations have hailed the health care reform measure as an unprecedented benefit to people with HIV and AIDS, some believe the law could prompt large numbers of patients to leave the community-based clinics and seek medical care elsewhere.
With a possible loss of clients, community AIDS clinics would be in jeopardy of losing government funding, which is based on the number of clients served. It would be ironic, some have said, if the benefits of healthcare reform result in the closing of community institutions that have served people with AIDS during a time of need.
“The LGBT community and people living with HIV are going to have options that they may not have now,” said Don Blanchon, executive director of the Whitman-Walker Clinic, which has served people with HIV and AIDS since the epidemic began.
“And so for us, health care reform has been a real motivator around us improving the quality of what we do because we know we’re going to have to get better,” Blanchon said. “We know at some point in time almost every District resident is going to have some type of public or private insurance, which means they, in theory, are going to be able to go to a lot of different places for their care.”
Blanchon noted that a financial crisis that Whitman-Walker faced four years ago forced it to take steps that have placed it in an excellent position to flourish under the health care reform law. The Clinic’s board hired Blanchon, a managed care expert, to help the Clinic survive at a time when private donations and fundraising efforts were faltering.
With the board’s full approval and over the objections of some of the Clinic’s longtime supporters and volunteers, Blanchon transformed the Clinic from a volunteer model operation into a managed care type facility with the status known as a “federally qualified health center look alike.”
According to Blanchon and other Clinic officials, the new status enables the Clinic to accept a greater number of Medicaid patients as well as patients with a wide range of private health insurance. Patients covered by these programs allow the Clinic to obtain reimbursement for its services by doctors, its own pharmacy, and other service providers, eliminating the need to rely more on private donors.
Unlike other community-based AIDS clinics, Whitman-Walker will be in an excellent position to take on new patients or retain its existing ones as the new health care reform measure enables the majority of patients to obtain private insurance or Medicaid.
Under the Patient Protection and Affordable Care Act, all lower income individuals, including people with HIV, will be eligible for Medicaid coverage if they fall below 133 percent of the federal poverty level, where an individual has an income of about $15,000 a year or lower.
Under current federal law, low-income people with full-blown AIDS are already eligible for Medicaid coverage. For years, Congress has declined to pass legislation proposed by AIDS advocacy groups calling for Medicaid coverage for low-income people with HIV, with the intent of providing medical services to prevent them from advancing to AIDS.
The new law makes that legislation unnecessary after 2014, when the Medicaid provision takes effect.
Jeffrey Crowley, director of the White House Office of National AIDS Policy, calls the Patient Protection and Affordable Care Act one of the nation’s most significant advances for the care and treatment for people with HIV/AIDS.
“It will fundamentally expand access to insurance coverage for people living with HIV,” he said. “Much of that will be through the mandatory expansion of the Medicaid program.”
He said that similar to all Americans, people with HIV will also be eligible for private insurance coverage through a variety of options based on their income. Among the options will be the purchase of insurance coverage through competitive insurance exchanges. He noted that by 2014, no insurance company can deny coverage based on pre-existing conditions such as HIV or other illnesses.
Keith Maley, a spokesperson for the U.S. Department of Health and Human Services, which will administer most of the provisions of the new health care law, said people with HIV and other illnesses could be immediately eligible for private insurance coverage through high-risk pools.
Those eligible for the immediate coverage must show that they have had no health insurance coverage for six consecutive months, have a chronic health condition, and are not eligible for employer provided insurance or Medicaid.
Crowley noted that the new law has other immediate benefits for people with HIV and other chronic health conditions. As of July 1, private health insurers can no longer use a rescission, a practice that cancels a policy when someone gets sick and needs expensive treatment.
He said the law also immediately prohibits insurers from imposing a lifetime “cap” on insurance benefits. Annual limits on coverage or benefits will end in 2014, he said.
Crowley, a gay man who previously worked for the National Association of People with AIDS before joining the White House staff, said he expects most community-based AIDS clinics and local and national AIDS advocacy organizations to continue to exist after the health care law is fully implemented in 2014. However, he said most will have to change the way they do business.
“I think we know from our experience with HIV that we’ve built up a great HIV workforce,” he said. “We have a lot of expertise. I want to make sure as we build and expand an insurance system through the Affordable Care Act that these HIV medical providers are making sure that they’re part of this new system.”
“Some of them might only receive funding through the Ryan White programs, and I would say they need to look at their future and say that they need to be part of the new insurance system,” he said. “But there’s no question that we’re going to need their expertise and commitment at providing medical care going forward.”
Crowley’s reference to the Ryan White CARE Act, the largest existing federal program created to provide care for low-income people with HIV/AIDS, is expected to change significantly following the full implementation of the Patient Protection and Affordable Care Act, according to officials with a number of national AIDS groups.
Nearly everyone, including Crowley, agrees that the Ryan White program should remain, but most likely in a scaled back form. Congress passed the act in the 1990s as a means of helping cities and states that were grappling with the enormous burden of providing care for people with HIV/AIDS who lacked health insurance coverage and were overwhelming local and state hospitals and health care facilities.
Carl Schmid, director of federal affairs for the AIDS Institute, a national advocacy organization; Michael Weinstein, executive director of the AIDS Healthcare Foundation, the nation’s largest AIDS-related medical care provider; and Jose Zuniga, executive director of the International Association of Physicians in AIDS Care, each said they believe the Ryan White program will be needed for at least some services the new law does not provide.
“It will not solve all of our access issues,” said Schmid of the new health care measure.
Weinstein said that state programs to expand health insurance have been slow to enroll as many people as expected for a variety of reasons, some bureaucratic in nature.
“So I wouldn’t expect an overnight change in 2014,” he said, pointing to a need to keep the Ryan White program operating for some time after 2014.
Weinstein said that in some states, including California, Medicaid reimbursement for medical services is far lower than that provided by private insurance companies. He predicted that people with HIV or AIDS who obtain coverage under the new law through Medicaid might be turned away by private doctors who declined to take all Medicaid patients.
“The reimbursement that we receive from Medicaid or from private insurance is far below our cost and far below what we get from Ryan White,” he said of the AIDS Healthcare Foundation. “So we will suffer a hit in that regard as well as most providers.”
Weinstein said his organization has a wide variety of income streams and the lower reimbursements under the new law “won’t be a fatal blow to us.”
Blanchon of Whitman-Walker said the benefits of the new law greatly outweigh its possible shortfalls.
“Health care reform is going to be a real help to our patients and clearly to the Clinic because more of our patients are going to be insured under more comprehensive benefit programs,” he said.
“And what that means at the end of the day is the Clinic is not going to have to shell out as much free care. So we’re going to be in a position to be able to offer more services to more patients and keep them healthy, and ultimately that’s what we’re here for.”
District of Columbia
Faith programming remains key part of Creating Change Conference
‘Faith work is not an easy pill to swallow in LGBTQ spaces’
The National LGBTQ Task Force kicked off the 38th annual Creating Change conference in D.C. this week. This year, as with years past, faith and interfaith programming remains a key part of the conference’s mission and practice.
For some, the presence of faith work at an LGBTQ+ conference may seem antithetical, and Creating Change does not deny the history of harm caused by religious institutions. “We have to be clear that faith work is not an easy pill to swallow in LGBTQ spaces, and they’re no qualms about saying that we acknowledge the pain, trauma, and violence that’s been purported in the name of religion,” Tahil Sharma, Faith Work Director for the National LGBTQ Task Force, said.
In fact, several panels at the conference openly discuss acknowledging, healing from, and resisting religious harm as well as religious nationalism, including one scheduled today titled “Defending Democracy Through Religious Activism: A panel of experts on effective strategies for faith and multi-faith organizing” that features local queer faith activists like Ebony C. Peace, Rob Keithan, and Eric Eldritch who are also involved in the annual DC Pride Interfaith Service.
Another session will hold space for survivors of religious violence, creating “a drop-in space for loving on each other in healing ways, held by Rev. Alba Onofrio and Teo Drake.”
But Sharma and others who organized the Creating Change Conference explained that “a state of antipathy” towards religious communities, especially those that align with queer liberation and solidarity, is counterproductive and denies the rich history of queer religious activism. “It’s time for us to make a call for an approach to LGBTQ+ liberation that uses interfaith literacy as a tool rather than as a weapon against us,” Sharma explained.
Recognizing a local queer faith icon
Along with the panels, fighting religious nationalism and fostering communion with aligned faith activists and communities is at heart of this year’s faith work. As Sharma shared, “the person that we’re honoring this year for the faith award is Rev. Dr. Sofía Betancourt, and Dr. Betancourt is an amazing leader and someone who really stands out in representing UUs but also representing herself unapologetically.”
Based in the Washington, D.C. area, Dr. Betancourt has more than 20 years of experience working as a public minister, seminary professor, scholar, and environment ethicist, and public theologian. Her activism is rooted in her lived identities as a queer, multiracial, AfroLatine first-generation daughter of immigrants from Chile and Panama, and has been a critical voice in advancing the United Universalism towards anti-racist and pluralistic faith work.
Creating a faith-based gathering space
Sharma also said that faith fosters a unique space and practice to encounter grief and joy. For this reason, Sharma wants to “create a space for folks to engage in curiosity, to engage in spiritual fulfillment and grounding but also I think with the times that we’re in to lean into some space to mourn, some space to find hope.” The Many Paths Gathering Space serves this purpose, where visitors can stop for spiritual practice, speak with a Spiritual Care Team member, or just take a sensory break from the bustle of the conference.
This also means uplifting and foregrounding queer religious ephemera with an ofrenda to honor those who have passed, a display of nonbinary Korean American photographer Salgu Wissmath’s exhibition Divine Identity, and the Shower of Stoles, a collection of about 1,500 liturgical stoles and other sacred regalia representing the lives of lesbian, gay, bisexual, and transgender people of faith.
The Shower of Stoles
The collection was first started in 1995 by Martha Juillerat and Tammy Lindahl who received eighty stoles that accompanied them and lent them solace as they set aside their ordinations from the Presbyterian Church. The whole collection was first displayed at the 1996 General Assembly of the Presbyterian Church in New Mexico. The stoles, according to the Task Force, “quickly became a powerful symbol of the huge loss to the church of gifted leadership.”
Each stole represents the story of a queer person who is active in the life and leadership of their faith community, often sent in by the people themselves but sometimes by a loved one in their honor. About one third of all the stoles are donated anonymously, and over three-quarters of the stoles donated by clergy and full-time church professionals are contributed anonymously.
The collection shows “not just the deep harm that has been caused that does not allow people to meet their vocation when they’re faith leaders, but it also speaks to how there have been queer and trans people in our [faith] communities since the beginning of our traditions, and they continue to serve in forms of leadership,” Sharma explained.
Explicit interfaith work
Along with creating a sacred space for attendees, hosting workshops focused on faith-based action, and recognizing DC’s rich queer religious history, Creating Change is also hosting explicitly faith services, like a Buddhist Meditation, Catholic Mass, Shabbat service, Jummah Prayer Service, and an ecumenical Christian service on Sunday. Creating Change is also welcoming events at the heart of queer religious affirmation, including a Name/Gender/Pronoun/Identity Blessing Ritual and a reading and discussion around queer bibles stories with Rev. Sex (aka Rev. Alba Onofrio).
But along with specific faith-based programs, Sharma explained, “we’re looking to build on something that I helped to introduce, which was the separation of the interfaith ceremony that’s happening this year which is a vigil versus the ecumenical Christian service which is now the only thing that takes place on Sunday morning.”
This includes an Interfaith Empowerment Service this evening and an Interfaith Institute tomorrow, along with “Sing In the Revolution,” an event where folks are invited “to actually engage in the joy and rhythm of resolution and what that looks like,” Sharma said. One of the key activators behind this work is Rev. Eric Eldritch, an ordained Pagan clergy person with Circle Sanctuary and a member of the Pride Interfaith Service planning committee.
Affirming that queer faith work is part of liberation
The goal for this year, Sharma noted, alongside holding space and discussions about faith-based practice and liberation and intentional interfaith work–is to move from thinking about why faith matters in queer liberation spaces to “how is interfaith work the tool for how we’re engaging in our understanding of de-escalation work, digital strategies, navigating a deeper visioning that we need for a better world that requires us to think that we’re not alone in the struggle for mutual abundance and liberation,” Sharma explained.
It may surprise people to learn that faith work has intentionally been part of the National LGBTQ+ Task Force since its beginning in the 1980s. “We can really credit that to some of the former leadership like Urvashi Vaid who actually had a sense of understanding of what role faith plays in the work of liberation and justice,” Sharma said.
“For being someone who wasn’t necessarily religious, she certainly did have a clear understanding of the relationship between those folks who are allies, those folks who stand against us, and then those folks who sit in between–those folks who profess to be of religious and spiritual background and also are unapologetically LGBTQ+,” he continued.
This year’s faith programming builds on this rich history, thinking about “a way to kind of open doors, to not just invite people in but our people to go out into the general scene of the conference” to share how faith-based work is a tool, rather than a hindrance, to queer liberation work.
Virginia
McPike prevails in ‘firehouse’ Dem primary for Va. House of Delegates
Gay Alexandria Council member expected to win 5th District seat
Gay Alexandria City Council member Kirk McPike emerged as the clearcut winner in a hastily called Jan. 20 “firehouse” Democratic primary for a seat in the Virginia House of Delegates representing Alexandria.
McPike, who was one of two gay candidates running in the four-candidate primary, received 1,279 votes or 60.5 percent, far ahead of gay public school teacher Gregory Darrall, a political newcomer who received 60 votes or 3 percent.
Former Alexandria City School Board member Eileen Cassidy Rivera came in second place with 508 votes or 24 percent and Northern Virginia criminal law defense attorney Chris Leibig finished in third place with 265 votes or 12.5 percent.
Each of the candidates expressed strong support for LGBTQ-related issues.
With less than a week’s notice, Democratic Party officials in Alexandria called the primary to select a Democratic nominee to run in the Feb. 10 special election to fill the 5th District House of Delegates seat being vacated by state Del. Elizabeth Bennett-Parker (D-Alexandria).
Bennett-Parker won the Democratic nomination for the Virginia State Senate seat being vacated by gay state Sen. Adam Ebbin (D-Alexandria), who is resigning from his seat to take a position in the administration of Democratic Virginia Gov. Abigail Spanberger, who took office on Jan. 17.
Bennett-Parker won the nomination for Ebbin’s state Senate seat in yet another firehouse primary on Jan. 13 in which she defeated three other candidates, including gay former state Del. Mark Levine.
McPike, a longtime LGBTQ rights advocate, first won election to the Alexandria City Council in 2021. He has served for 13 years as chief of staff for gay U.S. Rep. Mark Takano (D-Calif.) and has remained in that position during his tenure on the Alexandria Council. He told the Washington Blade he will continue as chief of staff until next month, when he will resign from that position before taking office in the House of Delegates.
He received the endorsement of Ebbin, U.S. Rep. Don Beyer (D-Va.), and the LGBTQ Victory Fund in his race for the 5th District Va. House seat. Being an overwhelmingly Democratic district, virtually all political observers expect McPike to win the Feb. 10 special election.
He will be running against Republican nominee Mason Butler, a local business executive who emerged as the only GOP candidate running for the delegate seat.
“Thank you to the voters of Alexandria for choosing me as the Democratic nominee in the House of Delegates District 5,” McPike said in a statement released shortly after the vote count was completed. “It is an incredible honor to have the opportunity to fight for our community and its values in Richmond,” he said.
“I look forward to continuing to work to address our housing crisis, the challenge of climate change, and the damaging impacts of the Trump administration on the immigrant families, LGBTQ+ Virginians, and federal employees who call Alexandria home,” he stated.
He praised Ebbin for his longstanding support for the LGBTQ community in the Virginia Legislature and added, “If elected to the House of Delegates in the Feb. 10 general election, I will continue to fight to protect the rights and freedoms of LGBTQ+ Virginians from my new position in Richmond.”
Gay candidate Darrall’s campaign website said he is a “proud progressive, lifelong educator, and labor leader running to put people first.” It says he is a political newcomer “with more than 20 years in the classroom” as a teacher who played a key role in the successful unionization of Fairfax Public Schools.
“He is a proud member and staunch supporter of the LGBTQIA+ community,” his website statement said.
District of Columbia
Sold-out crowd turns out for 10th annual Caps Pride night
Gay Men’s Chorus soloist sings National Anthem, draws cheers
A sold-out crowd of 18,347 turned out on Jan. 17 for the 10th annual Pride Night at the Washington Capitals hockey game held at D.C.’s Capital One Arena.
Although LGBTQ Capitals fans were disappointed that the Capitals lost the game to the visiting Florida Panthers, they were treated to a night of celebration with Pride-related videos showing supportive Capitals players and fans projected on the arena’s giant video screen throughout the game.
The game began when Dana Nearing, a member of the Gay Men’s Chorus of Washington, sang the National Anthem, drawing applause from all attendees.
The event also served as a fundraiser for the LGBTQ groups Wanda Alston Foundation, which provides housing services to homeless LGBTQ youth, and You Can Play, a nonprofit organization dedicated to advancing LGBTQ inclusion in sports.
“Amid the queer community’s growing love affair with hockey, I’m incredibly honored and proud to see our hometown Capitals continue to celebrate queer joy in such a visible and meaningful way,” said Alston Foundation Executive Director Cesar Toledo.
Capitals spokesperson Nick Grossman said a fundraising raffle held during the game raised $14,760 for You Can Play. He said a fundraising auction for the Alston Foundation organized by the Capitals and its related Monumental Sports and Entertainment Foundation would continue until Thursday, Jan. 22
A statement on the Capitals website says among the items being sold in the auction were autographed Capitals player hockey sticks with rainbow-colored Pride tape wrapped around them, which Capitals players used in their pre-game practice on the ice.
Although several hundred people turned out for a pre-game Pride “block party” at the District E restaurant and bar located next to the Capital One Arena, it couldn’t immediately be determined how many Pride night special tickets for the game were sold.
“While we don’t disclose specific figures related to special ticket offers, we were proud to host our 10th Pride night and celebrate the LGBTQ+ community,” Capitals spokesperson Grossman told the Washington Blade.
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