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. 2011 Sep 1;58(1):e11-6.
doi: 10.1097/QAI.0b013e31822101c8.

Public funding of HIV/AIDS prevention, treatment, and support in California

Arleen A Leibowitz  1 , Alison C Mendes, Katherine Desmond
Affiliations

Public funding of HIV/AIDS prevention, treatment, and support in California

Arleen A Leibowitz et al. J Acquir Immune Defic Syndr. .

Abstract

Objectives: To determine the amount of public financing for HIV/AIDS in California and its distribution among treatment, prevention, and support services. To determine the geographical distribution of public financing for HIV/AIDS within California.

Design: Data on HIV/AIDS expenditures were compiled across federal and state agencies supporting HIV/AIDS in fiscal year 2008.

Methods: Federal and state data on programs that finance HIV/AIDS treatment, prevention, and support services, including the Ryan White Program, the Centers for Disease Control and Prevention, and the California General Fund, were compiled. California-specific expenditures for Medicare and Medicaid were calculated from claims data. Other entitlement program spending was estimated from national HIV/AIDS data. Data on AIDS cases by county were obtained from the California State Office of AIDS. Mapping to California counties was accomplished with Arc-GIS software.

Results: Public funders accounted for approximately $1.92 billion in HIV/AIDS services in California in fiscal year 2008. Most (90.4%) supported treatment; prevention accounted for 6.4% and support services for 2.6%. The majority of treatment financing came from 2 Federal health entitlement programs, Medicare (36%), and Medicaid (28%). Counties with the highest case loads had lower expenditures per case, suggesting economies of scale.

Conclusions: Treatment expenditures overshadow prevention spending. The dominance of entitlement programs in funding for HIV/AIDS treatment challenges policy makers to monitor the extent and quality of HIV/AIDS care in California. A unified health information system for HIV/AIDS that bridged the fragmented health payment system's data silos would benefit policy makers' efforts to monitor the delivery of HIV/AIDS services.

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Figures

Figure 1
Figure 1
Total Public Funding for HIV in California and Funding per PLWH (FY08)
See this image and copyright information in PMC

References

    1. Office of National AIDS Policy National HIV/AIDS Strategy for the United States. 2010 Jul; Accessed July 13, 2010 at http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf.
    1. Kaiser Family Foundation U.S. Federal Funding for HIV/AIDS: The President’s FY 2011 Budget Request: HIV/AIDS Policy Fact Sheet. 2010 Feb; Accessed March 23, 2010 at http://www.kff.org/hivaids/upload/7029-06.pdf.
    1. National Center for Health Statistics . Health, United States, 2009: With Special Feature on Medical Technology. USGPO; Hyattsville, MD: 2010. - PubMed
    1. Centers for Disease Control and Prevention Domestic Awards By State: FY 2008. accessed August 31, 2009 at: http://www.cdc.gov/hiv/topics/funding/state-awards/pdf/FOA_AwardsbyState....
    1. U.S. Department of Labor, Bureau of Labor Statistics Consumer Price Index-Chained CPI. Accessed August 31, 2009 at: http://data.bls.gov/cgi-bin/surveymost.

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