“The reauthorization of the Ryan White CARE Act has enormous implications for people living with HIV and AIDS, and communities providing related health services.

“The communities I represent in East Los Angeles and the San Gabriel Valley have fought this disease since its onset over 20 years ago. Los Angeles is an epicenter of the HIV and AIDS epidemic in the United States. Estimates show between 50,000 and 60,000 persons live with HIV or AIDS within LA County. 

“As the epidemic grows, communities of color are disproportionately at risk. Although only 14 percent of the U.S. population, Latinos constitute almost 20 percent of the AIDS cases diagnosed since the start of the epidemic.

“The face of this epidemic is young girls and women.  Latinas represent 18 percent of new AIDS cases among women.

“I am proud that the Committee agreed to codify the Minority AIDS Initiative in this reauthorization, a priority of the TriCaucus. However, I still have concerns with this bill.  AIDS service organizations work hard to ensure delivery of linguistically and culturally competent care, including adequate translation services, which are critically important for persons with limited English proficiency.

“Yet this bill considers language services a support service, when in reality, for many racial and ethnic minorities, language services are necessary to ensure proper health care.

“A report by the Agency for Healthcare Research and Quality in January, 2006, showed that health disparities for the Latino population have widened in both quality of care and access to care.

“Language access services are especially important for these communities to ensure the highest quality of care is being received.  Language barriers can cause poor, erroneous communication, poor decision making or ethical compromises.

“As legislation that is supposed to modernize the treatment of HIV and AIDS it is important that the barriers posed by language access difficulties be recognized and dealt with appropriately.

“Mr. Chairman, I know that there have been conversations between my staff, minority staff, and majority staff about my concerns regarding linguistic services.

“I am encouraged that there may be an opportunity to address this in report language.

“In addition, I am also concerned about the funding mechanism in this legislation. While I recognize that Southern states are seeing incredible climbs in their numbers of people living with HIV and AIDS, those states with historically large populations living with HIV and AIDS, like California, continue to struggle.

“Yet because of the looming October 1st deadline, coupled with the Administration’s decision to not count any code-based state HIV data, the lack of a reauthorization would put my state of California in a very difficult position, jeopardizing the health of the 150,000 people living with HIV and AIDS in my state.

In addition, the existing situation limits what services their patients are able to receive.

“So today we are forced with a decision – support a piece of legislation which is less than perfect and which could still be improved, or risk losing significant funding and care for our states and constituencies. This is not an enviable decision. I only hope that as this legislation moves forward we commit to listening to the concerns of those who are on the front lines fighting this epidemic and to finding a cure.”