First Circuit Upholds Cut |in City’s AIDS Funding

     BOSTON (CN) – The U.S. Department of Health and Human Services did not adopt an unfair definition of ‘metropolitan area’ when it decided to cut federal HIV/AIDS funding to the Ponce district of Puerto Rico, the First Circuit ruled.
     Tuesday’s ruling, written by U.S. Circuit Judge William Kayatta Jr., reversed a district court ruling in favor of the municipality.
     The Ponce municipal government, which had argued in court sued HHS, arguing that the agency erred when it determined the city had fallen under the threshold for funding mandated in the Ryan White Comprehensive AIDS Resources Emergency Act.
     Ponce claimed the agency unfairly drew metropolitan boundaries that were too narrow and that three adjoining communities should be incorporated its metropolitan boundary for the purposes of determining funding.
     Congress passed the Ryan White Comprehensive AIDS Resources Emergency Act in 1990, empowering HHS to fund the combating of HIV/AIDS in metropolitan areas that are home to more than a specified number of AIDS cases.
     Ponce initially qualified to receive funding under the Act, but in 1996, Congress raised the eligibility requirements, in the process rendering the city ineligible for aid.
     To counteract that unintended consequence, lawmakers added a grandfathering provision to the amendment, thereby assuring Ponce still received funding under the Act.
     In 2006, Congress removed the grandfathering provision, but Ponce still received funding under a newly-created category of “transitional grant areas.”
     At the same time, Congress froze the boundaries of the metropolitan areas to be used by HHS in making its future funding determinations.
     When HHS announced Ponce no longer qualified for funding, the city and a number of community organizations and activists sued, arguing HHS drew municipal boundaries for Ponce that were too narrow to encompass the entire city, and that the addition of three adjoining communities would raise the total number of AIDS cases enough to qualify for continued funding.
     A district court judge sided with the plaintiffs, holding HHS unreasonably relied on the Office of Management and Budget’s delineations of geographical “Metropolitan Statistical Areas” to make its determination, making the boundary decision “arbitrary” and “capricious.”
     The district court also found the methodology employed by the federal agency was discriminatory because another method of defining geographical areas was used in New England and other parts of the United States.
     But on appeal, a three-judge panel of the First Circuit found HHS had acted lawfully because the boundary it relied on was dictated to it by Congress, and are the same employed by the Centers for Disease Control and other federal agencies to gather information.
     “While a court might, we assume, order relief if HHS refused to use the boundaries Congress told it to use, there is in this legislative scheme no license for a court to tell HHS not to use what Congress said to use,” Kayatta wrote.
     Funding across the United States is determined using MSAs, with the exception of Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and Connecticut which use the New England County Metropolitan Areas instead.
     This distinction was referenced by the district court determined that the different delineations reflected discrimination, which the circuit court said was a misunderstanding of the regions.
     “The district court apparently read this to mean that HHS chose not to adopt the OMB’s delineations for these few states,” Kayatta wrote. “In fact, the CDC (Centers for Disease Control) was merely describing how the OMB itself treats New England states differently.”
     He added: “While we acknowledge that Puerto Rico suffers the disadvantage of lacking formal representation in Congress, there is simply nothing whatsoever in this case to suggest that HHS treats the Ponce metropolitan area under the Act in any way differently than it does hundreds of similarly-situated areas across the United States.”

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