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GOAL NY Testifies at NYC Council Hearing About Critical Coverage Gaps For City Employees for HIV Med

Testimony by Brian E Downey, GOAL NY President

Joint Hearing of Finance and Civil Service & Labor Committees New York City Council

November 29, 2018

Good morning, Speaker Johnson, Chairman Dromm, Chairman Miller, Committee Members and Council Staff.

Thank you for the opportunity to address your committees on a matter of great concern for my membership and, frankly, for all City employees: the lack of coverage in some City-worker health plans for HIV medicines and the preventative drug, PrEP.

My name is Brian Downey. I am the President of the Gay Officers Action League of New York. GOAL exists to address the needs, issues, and concerns of LGBTQ criminal justice professionals in the metropolitan area.

We are also the go-to group for many across the country who need help advocating in the criminal justice community on LGBTQ issues or forming their own organizations.

This is a very meaningful opportunity for me because our founder, the late Sergeant Charles H. Cochrane, came before the City Council 37 years ago last week, sitting in this chair, and publicly out’ed himself so that he could shatter the myth that there were no gays in law enforcement. GOAL is here today thanks to Charlie’s bravery, but also thanks to the City Council – without the forum you gave Charlie that day, we may never have developed the voice we now have.

Like I mentioned a moment ago, I come to you today because some of my members are hurting, and GOAL needs your help – some of my members lack essential coverage in their health plans for HIV medications and for PrEP. To be clear – I am talking about a gap in healthcare coverage for:

(1) the antiretrovirals that are essential for HIV positive persons to control their viral load and live normal lives, and

(2) the prophylaxis treatment that can stop the spread of HIV.

And my members – they are not the only ones in the City’s workforce who lack this coverage.

Just a short while ago, we heard about the healthcare cost savings that the City achieved, and I could not imagine a better conversation to join in on in order to raise this concern – the chance to baseline who is and who isn’t covered through bargaining and the savings achieved by the City are absolutely essential to scope this problem and solve it.

Over the past two years, several of my members, in particular, uniformed officers, have quietly sought help from GOAL. All were police officers whose excellence as officers was recognized through promotion to the rank of Detective. Detectives are the investigative heart of the NYPD. And to achieve the rank of Detective is truly a special recognition for past successes that few receive in their careers.

And yet, after a coveted promotion, these officers were shocked to find that critical coverage – coverage for HIV medications for those who are HIV-positive, and coverage for PrEP for those are not – was not afforded them in their new rank under the City’s plan. Those costs were suddenly out-of-pocket.

Make no mistake. These are five-figure costs annually. Costs that rival rent payments. And costs that, as City employees, my members never expected to face.

I raised this matter with my membership, and, sure enough, other non-uniform members in and friends of our organization – current and former city employees – came to me and shared similar stories: they had no or limited coverage, either. They were stuck, too, asking themselves:

  • How do I afford PrEP?

  • How do I get my antiretroviral treatment covered or subsidized?

  • And, the most common question people have told me they find themselves asking, how is it that I work for a City that’s supposed to be committed to stopping HIV’s spread, but I’m not covered for PrEP, and I can’t afford medication that helps me live as an HIV positive person?

I don’t need to tell this body that City workers are the lifeblood of this City. A City this large and this critical to the nation’s economy would be nowhere without its workers. But many of them – and I represent some of them – feel left out without recourse. They make too much to qualify for assistance programs, such as Ryan White or the Mayor’s End the Epidemic support for non-profits, and they make too little for these payments to come out of pocket without great sacrifice. They’re left in a large middle that needs help, and needs it now, from the City.

The worst part, however, isn’t that I come to you with members who have no coverage for HIV medications and prophylaxis. Nor is that I have to tell you that as city workers they can’t afford those drugs. It’s also not that those persons have no solution yet, either. The worst part is that I know this problem is bigger than just my members who raised this issue directly with me, but I can’t tell you how much bigger – I can’t tell you the scope of the problem, and it’s not for lack of trying.

My organization has spent months trying to find out how many other employees for the City have the same coverage issues. We have made calls. We have spoken with officials. We have written letters. And the best we’ve received from the City is an acknowledgment, from the Mayor’s Office of Labor Relations, that yes, coverage gaps exist, and that the unions must provide.

GOAL does not find that answer at all adequate, but that’s what we got. A confirmation that the problem we know is real is, in fact, real. No offer to scope it. No acknowledgment that the City has a role it can play. And no indication that the City was exploring ways to fill this coverage gap in its work with the unions.

So, I come before you for help. Please. I know, my organization knows, that there are public servants whose job it is to serve the City that have no coverage for life-saving drugs, or for prophylaxis that might one day make a disease obsolete—a disease that was at one time so feared, and those who had it stigmatized and ostracized. We can’t tell you how many do not have coverage. Nor, of course, can we tell you the individuals who need it because living with HIV and taking precautions against HIV are still conversations shrouded in old biases and riddled with implications about bad judgment.

All we know for sure is that an unknown number of public servants don’t have what they need in their healthcare coverage, and that the City hasn’t offered to investigate and find a solution. We know that our City is sincere in its efforts to curtail HIV’s spread and enable people afflicted with it to live normal and dignified lives. We know PrEP is provided at City clinics for low-income persons; PEP is available to anyone who believes they have been exposed. The City has highly publicized its End the Epidemic project and lent its support for the U=U campaign. These are tremendous and necessary programs.

But that still leaves public servants without coverage. And no matter how the issue is sliced, that’s just wrong.

GOAL is asking for your support, Council Members to address this issue. We need the Council’s help to scope this problem and solve it.

There ought to be:

(1) data made available on which groups of employees lack this coverage, and

(2) a city-backed solution that helps its employees. Whatever form that comes in – whether adding HIV medications and PrEP to the basic HIP HMO and Emblem Health GHI/CBP plans, or adding them to the PICA program, or offering a program through the Department of Health and Mental Hygiene for City employees who can’t afford coverage – the City’s employees deserve that kind of commitment from the government they serve.

I’ve spent seven of the past ten years serving the City as a Police Officer, and the past three as a Detective. I often tell people who talk to me about this issue that I thank God that I’m healthy, that I’m not sick. I’d like all of us to be healthy, but I hope that when we’re not healthy, when we’re in need, like some of my members are right now, that our City will have our back. I’m waiting to find out if my hopes can be met.

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