Part F: Continued
MAI Fosters Culturally Sound Service Delivery
Funding levels grew substantially in the early years of the initiative, and the guiding legislative language changed significantly. Notably, the language increasingly emphasized the intent of the U.S. Congress that the funds be used to strengthen the capacity of minority community-based organizations (MCBOs) to serve people of color affected by HIV/AIDS. According to a report from the National Minority AIDS Council, “MAI funding historically has been slated only for MCBOs, even though many non-minority-specific CBOs have demonstrated their ability to provide culturally sound HIV services in communities of color. This issue has been debated since the MAI initiative began, and [congressional] Report language has changed yearly to reflect the changing opinions of members of Congress and community leaders around the topic in an effort to benefit MCBOs and CBOs that serve minority-based communities.”11
According to Robinson, one important impact of the MAI has been that AIDS service organizations, given the requirements placed on them for accessing the funds, have made an effort to diversify board and organizational leadership, resulting in the delivery of more culturally appropriate services.
The movement to include the MAI in the 2006 reauthorization grew from a concern about the initiative’s long-term survival and the desire to refocus on its original intent of capacity building, according to Ernest Hopkins, an HIV/AIDS advocate who has worked with CBC on the MAI since its inception.12 MAI-related discussions and proposals during the reauthorization process were wide ranging, but the legislative language ultimately maintained the existing MAI services and required the program to be consistent with the language in the FY 2002 appropriations. (PDF – 20.1 KB) One significant change, however, was to make Part A and Part B MAI awards to States and localities a competitive process. Those funds had previously been distributed on the basis of a jurisdiction’s proportion of the racial and ethnic minority AIDS case nationwide.
“The discussions about how to incorporate the MAI into the law were a moment to reflect on what has been done and should be done,” says Hopkins. Referring to possible future legislative efforts beyond the Ryan White Program, he notes that “many members of Congress were invigorated to do more and different things going forward.”12