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Loss of $4M Grant Threatens HIV Prevention Efforts in Tennessee

Healthcare providers across Tennessee are scrambling to find new funding for HIV prevention following the loss of a critical federal grant.

Tennessee lost the funding earlier this spring amid deep spending cuts at the Centers for Disease Control and Prevention (CDC).

United Way of Greater Nashville, the organization that directs federal HIV funding to nonprofits and healthcare agencies across the state, told the Institute for Public Service Reporting its CDC agreement “expired” on the last day of May. That funding, totaling $4 million, represents roughly half of all federal dollars spent in Tennessee for HIV prevention and treatment.

The cuts are expected to hit especially hard in Memphis, where HIV infection rates are among the highest in the country.

“This moment calls for creativity in how we fund HIV prevention and care at the local level especially in states that do not have a political appetite for action,” said Adrian Shanker, a senior official for the U.S. Department of Health and Human Services (HHS) during the Biden administration.

The Ryan White program, the federal program that covers HIV treatment and treatment-related needs for people who couldn’t otherwise afford them, appears to be left intact.

But the cuts are expected to decrease the accessibility of birth control supplies and trigger layoffs of social workers and employees who help people navigate access to PrEP, or pre-exposure prophylaxis, a key drug for at-risk individuals that greatly reduces the odds of contracting HIV.

The loss of the federal funding comes as Memphis health officials face rising rates of new infections of HIV and syphilis and an uncertain future of disease surveillance at state and national levels.

Data shows a steady climb since the onset of the Covid-19 pandemic in 2020 when the Shelby County Health Department logged 238 new HIV infections. In 2023, the latest year data is available from both the county and state health departments, that number jumped to 353. This total does not include individuals who may have unknowingly contracted the virus.

Ron Bobal, founder of the Memphis nonprofit A Betor Way, which faces a loss of $125,000 a year in funding, said the cuts in prevention funding have implications beyond the spread of HIV. Bobal’s nonprofit specializes in harm reduction, providing clean needles and rapid HIV testing for intravenous drug users who may otherwise reuse needles and spread infections.

Add to that, Bobal said, the funding cuts often translate to a loss of jobs and an overall weakening of an already underfunded infrastructure of community-based organizations.

“This is scary to me, you know? It just means that categories of people who were already underserved are going to be in a worse situation than they were before,” Bobal said. “You take all the CBOs [community-based organizations] out of Memphis, … I don’t know what’s left.”

Great uncertainty

Tennessee healthcare providers had a verbal commitment from the CDC under the Biden administration to continue the HIV prevention funding for another year, but discussions abruptly stopped after President Donald Trump took office in January, according to people familiar with the matter who asked to remain anonymous to discuss sensitive information. The CDC later initiated procedures to close out and discontinue the grant, these people said.

As funding sources for sexual and reproductive health continue to dry up, upheaval at the federal level adds another layer of complication for HIV surveillance, prevention, and treatment.

Since President Trump took office in January, HHS has discontinued research into a promising vaccine for HIV, just months before trials were to start. The federal entity, which houses the CDC, also is hurriedly rehiring hundreds of workers fired earlier this spring under the direction of the Department of Government Efficiency, or DOGE, which was overseen for a time by billionaire Elon Musk.

The disruptions are “not insignificant,” Shanker said.

“There was a light at the end of the tunnel, so to speak,” he said. “These are setbacks that will require massive investments from nongovernmental sources, just to stay close to being on track to where we were before. And that’s really, really challenging.”

The challenges will trickle down.

In Shelby County, when a person receives a positive result on an HIV test, regardless of where they are tested, they are told to contact anyone they have had intercourse with within the past year. Positive test results are also reported to the health department, where staff contact tracers work to contact any at-risk individuals associated with the positive test.

The positive test result then goes on a journey. If a person is tested at a community organization or a healthcare office, results are reported to the county health department. From there, the numbers are sent to the state health department, where the data is compiled.

Often preliminary data — data that is still being analyzed and verified — is the closest the public can get to the most recent information about how HIV is spreading. The latest data available from both the state and county stops in 2023.

Information gathered locally about new HIV infections is collected by the CDC’s National HIV Surveillance System. However, that system was disrupted this spring when numbers of employees were fired as part of a DOGE-driven restructuring. In all, some 10,000 HHS employees were laid off in March. A federal judge in Rhode Island ruled earlier this month that the layoffs were likely unlawful; it’s unclear how that decision may affect the surveillance program.

The court ruling aside, the federal government already is rehiring hundreds of previously fired workers, HHS Secretary Robert F. Kennedy Jr. told a U.S. House of Representatives subcommittee on June 24.

Even if every fired CDC employee that coordinated federal efforts to contain and eliminate HIV is hired back, the disruption, as Shanker said, is a significant setback.

Setbacks hit hard in Memphis

For cities like Memphis, a national leader in new infection rates, setbacks at the federal level hit especially hard.

HIV infection rates prompted Shelby County Health Director Michelle Taylor to sound the alarm over the past year. In February, she met with local hospital leaders and urged the implementation of “opt out” testing for HIV for patients treated in emergency rooms, meaning patients would be universally screened for HIV unless they declined the test.

Regional One Health, a public hospital that treats historically vulnerable communities, has flagged HIV infections as a priority for years. All patients who are admitted to the hospital are screened for HIV, Angie Golding, the communications director, told The Institute.

Meanwhile, other healthcare providers are bracing for the cuts.

CHOICES Memphis Center for Reproductive Health, an organization that once provided abortions and still provides midwifery services, has endured both Title X cuts and CDC cuts.

CHOICES CEO Jennifer Pepper said her organization’s ability to provide subsidized sexual and reproductive healthcare is in jeopardy. Clinics that provide similar services are also feeling the squeeze.

For Pepper, the stripped funding is a familiar scenario. She observed multiple efforts, many successful, to cleave funding sources from organizations that provided abortions in the years before the U.S. Supreme Court overturned Roe vs. Wade.

Now, she’s watching colleagues that provide sexual and reproductive health services go through their first rounds of targeted defunding.

“I feel like those who have provided abortion care are, unfortunately, particularly prepared for this moment. But this is a new experience, in some ways, for HIV treatment providers and community-based healthcare providers,” Pepper said.

“Unfortunately, other providers are now experiencing the same thing.”

Categories
Politics Politics Feature

Taylor Resolution Limping

After a lengthy period of inaction on it, state Senator Brent Taylor’s much-vaunted legislative resolution to remove Shelby County DA Steve Mulroy from office was scheduled for a hearing in the state House Criminal Justice Subcommittee on Wednesday of this week.

Asked about the matter following his appearance before the Downtown Kiwanis Club last week, Mayor Paul Young had this to say: “I don’t think they should remove a duly elected individual. I told Brent that, but I opt not to get into all of the public back-and-forth on DA Mulroy or the school board because I believe that Memphis needs a leader that can stay above the fray. And I get so sick of the drama. It’s just nauseating. Every day is some BS that people want us to respond to that’s all personality-driven that does not help our people, so I stay out of it and let them figure it out.”

What the House subcommittee will try to figure out was expressed this way in Taylor’s original Senate resolution: “General Assembly, Statement of Intent or Position – Authorizes the Speaker of Senate to appoint a committee to meet with a like committee from the House of Representatives to consider the removal of Steven J. Mulroy from the office of District Attorney General for the Thirtieth Judicial District by the Tennessee General Assembly acting pursuant to Article VI, Section 6 of the Constitution of Tennessee.” 

The Senate resolution has not so far advanced. It is the House version, more or less identically worded and co-sponsored by state Representative Kevin Vaughn, that will be considered on Wednesday, to be regarded either (in Young’s phrase) as “BS” or, as Senator Taylor has argued, as an important element of his soi-disant “Make Memphis Matter” campaign.

Taylor has issued a lengthy, if somewhat sketchy, bill of particulars to justify his essential claim that Mulroy’s tenure is injurious to the prospects for crime control in Memphis. 

Word to this point has been that few members of the legislature’s leadership or its rank and file have shared Taylor’s sense of urgency or timing.

The issue will be vying for attention with such matters as a pending measure authorizing state takeover of the Memphis Shelby County School Board and Governor Bill Lee’s announcement this week of a supplement to his budget.

And both Mulroy and Young, in his remarks to Kiwanis last week, have cited figures showing dramatic recent decreases in the incidence of crime in the city.

The mayor presented figures showing a 13.3 percent decrease in crime overall since 2022, with reductions occurring in every ZIP code except two. Homicides were down 30 percent, and motor vehicle thefts were down 39 percent, he said.

He also cited figures demonstrating that crimes in the FedExForum area were substantially lower than equivalent areas in Downtown Nashville.

“Results,” he said when asked why the city council, which failed to approve his reappointment of Police Chief C.J. Davis in 2024, had unanimously approved her this year.

• The appointment of Circuit Court Judge Valerie Smith to replace the retiring Judge Arnold Goldin on the state  Court of Appeals was finalized by the legislature on Monday.

• Inspired by the ongoing series of angry popular protests of Department of Government Efficiency (DOGE) actions at congressional town halls nationwide, Shelby County Democrats made ready to organize a protest action last Saturday at a scheduled local appearance by 8th District Republican Congressman David Kustoff.

The action had to be called off, however, when Kustoff’s speech to the men’s club at Our Lady of Perpetual Help Catholic Church in Germantown was canceled because of what church officials called “safety concerns.” 

Categories
News The Fly-By

MEMernet: Fun Muddin’, Monday Mood, Cohen on Musk 

Memphis on the internet.

Fun Muddin’

You’re in luck if you’ve ever wondered what it’s like to go muddin’ in the Wolf River bottoms near Covington Pike. ATV content creator Jp Stephens Youtube posted a Facebook Reel that takes you there without getting your work clothes dirty. 

Monday Mood

Posted to X by Memphis Zoo

Yawning gibbons drowsed in the spring sunshine last week in a post with the hashtag #mondaymood. I mean, you’ve gotta rest up if you’re going to entertain kids at the Cat House Cafe.

Cohen On Musk

Posted to X by Steve Cohen

U.S. Representative Steve Cohen (D-Memphis) promised to fight a DOGE proposal to close the Odell Horton Federal Building in Memphis. The closing would leave no place for federal court to meet, Cohen argued, while the Trump administration considers new judges to be named.

“Maybe we just take this bill and hold it for awhile until the greatest, most brilliant, smartest, most absolutely phenomenal judicial and real estate mind in the world, Elon Musk, can come and tell us what he’s going to do with the judges,” Cohen said.

Categories
Opinion Viewpoint

An Efficiency Problem

On January 20th, President Trump reorganized the United States Digital Service into the Department of Government Efficiency (DOGE) and ordered it to begin “modernizing Federal technology and software to maximize efficiency and productivity.” The task list soon became much larger to include, in the president’s words, “dismantle Government Bureaucracy, slash excess regulations, cut wasteful expenditures, and restructure Federal agencies.” 

DOGE has quickly gone to work, holding up millions of dollars of federal contracts and firing tens of thousands of government employees. Elon Musk, who is somehow involved in the department but not its head, claims the goal is to save up to $2 trillion by radically slashing the federal budget.

Efficiency is a tricky value. It’s hard to be against it. Why wouldn’t you want something to be efficient — meaning, fast, cheap, and accessible? But it’s not always obvious that efficiency is not the only, or the best, standard to have in all important matters. Fast food is efficiently delivered and relatively inexpensive, but no one pretends that it’s nutritious or even really that tasty. I doubt many people would choose a McDonald’s meal for Thanksgiving over a carefully cooked home meal, prepared with love and attention. 

Efficiency is about means-to-end thinking — what’s the cheapest, fastest, easiest way to get from here to goal X. Yet it appears that with DOGE efficiency has become an end in itself now. Efficiency for efficiency’s sake. What goals are we achieving by making government “more efficient”? Musk has floated the idea that the DOGE slashing might result in a savings dividend of $5,000 to eligible households. This sounds exciting to many, but at what expense? What services might no longer be accessible? What kind of government and society do we really want? An efficient one — but to accomplish what kinds of values?

It’s not clear that government efficiency was that high of a concern for the Founding Fathers. They were more concerned that government protect the liberty of its citizens. For that reason, James Madison, the fourth U.S. president, argued that our federal government ought to be organized in a way so as to work in a slow and complicated manner. 

The Founders were worried about groups of people seizing government offices to push their own agendas. So they built a federal republic — a government with multiple independent branches that check each other, splitting the legislative body in two to give public opinion different weight in consideration. All of this was to make government business gradual and deliberative, not necessarily efficient, in order to make sure that individual life, liberty, and property were not unduly infringed upon by the government.

There are some worrying signs about the operations of DOGE. Who exactly is directing it? President Trump has said it is not Musk; he is a “special senior advisor” directly to the president and therefore does not have to be vetted by other branches. The members of DOGE are “special government employees,” meaning they are not subject to ethical rules and conflict of interest regulations like other federal employees. DOGE records are also now classified as presidential records, meaning the public cannot have access to them until after 2034. 

If anything is clear, it seems that any possible “government efficiency” is being balanced against transparency and public oversight. Is getting a one-time check (that may or may not raise inflation, which is rising by itself already) worth a government that blocks insight into how it makes its major decisions about public welfare? 

This kind of power is even more worrisome when there is increasing evidence that these savings are not going to materialize in any significant way. All these developments seem like something that would have raised Madison’s suspicions. 

As he wrote in Federalist Letter 51: “In framing a government which is to be administered by men over men, the great difficulty lies in this: You must first enable the government to control the governed; and in the next place oblige it to control itself.” 

Jose-Antonio Orosco, Ph.D., is the author of several books and a professor at Oregon State University.

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News News Blog News Feature

State Dems Work to Hold Elon Musk Accountable in Tennessee

Posted to X this week by Elon Musk

State Democrats are taking aim at Memphis businessman Elon Musk’s activities involving government benefits and sensitive government data at the federal level. 

House Democratic Leader Rep. Karen Camper (D-Memphis) asked Tennessee General Attorney Jonathan Skrmetti and the District Attorneys General Conference to investigate Musk’s “potential unauthorized access and misuse of sensitive federal data.”  

Meanwhile, state Sen. Jeff Yarbro (D-Nashville) and state Rep. Jason Powell (D-Nashville) filed a bill to “hold people accountable for unlawfully interfering with the distribution of government benefits that Tennessee families rely on.”

Last year, Musk’s company xAI chose Memphis as the site of his massive artificial intelligence facility. The site powers Grok, the AI program from X.  

Camper on sensitive data

Camper sent a formal letter to Skrmetti and the conference Tuesday to investigate press reports of Musk’s activities through his new Department of Government Efficiency (DOGE). Report say Musk and his office have wide-ranging access to federal payment systems and personnel files of government employees. Camper said these activities could cause data breaches of sensitive information affecting Tennesseans and Tennessee-based federal employees. 

Specifically, Camper wants the AG to review: 

• If any data on Tennesseans of Tennessee-based employees has been accessed or extracted in DOGE’s activities.

• Where is this data now stored and who has custody over it?

• What is the chain of custody for such data?

• Has any data been given to any agency prohibited from handling such information? 

“Additionally, considering Mr. Musk’s public statements regarding his desire to see the United States default on its debts and his history of data misuse for personal gain, it is imperative that he be deposed regarding his intent and purpose in accessing these systems,” Camper wrote in her letter. “The risk of a ‘shock default’ — where the U.S. could default without actionable warning to Congress — poses a serious national security and economic threat that must not be ignored.”

Also, Camper said if Musk was not authorized to access federal Office of Personnel Management (OPM) systems, including disciplinary records, this could allow federal workers grounds to contest or block disciplinary actions. 

The STOP ELON Act

The Trump administration also caused a national shockwave of confusion last week as it paused federal funding to nearly every agency served by the federal government. This meant funds to any government contractor, like nonprofits or research groups, was halted, though they rely on that funding to continue work. 

This policy decision came from Musk’s DOGE. President Donald Trump reversed course on the matter after nationwide concerns on how business could get done. 

For this, Tennessee lawmakers Yarbro and Powell introduced the Shielding Tennesseans from Oligarchic Power & Eliminating Lawless Obstruction of Necessities Act  (The STOP ELON Act). 

The bill would create criminal penalties and a private right of civil action against any individual who obstructs or denies access to federal, state, or local government benefits, including Social Security payments, Medicare benefits, grants, and other financial distributions.

“If Elon Musk illegally hurts Tennesseans, he should go to jail regardless of being a trillionaire or whatever and regardless of whether he’s got a permission slip from the president,” Yarbro said in a statement. “Whether through malice or incompetence, if he unlawfully blocks our citizens from getting their Social Security checks or reimbursement from Medicaid or Medicare, his vast wealth should be on the table to compensate the people who get hurt.”

Rep. Powell emphasized the intent of the bill is to prevent abuses of power and ensure accountability, regardless of a person’s wealth or connections. 

The law would put fines and prison time on those who would obstruct lawful government payments. Obstructions of benefits valued at $1,000 or less would be a Class A misdemeanor. As the amount of benefits go up, so do the fines and penalties, up to $250,000 and prison time. Those harmed would be given a legal pathway to sue for damages in state courts.   

“Tennesseans who work hard and play by the rules should never have to worry about a billionaire meddling in their financial security,” said Powell in a statement. “People like Elon Musk need to understand that they are not invincible and the STOP ELON Act makes it crystal clear — no one is above the law. If you interfere with a person’s rightful benefits, you will be held accountable.”

It’s not yet known how state Republicans will respond to Camper’s request or the STOP ELON Act. However, House Majority Leader Rep. William Lamberth (R-Portland) reposted this from Musk on X Tuesday.