Volume 35, Issue 1
COUNTY'S NEWS MONTHLY - FREE PRESS
|Deadly Changes For AIDS Funding|
By Karen Nakamura
in the present unpalatable credit squeeze, California's Gov. Arnold
Schwarzenegger used his veto power on June 28, 2009 and threatened to
cut $85 million from the California Office of HIV/AIDS funding. Because
of this, effective Feb. 28, the respected Hospice by the Bay has been
forced to close its successful 20-year AIDS program.
San Diego's miketidmus.com/blog explained what this means statewide.
AIDS services were cut across the board with only "epidemic
surveillance and drugs that suppress HIV" spared. HIV-related education
and prevention both took an 80% cut, counseling and testing 70%,
primary medical care and home care 50% and housing 20%.
That includes the termination of all funding to the Office of the AIDS
Therapeutic Monitoring Program, which serves 35,000 Californians. The
program paid for viral-load testing, the only way to find out if an
AIDS medication "cocktail" is working on individuals or not. The
program also paid for drug resistance testing and monitoring when a
particular "cocktail" stopped working in an individual. This one-on-one
guides the physician to find a new combination of drugs for the
patient. San Francisco's AIDS community has become an experimental
laboratory that has led to breakthroughs in therapy So even if patients
continue to receive their medications and they're thankful for that,
they could get sick or die if they can't adjust their medications.
Also hitting the Marin AIDS community hard is the 50% cut in in-home
healthcare funding community-based care. In home care allows clients to
live independently helping them get to appointments, handling
complicated medication regimens, fixing meals and managing their homes,
difficult tasks for many.
president of the AIDS Healthcare Foundation, stated: "As California
grapples with a… budget shortfall and has slashed the state's AIDS
budget and services down to the bone, the drug industry continues to
enjoy one of the most larded corporate welfare programs around.
…Between 2000 and 2008, California's AIDS drug bill skyrocketed 165% to
$272 million per year while enrollment …jumped only 49.5%. Any new
money …has gone straight to the industry for drug price increases, not
to expand access for more patients or more drugs."
In the meantime, the highly respected Hospice by the Bay of Larkspur
Landing will lose between $50,000 to a $100,000 a year from the state.
And that's not counting the federal cuts in February. HIV/AIDS
healthcare isn't their only program with devastating reductions. Their
elderly and terminally ill Medicare clients are also facing drastic
cuts in in-home healthcare services, which give so many Marinites the
ability to die at home surrounded by loved ones, a hallmark of Marin's
growing humane healthcare community. Since 1989 Hospice has served
approximately 25 clients annually.
The timing is
especially troubling. New research shows that long-term AIDS patients
are aging at a faster rate than their non-infected generation. Serious
medical conditions are popping up such as osteoporosis, cancers, kidney
disease and dementia. Marin County and the Bay Area are known for their
number of long-term AIDS clients, a point of pride. These clients were
given short-term death sentences in the 1980s and 90s. Instead many are
still living. So while things may not be perfect, the job done deserves
praise and more funding. Instead, it's being disassembled.
The Coastal Post talked to the Department of Health and Human Services
Director Larry Meridith about the $85 billion in state cuts to his
department and other entities.
His answer was:
"As of this month, the California courts have made adjustments and
reduced the cuts to something more like $25 billion not the previous
$85 billion. For instance, Gov. Schwarzenegger was going to cut a
prison AIDS program that transferred seriously ill convicts from prison
and to their homes but the California Courts rejected that effort and
others as not complying with state regulations. That's still $25
billion and $7-8 billion this year alone. But even with the cuts to
AIDS, mental health services, child protective services and the like,
the governor still hasn't balanced the budget."
Asked what could be done, Meridith said more cuts in logical places or
the raising of revenues would help. The raising of revenues is the crux
of the problem as Republicans are staunchly against any new taxation.
"There are plenty of ways to raise acceptable revenue. They could
increase alcoholic beverage sales taxes. Or the governor could
re-instate the Vehicle License Fees cut at the beginning of his term.
There are ways.
The Governor is instead looking
at fraud and tax evaders. Let me tell you, there is very little fraud
or tax evasion among clients or their care providers. These are people
with marginal income living on the edge. They're not dishonest. It's
such a small matter.
"The problem cuts into
Marin's abilities to care. We were able to keep the AIDS clinics open.
The County has a 15 million shortfall this year and forecasts another
15 million next year. It's next year that worries me. There are going
to be people getting services now who won't be able to get them in a
The manager of Marin's HIV/AIDS program,
Cicily Emerson said in the Marin Independent Journal December 11, that
Marin will use the $125,000 from federal funds that formally went to
Hospice By The Bay to hire another agency, probably a non-profit such
as the Marin AIDS Project or the Marin Treatment Center, to continue
some services starting in March. "Our goal is to ensure that the
essential parts of the services are continued… so there is continuity
of care. It's a program for people …who are relatively homebound."
That's expected to be approximately 12 to 15 AIDS patients annually. A $125,000 a year isn't going to go far.
Whitney Engeran-Cordova, Director of the Public Health Division of the
AIDS Healthcare Foundation stated: "The AIDS service delivery system in
California is collapsing, the safety net for more than 30,000
Californians to stay alive. We have a moral responsibility to address
this crisis. We cannot sacrifice the lives of our clients and patients
in order to give PHARMA record profits. Failure is not an option."
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