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January, 2010 Volume 35, Issue 1



(415)868-1600 - (415)868-0502(fax) -
P.O. Box 31, Bolinas, CA, 94924
mailto:[email protected]

Deadly Changes For AIDS Funding
By Karen Nakamura

Caught 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 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.
    Michael Weinstein, 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 year."
    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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