AIDS funding shift to rural areas will hurt N.J. agencies
Thursday,
April 5, 2007
By ADRIENNE LU
STAFF WRITER
CARMINE GALASSO / THE RECORD  Goffredo Palladino of North Bergen, a client of Friends for Life, an HIV/AIDS services organization in Fort Lee. The group
will have to cut services.
|
New Jersey agencies have spent more than a decade building a network to provide the state's neediest AIDS and HIV patients
with a wide range of services, including help paying rent, transportation to medical appointments and legal services.
But in a matter of months, advocates say, much of that network will evaporate as the state loses millions of dollars in
federal funding.
Bergen and Passaic counties estimate they will lose 41 percent of their funding, dropping from $3.6 million to $2.1 million
this year. The cuts will affect 20 agencies locally, which together served 2,000 people with AIDS or HIV last year.
"This is devastating," said Steve Scheuermann, chairman of the Paterson-Passaic County-Bergen County HIV Health Services
Planning Council. "We're going to be pushed back to where we were 10, 15 years ago."
The money is being lost because of changes Congress made in December to the Ryan White CARE Act, the main source of federal
funding for fighting HIV/AIDS. Lawmakers added five metropolitan areas to the list of those receiving funding, with the intent
of shifting more money to rural communities affected by the disease.
Overall funding remained virtually unchanged, however, so with more communities drawing on the same sum, dozens will be
hit with massive cuts.
Experts estimate New Jersey, which has the fifth-highest number of HIV/AIDS cases in the country, could lose as much as
$27 million in Ryan White funding at the local level over the next three years.
Although Ryan White funding targets the neediest patients -- including the homeless, drug-addicted and mentally ill --
the budget cuts will have much broader impacts, warn advocates including Scheuermann, who also serves as executive director
of Buddies of New Jersey, a non-profit HIV/AIDS resource center.
Among their predictions:
As HIV patients lose many of the services that help keep them healthy, the progression from HIV to AIDS will
begin to happen much faster.
AIDS patients will resort to hospital emergency rooms more frequently, taxing already-overburdened charity
care.
Without support services, some patients will take their medications less frequently, making them more infectious
to others.
Patients who fall out of treatment may develop strains of HIV more resistant to medicine.
New Jersey's congressional delegation -- Democrats and Republicans alike -- fought to preserve the state's Ryan White funding.
Rep. Frank Pallone Jr., D-Long Branch, who proposed an amendment that would have preserved funding levels for one more
year, said Democrats initially sought to increase the total amount of funding to both preserve funds for previous recipients
and add new money for new recipients.
"Ideally you would have held New Jersey harmless and still increased funding for states in the South," Pallone said. "Instead
we got the worst combination -- not enough money and a shift in funding to states in the South and rural areas that haven't
addressed [HIV/AIDS] and now have a larger HIV population."
Nassau and Suffolk counties on Long Island, which will lose millions in Ryan White funding, have filed suit against the
U.S. Department of Health and Human Services. Bergen and Passaic counties are also considering filing suit.
Rep. Mary Bono, R-Calif., one of the primary sponsors of the bill, has said that the changes would ensure that funds go
to the areas in greatest need and address the increased life expectancy for people with HIV/AIDS.
"Once predominantly an urban phenomenon, we now see dramatic increases for HIV services in rural America," Bono said. "Some
of the geographic areas that are home to the most rapid and dramatic increase in HIV diseases are areas that are ill-equipped
to respond."
Another change that will hurt New Jersey is a new mandate to allocate 75 percent of Ryan White dollars to "core medical
services," which covers direct medical care. While the intent was to preserve what some consider the most crucial services,
the impact will be to end many support services including respite care and community case management.
In Bergen and Passaic counties, the number of vans to help take patients to medical appointments will drop from three to
one. Some patients simply won't get to their medical appointments, advocates say.
"We're not talking about luxury items, we're talking, for many people, survival items, basic life and death," said Karen
Walker, director of HIV services at Paterson Counseling Center, a non-profit methadone drug treatment facility. "People are
not going to get the things they need and they're going to get sick more quickly and die more quickly. That's the harsh reality."
Friends for Life, based at the Church of the Good Shepherd in Fort Lee, has been helping HIV/AIDS patients for 15 years.
The non-profit serves about 200 people from Bergen and Passaic counties a year.
Friends for Life runs a day program where patients receive a range of services, including counseling, therapies such as
acupuncture and massage, transportation and meals.
With the funding cuts, the nonprofit will lay off three of its four paid employees as of May 1. Friends for Life will hire
a part-time coordinator to keep a bare minimum of services going with the help of volunteers. The agency received about 65
percent of its budget from Ryan White funding and has been unable to make up the loss through fund raising said Judi Millian,
the director.
Support groups and case management will be among the services cut. Doors will be open to clients only two days a week,
and free transportation to pharmacies and medical services has been cut.
One client, Theresa, who didn't want her last name published, has been coming to Friends For Life since 1998, the same
year her HIV developed into AIDS. A former nurse's aide, she has diabetes and is blind in one eye. An implant in one leg helps
keeps blood clots from traveling elsewhere.
Like most at Friends, she's worried about how the funding cuts will affect her life. Theresa, 49, is worried about her
teeth, but Friends will no longer offer a dentist. She relies on the food pantry when money gets tight for groceries. She
said massage helps ease her pain and relax her mind.
"It basically gives us a place to come so we can continue being," Theresa said. "My life is going to change dramatically."
Goffredo Palladino, 62, who has been coming to Friends For Life for eight years, said even though he has a good network
of friends and family, the group has been a great resource for him over time.
They've helped him navigate the bureaucratic maze of government benefits, and more importantly, provided a caring ear when
he needed one.
"I don't know what I would have done without them," said Palladino, who worked as a hair cutter for 42 years. "They've
been there for me and I've been there for them, too."
E-mail: lu@northjersey.com
* * *
Facts and figures
The Ryan White CARE Act was named after a teenage hemophiliac who contracted AIDS through a blood transfusion.
It provides more than $2 billion a year in federal funding to fight HIV and AIDS. Enacted in 1990, it must be reauthorized
by Congress every five years.
Twenty-nine communities nationwide, including Bergen and Passaic counties, have been downgraded to "Transitional
Grant Areas," which translates into less funding.
Seventy-five percent of Ryan White funds now must be spent on "core medical services."
Previously, half of Ryan White funds were allocated based strictly on the numbers of AIDS patients in an area
and the other half based on competitive grants. Now, two-thirds will be allocated based on the number of AIDS and HIV patients,
one third on competitive grants.
Number of people living with HIV/AIDS in New Jersey: 33,349, including 1,420 in Bergen and 2,563 in Passaic.
| 