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AIDS Agencies Deal With Funding Restrictions

Posted on: Thursday, 3 May 2007, 06:00 CDT

DALLAS -- Shalonda Henderson lives in a world of shadows formed from the HIV that robbed her of vision and her husband and left her near destitution.

For transportation, counseling and day care, Henderson depends on services from Dallas-based agencies such as AIDS Arms, Bryan's House and AIDS Resource Center.

The 35-year-old is one of 18,000 people in the Dallas area with HIV/AIDS, according to the Texas Department of State Health Services.

But changes in the Ryan White HIV/AIDS Treatment Modernizations Act, passed by Congress in December, threaten those services, which help her care for her two children.

The Ryan White Act, the federal funding program for HIV/AIDS, doles out $2 billion annually to states and cities. But new rules in the act mandate that 75 cents out of every dollar spent has to be used on medical care, while only 25 cents can be used on case management, including food, housing, transportation and other needs.

Previously, there was no requirement that funds be used primarily for medical care. The changes will mean that AIDS agencies throughout the country will get less money for social service programs, forcing them to cut budgets and reduce services.

In Dallas, AIDS Arms has been forced to slash its budget by more than $350,000 because of Ryan White changes over the past two months. The agency, which serves more than 3,200 people, had to lay off three staff members in January.

"Things have gotten much worse for AIDS support groups since Congress reauthorized the Ryan White Act," said Raeline Nobles, executive director of AIDS Arms. "Most of the HIV population lives below the poverty line, and they're going to look out for their daily needs such as food and clothing before they go searching out medicine."

Texas is receiving $76 million through the Ryan White Act in 2007, according to the U.S. Health Resources and Services Administration. Dallas County, which administers the funds for Collin, Denton, Tarrant and Grayson counties, is receiving $20 million. In 2006, Dallas County divided its federal funding roughly 50-50 between medical and social services, said Zachary Thompson, director of Dallas County Health and Human Services.

"We're very sympathetic to the plight of the agencies," Thompson said. "I don't agree with the change, but I'm bound by the congressional order. There needs to be a balance between medical and outpatient care because both are equally important."

Concerns about changes to the act aren't limited to Dallas. In Connecticut, legislators lobbied for more money after the funding formula shifted money away from some large cities based on the number of new HIV cases that they had. Nassau and Suffolk counties in New York took the U.S. Department of Health and Human Services to court to stop cuts to their HIV programs based on how the funds were distributed.

David Bowman, spokesman for the Health Resources and Services Administration, said that while he understands the concerns, the changes emphasize medical treatment, home health care, nutrition and other such services. Others say that moving more funds to medical care is critical because thousands of people with AIDS nationwide don't receive treatment.

"The ultimate priority is on the delivery of medical care, and it's expected that these agencies will find other sources of funding," Bowman said.

Some agencies have already started reaching out to donors in Dallas or started shifting their services in response.

Legal Hospice of Texas, which provides legal services to low-income people who are terminally ill or HIV-positive, saw its allocation of federal funds reduced by 48 percent, or $44,000, this year. It was able to offset its cuts with grant money. But it doesn't expect that to happen next year. The group is preparing a two-year plan that will offer fewer services, said Roger Wedell, executive director.

David Thomas is the director of Bryan's House, a nonprofit that provides medical care for children with HIV/AIDS. Thomas said his agency cut its budget by $250,000, sought more donors and trimmed programs.

"I think that we're going to see more people becoming infected with HIV, even among children," he said. "Not being able to offer case management, basic services and education is going to have a profound impact."

Nobles says those in need will have to rely more heavily on other social service organizations and HIV/AIDS groups such as White Rock Friends, a church ministry, that doesn't receive federal funds.

"These cuts means ... groups like White Rock Friends are going to pick up more of the slack," she said.

White Rock Friends, a ministry of White Rock Community Church, has served more than 4,700 people with HIV/AIDS since 1992.

The program features a general store offering free personal hygiene items such as deodorant and toothpaste. The store also offers cleaning supplies and a clothes closet. On Saturdays the church also cooks a hot meal for its clients, who range in age from 15 to 75.

Henderson is a client of White Rock Friends. The impact of the federal funding changes weighs on her mind.

"There already aren't enough services out there for us," she said. "And the services that are available are so spread out that it's almost impossible to get help."

Henderson was diagnosed with HIV 15 years ago while living in Los Angeles. At the same time, she learned she was six months pregnant. She became infected with HIV from her boyfriend at the time.

After her son was born, without the virus, she moved back to Texas.

By 1997 her HIV had progressed into AIDS. Later that year she came down with cryptococcal meningitis, a brain infection that can cause severe illness in people with HIV. The sickness caused her to lose her vision, though she can still discern shapes.

Over the years, Henderson lived life to the fullest. She met and married a man who was HIV-positive. They had a girl together, who did not have HIV, and then last year her husband died from the disease.

"A lot of people think that would make you angry," Henderson said about the circumstances in her life. "I prayed a lot and just believed that God would help me get through it."

At White Rock Friends on a recent Saturday, Tommy Ufert, 41, sat in his wheelchair reading a James Patterson novel and waiting for a bus to take him home.

In 1992 his spine was fractured in a car accident when his friend lost control of the car he was driving. At the hospital, Ufert was given a blood test and was diagnosed with HIV. One month before the accident, he had been diagnosed with multiple sclerosis.

"My grandmother always tells me that adversity builds character," he said. "That's how I look at all of the things that have happened to me."

For a while Ufert worked as a customer service representative, but the HIV left him fatigued, and now he spends his days with his cats in the house he shares with his partner.

He says White Rock Friends saves him about $40 to $60 a month in household items such as toilet paper and pet food.

"I can't work, so my finances are quite limited," he said.

Nobles said once the changes in the Ryan White law take hold, local social service groups will be swamped with thousands of HIV/AIDS patients.

"It's going to be like Katrina," she said. "But instead of happening all at once, it's going to happen gradually."

Source: The Dallas Morning News

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