California HIV Budget Cut 'Recession Patients', 'many patients come in after going months without medical attention'
As the recession continues.....people who, after losing their jobs and private health insurance, turn to public and nonprofit clinics for the first time........"Recession patients," are responsible for a 12% increase this year in the HIV clinic's overall patient visits.....many patients come in after going months without medical attention......After losing his job and health insurance, Brodt, 37, now relies on the same services that he raised money for in the past for his own HIV treatment.|
AIDS/LifeCycle charity bike ride gets personal when recession hits
Timothy Brodt has raised $15,000 for the L.A. Gay and Lesbian Center by participating in the annual event. Since losing his job, he relies on the center for the HIV treatment he can no longer afford.
By Joanna Lin
2:03 PM PDT, May 31, 2009
Timothy Brodt is among more than 2,000 bike riders who left Sunday on a 545-mile trek from San Francisco to Los Angeles as part of the AIDS/LifeCycle benefit. He carried with him a small black-and-white photo of his Uncle Richard, who died of AIDS more than 20 years ago.
For the last two years, Brodt has participated in the annual bike ride to raise money for HIV and AIDS-related services at the Los Angeles Gay & Lesbian Center and the San Francisco AIDS Foundation.
"I had this idea of me doing a great thing," Brodt said, recalling how he felt when he first participated in the bike ride. "I'm helping others."
But Brodt, once a television producer with a six-figure salary, never thought "others" could include him.
After losing his job and health insurance, Brodt, 37, now relies on the same services that he raised money for in the past for his own HIV treatment.
He was laid off last April. Although he was offered another job in the industry, he decided to take time off to reassess his career. When he was ready to return to work, previous job offers had dried up. By then, he said, people who had provided job leads were losing their own positions.
Savings stretched only so far. Brodt moved into an older, cheaper apartment on the edge of Hollywood and gave up his car. Some weeks, he said, he had less than $20 in his bank account.
After six months, Brodt could no longer afford the $500 monthly payment for COBRA health insurance benefits. His HIV medications could run several thousand dollars a year. He stopped taking them.
It wasn't long before he started to feel fatigued and depressed.
"I thought, maybe I need to talk to someone . . . Maybe I'm just depressed. I can't find a job," Brodt said. "I didn't really think it had to do with HIV."
Brodt's symptoms were a textbook example of what can happen when someone who is HIV positive stops taking medication, said Brad Hare, medical director of UC San Francisco's Positive Health Program at San Francisco General Hospital. A lapse in treatment can increase the risk of disease progression and medication resistance, he said.
As the recession continues, Hare said he's seeing more patients like Brodt -- people who, after losing their jobs and private health insurance, turn to public and nonprofit clinics for the first time.
"Recession patients," he said, are responsible for a 12% increase this year in the HIV clinic's overall patient visits.
Hare said many patients come in after going months without medical attention.
"It's denial, it's fear, it's stigma of coming to a public HIV clinic," he said. "It's also depression."
Reluctantly, Brodt went to the Los Angeles Gay and Lesbian Center, for which he has raised about $15,000 through AIDS/LifeCycle.
"When I first walked in there, I was scared and felt hopeless and ashamed that I was maybe taking services from someone else," he said. "The reality was that I needed the services; I wasn't taking anything. But my ego was telling me otherwise."
The nonprofit center has provided Brodt with free HIV treatment since December. Over the last year, the number of new patients, many of whom recently lost their health insurance, has doubled, said Thomas Soule, a spokesman for the center.
"It's been a year of practicing humility and abandoning ego and learning how to ask for help," Brodt said.
Brodt has always carried his Uncle Richard's photo with him on the bike ride. But this year is different.
"I'm riding for every single one of us, because I know at some point, every single one of us could be in the same position," Brodt said. "There's a particular face of who I'm raising money for now -- it's mine."
HIV California Services on chopping block
California's most vulnerable population has its services on the chopping block again in the latest round of proposed state budget cuts.
While the cuts add up to an estimated savings of $5.5 billion over the next two fiscal years, the number of people that could be affected in Santa Barbara County is staggering, according to local officials.
Needy families dependent on welfare and Medi-Cal, children of low-income families, and individuals suffering from HIV or AIDS were all part of Gov. Arnold Schwarzenegger's May budget revise reductions, according to the state Dept. of Finance.
Also included is a proposal to stop all general fund contributions to up to 220 state parks, which could include the La Purisima Mission and parks along the Gaviota Coast.
An elimination of the CalWORKS program, as the governor proposed Wednesday, would affect up to 3,500 families in Santa Barbara County, according to Kathy Gallagher, the director of the county Social Services Department.
"We would be the only state and the first world country of civilized nations in the world to not have a catch program for poor families," Gallagher said. "It's a wild idea to totally eliminate it."
A disappearance of the welfare program, which gives cash aid and services to eligible needy California families, would place the burden directly on the county, Gallagher said.
Even if just 2,000 of those CalWORKS families turned to the county's General Relief program, the last resort for many people, it would cost Santa Barbara County $900,000 a month or
$10.8 million annually, Gallagher estimated.
Also up for elimination is the Healthy Families Program, a low-cost insurance that provides health, dental and vision coverage to children who do not have other insurance and do not qualify for the no-cost Medi-Cal.
In Santa Barbara County, there are 7,300 Healthy Families program members who could lose their coverage, according to CenCal Health, which administers publicly funded health-care plans in Santa Barbara and San Luis Obispo counties.
Also, certain Medi-Cal state programs, including undocumented non-emergency services such as breast and cervical cancer treatment and postpartum care, would be unfunded.
At the Santa Barbara County public health clinics, more than half of its 30,000 patients are Medi-Cal beneficiaries, any one of whom would no longer be covered for major services, according to Michele Mickiewicz, the deputy director of community health for the county Public Health Department.
Anyone, regardless of his or her insurance status, will get treatment at any of the county health clinics, but the individual or family would receive the bill for payment as opposed to Medi-Cal or Healthy Families, Mickiewicz said.
The county clinics receive an estimated 125,000 visits annually, she added.
The governor also proposed reducing the state's general fund contribution to AIDS Drug Assistance Program (ADAP) and other AIDS services, including counseling, testing and home-based care, according to the Dept. of Finance.
There are 461 people living with HIV/AIDS in Santa Barbara County, Mickiewicz said. And there are 120 people involved in the county's ADAP, the least number of people that could be affected by the proposed cut, she added.
"The scope and the breadth of this recession and the swift and severe decline it has caused in our state revenues has forced us to put proposals on the table that would have been unthinkable just several short months ago," said Schwarzenegger's finance spokesman, H.D. Palmer.
"Zeroing out funding on the parks system is a concrete example," he added.
Upon hearing that the governor proposed slicing $213.4 million from state parks, the state Parks Department released a tentative list of parks that would close or remain open.
Those that will stay open include parks that are funded by self-generated revenue, such as Hearst San Simeon State Historic Monument, or are funded by off-highway motor vehicle gas taxes and fees, such as Oceano Dunes State Vehicular Recreation Area and Pismo State Beach.
However, Carpinteria, El Capitan, Refugio, McGrath and Emma Wood are on the shut-down list, along with Chumash Painted Cave State Historic Park and Gaviota State Park.
And still more proposed cuts are coming down from the capitol, such as Friday's call for cutting in-home care for all, but the most frail and immobile residents, according to the Associated Press.
Officials also proposed eliminating funding for centers that care for people with Alzheimer's disease, while K-12 schools would be cut by an additional $680 million, the AP reported.
"There is absolutely no question that there are going to be significant impacts if these proposals go forward, and if they do not, the alternative is that the state will run out of cash by July," Palmer said Friday.
According to the latest projections from State Controller John Chiang, beginning July 29, California will not have the cash needed to pay all of its bills.
"On that date, the state will be in the red by $317 million; two days later, on July 31, our cash deficit increases to a negative $1.02 billion," Chiang wrote in a letter to legislators.
He added, "I strongly urge you to take action no later than June 15."
Until then, Santa Barbara County department officials are watching, waiting and preparing for the worst.
"The difficult part is going to be that our fiscal year starts in July, and if the state budget process is anything like last year, there will be some time for our budget (situation) to evolve," Mickiewicz said. "It leaves everything up in the air."
May 31, 2009
Proposed budget cuts could eliminate $1 million in AIDS funding locally
Nicole C. Brambila · The Desert Sun · May 29, 2009
The governor's revised budget could mean $1.8 million in cuts to Riverside County to public health care programs for low-income Californians living with HIV/AIDS, health officials said today.
Roughly $1million of those funds are earmarked for the Coachella Valley, said David Brinkman, executive director of the Desert AIDS Project in Palm Springs.
Established in 1984, the Desert AIDS Project serves about 2,300 people in the valley living with HIV and AIDS with medical care and social services.
"It's horrific for the Coachella Valley because our rate of infection is 400 percent higher than the national average," Brinkman said. "To stop testing folks for HIV is just the worst possible choice."
The revised budget, HIV advocates say, hits those with the lowest income living with a chronic disease the worst.
The average DAP patient lives on roughly $10,200 annually, Brinkman said.
HIV/AIDS is a particularly important issue in the Palm Springs area, which boasts one of the largest gay populations per capita in the United States. Gay and bisexual men of all races account for the majority of those living with HIV.
Each year in California, an estimated 5,000 to 7,000 people become infected. About one in five do not know they are infected.
California has one of the highest infection rates in the U.S. with more than 100,000 people living with HIV/AIDS, according to the California Department of Public Health Office of AIDS. Riverside County ranks sixth in the state with about 3,170 people infected or living with AIDS, 2,098 of whom live in East Riverside County.
The governor proposes cutting $55.5 million next fiscal Year and $58.9 million in 2010 Ð 2011, as well as $24.6 million in HIV prevention and education.
Those proposed cuts represent roughly half of the county's budget, said Victoria Jauregui Burns, HIV program chief for the Riverside County Department of Public Health.
"Remember, this is the governor's proposal," Burns said. "Where it may end up no one really knows."
"We will feel this. We will feel this at all levels from staffing to clients."