World AIDS Week concludes today.
Events around the globe brought attention to the needs of the millions of people living with AIDS and HIV.
Health officials and politicians proclaimed greater fiscal commitments to battling the disease.
Yet New Hampshire is facing the potential of losing nearly all its federal funding to care for people living with AIDS and HIV.
New Hampshire Public Radio’s Kerry Grens reports.
New Hampshire receives several million dollars a year from the federal Ryan White Care Act.
The money goes to caring for low income residents living with HIV or AIDS—getting them drugs, counseling, doctors appointments, and help with daily activities.
But that money stands to be wiped out by pending reauthorization of the Act—leaving just a few hundred thousand dollars in its wake.
Ascheim: It’s a really difficult, difficult problem that we have.
Joan Ascheim from the state’s Department of Health and Human Services.
Ascheim: My understanding is that through reauthorization what Congress is looking at is moving some of the money to the larger cities where there is a denser population of persons living with AIDS. Which in theory makes sense, but in reality it still hurts individual people living with AIDS.
Currently, Hillsborough, Rockingham, and Strafford Counties receive money through Boston’s share of the Ryan White Care Act.
But those drafting the reauthorization are considering splitting the New Hampshire counties off of the Boston metro area.
The result could be a loss to New Hampshire of some two million dollars.
Ascheim: We would have to make some serious decisions about do we cut back our formulary, which determines what drugs we will pay for, do we put people on waiting lists, do we cut out other primary care services for people. We’d have really difficult decisions to make with decreased resources.
And resources have already decreased.
This year New Hampshire received five percent less from Boston’s Ryan White funding than last year.
State Senator Iris Estabrook says that New Hampshire has introduced ways to stretch the money further.
The state has adopted a preferred drug list and negotiated with pharmaceutical companies for lower prices.
Estabrook: We’ve unfortunately reduced the eligibility in terms of who can get drug assistance funding by changing the T cell count at which you qualify for that. So you now have to be sicker in order to get state assistance for AIDS drug program.
Estabrook led a legislative study committee to find solutions to limited funding.
One of the recommendations is to make HIV testing a regular part of routine medical care, since about a third of those living with HIV are unaware they carry the disease.
But the study did not detail what would happen if reauthorization means New Hampshire loses out on Boston’s funding.
Estabrook: There’s no way that the kind of services that now exist could be continued with that kind of a cut.
The National Alliance of State and Territorial AIDS Directors, or NASTAD, is lobbying Congress to reauthorize the Care Act as soon as possible.
NASTAD’s Director of Government Relations, Laura Hanen, says the Act is in need of updating.
Hanen: It was originally more of a support services bill because at the time in 1990 there weren’t medications and so the Care Act was envisioned to sort of help people in the end stage, essentially, of the disease.
Hanen says the bill has switched to a more chronic care model, and NASTAD would like to see more resources devoted to treatment rather than just making the last days as comfortable as possible.
New Hampshire’s woes are not ignored in NASTAD’s lobbying efforts.
Hanen is urging Congress to provide supplemental funds for states that lose out on money going to metropolitan areas.
She says there’s no way to know at this point how Congress might decide.
Among the fear of unknowns, there is some good news for New Hampshire.
Nashua received one point four million dollars from the Department of Housing and Urban Development to house about twenty people living with AIDS.
And for the first time, the state is contributing money to AIDS and HIV treatment.
One hundred eighty thousand dollars is pegged for drug assistance.
And there is always a chance that Congress could keep funding the Ryan White Care Act without changing how money is distributed.
But the reality, Hanen, predicts, is that with or without reauthorization the Act can expect tough times ahead.
Hanen: There’s likely to be an across the board cut this year as there have been in the past four years to pay for other emergencies like avian flu and Katrina.
Hanen says Congress is expected to pass continued funding for the Care Act later this month, and draft a reauthorized bill in early two thousand six.
SOQ
