Resources Dry up for HIV/AIDS Patients Ryan White Program Struggles Under Bush Budget Cuts by Rob Orton
month on drug costs alone. In February this year, an Early Treatment for HIV Act (ETHA) was introduced in the U.S. House of Representatives by Minority Leader Nancy Pelosi, D-Calif, Rep. James Leach, R-Iowa, and 68 other members of Congress. ETHA provides states with incentives to enroll HIV-positive individuals in Medicaid before they are diagnosed with AIDS — reducing the strain on drug assistance programs. This is not the first time this has come to legislators. According to David Ferguson, program director of the Utah AIDS Foundation, similar legislation has been proposed twice before. Ferguson notes that other states have already changed the structure of their
Medicare requirements to allow services to anyone who is HIV-positive. “The lack of response by our legislators marks their philosophy and is making healthcare a luxury. The poorest are becoming the sickest because of inaccessibility to healthcare,” he said. People who are asymptomatic with HIV or are not disabled are generally not eligible for Medicare or Medicaid. “Individuals have to advocate for themselves to find benefits,” said Ferguson, “but if you are a person who is already not feeling well, these systems can be very defeating.” Medicare is the second largest source of funding for HIV/AIDS care after Medicaid. But according to Gay Men’s Health Crisis, plans under Medicaid and Medicare do not
HIV Education Lacking in Utah Schools by Rob Orton
“I’ll make that decision when I get to the voting booth.” —Governor Olene Walker on how she will personally vote on Amendment 3.
“Bush is filled with hate and is trying to bring hatred into the Constitution.” —New York Parents and Friends of Gays and Lesbians president Jerry Goodman before a march protesting the Republican National Convention in New York City.
“I just can’t stomach this — the thought of those girls being raised in that kind of setting.” —Mormon activist Sheri Dew commenting on a March Newsweek photograph showing a gay couple and their children. Dew gave the invocation at the Republican National Convention on Monday, August 30.
“You mean to tell me all you have to say is sorry … sorry that I lived all that time believing I was going to die?” —Jim Malone to his doctor after being told that his HIVpositive diagnosis eight years ago was incorrect.
“My general view is freedom means freedom for everyone.” —Vice President Dick Cheney after being asked his stance on same-sex marriage. Cheney’s daughter, Mary, is a lesbian.
“Our country right now needs to fight terrorists, not pry into people’s private lives.” —C. Dixon Osburn, executive director of Servicemembers Legal Defense Network after the nation’s highest military court declined to strike down the armed forces’ ban on consensual sodomy.
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SALT LAKE METRO ■
When the Gay, Lesbian and Straight Education Network (GLSEN) issued its “2004 State of the States” report, Utah received a failing grade, ranking near the bottom of the list of states that provide a safe place for queer students to learn [“Utah Fails to Provide Safe Schools,” July 8, Rob Orton]. However, that was only half the story. According to the report, educators here are also unwilling — or prevented from — addressing curricular issues that could save gay and lesbian students’ lives. “Human sexuality” is one of the issues assessed by the GLSEN in grading Utah’s safe school policies. While Utah educators cannot advocate or educate the use of contraception or homosexuality, this is nothing new in our country. Most states require abstinence-only instruction and receive funding for it under the Planned Parenthood Act. Most states do not provide information or advocacy of contraception, let alone contraceptive devices themselves. According to a report in the Boston Phoenix, “Federal programs sponsored by the Christian Right Campaign are causing teens to learn less about AIDS and sexually transmitted infections (STIs) than they were a decade ago. And they’re still having lots of sex.” The Advocates for Youth, a national statistics and trends resource, reports the United States has one of the highest rates of STIs among adolescents in the developed world. Centers for Disease Control reports 51 percent of new HIV infections are among people under the age of 25, and 25 percent of new HIV infections are contracted during the adolescent years. “With STIs, the stakes are just too high to talk only about abstinence,” said James Wagoner, president of Advocates for Youth. “Over 27 million people between the ages of 15 and 24 have had sex, and they need all the facts — including medically accurate information
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on condoms — to protect their health.” Early in the 1900s, typhoid fever was at epidemic levels. It took the education system to educate young people the importance of personal hygiene and the ramifications of ignoring it to ameliorate this public health crisis. “Educators have a responsibility outside of parental values. We’re going to make parents mad about many things,” said Olsen. “This is an ‘open door’ system designed to have input from the community at large.” According to Mark Peterson, public relations director for the Utah State Board of Education, “The administrative rules which we deal with don’t have to go through the legislature. School policies by legislative mandate have to have input from school district employees, teachers, students, parents, as well as community members. So as districts are putting policies together, they certainly follow the democratic process to get that input from everyone in the community.” The fact that topics are not as thorough as the national community would like, and that they enable parental “opt-outs” for sexual education, shows a lack of responsibility to prepare youth for healthy interactions in society by Advocates for Youth. According to state board attorney Jean Hill, educators’ hands are tied: “Educators agree: The law is limiting. There’s no question about that. In order to change this, we have to go to the legislature and get the laws changed. We also need to do more training with the educators.” A public comment period is provided in every school district board meeting where community members can come and make their comments and concerns known. This is where policies that encapsulate race, gender, and disability have made way into the education code. Concerned community members can contact the local school district to get a schedule of board meetings and are encouraged by officials to attend. As Olsen states, “It is very important that these discussions continue.”
Notable Quotes
SEPTEMBER 2, 2004
According to the Utah Department of Health (UDOH), there are more people than ever before living with HIV/AIDS — and those who depend on public assistance are being turned away, as federal budget cuts take their toll. While President Bush requested a $25 million increase for the federal Ryan White Title II AIDS Drug Assistance Program (ADAP) for the current fiscal year, there was no concurrent increase in funding for other Comprehensive AIDS Resources Emergency (CARE) Act programs. Locally, this means that newly diagnosed people will have more challenges getting assistance under certain federal programs. UDOH reports there are currently 1,803 people living with HIV / AIDS in Utah. 750 of these qualify for benefits under Title II. As a result of the level in funding and increases in medication costs, UDOH has announced that they will no longer take any new applicants for Ryan White Title II benefits. Fourteen other states have had to institute similar containment strategies, and 10 more will follow by the end of this year. The decision to limit new enrollment in Title II programs is a recommendation by the national ADAP Advisory Committee to ensure treatment of currently enrolled individuals. A report by the National Alliance of State and Territorial AIDS Directors (NASTAD) states that the medical benefits and support services provided by Title II not only improve quality and length of life for people living with HIV/AIDS, but by delaying the progression from HIV to AIDS, the overall cost of treatment is reduced. AIDS is the advanced and often more chronic condition of an HIV-infected person. Persons who are diagnosed with HIV undergo rigorous drug therapies the keep the viral count in check with the objective of preventing or slowing the progression to AIDS. Research in 2002 by the University of Alabama at Birmingham showed that the yearly expense for treatment averages $34,000 for people in the advanced stages of AIDS compared with $14,000 for those who are taking drug therapies to keep the virus controlled. The Title II Act provides grants to all 50 states for comprehensive AIDS services for all individuals with HIV: home care services, health insurance continuation programs, community-based services, and the AIDS Drug Assistance Program. Other Title II provisions include dental, nutrition, mental health, substance abuse, food vouchers, and legal services. There is no state funding in Utah for HIV/AIDS treatment apart from Medicaid and Medicare. According to UDOH, less than $100,000 of the total HIV/AIDS treatment budget comes from the state — and that is directly associated with administrative salaries. Theresa Garret, director of the state Bureau of Communicable Disease Control, says that it is not uncommon for the costs of prescription medication for people with HIV/AIDS to increase 200-400 percent in less than a year’s time. Even with drug assistance programs, some clients will spend $1,500 or more per
cover all the drugs needed by HIV individuals. They also lack choices that physicians need to prescribe comprehensive drug therapies. UDOH estimates that as much as $800,000 is needed just to maintain services at the current level. While options are being explored to secure additional funding, existing clients will continue to receive services. Garret concedes that despite the budget limitations, there is still a very strong support from UDOH administration.