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NC Now: AIDS Funding
Of the estimated 29,500 North Carolinians living with HIV, the virus that causes AIDS, a significant percentage of them depend on public funding to pay for medications, housing, and other necessities. But where does the money come from, and is there enough?
James Grissom/HIV Positive: I put it this way, I have good days and bad days.
Today is a good day, and James Grissom can enjoy tending the garden outside his apartment. He has lived with HIV for eight years. He moved to Winston-Salem in 2002 with barely more than the clothes on his back.
James Grissom: I didn't have anything. All I had was one box about this size. It was raining the day I got here, and I was really scared to death.
He depended on the kindness of strangers - and on help from government programs - to get the medication and other support he needed. And he is far from the only one. John Peebles, of the state's HIV/STD Prevention and Care Branch, says thousands of North Carolinians with HIV need help. He says it comes from a variety of sources, both state and federal.
John Peebles/Deputy Branch Head: We get resources from HRSA, the Health Resources and Services Administration, and those resources are primarily geared towards care for people living with HIV and AIDS. We get money from the Centers for Disease Control and Prevention, CDC, primarily aimed at prevention both HIV and AIDS and other STDs, for example syphilis. We also get a hunk of money from HUD for the Housing Opportunities for Persons With AIDS, the HOPWA program, that helps folks living with the disease and their family members find and maintain a place to live.
Much of the federal funding comes through the Ryan White CARE Act. For fiscal year 2005-2006, North Carolina got about $23 million. The money pays for things such as health care, dental care, and the AIDS Drug Assistance Program, or ADAP. The state also picks up part of the tab for ADAP, covering about 45% of the cost each year. North Carolina's AIDS Drug Assistance Program currently serves about 4,000 people. To qualify, program director Steve Sherman says you must make below 125% of the federal poverty level, or just under $12,000 a year. It's the toughest criteria of any state in the nation, and there has been a waiting list off and on since 1997.
Steve Sherman: Unfortunately the amount of money we have doesn't go as far as it needs to go in terms of being able to serve everybody who qualifies for the program and needs the services. The last thing we want to do is enroll somebody in the program, bring them in and start serving them, and then somewhere down the road during the course of that year get into a situation where we find we don't have enough money to serve the people who we are serving.
James Grissom found himself on that waiting list.
James Grissom: It was scary then because I was wondering, my God, it seemed like one time I was trying to kill myself, now I want to live and what's going to happen if I don't have the money to buy my medicines?
He says without the help of case managers and AIDS organizations, he wouldn't have been able to navigate the system and get the medicine and other support he needed. He says he's living proof ADAP saves lives. HIV and AIDS advocate Patrick Lee agrees. He helped to organize the North Carolina AIDS Action Network to lobby state lawmakers for more money. He also benefited from ADAP.
Patrick Lee/HIV/AIDS Advocate: When I was in law school, one of my big worries was that I wouldn't be able to get my medication because I didn't' have insurance, I didn't have an income, and then I heard about this program. And I realized that was a big burden lifted off my shoulders because of the fact that I didn't have to worry about where I was going to get the money for my medication.
John Peebles says funding for HIV and AIDS prevention has stayed flat or been slightly cut over the past several years. But there is better news for the AIDS Drug Assistance Program. The state legislature approved almost 2.8 million additional dollars for ADAP, bringing the total appropriation to more than $11 million for fiscal year 2004-2005. AIDS advocates say that money will go a long way.
Steve Sherman: For every million dollars that's there, we can serve somewhere between 80 and 100 people a year, so I think it will help a lot.
State leaders and grassroots advocates agree there's not enough funding for HIV and AIDS. So they say it comes down to prioritizing.
Steve Sherman: I think that we need to take care of people who are ill and who are low income, and when we know what it is and we have a resource - the drugs - that will help make a difference in their lives and maintain their lives, yeah, I think that's about as high priority as you can get but we better do something in prevention also or we're just going to get further and further behind.
Patrick Lee: I think North Carolina does a wonderful job with the resources it has. The federal dollars that we get in through the Ryan White CARE Act, they go a long way and they help a lot of people the state dollars that we get in go a long way and they help a lot of people in terms of the ADAP program. I just, I don't think it's enough, and I don't know what the magic number would be to bring it up to where everyone who needs the help will get the help.
They also agree, the need for that help is not going away.
John Peebles: The need is not likely to go down anytime soon. Folks are in fact living longer with the disease and we have a long way to go clearly in prevention because the rates continue to be high, and so the need for resources I think for the foreseeable future is just going to continue growing.
For the people who need the resources, James Grissom says the key is having the courage to ask.
James Grissom: If they get enough nerve to ask somebody for help, there are programs here that will help, and there are people who love people and will do anything to help people.
He says he had to find that courage in himself.
James Grissom: I'm not afraid today, being in the position I'm in, I'm more aware of a whole lot of stuff today than I used to be.
And he says, nobody else could ask for the help that saved his life.
James Grissom: If it weren't for the help there, I wouldn't be here. I really wouldn't. |
