Monday, August 27, 2007

AIDS services groups lose patient meals program funding

By John Wright of Dallas Voice

Dars Wood, head cook, serves up catfish for hungry HIV-positive clients at the Resource Center of Dallas.

Dars Wood, head cook, serves up catfish for hungry HIV-positive clients at the Resource Center of Dallas.

When he was diagnosed with HIV in 1988, doctors gave Iyron Butler six years to live. Nineteen years later, Butler is still going strong, and he gives much of the credit to the Resource Center of Dallas’ hot lunch program.

“It’s helped me survive, because there were times that I couldn’t cook or was too ill to cook,”said the 54-year-old Butler, who has been utilizing the program for the last five years. “I could go to the meals program and get a quick meal or get a box to go so I wouldn’t go hungry for a day.”

Butler is one of hundreds of low-income, HIV-positive clients who eat each weekday at the Resource Center or the AIDS Interfaith Network.

For many, it’s often their only meal. For others, it serves as a reminder to take medication, which in some cases can’t be done without food. For still others, it’s a rare opportunity to meet and socialize with those who can relate to their problems. But the meals soon may be going away.

Due to changes in federal guidelines, Dallas County Health and Human Services recently informed the Resource Center and AIN that it won’t fund the programs after February.

The cuts —largely unexpected — are part of an ongoing effort to comply with changes under the Ryan White Treatment Modernization Act of 2006, passed by Congress in December. Under the updated act, 75 percent of federal HIV funds must go to core medical care, with only 25 percent left for support services such as food, transportation, housing and legal aid.

Representatives from Health and Human Services and the federal Health Resources and Services Administration, both of which administer Ryan White funds, did not return phone calls seeking comment this week.

In a letter dated Aug. 8, Karen Petties, assistant director for Ryan White Grants Compliance at Health and Human Services, cited federal HRSA guidance as the reason behind the cuts.

“Specifically, the guidance stated that HRSA will not support a program that provides meals to people who are ambulatory, can stand for periods of time to prepare a meal and who otherwise can cook for themselves,” Petties wrote in the letter to Bret Camp, associate director of the Resource Center. “A stand-alone meal service does not link to medical outcomes and needs to be eliminated.’”

Congress switched to the 75-25 formula because people with HIV are living longer, resulting in increased medical costs. But providers of support services say the formula fails to recognize the critical nature of things like food.

Steven Pace, executive director of AIN, said with the most recent announcement, his agency will have lost $600,000 — or one-third of its annual budget – in a matter of a few years.

AIN, the area’s primary HIV transportation provider, has been operating a meal program since 1986. The program serves 18,000 breakfasts and lunches annually at a cost of about $80,000, Pace said. Forty-eight percent of AIN’s clients are either homeless or have uncertain living situations.

“Many of them don’t have access to a kitchen or kitchen facilities and are dependent on meals programs for the majority of their meals,” Pace said. “HRSA’s belief is that if someone is ambulatory, they’re able to cook for themselves. That might make sense if you have a home or a kitchen or access to a kitchen. …

“This is a very callous move,” he added. “It’s so shortsighted.”

The Resource Center, which has been operating its meal program for more than 10 years, provides lunch for up to 170 clients a day and served 3,167 meals last month alone, according to Sheryldine Samuel-Fall, HIV/AIDS nutrition and education program manager. The program costs about $200,000 annually, the majority of which comes from federal Ryan White funds that are funneled through the county. About 30 percent of the Resource Center’s clients are homeless.

Both Pace and Samuel-Fall said they plan to look for other funding sources to continue serving the meals. But in the absence of long-term grants, Samuel-Fall admitted the Resource Center’s program likely will have to be “scaled way back.” She said the center may end up referring clients to other places, such as the First Presbyterian Church’s Stewpot ministry or the Salvation Army.

“What we’re trying to do internally is go through all the options and scenarios,” Samuel-Fall said. “This was pretty sudden. I did not see this coming.”

Pace and Samuel-Fall said they informed clients of the cuts earlier this week. As they dined on fried catfish, corn, green beans and garlic bread Wednesday, Aug. 22, many at the Resource Center seemed to share Butler’s frustration.

“I don’t think whoever is doing this is looking at the big picture of what’s going on with these clients and what their needs are,” Butler said. “I think if they take this away, we’re going to start seeing more of a sick community of HIV and AIDS clients. I foresee it’s just really going to go downhill.”

Pegasus News content partner - Dallas Voice, the community newspaper for gay & lesbian Dallas.

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