Crist AIDS Cuts Hurt Gays And African-Americans Most

Armen Hareyan's picture

A coalition of physicians, nurses, social workers, concerned community members, and Florida HIV/AIDS patients, will participate in a Lobby Day and protest of Governor Charlie Crist's AIDS policies.

The group is protesting recent changes to Florida Medicaid's HIV/AIDS programs that threaten to negatively impact nearly 8,000 people living with HIV/AIDS and their families. The destructive changes include a cut in nursing staff statewide from 70 nurse care managers to only 16 field nurses-a 77% reduction in nurse to patient ratio-for the state's low-income HIV/AIDS population, the majority of whom are gay men and people of color, including African-Americans and Latinos. The coalition will ask Governor Crist to "Have a Heart" and to "Be the Governor for People with AIDS." Over 3,000 letters appealing to the Governor to reverse these harmful changes have already been written by AIDS patients from across the state.

The coalition is also alarmed by recent changes to the statewide HIV/AIDS disease management program that allows a for-profit corporation with little experience providing care for HIV/AIDS patients to operate the program -- a move that seriously threatens the continuity and quality of care for thousands of HIV/AIDS patients. This decision effectively dismantles an eight-year-old highly successful and cost-effective disease management program, Positive Healthcare, run by AIDS Healthcare Foundation (AHF), the nation's oldest and largest non-profit HIV/AIDS healthcare, research, prevention and education provider, as well as a strong patient advocate. The move places the state's AIDS patients in the hands of a company with no appreciable infrastructure and with minimal HIV/AIDS experience, the bulk of which was acquired more than five years ago and is now obsolete. The proposed plan lists 16 statewide field-based RN/LPN nurses and 71/2 call center nurses located in Jacksonville for the entire program. By contrast, AHF/Positive Healthcare currently employs more than 70 RNs who work directly with the program's patients along with AHF/Positive Healthcare community outreach workers.

In a letter addressed to Governor Crist, dated May 8, 2007, John M. Augello, a resident of Winter Springs, Florida, wrote: "I am writing withconcern for Positive Healthcare...who up until recently coordinated the health management of my brother Lenny. Lenny died on March 25, 2007 from HIV/AIDS complications. Personally, I was overwhelmed with the efficiency, respect and concern that I as a family member received from the Positive Healthcare staff...With this affliction, we don't have the time for an organization to get up to speed on HIV/AIDS treatment and protocols or wait for staff to learn sensitivity training. What we need is to keep the infrastructure as it stands with an organization that already knows what's going on and does it better than anyone out there."


Mr. Augello ends with an appeal to the Governor: "I hope that you will do whatever you can to see that Positive Healthcare continues to offer its array of services to the people of Florida. More importantly, I hope that you will do whatever you can to see that Positive Healthcare continues to offer its compassion -- there is no line item for that in any contract."

AHF has operated Positive Healthcare, Florida's HIV/AIDS disease management program serving nearly 8,000 Floridians living with HIV/AIDS, for more than eight years and, in that time, has met or exceeded all clinical performance measures and saved the state more than $20 million in healthcare costs. Positive Healthcare is the first of only two disease management organizations to receive full accreditation from the National Committee for Quality Assurance (NCQA), a national non-profit organization that measures and advocates for health care quality.

"Governor Crist, we ask you to live up to your promise to improve access to healthcare for all in Florida and challenge you to truly be the 'People's Governor' for all the people of Florida, including people living with AIDS," said Michael Weinstein, President of AIDS Healthcare Foundation. "This reduction in nursing staff and move from a long-time and proven provider of high-quality HIV/AIDS care to a company with no infrastructure and limited expertise to care for HIV/AIDS patients threatens to harm thousands of the state's most vulnerable population -- low-income patients the majority of whom are gay men and people of color. We ask the Governor to put AIDS patients first and stop these changes."

In May 2003, Florida's Office of Program Policy Analysis and Government Accountability (OPPAGA) reviewed AHF/Positive Healthcare's disease management program for clinical performance and cost savings. While all of AHCA's other disease management programs had not met their cost-savings goals and health outcomes expectations, AHF/Positive Healthcare did. According to a May 2004 report, AHF/Positive Healthcare was projected to save the state a total of more than $20 million in healthcare costs over the five-year term of its contract. AHF/Positive Healthcare has been so successful that AHCA has consulted its staff to help turn around the state's other disease management programs.

"Florida's HIV/AIDS disease management program has been very successful at serving AIDS patients for the past eight years. Patients have reported extreme satisfaction with their care. Positive Healthcare has been able to significantly improve health outcomes while saving the state tens of millions of dollars," added Deborah Moffett, AHF/Positive Healthcare Registered Nurse (RN) Manager. "I am concerned that the disruptions in care and access to experienced HIV/AIDS specialists will place the most vulnerable individuals living with HIV/AIDS at risk. Compassionate, expert HIV patient care within a structured disease management program is not something that is learned or established overnight nor is it managed with a for-profit mindset. Florida's AIDS patients deserve better."