Money for prevention and treatment of AIDS across Kansas has been quietly cut by a third, and Douglas County agencies say they are feeling the strain.
"It's having an impact on the ability to provide services," said Karl Milhon, director of the HIV-STD section of the Kansas Department of Health and Environment. "Not a critical impact, but it's a pretty strong impact."
Faltering state revenues forced KDHE to cut its budget for HIV/AIDS programs in January, from $312,000 to $175,000. But the cuts were little noticed outside the community of AIDS victims and activists.
They even came as a surprise to some key policy-makers.
Rep. Brenda Landwehr, R-Wichita, is a member of the Health and Human Services Committee and the Appropriations Committee in the House. Until the Journal-World called her Thursday, she said, she was unaware of state cuts to HIV/AIDS programs.
"I think we've always been pretty accepting," she said. "I think we've always seen increases in funding."
Officials said there could be long-term health consequences.
"If we're not getting the education out into the community about avoiding HIV, we're putting people at greater risk of contracting the disease," said Sidney Hardgrave, executive director of the Douglas County AIDS Project.
One AIDS patient said the reductions made him fearful. Douglas County AIDS Project has already tightened purse strings on privately funded financial assistance to patients because of the sluggish economy.
"To me, it's devastating that there's budget cuts," said Greg, the middle name of a 41-year-old Lawrence man who has had AIDS for four years. "I don't really understand that."
He asked not to be identified because he feared a backlash if the public was aware of his condition.
The reductions come even though the number of patients appears to be growing.
KDHE, during its last survey in 2001, estimated there were 50 people with HIV or AIDS living in Douglas, Franklin and Jefferson counties. Hardgrave said that in 2003, her agency serves 60 clients.
"It's growing," she said, "by two or three a year."
'Across the board'
Milhon said his programs were the victim of unfortunate timing. Most of the money for other KDHE programs had already been disbursed by January -- which is halfway through the state's fiscal year -- when the call came for reductions.
"When it came down to it, we had to make cuts across the board to all the state funding that was left, no matter where it was," he said.
But the AIDS programs took the lion's share of the hit. The other "major cut," officials said, was a $12,000 reduction in the state's $350,000 budget for immunizations.
Milhon said the reductions didn't affect $4.9 million in federal funding for AIDS prevention and treatment programs administered by the state.
But he said the state money was critical to ensuring the federally funded services were delivered to the people who needed them.
"We don't have a lot more give, or some of our infrastructures will begin to go," Milhon said. "We've used up any slack we had, and we didn't have much slack."
Milhon said it appeared legislators would restore $50,000 of the reductions in the 2004 budget.
Douglas County effects
"We're trying at this point for it not to have a significant impact on services," said Kay Kent, director of the Lawrence-Douglas County Health Department.
Her agency had funding for HIV prevention and testing programs cut from $9,264 to $5,575 for the state fiscal year that ends in June.
The department sends nurses to speak to groups about how to prevent HIV infection. The Douglas County Juvenile Detention Center receives regular visits.
"It's important for our kids to have the information, so they can make better choices," said Pam Weigand, the detention center's director. "I think it's been really helpful."
The Health Department tested 616 Douglas County residents for HIV in 2002. None of the tests was positive.
Kent said the department would now combine its HIV testing program with its walk-in nursing program that allows people to get treatment for minor ailments. The result is a drag on both programs.
"People may have to wait longer -- that day -- to receive service," she said.
The cuts also affect care for AIDS patients. Douglas County AIDS Project had its state funding for case management cut to $52,099 from $58,819.
Greg said Douglas County AIDS Project had helped him receive medication, money and moral support during his four years with the disease.
"I feel like having them is a safety net," he said. "Quite frankly, I don't think I'd have made it this far without them."
Hardgrave said the AIDS Project would seek to restore the funding from other grants and probably would hold a fund-raiser this summer.
"It's such an essential service. I know every social service can say the same thing," she said. "We're just setting ourselves up for more challenges down the road."