Drug program for HIV patients may have to be revamped

Participants may have to meet stricter income qualifications, wait for assistance until they are sicker, or tap into a different formula of drugs entirely, said Christine Mann, DSHS spokeswoman.

"We will have to consider restructuring the program completely," she said, referring to a decision this week by state lawmakers to decline a request for an additional $19 million to keep the program afloat for the next two years. Budget writers agreed to fund the program at its current $109 million level for this two-year cycle, but denied the request to pay for the rising caseload.

She added that her agency has scheduled a series of public meetings, including one in Austin on Friday, to receive input from clients to discuss possibilities, "We need to address the increase in caseload" which she attributed to the recession, and a longer lifespan of participants.

By not responding to the extra need, state lawmakers were deciding "who lives and who dies," said State Sen. Judith Zaffirini, D-Laredo.

Zaffirini said Friday she would continue to fight for funding.

The Texas Legislature has been struggling to write a new budget with an estimated $15 billion to $27 billion shortfall, with the larger number reflecting the amount necessary to continue services as their current level for a growing population.

State Rep. John Zerwas, R-Richmond, said he considered the program highly valuable and cost-effective, and that locating cuts has been difficult.

Not enough money

"It gets down to the point where we just don't have enough money," he said. "We don't have enough money to take care of everyone."

Randall Ellis, an advocate for Houston's Legacy Clinic, said if state lawmakers fail to add the additional money, local taxpayers ultimately will pick up a much larger tab. At least 2,000 people will be turned away from the state program, Ellis said, and eventually will become so sick they require hospitalization, paid for by local property taxes.

A complex cocktail of medications can turn the deadly HIV-virus into a manageable illness, but the cost ranges from $16,000 to $24,000 a year. The state program assists only patients earning $20,000 a year or less.

Cost of care

The state is able to care for HIV patients at a cost of about $6,500 for medication, while the county's cost of purchasing the same drugs runs $10,000. "And that's just for medication," he said. If an HIV patient is hospitalized at Ben Taub General Hospital, for instance, he said the cost easily would be "an additional $11,000."

"It's going to catch up with us through our property taxes," Ellis said.

The state is expecting a 14 percent growth in the number of people who qualify for help in the next two years, Mann said.

Ellis said that making the program more restrictive means the state is reneging on a commitment.

"There's a sense of being sold out and thrown under the bus," he said.

patti.hart@chron.com