Associated Press - December 11, 2006
Desiree Hunter

Advocates said Monday that long-awaited transportation programs in parts of the South can become a reality under a compromise national funding measure. Along with $70 million in new money, it adjusted the funding formula to help Southern points where the disease is spreading fastest.

"If you look at our urban areas, primary care may be available, but if you go out beyond the reaches of cities like Birmingham or Charlotte, N.C., or Raleigh-Durham, it is not unusual for people living with HIV/AIDS to travel really far distances to get to a primary care provider," said Evelyn Foust, who heads North Carolina's HIV prevention branch.

"They can have a real difficult time getting primary care, and that access makes all the difference in the world," she said.

The House renewed the $2.1 billion Ryan White Care Act on Saturday, ending a long-running tug-of-war between Southern states and those with larger urban areas, which previously had the highest rates of HIV/AIDS and receive more funding.

Advocates say the new act, which runs for three years instead of five as originally proposed, would make services in the South more comparable to those in other regions.

AIDS Alabama CEO Kathie Hiers said the extra $7 million Alabama has been authorized to receive would be used to expand transportation programs and the number of medications that are available through the Alabama Drug Assistance Program.

Alabama has 35 medicines on the list now. New York has 500 medications on its list and patients in Massachusetts can have "just about any drug they need," Hiers said.

She said officials from states with bigger urban areas kept turning down the compromise "out of fear of losing money, which I could understand. But I keep telling them 'I wish you could work in Alabama for about a month and see how it is to try and serve people when you don't have the funds for even basic services.'"

In addition to increasing available medications and transportation programs, advocates say Southern states will work to add case workers, give more funding to clinics, raise income caps so more people will be eligible for assistance through the Ryan White act and increase funding to help patients with utility bills.

Some parts of Alabama have transportation programs that are funded privately or through federal grants, West Alabama AIDS outreach executive director Mona Ochoa-Horshok said.

Her organization's two vans traveled 24,915 miles from January through September, taking 51 patients to their doctor visits, she said. The agency serves about 200 patients, but has just two case workers.

"Our numbers illustrate the fact that there's a need for these services. Even though we only have about three percent of the state's cases in our public health area, about a quarter of our clients need transportation services," she said. "Without this, these people would have no other way to get medical care."

David Little, head of South Alabama Cares in Mobile, said nearly all the 900 people his organization serves must travel to Mobile for treatment. A roundtrip from the furthest of the 12-county service area is almost 400 miles, he said.

According to estimates from the U.S. Senate Committee on Health, Education, Labor and Pensions, North Carolina would get an additional $10.2 million annually while Georgia would get $4.1 million, Louisiana would receive $1.1 million, South Carolina would get $2.3 million and Mississippi would gain $1.7 million.

Janet Johnson, who was diagnosed with HIV in 1985 and now has AIDS, said she and her friends were encouraged by news of bill's passage and looked forward to its benefits.

She said they've heard of some states paying for patients to receive massages and other luxuries but said she'd be happy with more assistance with necessities like food and housing.

"If we could go somewhere and get an hour massage for free, shoot, we'd think we died and went to heaven already," she said from her Birmingham home. "But that's just an add-on, extra pleasure.

"The services we're looking at are making sure people in the state of Alabama and in the rural South can get to the doctor, can get their medication, can get some food, can get some personal hygiene supplies - all the things that make you exist."

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