Miami Herald; Friday, October 4, 1991
Dan Keating, Herald Staff Writer

Due to the state's tax-revenue shortfall, the Department of Health and Rehabilitative Services has recommended cutting the adult walk-in medical clinic located next to Lower Keys Health Systems hospital on Stock Island.

The paradox is: Although the cut is intended to save money, it probably will end up costing more money to taxpayers.

People who can't afford treatment will postpone care. When an ailment gets bad enough, the patients end up in the hospital emergency room with a serious problem, where care is harder to get and a lot more expensive.

"It's the elderly and indigent people who have no other sources of medical help," said Richard Sherer, acting health clinic administrator in the Keys. "That would throw them into the emergency room at the hospital. "

Once they get to the emergency room, they may have to wait hours while those who need more immediate care -- such as trauma cases -- are treated, said Roberto Sanchez, administrator of the hospital.

More than 40 people a day visit the adult walk-in clinic run by Dr. Alexander Kelly, who is assisted by interns and medical students from the University of Miami medical school.

Eliminating the clinic will also cut off vital medical care, said Dave Nolan, director of the health department's AIDS program.

"In Key West, as around the country, perhaps the most outstanding AIDS risk factor now is being poor," he said.

Heterosexual transmission of the disease from intravenous drug-using men to women is increasing rapidly, he said. Nolan said of 66 people given a routine test for AIDS at the clinic in July and August, 11 of them had HIV, the virus that can lead to AIDS.

Reaching out to the population at risk is a key part of the AIDS program, Nolan said. Without the clinic, people who could benefit from early intervention will not be found.

Other HRS cuts in the Keys would involve food stamps, elderly assistance and housing assistance.

Many of the programs being targeted for cuts -- like the health clinic -- save money by preventing more expensive bills later, said Rep. Ron Saunders, D-Key West, chairman of the House Appropriations Committee.

"Now we're cutting programs that save us money," he said. "In a way, it's short-term gain, long-term loss. We're saving money by cutting the budget now, but it will cost more in the long-term."

Many of the people affected by the cuts, such as abused children, sick people and food stamp recipients, either cannot or have not spoken out to express their needs.

"Obviously, you're not going to get a lot of abused children at a budget hearing," Saunders said.

Gov. Lawton Chiles and the Cabinet are expected to review the recommended cuts Oct. 23. If the cuts are approved, the clinic would close its door about the beginning of the year.

CAPTION: PHOTO University of Miami medical student Eric Harris examines a woman with a sore throat (s)

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