The Miami Herald, Inc.; Sunday, April 6, 1997
Peggy Rogers; Herald Staff Writer

TEXT: Alfredo Linares, a Cuban immigrant, knew he could live with AIDS.

What he couldn't live with was the fear of losing his medical care and being deported.

He tried to kill himself last week, swallowing bottles of the pills meant to keep him alive. On Saturday, the Miami Beach man lay in a coma on a respirator at South Shore Hospital, his condition worsening and his prognosis bleak.

Quite simply, Linares fell victim to the community panic over a new immigration law that will cut thousands of noncitizens off from medical care and disability pensions. Among those facing possible cutoff: uncounted hundreds of HIV patients.

Already accustomed to battling disease and discrimination, they are now receiving letters warning they may no longer receive the medical benefits they depend on for life.

Linares did not even wait for his warning; the letter arrived in the mailbox a day after his suicide attempt. But he knew it was coming, said his brother, who lives with Alfredo. That's because Gustavo Linares also has a medical disability and had received notice of a possible cutoff days earlier.

As Gustavo napped a few feet from Alfredo's bed last week, his brother worried aloud that he was sure to lose everything and be deported. Then he swallowed dozens of pills, including an overdose of the protease inhibitors that offer the best hope of extending his life.

"I was aware of him talking to himself and I woke up and saw him bending down on the floor," said Alfredo's brother, Gustavo Linares. "I said, `What are you doing?' And he said, `I just took all my pills.' "

Many South Florida immigrants with AIDS are similarly unprepared, local experts report.

"The government passed these laws and basically left it up to the rest of us to deliver the bad news and deal with the consequences," said legal services attorney Terrence Smith, who had a client with AIDS talk of killing himself rather than deal with the prospect of losing benefits.

"Welcome to our nightmare," said Smith, director of the AIDS Legal Advocacy Program at Legal Services of Greater Miami. "They're making it very difficult for many of the public indigents who are HIV-positive. You have to establish that you're not a public burden."

At South Shore Hospital in Miami Beach, the AIDS doctor attending Alfredo Linares had another fear-stricken patient. The man spoke of wanting to be sick enough to be deported back to Cuba rather than face destitution here, said Dr. Henry Julme, director of South Shore's Immunology Program.

"There's a general panic from a lot of our patients who will not be qualified for Medicaid and Medicare," Julme said.

Instead of panicking, HIV patients should talk to their doctors, social workers and attorneys about options for treatment and changing their immigration status, said Marc Cohen, vice president of the United Foundation for AIDS. The foundation helps support the Comprehensive AIDS Program at South Shore, which treats Linares and many other poor and immigrant patients.

Legal residents with AIDS are still eligible for citizenship and sustained benefits, as long as they are not a "burden to the community," a U.S. Immigration and Naturalization Services spokesman said Friday. "The INS does not discriminate against persons with AIDS."

When asked what constituted a "burden," the spokesman promised to quickly respond but had not as of the weekend.

Linares' prospects for maintaining his benefits remain unknown. He was a Mariel refugee, arriving in 1980.

Until last year's changes in federal immigration and welfare laws, Linares maintained standing to receive Medicaid and a $480-a-month Supplemental Security Income pension. But he lacked the money and persistence to become a legal resident, said his brother, Gustavo.

And Alfredo never sought advice on options from the social workers at the Comprehensive AIDS Program, which is counseling and calming others in his plight, Marc Cohen said. Another patient who became hysterical, fearing deportation, is receiving psychological therapy and continued care, whether she can pay or not, Cohen said.

The prospects for Gustavo Linares appear better than those of his brother. Gustavo, 53 and a legal resident, has started applying for citizenship.

But even if Gustavo Linares keeps his disability pension, he and his brother relied on their pooled incomes to survive in a tidy but tiny one-room efficiency near doctors and friends.

"This is all because of the immigration law," Gustavo Linares said Saturday. "I have a lot of control. My brother was not as strong. He kept worrying, saying he was going to be deported."

CAPTION: photo: Alfredo Linares (a); box: LOSS OF BENEFITS

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