INPUT SOUGHT AT HEARING ON FUTURE OF RYAN WHITE FUNDS

Travis Clayton hopes the state will learn from mistakes that put a federally funded AIDS-assistance program more than $1 million in the red.

Wallace McMullen hopes lawmakers will renew a federal law authorizing the program and its funding before the law expires.

Clayton, the president of the Southeast Missouri AIDS Project, and McMullen, a planner in the Missouri Department of Health's Office of HIV-AIDS Care, are worried about the future of the Ryan White AIDS program and the HIV-AIDS patients it serves.

The Missouri Department of Health will hold a public hearing Jan. 9 to get input on AIDS-related programs as part of the planning process for the Ryan White AIDS program. The hearing starts at 3:30 p.m. at the Department of Health Area Office, 2875 James Blvd., in Poplar Bluff. The service plan is expected to be presented by speakers at the hearing.

State health officials urge anyone interested in AIDS care and HIV prevention to attend.

"It is absolutely critical that we get input from the AIDS community on how these funds are to be allocated," said Beth Meyerson, AIDS director for the state health department. "We especially want input from anyone who is affected by AIDS, is HIV-positive or is an AIDS caregiver."

Confidential, written statements and verbal comments are welcome.

The program funds a variety of services for HIV-AIDS patients, including rental assistance, nursing and medical care, medications, and food and utility assistance.

Approximately 2,700 people in Missouri have received services through the Ryan White program the fiscal year beginning April 1, McMullen said. The state will request $2.5 million for fiscal 1996-97.

"At the moment it's sort of a two-headed process," McMullen said. "It's all part of the process of creating the state's next application for the Ryan White program."

The application must be turned in to the U.S. Department of Health and Human Services next month, he said, and the new funding cycle starts April 1.

McMullen said he hopes the federal budget crisis and government shutdown will be resolved before the funding cycle starts.

The budget showdown has had other ramifications for the Ryan White program, he said. The act that created the program expires March 31. Both houses of Congress have approved separate bills renewing the program, but no joint legislation has been approved, he said.

If the program is not renewed, state health officials have been told they will receive some funding through existing revenues, McMullen said.

"Missouri's percentage of the national AIDS cases has dropped," he said. "Apparently other states are seeing more cases than we are, so we'll only get 65 percent of our present funding under that scenario."

The program came under scrutiny in September when Coleen Kivlahan, Missouri health director, announced that grant funds had been over spent by $1.6 million, endangering services to clients throughout the state.

"It meant that services were substantially reduced in the second half of the year," McMullen said.

Clayton said he hopes the new service plan won't allow that to happen.

"I think we can do a lot better," he said. "After the shortfall this year, the state wound up admitting something that several individuals had pointed out: that in a lot of cases we were duplicating services or duplicating funding for services that were either taken care of by other sources or were non-essential."

In-home medical care, including nursing, home infusion of drug therapies and other services, are essential services for people with AIDS, Clayton said. They are also very expensive.

"Most people with AIDS, especially toward the end of the disease process, require a lot of in-home health care," he said. "It runs up very, very quickly. There are so many opportunistic infections; they're vulnerable to so many things. The cost can become outrageous, just astronomical. You may be dealing with somebody who's battling three or four diseases at a time."

Clayton said too much of the $2.2 million grant went for overhead and administrative expenses. "Hopefully this year we'll be able to get things better organized," he said.

In addition to services for AIDS victims, increased public education is needed, said Clayton. "The word is still not getting out there quickly enough. There's a lot of resistance from people who don't understand the situation and who don't understand the risks," he said.

Clayton said he would like to see increased education on how to avoid becoming infected with HIV.