Women and children with AIDS may soon be able to find a hot meal, someone to talk to and medical care in a Baltimore drop-in center. And, rather than going into a nursing home, other AIDS patients will be able to spend their days in a cozy place designed for them.
Announced yesterday by several nonprofit groups, the proposed drop-in program and day care center are partly the products of the new realities in health care.
Managed care is rapidly taking over the traditional, often fragmented way people got medical care.
At the same time, with a Congress talking about cutting various programs, advocates worry that there will be less money for patients with acquired immune deficiency syndrome.
"We can no longer afford a situation where we work against each other. We must work together and pool our resources," said Deborah McCallum, president of HERO, a major provider of AIDS services and education.
Other partners in the unusual collaboration are Chase-Brexton Health Services, the League, Lifesongs for AIDS, AIDS Interfaith Residential Services and the United Way.
Maryland, which ranks 24th in population, ranked eighth nationally in AIDS cases, according to the latest available figures from the U.S. Centers for Disease Control and Prevention.
Nearly 11,000 Marylanders have been diagnosed with AIDS since the start of the epidemic in 1981. By the end of last year, 6,054 of those people had died, state figures show.
HERO already runs a crowded drop-in center in Baltimore for about 700 male AIDS patients. Dr. Leonardo Ortega, the agency's executive director, said his staff will create another to serve about 300 women and 44 children under age 12.
Women are among the fastest growing groups becoming infected with HIV, which causes AIDS. In 1987 women made up made up 13 percent of newly diagnosed cases, state figures show, but by 1993, that number grew to 23 percent.
At the new drop-in center, these women will be able to talk with a social worker, vent their frustrations in a support group or get leads on temporary jobs. The services will be free.
The second piece of the collaborative effort -- the day care center -- will be just one of five such centers in the country, officials said.
The center would serve about 60 to 70 AIDS patients starting in September. It would be run by the League but funded by several groups.
Philip Holmes, executive director of the League, said it already runs a day care center for victims of head trauma, providing transportation, occupational therapy, counseling, meals and medical care.
The United Way of Central Maryland will donate $243,000 for start-up costs, subject to the approval of its board. Lifesongs has promised $25,000 a year for five years for operating costs. Federal money will also help fund the center, and Medicaid may reimburse for the services, Mr. Holmes said.
In another sign of health care changes -- in which purchasers are increasingly demanding proof that their dollars are being put to good use -- the nonprofit groups plan to do cost-benefit analyses. Both projects will include case managers.
"We are going to tell the community where their dollars are spent and how," said Norman Taylor, United Way president.
Eventually, the day care program and drop-in center might be presented to managed care companies as affordable alternatives to existing ways to care for AIDS patients, said David Shippee, executive director of Chase-Brexton Health Services.
Dr. Peter Beilenson, city health commissioner, lauded the effort to make things easier for AIDS patients by pulling together services.
"It's a great idea," Dr. Beilenson said.
"Hopefully, that concept would be expanded on to make entire AIDS/HIV health centers."