State health authorities are planning to cut federal AIDS funding in nine Maryland counties despite having 5 percent more money overall, sparking heated protests from activists and counties that stand to lose.
Howard and Frederick counties would lose more than 40 percent of their Ryan White Title II funding over three years -- a combined total of $82,000 -- while Baltimore, along with Anne Arundel, Baltimore and Prince George's counties, would receive more money. Montgomery County would lose about $70,000 over the three-year period. The state has received a total of $6.5 million in federal funds for the next fiscal year.
Local officials faced with reductions said they have protested and hope for revisions. Barring such changes, however, they will be forced to shuffle funds to compensate. Carroll and Harford counties each will lose about 30 percent.
"What I'm going to have to do is rob Peter to pay Paul. The patients are the ones who will suffer," Deborah Middleton, supervisor of communicable diseases in Carroll County, said yesterday.
State officials say the change is the result of a three-year effort to devise a fairer formula for distributing the money, which is funneled through local health departments to help AIDS patients pay for medical services, medications, nurses and social workers.
"We're trying to match the resources with the greatest need," said Dr. Liza Solomon, director of the state AIDS Administration in the Department of Health and Mental Hygiene. She said the new formula includes factors such as poverty rates and the number of gonorrhea cases, which might have affected how much funding several counties received.
Donald S. Baker, an AIDS patient who is the volunteer director of the AIDS Alliance of Howard County, said his group will be forced to try to take up the slack, though the alliance has no extra money.
Angry because the state has more money to distribute but is still taking funds from Howard County, Baker said the state is "top heavy" with administrators.
Baker and 30 or so other activists and local government officials attended a public meeting Wednesday to protest the changes. Solomon said she will consider the protesters' comments and see if any changes are merited.
Others argued that using poverty rates to determine AIDS funding is wrong.
"You could live in the richest city in the world but live in a desolate area," said Dr. Roman Ratych, a former member of the Greater Baltimore Ryan White Planning Council, who said AIDS patients in wealthy suburbs are often isolated because they tend to be avoided or shunned.
"We don't want to force people to migrate," he said.
State figures show that about 7,600 people with AIDS live in Maryland, with 3,902 of them in Baltimore, 1,217 in Prince George's County, 635 in Montgomery and 561 in state prisons. Baltimore County has 444 cases, Anne Arundel has 210, Howard County has 90, Carroll has 22, and Frederick County has 56.
Carol S. Jordan, administrator of communicable diseases and epidemiology in Montgomery County, said, "We have the highest immigrant population in the entire state," which she contends the state formula ignored. In addition, she said Montgomery has worked vigorously to combat gonorrhea, which also penalized the county in the formula.
Solomon defended the formula, saying, "I don't discount that [losing funds] is a problem." She said that's why the changes are being phased in over three years and why no jurisdiction will lose more than 25 percent of its budget during the first fiscal year, which starts July 1.
In Baltimore, where the state plans to deliver $99,000 more, a 4 percent increase in the city's budget.
"Baltimore City has 52 percent of the cases," Solomon said, explaining why it deserves more funding.
Dr. David Rose, assistant city health commissioner, said the extra money won't pay for more services but will compensate for inflation. However, he said, other state funding going directly to specific hospitals and programs in the city will increase the availability of resources for Baltimore residents.
Baltimore County's health officer, Michelle Leverett, said she's happy to get the extra money but doesn't know how it will be used. "We wish there was enough money to go around so nobody would have to be cut," she said.
Major Maryland jurisdictions and what they will gain or lose in AIDS funding over three years.
Baltimore $98,991 (4% gain)
Anne Arundel $11,364 (6% gain)
Baltimore County $61,796 (19% gain)
Carroll $13,979 (30% loss)
Frederick $31,568 (41% loss)
Harford $31,997 (31% loss)
Howard $50,966 (48% loss)
Montgomery $69,692 (14% loss)
Prince George's $41,476 (4% gain)
Source: AIDS Administration, state Department of Health and Mental Hygiene
Pub Date: 1/30/99