Tell Texas’ health commissioner to request funds needed to avoid HIV/AIDS ‘death panels’

Posted on 26 Jul 2011 at 1:07pm

NOTE: This post has been updated with a response from the Department of State Health Services. See below.

One of the victories from the 82nd Texas Legislature was the preservation of funding for the Texas HIV Medication Assistance Program. Early drafts of the state budget cut funding for the program, or eliminated it all together. Through concerted lobbying efforts the Texas HIV/AIDS coalition, in cooperation with other groups and activists around the state, convinced lawmakers to preserve funding at current levels, and to create a method by which Dr. David Lakey, commissioner of the Department of State Health Services, may request additional funds if he feels that they are necessary.

Whether or not Lakey will requests those funds is still in question. Lakey has a history of dismissing the importance of public input into how the medication assistance program is run. Earlier this year he eliminated the Texas HIV Medication Advisory Committee, a body designed to provide input from service providers and clients of the program. Lakey’s actions prompted the Texas Legislature to remove the commissioner’s ability to disband the committee by making it permanent in the state’s Health Code. Lakey also routinely doesn’t attend meetings of the Advisory Committee, one of the few open forums for the public to provide input on how the program is operated.

HIV rates in Texas are on the rise. According to the Texas Department of State Health Services, there were 3,126 new cases of HIV diagnosed in Texas from January through September of 2010 alone. Januari Leo of the Texas HIV/AIDS coalition says Commissioner Lakey will need to request an additional $19.2 million in funds to keep pace with the increased infection rates over the next two years:

“By not asking for the $19.2 million that is necessary to ensure that eligibility requirements will not be altered for those coming into the program, administrators are essentially setting up death panels,” says Leo. “What constitutes sick enough to have access to life-saving medications? Commissioner Lakey has the lives of thousands of HIV positive Texans in his hands, we hope he will choose to do the right thing and ask for the money.”

The Texas HIV/AIDS coalition is asking Texans to contact Commissioner Lakey to encourage him to request the additional funds. A simple on-line form is available HERE.

UPDATE: Christine Mann, a spokesman for the Department of State Health Services, disputes several of the assertions made in this post. Below is the text of an email Mann sent us:

• “Early drafts of the state budget cut funding for the program, or eliminated it all together.”

This is not true. There was never a proposal in the budget to cut funding for the HIV Medication program, nor was the program ever in jeopardy of being eliminated. We requested $19.2 million in additional funds via an exceptional item to address increasing caseloads and medication costs, but that money would have been in addition to the program’s current budget.

• “Whether or not Lakey will requests those funds is still in question. Lakey has a history of dismissing the importance of public input into how the medication assistance program is run.”

We very much welcome public input, and we are not sure what the “history of dismissing” is based on. The HIV Medication program is expecting a shortfall some time in FY13 due to increased caseload growth and increased medication costs. We are looking at a full range of options to deal with the shortfall and are in the beginning stages of looking at when and how we can make a request for those dollars, as allowed by the budget rider.

• “Earlier this year he eliminated the Texas HIV Medication Advisory Committee, a body designed to provide input from service providers and clients of the program.”

This is not true. There was no specific action to eliminate it. The HIV Advisory Committee disbanded due to an oversight in the rules. That oversight was discovered last summer and DSHS requested the committee be reinstated. The request was approved by the Health & Human Services Commission in February 2011.

• “HIV rates on are the rise.”

New HIV infections are not on the rise in Texas. HIV infection rates have been relatively stable over the last five years.

• ”Commissioner Lakey will need to request an additional $19.2 million in funds to keep pace with the increased infection rates over the next two years.”

The HIV Medication Program is expecting a shortfall of $19.2 million sometime in FY 13 due to increased caseload growth (new applicants) and the increased costs of prescription medication. As previously noted, HIV infection rates have not increased in Texas.

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