Tuesday, November 28, 2006

What DSHS says about HIV

On August 31, Commissioner Eduardo Sanchez presented the Texas Department of State Health Services Legislative Appropriations Request to the Legislative Budget Board. He used a PowerPoint presentation that included 44 slides. Slides 27 and 28 are reproduced below.

Regarding Slide 27 (above), his Notes page said:
DSHS also administers programs to prevent the spread of HIV. Treatment has improved dramatically. As it does, the number of Texans with HIV grows. People are living longer with HIV--but we must also remember that they are working, paying taxes, and leading healthier, more productive lives.

Regarding Slide 28 (above), his Notes page said:

Clients of our HIV medications program are living longer as well. Again, the medications allow these Texans to live fuller, more productive lives and to contribute to the economy. Unfortunately, the cost of the medications used in this program has also grown--by 33% per client since 2000.

This is somewhat old news. However, the new news is that the whole question of an Exceptional Item for HIV in the Department's LAR is now somewhat up in the air. Discussion at the November 17 meeting of the HIV Medication Advisory Committee revealed that, while the estimates for potential funding needs for FY 2008-2009 continue to be based on a shifting foundation, the latest shift in the sands of this foundation suggest that the amount of funding needed will be substantially less that earlier proposed. Indeed, the amount may be sufficiently low that no Exceptional Item request will be made for HIV medications at all--with any amount needed being taken from other programs or resources at DSHS.


The questions that next come to mind are: If that happens, what will happen to the funds that were targeted for prevention, services, and surveillance? Will they just disappear also? If they continue to be included in the LAR, do they stand a chance of approval without the added "muscle" of a request for medication funds?

To begin looking for answers to those questions I returned to the Commissioner's presentation to see what he was saying before these questions arose. Oh dear! It looks like HIV prevention, services, and surveillance weren't even part of his spiel. He made nice "Republican" arguments about "productive lives," but he didn't make the connection between the need to increase prevention so that the upward curve of people living with HIV could be straightened out, if not reversed. It looks like we'll have to make the connection for him.


Anonymous said...

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Tarun Kumar said...

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