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Letter Opposing Cuts to County Health Budget January 24, 2007 The Honorable Todd H. Stroger Dear President Stroger: The Service Providers Council of the AIDS Foundation of Chicago is writing to express our grave concerns about the proposed cuts to the Bureau of Health in the 2007 budget. This open letter describes our concerns about the likely impact of deep healthcare funding cuts to the local fight against HIV/AIDS. The Service Providers Council (SPC) of the AIDS Foundation of Chicago is a membership coalition of more than 160 local organizations providing HIV/AIDS services and conducting HIV/AIDS education/prevention programs in the Chicago metropolitan area. The only coalition of its kind in the entire country, the SPC works collectively to identify service gaps and expand and improve HIV care and education programs. The SPC also serves as the lead agency for the Cook County and Collar Counties HIV/AIDS services consortia under contract with the Illinois Department of Public Health. As you know, the Bureau of Health Services plays an essential role in providing care to people with HIV/AIDS. Every year, the Bureau cares for almost one-quarter of the 30,000 people with HIV/AIDS in Cook County. The Ruth M. Rothstein CORE Center is the largest HIV/AIDS care provider in the State of Illinois and has played a central role in providing quality care to people with HIV/AIDS—a legacy that must be maintained and protected for uninsured, vulnerable, low-income people with HIV. In Chicago alone, about 1,000 people test positive for HIV every year. Federal grants to care for people with HIV, such as the Ryan White CARE Act, are not growing fast enough to keep up with the demand; many people with HIV are ineligible for Medicare or Medicaid because they are not yet disabled. They represent some of the uninsured individuals for whom the County must provide medical care. Any healthcare funding cuts adopted by Cook County government, and clinic shut-downs in particular, are harmful to the fight against HIV/AIDS in Cook County. Considering that more than 70% of state HIV cases occur in Cook County, clinic closures promote the escalation of the crisis across Illinois by delaying HIV testing, treatment, and prevention education, particularly among low-income residents. Without available healthcare centers, our local community will have diminished opportunities to reach at-risk individuals with voluntary testing for HIV, sexually transmitted diseases, hepatitis, TB, and pregnancy. Fewer County residents will receive reproductive health services and HIV/STD prevention education from health professionals; vaccinations for Hepatitis A and B, pneumonia, and other vital care and services needed by HIV-positive people. Moreover, closing ambulatory care clinics will certainly increase wait times at remaining County clinics, making it more difficult to obtain needed care. If patients delay preventative care for HIV and other conditions, they will become sicker and be forced to go straight to emergency rooms and acute care settings, thereby costing Cook County and Illinois taxpayers more money to treat sicker residents. Although much of HIV care in the Bureau is grant-funded, the Bureau’s programs provide functions, such as physicians, nurses and other patient care services, clerical support, and lab services. These services cannot be cut without impacting HIV care for Cook County residents. Moreover, because HIV is stigmatized, many people with HIV are reluctant to go to the CORE Center for care. They would prefer to walk into a neighborhood clinic where they could be seen for any number of conditions, including HIV. For this reason, HIV care must continue to be available in the neighborhood-based ambulatory care clinic network. There are three areas we ask that you pay especially close attention to and exempt from budget cuts: • Cermak Health Center: It is essential that Cook County maintain public health interventions at Cook County Jail related to HIV and particularly STDs. Gonorrhea infection rates among Illinois African Americans are 26 times higher than among whites, Chlamydia infection rates in African Americans are 14 times higher than among whites, and syphilis rates are four times higher than among whites, according to the Illinois Department of Public Health. An estimated 100,000 people pass through Cook County Jail each year, and the majority is young people of color. Cermak is the lynchpin of Chicago and Cook County’s STD control system, and if screening is curtailed, the outcome will be dire and could lead to even longer waits for primary care and STD treatment. Moreover, STD infections make individuals 3-5 times more vulnerable to HIV infection, further increasing the future cost of treatment. • Cottage Grove Health Center. We urge you to keep open the Cottage Grove Health Center, which is the largest and only publicly-funded HIV care site in the far South Suburbs. Cottage Grove cares for 197 patients living with HIV/AIDS. The nearest publicly-funded HIV care sites are 7 and 13 miles away in Phoenix and Robbins, IL. The number of people living with HIV in the South Suburban area more than doubled from 382 in 2000 to 820 in 2006, according to the Cook County Department of Public Health. The 115% increase in the number of people living with HIV is evidence of the tremendous need for HIV primary care in the South Suburbs. Because public transportation in the area is scarce and patients are overwhelmingly poor, their ability to access primary and specialty care in Chicago or neighboring towns will be extremely limited. • Sheriff’s Department of Women’s Justice Services. Programs in the Department provide critical HIV/AIDS prevention services for women at high risk for HIV in Cook County. In fact, in 2007, the Chicago Department of Public Health (CDPH) funded the Chicago Women’s AIDS Project (CWAP) to conduct HIV interventions with women in Justice Services programs. Your budget will deny women the opportunity to build skills that will help them reduce their risk of HIV infection and remain HIV negative. Finally, the SPC strongly encourages an aggressive expansion of third party billing to increase Medicare, Medicaid, and other insurance revenue. In addition, we urge that the County hire benefits counselors to ensure that patients are enrolled in all the services and programs for which they are eligible, receive information on how to access them, and are in fact accessing them. County services and programs must be protected for people with no other means to pay for care. The Service Providers Council stands ready to assist in any way possible. Please contact John Peller at (312) 334-0921. Sincerely, The SPC Executive Committee:
Alicia Bunton, Jackson Park Hospital CC: Cook County Board of Commissioners |
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