Lexington Herald-Leader examines funding issues in Kentucky HIV/AIDS clinic

Mar 16 2009

The Lexington Herald-Leader on Thursday examined funding issues faced by the Bluegrass Care Clinic, a Kentucky-based HIV/AIDS clinic that has seen a twofold increase in the number of patients over the last eight years, despite receiving no federal funding increases.

According to the Herald-Leader, the clinic currently treats 850 patients -- an increase from 481 patients in 2001 when the clinic first received federal funding -- and averages between 50 and 100 new patients annually. Services are provided to the patients on a sliding scale based on income, and most of the patients either have no private health insurance or are enrolled in Medicare or Medicaid. The clinic receives about $688,000 from the federal Ryan White Program, in addition to assistance that totals about $1 million annually from the University of Kentucky, which provides office space, receptionists and some of the physicians' salaries.

Alice Thornton, an infectious disease specialist, said that Kentucky clinics have been doing what they can to provide medical care at as low a cost as possible. However, she said that the clinics can only do so much before the quality of care begins to suffer, adding that they have "already had to take away things that we view as important." Thornton on Thursday met with members of Congress to encourage them to increase funding to the clinic and similar ones nationwide. Andrea Weddle -- executive director of the HIV Medical Association, which is urging Congress to double federal funding for the clinics by 2012 -- said that it is "becoming really difficult to provide the basic services."

According to Thornton, recent funding cuts have left the university unable to afford another receptionist for the clinic. In addition, state budget cuts have prompted the Lexington-Fayette County Health Department, another partner of the clinic, to send only one worker to teach HIV prevention methods and ensure that patients contact their sexual partners who might have been exposed to the virus. The health department used to send four workers, Thornton said.

The Herald-Leader reports that Kentucky has four clinics that receive Ryan White funding but that the Bluegrass Care Clinic is the only one of its kind in eastern and central Kentucky. Patients travel from 63 counties -- many for several hours -- for a doctor's appointment. Thornton said that many patients from rural areas do not want to visit a doctor where they live. She said, "They don't want people in their area to know they have HIV, because there's still, in 2009, a lot of stigma." Thornton also said that more than 40% of patients at Bluegrass have progressed to AIDS in part because most patients in rural areas are unaware they have the virus until they are treated at a hospital for a more serious illness (Vos, Lexington Herald-Leader, 3/12).