Illustrated Daily; 6073; Legislature: AIDS Funding

And in hopes of alleviating that suffering of the person, not only the person who's dying of AIDS, or people like me who have AIDS-related condition who may die of AIDS also, but to help alleviate the suffering of the families, the people's children, their parents, their lovers, their sisters, their brothers, I urge you very earnestly to pass hospital 238 as is so that we do not have to face the same size of an epidemic and a problem that the other states are facing right now. The Illustrated Daily, Managing Editor Howe Roads, Good evening. Last week, the House Appropriations and Finance Committee held hearings on a measure which would appropriate some $480,000 for purposes

of responding to the growing AIDS epidemic in New Mexico. Officially, there have been 22 cases of acquired immune deficiency syndrome registered in New Mexico to date, but there are known to be far more than that. Perhaps as many as 36 individuals with AIDS are currently living in the state. From diagnosis to death, the cost of providing treatment for this deadly disease is roughly $150,000 per patient, the bulk of which is the result of inpatient hospital care. For some time now, the rate of AIDS diagnoses in New Mexico has doubled every six months, and it is estimated that within two years there may be as many as 1200 AIDS cases in the state. This at a total projected hospital cost alone of $137 million. Even today, the financial strain is apparent, and private fundraising efforts to provide support

for those with AIDS and education for prevention have been impressive. But those closest to this nation's number one health problem say substantial governmental support will be required in New Mexico to avoid an all-out crisis. Tonight, with the state already in financial distress, can New Mexico afford to do what must be done? Can it afford not to? This, with Democratic State Representative Cisco McSorley, one of the sponsors of House Bill 238 that AIDS funding measure currently before state lawmakers. Republican State Representative Lynn Titler, Vice Chairman of the House Appropriations and Finance Committee, both like the State Librarian Santa Fe. Don Schmidt, Executive Director of New Mexico AIDS Services, a private largely volunteer organization at the cutting edge of the AIDS epidemic in New Mexico. And William Johnson, the administrator of the University of New Mexico Hospital.

First, however, the Illustrated Daily's Matthew Sneddon attended those AIDS funding hearings before the House Appropriations Committee last week and has prepared this abbreviated version of what state lawmakers heard at that time. It is time for us at the state level to stop hoping that this epidemic will go away by itself. There is no cure for AIDS, there is no vaccine to prevent AIDS, and none is immediately available in horizon. We need to take action now to stop this epidemic as much as we can. I'd like each of you to very carefully consider the impact that this epidemic is going to have on New Mexicans. I ask you to vote for House Bill 238. I think that in the long run, the citizens of New Mexico will be pleased with the wisdom and the leadership that has been shown by passing this bill that will save many lives and save many, many, many dollars.

I'd like to speak to what I think is the incredible professionalism and dedication that the staff of New Mexico AIDS Services demonstrates. I have served on probably 50 volunteer boards in Albuquerque in the last 20 years. And without a doubt, I do not think that there is a finer group of people than the staff of this agency. Several of them have been working at halftime salaries of $10,000 a year, often working 50 and 60 hours a week. The full-time staff people undoubtedly work 50 to 70 hours per week every week and have done so for over a year. They have done an outstanding job of stretching dollars, both from the state and from the city of Albuquerque, operate an extremely efficient operation and a very frugal one. I would urge you strongly to support House Bill 238. It is an incredible investment in the future health of the state of New Mexico. I can assure you from my knowledge that both the board and the staff

of New Mexico AIDS Services will spend those dollars very wisely. I am one of those that is depending upon this bill for my life over the next few years. I am not here only because of that. Over the last three years, I have helped deal with at least 50 friends who have died of AIDS. I have treated them as clients because I am a substance abuse counselor. I have sat with them in the hospital and by their deathbed. I know the suffering that they go through. I know the suffering that their families go through and in hopes of alleviating that suffering of the person, not only the person who is dying of AIDS or people like me who have AIDS related condition who may die of AIDS also, but to help alleviate the suffering of the families, the people's children, their parents, their lovers, their sisters, their brothers. I urge you very earnestly to pass House Bill 238 as is so that we do not have to face the same size of an epidemic and a problem that the other states are facing right now. Thank you.

Our son was in the hospital with what then was called asthma. He was tested for AIDS and it was found at that time that he did not have AIDS. He was tested for numerous cystic. On February 10th, almost a year ago, I went to see him in California. In March, he was given the diagnosis of AIDS. Our plans were to bring our son home on the 16th of May. Instead, we received a call that he had severe seizures. He suffered with three brain lesions at that time and we were told that he would be in a coma soon. We went to his bed sign. My husband and I stayed in San Francisco four weeks until our son passed away. He died of brain cancer, leukemia, and malnutrition. One of the things that we dealt with that was very difficult was after we got to California,

our oldest daughter had shared with us. Our family is concerned about you being with with Randy with our brother because we are afraid that you might transmit this back to our children. I want to tell you that is a very difficult thing to deal with that you have to think that you might not be able to be with your grandchildren. Fortunately for us, our fears were allied. Our children were sent to talk to Dr. Hall and Dr. Kaufman at the family practice clinic and their fears were allayed and our families very close together because of this experience. I just am sharing this with you so that you know what the personal things to your own families would be involved if you were to go through this sort of experience. In closing, I just want to say that last week I met a friend whom I had not seen for 30 years and we started, we were at a funeral at the Braveside with a coworker.

We met and we talked about how are the children, where are the children, how many grandchildren do you have and I had said well my son had died and she says well my son is very ill in San Francisco and I says mine died in San Francisco and she says you too and this I just want to share it could be you too and all of us could be touched by it. Thank you very much. So some of the testimony at those AIDS funding hearings of the legislature last week and representative McSorley you are one of the sponsors of this AIDS funding measure. What exactly representative McSorley is that? $480,000 intended to do. Well how there's two things it's going to do. The first thing it's going to pay and train professionals who deal within the department and also in private industry to cope with this disease but second of all the department of health and environment. That's correct. And also it goes to contracting out to those individuals who will be

actually on the front line the counselors and those type of people. All right given all of the other demands on the financial resources of the state of New Mexico today this lean budget year why now? Because how the epidemic is now there's nothing we can do about it we can't choose the time for people to get sick. People are dying today. Furthermore if we don't spend this money now in the future we'll have to spend much much more money as you said in the beginning it's a $150,000 just for the treatment of one person. We're looking for a half of million dollars approximately to look into the future to save as many people as we can. If we save two or three people from this disease we've made our money back today. All right so you buy the projection that we could be looking at 1200 cases in New Mexico within two years and at $150,000 as it were per individual for the privilege of dying with the AIDS. That costs out about $140 million. You buy that whole scenario is that right? How that's what the experts tell us and nobody has told us

anything different. The other states that have had experience with this confirm those figures. I was going to say have you consulted the other states on this major so we have a sense of just how we do indeed compare on these matters. Yes yes all those statistics and all the data has been completed and the statistics that you give so far are considered conservative. All right sir I'll be right back with you in a little while. Don Schmidt of New Mexico AIDS Services. Your organization been at the very cutting edge of this epidemic now for a year here in New Mexico. I'm told you currently have roughly a hundred thousand dollars in public funds state and municipal funds either direct or under contract in some fashion. What kind of private fundraising efforts however do you have going for you and what do you do with your money? Okay first in terms of private dollars we're bringing in about four to five thousand dollars every month right now and that's through people having fundraisers in their homes. That's through people like 82 artists having a fundraiser in Santa Fe on Valentine's Day donating their art and then selling that art to benefit New Mexico

AIDS Services. We're negotiations with Elizabeth Taylor and some of the people working on a national level to raise money for AIDS to have a couple of those kinds of fundraisers this year. We're estimating that if in fact this bill goes through and if we are the nonprofit agency that gets much of the contract money in terms of providing frontline work we will be bringing in about equal amount of private sector dollars about the same amount of private dollars as well as public dollars in order to provide in-home care in order to do education projects to try to limit the spread of this virus from one person to another the virus that causes AIDS in order to provide emotional support and counseling dealing with death and dying that we believe that by providing this in-home care and doing this education we can have a significant impact on reducing the spread of the virus and holding down hospital costs. All right five people have died of AIDS in New Mexico in the last five weeks. Are we beginning to see the worst of it? Is that what's happening here? Oh I wish that was the case. I'm afraid we're beginning to see the very beginning of the worst of it.

We're in a situation now where there's an estimated seven to 10,000 people in the gay and bisexual male community of this state who have the virus in their system. 10 to 30 percent of those people will die of this disease in the next five years. We don't know what the numbers are in terms of the general public population. We have not been able to date to be able to fund the kind of testing programs that would be necessary to project the kinds of numbers in the communities other than the gay male community. And we do know nationwide that 28 percent of the people who get AIDS are not gay and bisexual men. We know this is primarily a heterosexual disease in Africa and we know that it is spreading out of the highest risk group. Other communities have organizations similar to yours in New Mexico AIDS services. Where do we stand right now in New Mexico in terms of private volunteer response to this AIDS crisis and how does that compare to what's happening elsewhere? Well other communities do and don't have similar organizations. As far as I know New Mexico AIDS

services is the only statewide organization of this type in this country. We're in a very strange situation having such a small population if you will in such a large geographic spread. We're not in a place where we can have a number of different organizations in every one of the small towns. Most of the places with AIDS service organizations made up of community volunteers are in very large cities. Not facing the problems of driving four hours to get to some place where someone was just diagnosed and dealing with that hospital staff, etc. So we're kind of on the cutting edge of setting up a model for providing rural AIDS health care on a community-based framework. In terms of volunteers, 150 people have come forward in the last six months. People are engaged in answering the hotline, providing information, making referrals, providing in-home hospice care, providing counseling, doing family counseling. And many volunteers engaged in doing the fundraising efforts to bring in the private sector dollars to assist and match those private dollars with the public sector dollars to make a response to this epidemic. That 50-50 match. Is that sort of the norm around

the country? How do we, how do we compare? Do you have a sense of that? Private dollars are, we're trying to get more private dollars in terms of percentage-wise. Here in New Mexico, we have not seen to date a real movement or leadership in this state. In terms of the public dollars, I think that's turning around very quickly at this time. In New York City right now, over a million dollars a week is being spent on hospital-based care. They're projecting two to three million dollars a week by the end of this year. I think we are in a place of hopefully getting in on the front end of this epidemic and doing what we can do to reduce the spread of the virus and putting in place in home care. So you think there's still time? You think there's still time. We're going to have a big, big, big, expensive epidemic here in New Mexico. Right now, we're wondering what can be done now to reduce just how big that is. And I think we know what can be done. The question is, are the resources going to be there to do it, how? All right. William Johnson demonstrated at the University of New Mexico hospital in his testimony at the House

Properations and Finance Committee last Wednesday, I believe it was. The state epidemiologist, Harry Hall, estimated age-related hospital cost in New Mexico just was in the next two years of roughly $140 million. Is New Mexico prepared for that? Based on the current revenue picture, I don't think they are prepared for it. I believe that the money I asked for on the House bill 238 is really modest. I think Don indicated, Harry has the epidemic is here. If tomorrow we were able to have a vaccine to prevent any further cases, the 1200 to 2000 cases are in the system and would require health care. There's no way to get around that. We have no cure. We have no vaccine at this moment. Therefore, the proposal 238 for education testing and outpatient management services seems to be the only course of action that we can take at this time to try and alleviate some of the potential cases that are going in the city. The projections that you saw are based on

current straight line projections from generally the gay community. We've not tried to factor in the impact of the drug culture, which will apparently arrive here at some time. Do you say that's low? That $1,200 could be low. I mean, 1200 patients could be low. Yes, I think that's very low. We know as Don said, the number of gays that are already tested for the virus are apparent in the community and there's going to be a great number of people who will in fact contact AIDS. Let me ask you this. Do you buy the analysis that volunteer support of in-home medical care for persons with AIDS can in fact substantially reduce this astronomical figure of $140 million in hospital care within two years? I don't think there's any question it can reduce it significantly. If you look at the first 10,000 cases with the 147,000 lifetime costs and you look at the lengths of stay, they averaged about 31 days per hospitalization each patient. We went out and spent significant time in San Francisco at San Francisco General as we developed our own in-hospital AIDS task force.

The very nature of our institution will dictate that we have patients coming here. They've reduced their in-patient stay to less than 12 days at about 11.8 days. This has been attributed to the development of the outside support network, Shanti, the volunteer groups that have permitted an exit from the hospital. We've learned that AIDS patient does not need to stay in the hospital for a protracted time only when they're subjected to the opportunistic infections. We have reduced our length of stay to about 15 days and we have seen a dramatic reduction in the per-hospital cost of the AIDS patient by relying on AIDS service. If that system isn't in place, what system is there to take its place? They will do as the AIDS patient will remain in the hospital with an acute care facility for more custodial care at a very, very high expense. All right. Representative Taitler, Vice Chairman of the House of Appropriations.

I guess the question I posed at the beginning of the program is still with us. Can New Mexico afford now to do what must be done? Can we afford not to? Howell, you've really posed a quandary because we're sitting in the Appropriations Committee with over 250 million dollars of special bills, which doesn't address the money we already had to cut out of House Bill 2. The tax bill doesn't come anywhere near covering any of it. Howell, it's a problem. It's a serious problem and it's one that is going to be one of the toughest ones to answer. Personally, I don't think we can afford not to. The numbers you've been talking about are conservative. You were talking about $150,000 of hospitalization expense per case. I've heard numbers as high as $250,000. Yes, I have two. Our Medicaid budget is already climbing astronomically and these are the people. These are the people who, either once people find out they have AIDS or they become too sick to work, they may have had insurance before, but they lose that insurance. And then how it's Medicaid budget, it's public hospitals,

like those run by Mr. Johnson, taking away the human aspects, which we can't. This is a heart breaking disease. But if you take away the human aspects, you're still talking about financial impact that I don't think very many people in the state are even beginning to comprehend. To what extent of this legislature are they beginning to comprehend that there's a real crisis on their hands and the making here and they might have an out as it were? Well, I can't speak for the entire legislature. I know that some of the members, especially some of the members on my subcommittee of appropriations and finance, who never before had a grasp of what we were facing, we had subcommittee hearings before that full committee hearing on Representative McSorley's bill. And I know that several of the members came up to me afterward and said, my God, now I understand what you've been telling me since last spring. But how I'm not confident that that awareness, that that conceptualization has really permeated the legislature yet, I don't think there are many who understand. And unfortunately, there are still some who equate this to a lifestyle problem,

and they're saying it's their problem, let them keep it. And good Lord, how it's all of our problems, it's not just within one segment of the community. I was going to see, even if it were a lifestyle problem, it would still be a problem with us that we would have to respond to one way or the other. Can you envision this legislature two years from now saying, we have to come up with $150,000, let us say, just to underwrite hospital care for people who are dying in the streets. I mean, I guess the question is, it sounds to me like you put a little bit of money here. Now you have an organization capable of doing a lot of private effort. How does that message get conveyed to members of the legislature? And is it apt to happen at this session, do you think? How I think that message has to be conveyed. And I know I've certainly been doing my minor part, former Secretary Mullin, and I talked about this entire problem last winter. And ever since then, I've been trying to convince people of what we were facing. I can't answer, and I wish I could positively say right now that this house bill with the money in it is going to pass out of finance

committee tomorrow. We can't do that until we know where the tax bill is going until we can get agreement once we get that tax bill solidified between House and Senate. Even then, we're going to have to be in a fight as to how it would be spent. And of course, every legislature has priorities, has funding priorities. And this is not very frankly high on the list with a number of them. It's high on my list. It's one of about my top two or three bills. But it's going to take some convincing, it's going to take some education. And half of, you know, half of the money that's in this bill is to educate the public and to provide the emotional support and the instruction that is needed to prevent further spread. We've heard 20% of our gay community already shows HTLV3 virus. They're exposed. They've got it. They're contagious. We've got to make sure that that amount, that segment of the population, doesn't increase. Just as that's an education effort, we've got an education effort on our hands right up here in the legislature. I just pray to God we can achieve it. Do you expect anything to come out of this session, which you'd be surprised

if nothing came out? Hal, if nothing comes out, it's going to break my heart. And it's not only going to break my heart, it's going to cost the state untold millions, both in terms of dollars and in human suffering. I can't predict it though. You're a conservative leader in this legislative session. I guess I'm a little surprised to hear you say this. Do you have the lines of, I don't know why I'm surprised. It would seem to me that you could just as easily say we just plain can't afford it. Do you have lines of communications or the other leadership? Are they interested at all? I've tried to talk with them Hal, but we have been so busy trying to resolve some of the other overwhelming issues and trying to keep this legislative session together so we don't have the problems that we had last year. I've discussed it in some detail with some of the leadership. I plan as soon as and hopefully within the next day or so we're going to get this revenue issue settled once and for all. And then you can count on the fact that I'm going to be beating on a few heads as well as a few doors. Yes, I am concerned about that. I wouldn't want Lin-Titler beating on my

head. I know she doesn't have to beat on your head. You're one of the co-sponsors of this measure, but are you encouraged or discouraged by what representative Titler just had to say to us? Well, I can't say as I'm encouraged. Let's face it. Representative Titler is in the leadership of the House of Representatives and of the legislature and that's what it'll take. Leadership. This is not something that's just come to the forefront in the last couple of days. The new Reaganism, the new federalism, this has all been orchestrated for the last six years. These very problems are the problems that New Mexico should have known. It was going to have to face. This is nothing new. We should have known this was coming all along and it takes leadership now. Certainly, we all have our own bills that we'd love to see, but it just boils down to leadership. If the leadership of our state today cannot take responsibility for these problems, then it shouldn't be in the leadership. Let me ask, let me just ask Adon Schmidt before you run out of time here. Without additional public funding, is New Mexico aid services upon the rocks?

No, Hal, we can continue to support the number of people we're supporting now. When we are serving 37 people with AIDS, another 27 people currently with ARC and significant others, we're doing all right. If this case, if this, the numbers continue to double every six months and I'm unfortunately believe that's clearly going to happen, at least that is going to happen. We can't even make a dent in providing the kind of alternative services we're providing now. People are going to go to the hospitals. They're going to stay there. We're going to spend lots and lots of state dollars. I refuse to have any of my volunteers out there providing assistance in homes if they don't know how to move somebody in and out of a wheelchair without hurting the patient or themselves. If they don't know how to move somebody in and out of a bathtub, we're not going to try to do what we can't do. And I need some more staff people to do the supervision, the education, the training of the volunteers so we can do what we do and we'll have the ability to do. Well folks, I thank you all. I know you're all concerned. It was kind of you to come by and help us understand this. Again,

every time I do this story, I find myself depressed, but I'm afraid that's it for this occasion. Tomorrow, media coverage of high-profile crimes like the slain of Linda Daniels are constitutional rights and conflict. Meanwhile, thank you for joining us. I'm Hal Rhodes. Good night. For AIDS-related information, call the AIDS hotline 1-800-858-AIDS.