Grant money to be used for HIV/AIDS health care reform
By Chris Benderev
June 21, 2009 10:15 p.m.
For someone with AIDS who owns little to no insurance and lives in small, rural California regions, health care options are not always so great.
As of today, the simple truth is that you would be better off in San Francisco, for instance, where AIDS services are more plentiful and effective, said Kevin Farrell, executive director of the UCLA Center for HIV Identification, Prevention and Treatment Services.
The difference between San Francisco and smaller cities is only a hypothetical example, but it illustrates a larger problem in California: the inadequate balance of funding for HIV/AIDS treatment and prevention across the state’s geography.
“AIDS services should be equitable,” Farrell said.
The disparities in California AIDS funding between counties is one of many issues Farrell and others at UCLA try to tackle.
AIDS Project Los Angeles, UCSF and two other San Francisco institutions will begin attempting to alleviate the disparity with a $2.1 million grant awarded in May by the California HIV/AIDS Research Program of the University of California.
One of UCLA’s primary objectives with the grant money will be the creation of an innovative mapping project designed to better monitor the differences in flow and use of HIV/AIDS service money to the uninsured and underinsured in California.
Farrell said that California politicians need to better understand the inequities in HIV/AIDS services between different state counties, something the mapping project seeks to address.
“In order to make sound policy decisions, you have to know what data and what funding you are working with,” Farrel said. “(The mapping project) gives them better information.”
In addition to the mapping project, the grant money will also be spent to identify room for efficiencies in administering and overseeing patient progress.
Dr. Arleen Leibowitz, a professor of public policy who will lead the new research efforts, said that the state currently does a poor job of consolidating its efforts to protect HIV-infected citizens. For instance, she said, the bureaucracies governing HIV prevention and treatment are largely separate.
“There’s no way in the current system to figure out, for example, if a patient tests positive for HIV, if that person actually ever ended up in care,” Leibowitz said. “It’s not a very good way to promote health.”
The need for a more unified data system in the area of HIV/AIDS is emblematic of health care reform needs nationwide, Leibowitz added.
The UCLA team hopes to determine whether increased efficiency in HIV/AIDS care can be achieved by altering the location or methods of administration of prevention and care services, said Thomas Coates, the director of the UCLA Program in Global Health.
Coates said the grant will go partially toward determining if better organization can lead to more effective care.
He said researchers will ask whether certain services could be more efficiently administered by phone, via the internet and in groups as opposed to individual one-on-one counseling.
Another major goal for the research endowment will be to concentrate on the financial realities of the HIV/AIDS situation.
“There’s a big question about the rate of growth of people living with HIV in the state,” Coates said.
He added that in the past, HIV-infected patients commonly lived 12 to 15 years before their death.
“That’s no longer the case,” Coates said. “People live longer.”
Researchers will work, he said, to develop a better understanding of AIDS patients’ life expectancies, costs of treatments and the necessary resources.
Throughout the research process, UCLA will collaborate with AIDS Project Los Angeles, a local support service provider. APLA works daily with HIV/AIDS patients, providing a crucial view of the real-world repercussions of policy decisions for university researchers, Farrell said.
“We run the same risk that people in Washington and Sacramento do,” Farrell said. “Here at UCLA, that we would be in our sort of ivory tower … not understanding exactly what’s happening at the street level.”
At the end of June, researchers from Los Angeles and San Francisco met to discuss further plans for the grant money, Farrell said.
A state budget panel in June dulled down a proposal by Governor Schwarzenegger to cut HIV/AIDS education, prevention and treatment efforts from roughly $80 million to $33.5 million, according to the Los Angeles Times. The amelioration of the cuts is promising, though not exactly uplifting, Farrell said.
In the end, the findings from the research are intended to inform the decisions of politicians.
While acknowledging their simultaneous humanitarian interests, the need for financially-minded advice to policy makers will be of paramount importance in the effort against HIV and AIDS, Leibowitz said.
“Policy-makers do pay attention when it’s a drain on resources,” she said. “Maybe that’s the way you have to speak to them.”
