Difficulties, even death, stalk needy
• State budget game is 'playing with people's lives,' AIDS patients lament
Bill Hancock and William Reed think the state delivered a death sentence to them Saturday when it stopped paying almost $4,000 a month for powerful drugs they need to battle the deadly AIDS virus.
The partners, who met at Our House of Portland hospice in 1995, are among the thousands of low-income, sick, disabled, mentally ill and/or elderly Oregonians who depend on the state for lifesaving medical care.
On top of that, Hancock and Reed said, the state didn't give people time to adjust to the news that medical benefits would end. Notices went out the second and third week of January that most of the cuts would be made Feb. 1. Their letter from the state was sent Jan. 16.
'They're playing with people's lives,' Hancock said. 'It's a political game in Salem, and we're the pawns.'
Hancock and Reed are not alone in their opinions.
For example, at least nine elderly residents will lose long-term care services in April at the Harvest Homes assisted living facility in North Portland's St. Johns neighborhood. Several more came close to losing benefits, including 90-year-old Verne Weber Sr., but last-minute intervention by his family and an attorney helped prevent it.
'I've never seen anything like this, not even in my worst nightmares,' said facility Administrator Dee Dee Haliski.
State health officials say the service cuts were necessary because the Legislature had ordered the Oregon Department of Human Services to reduce its current budget by $140 million to make up for a budget shortfall that resulted from lower than anticipated tax revenues.
Measure 28, defeated last week in a 54-percent-to-46-percent vote, would have restored $88 million of those cuts, but not enough to avert all of the reductions.
'We could not realize significant savings without major cuts to services,' said department Director Jean Thorne. 'We sought to protect the most vulnerable people, although all of our clients are vulnerable.'
But critics, including members of the Libertarian Party of Oregon, say cuts that make people suffer are unnecessary and unacceptable.
'There is fat all over the place in state government,' said Richard Burke, the party's executive director.
'Government has a moral obligation to divert dollars from unnecessary and wasteful programs to core government services.'
Burke listed several immediate actions the Legislature could take to restore cuts to human services, law enforcement and education. Among them: make changes to the PERS retirement system, privatize the Oregon Liquor Control Commission and reduce from five to four days the workweek of middle managers whose jobs do not involve public safety.
'If people suffer, legislative inaction will be to blame,' Burke said.
So far, Gov. Ted Kulongoski and most state legislators have no plans to change cuts already made.
Lives may unravel again
For Reed, 39, and Hancock, 47, the cuts mean they may again face an agonizing death from AIDS. It happened before, in 1995, when they were at Our House hospice waiting to die.
Their reprieve came in the form of then-new but expensive drug 'cocktails' that have prolonged their lives for more than seven years.
'We were the first to leave Our House alive,' Hancock said.
Together, they have spent the last seven years 'rebuilding our lives and working hard to rebuild our health,' he said.
Reed's health is more fragile than Hancock's. He takes 16 pills in the morning and 19 at night to keep the AIDS virus at bay, to counteract the drugs' severe side effects and to ease debilitating pain. His drug bill amounts to about $2,100 a month.
Hancock, recovering from a recent heart attack, takes drugs to fight AIDS and to combat heart problems that he developed as a side effect from the AIDS drugs. His drug costs amount to about $1,800 a month.
Besides paying for their drugs, their health plan also covered the services of a home health-care worker. That benefit was cut, as was coverage for dental and mental health services.
The two men devote much of their time now applying for various programs that help low-income patients get free or discounted medications.
They've applied to a federally funded local program called CareAssist, which helps low-income HIV/AIDS patients pay for drugs and other medical costs.
The program has 'a huge waiting' list, which will only grow with the state budget cuts, said CareAssist spokeswoman Veda Latin.
'It's been real stressful and not healthy for me,' Reed said.
The 90-year-old Weber and his family spent the last two weeks of January dealing with similar fears and frustrations, but their story has a happier ending.
Two weeks after Weber received a letter telling him the state would no longer pay for his care at the assisted-living facility after Feb. 1, health officials reversed that decision last Tuesday.
'Everybody was ecstatic. It was pretty much a relief,' said Verne Weber Jr. of the reversal. 'We didn't know whether he would be out on the street.'
Weber Sr. was one of about 4,200 elderly and/or disabled Oregonians who were notified that state-paid medical services would end Feb. 1. These services included care provided in their homes, in nursing and adult foster homes and in assisted-living facilities.
Another 4,800 people will lose similar long-term care April 1.
These cuts affect people who have been rated according to a 'survivability index' that ranges from 1 to 17. The index rates people according to their ability to perform daily activities, such as walking or eating on their own. Those at the lowest levels need the most assistance.
Last Saturday, seniors at levels 15 through 17 lost state funded-medical care. In April, medical care for people rated 10 through 14 will be eliminated.
Weber was fortunate to have a family that fought aggressively to keep him in his Harvest Homes apartment, said Becky Wehrli, executive director of Elders in Action, a Portland nonprofit group that advocates for senior citizens.
His four children enlisted the help of Elders in Action, Harvest Homes staff and Jenny Kauffman, a senior law advocate for Legal Aid Services of Oregon. Through innumerable phone calls and e-mail messages, they persuaded health officials to change Weber's status from 15 to 3, virtually assuring that his state aid will continue.
Similar efforts by Harvest Homes staff, residents' families and advocacy groups resulted in reassessments that changed the rating of six more residents to under 10, said facility administrator Haliski.
Wehrli worries about senior citizens who don't have families to fight for them as the Webers did for their father.
'But for those who have no family, they might be overlooked,' she said.
Heading for court
At least three lawsuits have been filed in Multnomah County Circuit Court to stop the state's cuts.
And more lawsuits are likely to be filed, said Steven Goldberg, an attorney with the Portland firm of Goldberg, Mechanic, Stuart & Gibson.
Goldberg's firm, the Oregon Law Center and Legal Aid Services of Oregon filed a suit last week to stop the state from making cuts to the Medically Needy program, which the state eliminated Feb. 1. That program provided money to 8,000 elderly, blind and disabled low-income Oregonians to help pay for prescriptions, transportation and other medical services.
The motion was due to be heard Monday afternoon.
In another lawsuit, the state has agreed to postpone until April 15 the eviction of about 100 mentally ill residents from two state-funded care facilities, the William Elaine on Southeast 74th Avenue and the Hoodview in Gresham.
The facilities were due to close Saturday. The postponement gives both sides time to prepare their cases, said Bob Joondeph of the Oregon Advocacy Center, which filed the suit.
In a third suit, the Oregon Advocacy Center seeks to stop the state from making cuts to the Oregon Health Plan that would leave about 118,000 low-income Oregonians without treatment for problems
involving mental health, drugs or alcohol. The cuts are set to go into effect March 1. A ruling should be announced later this month.