Florida's budget cuts went into effect Friday, drastically reducing the number of meals, companion programs and various other services that thousands of clients have received through Medicaid's Project AIDS Care (PAC) Waiver Program. "Look at my condition. This is ridiculous," said Jorge Correa, holding on to the oxygen tank he brought with him to a North Miami protest last week. "I can't walk. I can't do anything in my house." Correa and others -- patients, activists, massage therapists and case managers -- demanded that the Legislature reconsider the cuts.

Gov. Jeb Bush's budget plan eliminated $10 million this year from the PAC Waiver program, including a $5 million cut that was effective Friday. The cuts were implemented to help cover a $1.3 billion state budget shortfall. The result: 14 countywide agencies providing these services will have less to offer AIDS patients. Patients, case managers and activists worry that the cuts will greatly reduce the quality of critical client services.

By Friday, 12 PAC Waiver services were eliminated, including companionship, physical therapy, respiratory therapy and substance abuse treatment programs. Seven other services, such as case management and home-delivered meals, were reduced. Before the cuts, patients received seven hours of personal care a week. The budget now allows for five hours a month. Meals totaled 62 a month; now only 27 will be provided.

Before the cuts, case managers could bill up to $6,000 or $7,000 a month per patient. Now, only $2,000 per month is allowed. The agencies' maintenance costs haven't changed. Case managers are left with reduced payments. "This particular time I have to tell the patients there are no more services. That's like throwing them out to the wolves," said Nadine Proctor, director of Carol City's Northpointe Center, which has to shut down because of the cuts.

"We tried to emphasize as many medical programs as we could. We did not cut any services in pharmacy," said Bob Maryanski, Agency for Health Care Administration administrator. Maryanski said he hopes that through good case management, other service providers can be found, either on a paid or voluntary basis.

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