South Florida Losing Out on AIDS Funding as More Patients Move There

South Florida gets bypassed for millions of federal HIV/AIDS dollars because the federal funding formula does not count people who move there after they become infected, local AIDS officials say. The federal government's theory is that just as many AIDS patients move out of an area as move in, but local officials contend that the sun, fun and well-established HIV programs of South Florida attract thousands more patients who migrate here than who leave.

Under the federal formula, the money to support migrant patients goes to the city where they lived when they were diagnosed. The same is true for thousands of AIDS patients who move here for months at a time. Large cities such as San Francisco and New York -- meccas for AIDS patients -- have raised the migration issue for years, to no avail.

Broward's Health Department reported Friday that 3,253 of the 18,554 county residents who had HIV/AIDS, or 17 percent, were diagnosed elsewhere and not funded here. Seventeen percent added to Broward's $14.9 million Ryan White allotment this year would be $2.5 million more. Palm Beach County would gain $1.6 million and Miami-Dade County would gain $4.6 million. Florida ranked third as of June 2001 in the number of AIDS patients, with 37,300, but ranked 26th in Ryan White funds per AIDS patient during 2000.

States count HIV patients differently, with 35 counting by name. Georgia does not count them at all, and 15 other states use 14 different counting methods. A bigger issue, said Tom Liberti, chief of the HIV/AIDS bureau at Florida's Department of Health, is that the formulas count only AIDS patients. HIV patients are living longer without AIDS, but still need and use services, straining support programs.

Congress mandated the Institute of Medicine to study whether HIV counting could be standardized and reliably added to the formula to make Ryan White funding fairer. That report is due by fall 2003 and the Department of Health and Human Services hopes to take action for spring 2005.

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