Healthcare Delivery in Georgia: Follow the Red Dots
On June 18, Jeff Graham and I went to the Georgia Department of Human Resources (GDH) and Georgia Department of Community Health (DCH) 2001 Budget Forum/Workshop held here in Atlanta. Several of these are held around the state ideally to allow input from advocates and consumers from all regions of Georgia. Although this potentially user-friendly and open forum could make a difference in what services are available and how they are delivered -- there are some flaws.
Picture it: about 150 people gathered atop the "Sloppy" Floyd Building in Atlanta. (Southerners have some unusual terms of endearment for our public figures.) These 150 or so folks were seated around about 18 tables. Our table included a representative from the Spina Bifida Association, someone working with youth in recovery, another woman who was a lobbyist for adult alcohol and drug rehabilitation, a speech pathologist as well as Jeff and myself representing the AIDS Drug Assistance Program (ADAP).
Each of these advocates was representing worthwhile and badly needed programs for Georgians with serious health care needs. Interestingly, in our little blue and red booklets were new Georgia Department of Human Resources unsharpened pencils. I now believe this was symbolic of just how much input we were about to have.
The process began with our being told to decide on five "top priorities" for each table. Being good sports, our table managed to combine and compromise on which issues were our priorities. Since this particular forum was a combination of both the Georgia Department of Human Resources and the Georgia Department of Community Health, Jeff and I agreed to barter our Georgia Department of Community Health priority for ADAP on the Georgia Department of Human Resources side. After deciding on our top five priorities, we write them on big sheets of paper and these are pasted along the walls of the room. Representatives from the Georgia Department of Human Resources then go around and decide which of these priorities appear to them to be duplications. Interestingly, they decided that ADAP was a duplication of the broad category of "Infectious Diseases." After a vocal outcry, ADAP was restored to a separate program -- which it is.
As mentioned earlier, this system is potentially user-friendly. One does not have to be an expert in the area being represented. In fact, consumers (read: those who received Georgia Department of Human Resources and Georgia Department of Community Health services, including ADAP) can participate fully in the process. This is a good thing. The unsettling part of this process is the "Power of the Red Dot." What is a red dot, you ask? Just that -- a little red dot, actually three red dots per person. We mill around the room looking at the Georgia Department of Human Resources-culled priorities and, like pin the tail on the donkey, place our dots next to our favorite program(s). The three programs with the most red dots magically become the top three priorities for next year's Georgia Department of Human Resources budget -- maybe.
I asked the nice woman sitting next to me why we go through what seems to be an exercise in futility. Her answer was sobering: "federal mandate." We were going through motions the federal government required of the Georgia Department of Human Resources. However, not bound by any of the recommendations made by us, I believe they are influenced by them on some level.
Now for the clincher -- someone somewhere organized and apparently bussed in several dozen chiropractors. These chiropractors were able to put all their red dots on "Chiropractic and Alternative Healthcare" as their priority. Because of sheer numbers they "won" with the most red dots. I am not diminishing the benefits of chiropractic or complimentary therapies; but I have never seen a case of spina bifida, or AIDS for that matter, cured by chiropractic. While I have to give credit to the chiropractors for their organization and tenacity, I do not think the Georgia Department of Human Resources is suddenly going to shift funding to alternative therapies.
Now you might wonder, "What is his point?" Let me spell it out. There are at least 15 AIDS service organizations in the Atlanta metropolitan area employing probably at least ten to 80 people each. Let me see, if each sent just five staff persons to represent their agency, that would be at least 75 folks times 3 red dots equals 225 red dots. Where were these representatives? Now imagine if each had brought just one client with them. We would have had 270 red dots! The Georgia Department of Human Resources would then realize that we really do believe ADAP and other AIDS services should be a priority for funding.
This is really not about red dots but about live faces and active voices. Voices of AIDS service organizations and of each person who receives services. That, gentle reader, would be you. If you have not heard, there is a waiting list again in Georgia for ADAP. President "Shrub" has flat-funded Ryan White and 40,000 new infections are recorded annually in the US.
"The AIDS Crisis Is Not Over," the signs read on our truck during the Pride Celebration on June 23. Apparently, many of us in this community must believe it is.
I just hope the Georgia Department of Human Resources doesn't. I hope you don't.
This article was provided by AIDS Survival Project. It is a part of the publication Survival News.