Alabama's Proposed Budget Could Leave Low-Income, Elderly in the Lurch

Gov. Bob Riley's proposed budget for next year includes cuts to the state's AIDS Drug Assistance Program (ADAP) and a cervical and breast cancer screening program for the poor, a senior Alabama health officer said recently. Riley's $1.95 billion General Fund budget provides flat or reduced spending for most agencies, as tax receipts have been declining with the economy.

"No matter how you cut it, there aren't enough dollars in the General Fund to pay for all the activities of state government," said Dr. Don Williamson, who heads the state Department of Public Health (DOH).

Alabama's ADAP had a client waiting list for years, until the federal government last year boosted its assistance and the state allocated $5 million for the program, which helps about 1,400 low-income HIV/AIDS patients buy antiretrovirals. But that $5 million is not in Riley's proposed budget. A $700,000 allocation to 10 AIDS service organizations is also missing.

"It's so frustrating," said Kathie Hiers, CEO for AIDS Alabama. "This is a heck of a place to cut."

The state Breast and Cervical Cancer Early Detection Program received $400,000 and served more than 10,000 poor women last year. Without that money, 1,200 women would not receive screenings, and the program has already scaled back services to target women at highest risk.

Both programs receive some federal money, but the state cuts will trigger reductions to federal matching funds for many of the services targeted, said Williamson. The vast majority of DOH funding comes from the federal government, and matching state funding is usually required, he said.

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