California: State Budget Could Cut AIDS Drugs in County Jails

Gov. Arnold Schwarzenegger's budget proposal, released in January, includes $87.5 million for the state's AIDS Drug Assistance Program. However, excluded from that amount is $9.5 million to provide ADAP services to HIV-positive inmates in county jails. Under the proposal, the cost of supplying AIDS drugs to inmates would likely shift to the jails.

"The governor's proposed funding switch introduces a new layer of uncertainty about treatment continuity and increases the expense of treatment," said Kabir Hypolite, director of Alameda County's Office of AIDS Administration.

AIDS drugs cost the county's Santa Rita Jail in Dublin about $525,000, a bill that has been previously paid by the state ADAP, Hypolite said. Neither the county jails nor health department is in any position to pay for inmates' treatment, he said. About 250 county inmates receive treatment through ADAP.

"The counties have been strapped by state funding, and the state also asking for money back," said Anne Donnelly, director of health care policy for San Francisco-based Project Inform. "Nevertheless, the concern is for the people who are incarcerated to get their treatment."

The counties may have to join together to bulk-purchase HIV/AIDS drugs at discounted prices, Hypolite said. Not all county jails follow the practice of Alameda County, which offers inmates HIV testing at intake: This may complicate efforts to secure the drugs without help from ADAP. Many inmates also refuse consent for testing, fearing other prisoners would use any disclosure of HIV status as a pretext for assault, he added.

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