Changes Congress made in December to the Ryan White Care Act, the main source of federal HIV/AIDS funding, will cause Bergen and Passaic counties to lose some 41 percent of their funding, say local advocates. The cut, from $3.6 million to $2.1 million this year, will affect 20 local agencies that served 2,000 HIV/AIDS patients last year.

Congress added five metropolitan areas to those receiving Ryan White funding. The intent was to shift more money to rural communities affected by HIV/AIDS. But more communities are drawing on the funds, which remained basically unchanged. Experts estimate New Jersey, with the fifth-highest number of HIV/AIDS cases in the nation, could lose as much as $27 million in Ryan White funding at the local level over the next three years.

"This is devastating," said Steve Scheuermann, chair of the Paterson-Passaic County-Bergen County HIV Health Services Planning Council. "We're going to be pushed back to where we were 10, 15 years ago." Scheuermann and other advocates predict that the budget cuts will have broad impact, including the following likely results:

• As patients lose services to keep them healthy, they will progress from HIV to AIDS more quickly
• Patients will resort to emergency room visits more frequently, taxing already overburdened charity care
• Without support services, some patients will not adhere to medication regimes, making them more infectious to others
• Patients who fall out of treatment may develop more drug-resistant HIV strains

A new mandate to allocate 75 percent of the funds to "core medical services" means such services as respite care, community case management, transportation, and support groups will be cut, said advocates.

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