Dallas County, Texas, will be forced to cover about $283,000 in unpaid Parkland Memorial Hospital bills left last year by 350 HIV-positive patients who do not live in the county, Parkland's board of managers was told Tuesday, the Dallas Morning News reports. Hospital officials said they could not send the bills to counties where the patients reside because the hospital had contracted with the federal government to provide HIV/AIDS-related care to low-income patients in a 24-county area of North Texas.

Parkland last year was awarded $7.6 million in federal grants and $11 million in other payments, including Medicaid and Medicare, to provide HIV/AIDS care. About $5 million was provided by Dallas County taxpayers. If Parkland stopped treating nonresidents living with HIV/AIDS, the hospital would lose about $4.6 million in federal funding and, ultimately, cost county taxpayers an additional $300,000, Jody Springer, Parkland's vice president of finance, said. HIV/AIDS care "is a regional issue, just like mental health and trauma," Ron Anderson, Parkland's president and CEO, said, adding, "But we do get additional federal funds that make up some of the difference."

According to Springer, the Ryan White Program, which has funded counties with a large number of HIV/AIDS residents, does not cover all HIV/AIDS-related medical costs, including inpatient care and some medication costs. About $1 million to $1.5 million in drug costs for outpatients are not included, she said. A majority of the 4,300 HIV-positive patients who participated in Parkland's program were from Dallas County. About one-third of the county's HIV/AIDS-related caseload is managed by Parkland, the Morning News reports (Jacobson, Dallas Morning News, 9/25).

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