JEFFERSON CITY _ It's been six weeks now since Health Department officials reported the Ryan White AIDS program had gone broke and stopped authorizing services.
In Columbia, people with AIDS are facing angry landlords and empty medicine cabinets.
"The situation is desperate," Matt Wagner, director of the Moving On Coalition, said. "This crisis is draining all of us spiritually and physically."
"We're reaching out to the community for resources," Wagner said. "But donations are down because this has caused people to distrust groups associated with AIDS."
He said termination of the services had caused needless suffering for one AIDS patient in Columbia who recently died.
"It's debatable that he was given appropriate care because of the Ryan White mess. When I heard about the final care he was getting, it made me sick," Wagner said. Wagner said the man was too dehydrated to swallow a pain pill.
Wagner charged the state has refused to take responsibility for the effects of the funding problems. "Their number one priority was to cover their butts."
But Nanci Gonder, spokesperson for the Health Department, denied the department was avoiding responsibility. "We immediately took responsibility." She cited the audits performed by the department, and the restructuring of the program.
The Health Department has asked drug companies to speed up acceptance of patients in drug company programs that provide free medication.
"The free drugs have always been there," said David Peters, director of the AIDS Project of the Ozarks. "But the Department of Health is helping get them faster."
The Health Department also has said it will ask doctors and dentists to provide free services for AIDS patients, but Wagner said he had yet to see a list of pro bono providers in his area.
"I don't know for sure that is being done," he said.
But Peters said some doctors in the Ozarks region are providing free services. "But not because of any arm-twisting from the Department of Health," Peters said. "It's because of our contacts and the commitment of the providers."
Wagner could not cite similar generosity in Columbia. The only professional providing free services is a group facilitator.
The Health Department has taken steps to repay the $1.6 million debt run up earlier this year. A hiring freeze is in effect until further notice, some funds have been redirected, some funds held in reserve have been released, and Medicaid is being asked to pay for past services for eligible clients.
Personnel changes have been made, including reprimanding one employee, and demoting three others.
And the implementation of the program is being redesigned to be more effective next year.
"How they cover their tracks doesn't matter," said Wagner. "They lost the money, and we need it back."
Wagner said he thinks the situation is a time bomb. "In a few months we'll be finding people in the hospital more than we would have if they'd had access to the proper nutrition and preventive care the Ryan White funds were providing," he said.
Gonder said she did not feel qualified to speculate about that. Kivlahan, the Health Department director, was not available for comment.