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LEAD-IN BY HOST DAVID STILES: It looks like new state budget shortfall may have an alarming effect for a growing number of HIV-positive Texans in the coming years. The state's Department of Health is considering changes in its allocation process that would drop or turn-away roughly a third of those seeking help from the Texas HIV Medication Assistance Program. Renee Feltz has the story: STORY: "So far this year -- and we're not even through our full budget year -- we've spent approximately $56 million and we've served around 11,400 clients." That was director of the Clinical Resources Division of the Texas Department of Health, Linda Moore, describing what the Texas HIV Medication assistance program has done in 2002 on an admittedly limited budget. Next year's budget doesn't look much better: "What we're facing for 2003 is an estimated $7 million budget shortfall. And there are two things that have caused this; and one - it's a good thing -- is that clients are living longer, that's a good thing. Clients are staying on the program more. And the patient medication utilization has gone up, and what the cost is that people are living longer, staying in the program longer and medication utilization going up, that automatically increases your cost." The Texas HIV medication assistance program is one of the largest of 50 similar programs across the nation. Most of its funding comes from the Federal government, and is distributed through a state level administration. According to the comptroller's office, Texas is projected to experience a 9 billion dollar budget shortfall in 2003, which makes the lack of funding for HIV programs only one problem the mostly Republican government will have to deal with. Several HIV AIDS activist organizations around the state have teamed up as ACT - AIDS Coalition Texas - to focus public attention on the effect this shortfall will have: "Is this financial ethnic cleansing? Or is this about dollars and cents, or is it about lives? And when do we get real and realize it's about life: human life." Under the current plan to re-organize medication assistance, large numbers of HIV positive people will be forced into poverty under new eligibility requirements. Moore explains: "Currently the requirements are 200 percent of poverty, with a spend-down. What that spend-down includes is we subtract the cost of the medications for a client for one year, so whatever medications are prescribed by their physician when they first go on the program, that cost is subtracted from whatever their gross annual income is. If the new eligibility plans go into effect, we are going to go to a 245 percent federal poverty level, and drop the spend-down." AIDS activists argue patients will have to choose between going to work and earning to much money to receive assistance, or not working and getting enough funds to purchase medication, but not enough to buy food or pay rent. So just who will be effected by the proposed allocation changes? 60-year old HIV positive transsexual Brenda Thomas is quick to dispel common myths about those with AIDS: "The single, white gay male is the minority when it comes to HIV and AIDS today. The bulk of the population is African-American. There's a huge percentage of African-American women who have HIV and AIDS. And the largest rise in the country today is the African-American population. For years, people identified HIV and AIDS as a gay disease. It's not a gay disease, it's an equal opportunity disease, unfortunately." The latest epidemiological statistics show that African Americans account for 58 percent of the new HIV infections in Harris County. Member of the Texas HIV AIDS legislative working group, Tracy Wilson, explains what will happen to these people under the new assistance program guidelines: "Over the next 30 months, we're looking at losing 1700 new applicants to the program that will be denied access, and 2500 existing clients that are currently enrolled in the program that will be dropped from the program, for a total of 4200 clients, statewide. The majority of which will be here in Harris County and Tarrant County in Dallas." As bad as things look, the activists don't consider themselves out of the game yet. Recently, they spoke before the state health department's advisory committee to share their views in an effort to re-design the expected changes. Local HIV positive activist, Ricky Martin was one of those who spoke: "The worst pain I have ever seen in any people, and unfortunately I say people that I've seen in my life go through, is the loss of a child bar-none. And I've told them I don't know what to do to solve this problem, but I'll do anything I can do to keep that look out of my own mother's eyes." Ricky, Tracy, and Brenda are working through the Thomas Street Clinic - part of the Harris County medical district - to gather public commentary on the proposed changes to the medication assistance program. After the board of the Texas department of health makes their decision, proposed changes will go into effect in February for new clients, and July or August for existing clients. Renee Feltz, KPFT News, Houston. E-mail Renee Feltz at chickpea_@ziplip.com . This story was broadcast on November 8, 2002.