Discount plan may draw few HIV patients (video)

Betting on Reno

(Editor’s Note: This is the seventh in a series of articles on the Athens uninsured initiative, produced by graduate students in the Health and Medical Journalism Program at the University of Georgia.)

When Vincent McDaniel was diagnosed with AIDS in 1991, doctors gave him a year to live.

But 22 years later, he was working as a volunteer bagging canned goods, cereals and other foods for himself and other clients in the food pantry at AIDS Athens, an HIV/AIDS outreach clinic.

AIDS Athens, housed in a nondescript office building on the edge of the historic Georgia city, supports a few of the estimated 5,000 local residents who have no health insurance.

When the Affordable Care Act is fully implemented in 2014, most Americans will be required to buy health insurance or pay a fine. But for those whose incomes are low enough, the requirement will be waived. Many of those low-income residents of Athens may opt to join a discounted medical plan run by Athens Health Network, which will roll out next year for those who cannot afford health insurance and won’t be required to buy it.

But many people with HIV/AIDS, such as McDaniel, may stick with the services they receive from AIDS Athens.

The poorest residents of northeast Georgia who are living with HIV or AIDS can get free medical care through AIDS Athens, including mental health services. They also receive transitional housing, case management, financial planning, employment help, support groups and subsidized transportation to the clinic or appointments elsewhere.

The food pantry gives clients access to nutritious foods that can help manage symptoms of HIV and AIDS and improve their response to medications.

McDaniel said AIDS Athens helps him manage all aspects of his condition. Not everyone is so fortunate. Many HIV-positive people find it easier to obtain treatment for the virus itself than to find treatment for the depression, anxiety and other mental health complications that often strike when HIV/AIDS is diagnosed.

He cited the battle against the social stigma of having HIV and AIDS, and the stress of keeping that status a secret.

“There are too many people dying that don’t need to be,” he said. “We’ve got medicine out there now that will help you live as long as anybody else if you take care of yourself. But people are dying because they don’t want to open up and tell.”

More than 40,000 people in Georgia are living with HIV or AIDS. Georgia ranks in the top 10 states for the rate of new HIV/AIDS diagnoses and for the total number of people living with the disease.

More than 1.1 million people in the U.S. live with HIV, and nearly half of them show signs of mental health disorders, according to the American Psychological Association.

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In Athens, people with HIV/AIDS have access to a comprehensive treatment program that includes mental health services.

“Of all the nonprofits that I’ve seen, especially in Athens, we offer probably the most services . . . , and it’s all free,” said Jessica Parker, former client services coordinator for AIDS Athens.

Next year, the Athens Health Network will replicate a health assurance plan that was launched in Reno, Nev., seven years ago. The membership plan will offer uninsured enrollees, in exchange for a small monthly fee, wholesale-type prices on a number of health services, from primary care to specialty care, provided by participating doctors and health care facilities. It could radically improve the lives of many of Athens’ poorest residents.

But one group may prefer to remain uninsured: Athens residents living with HIV or AIDS.

Olivia Long, AIDS Athens executive director, said she is unsure if the new discount plan, which requires fees and upfront payment, is something that her clients need or would be interested in. AIDS Athens, which gets about 45 new clients monthly, currently offers clients the chance to be seen by a visiting doctor for free once a month.

They can also receive free specialty care treatment at the facility, based on referrals from AIDS Athens, if they qualify.

Alicia Smith is currently pursing her master’s degree in Health and Medical Journalism at the University of Georgia.