State pulls AIDS money from non-urban counties following drop in rural cases.

When it comes to caring for people with HIV and AIDS, Monterey County’s got different challenges compared to urban areas like Los Angeles and San Francisco. Next year, it will have less money to fund disease prevention programs, too.

An increase in new HIV cases in six urban areas in California will mean a 22 percent decrease in funding for Monterey County in 2005-2006.

The state has begun redistributing prevention money, pumping more into bigger, urban counties and putting a financial squeeze on places like Monterey and Santa Cruz counties.

Katherine Thoeni, executive director of John XXIII AIDS Ministry, finds that troubling.

“Clearly, the needs of urban areas are very important,” Thoeni says. “We understand that and we support that. But really, what was looked at here is large, urban areas versus small, rural areas—defined as less than eight AIDS cases in the county.

“If your county is serving eight people in your community, you are probably going to be able to scrape together the resources.”

But Monterey County falls somewhere in the middle. It’s a non-urban, semi-rural area. Thoeni calls it a “squeeze county.”

“Our challenge is different,” she says. “In Monterey County, there are 1,000 people at any given time living with HIV. And it lasts a lifetime.”

Monterey County received $80,000 from the state to fund HIV prevention this year. The money is funneled through the county’s health department, which then distributes the dollars to community groups. John XXIII received about $60,000. Monterey County AIDS Project and Planned Parenthood got the other $20,000.

If the funding cuts do come to pass, Thoeni says, she will have to reduce her full-time staff to part-time.

But the cuts will be felt beyond AIDS Ministry workers.

“The dollar amount directly relates to what can we do to help people who are living with HIV and AIDS,” says Ethan Brown, a chronic disease prevention specialist for the county, “And how can we prevent further infections. That’s what it’s all about at the end of the day.”

This week, AIDS care providers and health department officials from similarly sized counties will meet in Monterey and begin addressing the funding cuts as well as ways to work together.

Brown says the group will try and address a difficult question: “What are the best ways to continue to provide service to an increasing client base at a time when dollars are decreasing?”

There are 16 other similar jurisdictions in California.

“If you look at it from an urban versus rural perspective,” Thoeni says, “it makes sense. But when you slam these jurisdictions in the middle of it, that’s where we have a problem. It’s not possible for a community of our size to cobble together the services needed to help those people living with HIV.”

In response to the impending cuts, Thoeni, along with Christopher Smith, the executive director of the Santa Cruz AIDS Project, asked the state Office of AIDS to convene a meeting. The state said yes, and on Feb. 23-24, all of these counties will meet at the Beach Resort in Monterey for a summit. The goal, Thoeni says, it to develop regional strategies for leveraging funds.

“We want to make sure that there is equal access to all Californians to treatment and outreach,” she says. “We want to make sure that every person who is at risk, that their health is protected and it’s a priority. The basic right to live should not be predicated on your zip code.”