Originally created 02/15/99

Medication funds threatened



Like Cinderella at the stroke of midnight, Cynthia Knight could turn around July 1 and find she has suddenly lost her trusted health care provider, her daily blood pressure medicine and probably years off her life.

She is one of 731 people in the Augusta area, and one of more than 16,000 statewide, who will lose their treatment for high blood pressure if the Georgia Department of Human Resources follows through on a proposed cutback in the Stroke and Heart Attack Prevention Program.

The cut comes despite strong evidence from Augusta cardiologist Albert A. Carr that people on the program are twice as successful at controlling their blood pressure than the national average. And it comes when the number of strokes deaths in the state is rising, particularly in rural areas.

Those dropped by the program will likely end up at public hospitals like University Hospital and Medical College of Georgia. Without proper treatment their problems could fester into heart disease and kidney failure that could cost taxpayers for years, Dr. Carr said.

"All the city- and county-owned hospitals, their tax (support) is going to increase to provide this care," Dr. Carr said. "The taxpayers of Richmond County are going to pick up the tab."

The Department of Human Resources has to "redirect" or cut $50 million from its $1.2 billion budget and the stroke-prevention program is being cut in half from $2.2 million to $1.1 million. Instead of treatment, the money will now be spent on education and prevention, according to state officials. The program's budget in the Augusta area is $69,741 to cover the 731 patients, or about $95 per patient per year.

House Speaker Pro Tempore Jack Connell, D-Augusta, said last week he was looking into the cut and talking to those shaping up next fiscal year's budget.

"We'll ask them if there's any way they can put all or part of this money back in," Mr. Connell said.

The program's success rate is undeniable and has sparked interest from other states, said Dr. Carr, who has worked with the program since it began in the early 1970s.

Last year, he published findings from the program which showed that while nationally only 27 percent of those treated for high blood pressure successfully control it, the success rate was 66 percent for 781 patients he studied from Georgia's East Central Health District.

"I think we're making inroads here," he said.

East Central Health director Frank Rumph informed the Richmond County Board of Health at its monthly meeting last week that the program was being targeted.

"If they cut us, basically it would for all practical purposes destroy our program," Dr. Rumph said. "And a number of the people don't have the money for the medicine. That money competes with food and clothing and housing.

The majority of the people in the program are poor and, like Mrs. Knight, have no health insurance and no other way to get her blood pressure medicine, Dr. Carr said.

Mrs. Knight has been on the program for four years and has seen a definite improvement.

"I've been feeling better and I haven't had a lot of headaches," said Mrs. Knight, 43. "A lot of times I woke up with a headache." Her energy level is better and she has begun trying to moderate her diet and work on her weight.

She credits a lot of it to Pat Lynch-Hayes at St. Vincent dePaul Health Center, who cares for 50-60 patients in the stroke-prevention program. Those patients would have to go elsewhere if the program was cut because the clinic can't afford to continue to see them or provide the medicines they need, Mrs. Lynch-Hayes said.

"Probably University Hospital clinics would take a big hit," she said. And likely MCG as well.

University realizes that those patients, particularly those who are indigent, may come seeking help, said Cindy Lunsford, vice president for community affairs.

"I wouldn't be at all surprised," Ms. Lunsford said. "If bottom line they're going to move from one payer source (the state) to another payer source (if they qualify as certified indigent), the cost is not going to go away."

Other providers need to coordinate with the health department if the program is going to end, Ms. Lunsford said.

There will be a need "to try to set up some mechanism to try and pass those patients off to someone who is going to take responsibility for them so that they don't go two to three months without their medicines and get into congestive heart failure or some of the other problems," Ms. Lunsford said.

It is those future diseases and deaths, which may not show up immediately, that will far outweigh the current savings, Ms. Lynch-Hayes said.

"All of those things are tremendously expensive, not only in health care dollars but in quality of life and loss of life," she said.

Mrs. Knight is not sure what she will do to keep up her medication, though she may end up using the outpatient pharmacy at MCG, which provides her husband, Joseph, with his high blood-pressure medication.

"Only thing I can do, like when MCG pharmacy was going down -- is pray," she said.

That pharmacy was at the center of a conflict earlier when hospital officials tried to curtail it and legislators objected. If MCG physicians pick up some of the stroke-prevention program patients, they likely will use the pharmacy, said acting director Rusty May.

It is a mystery to Mrs. Knight why the state would cut her off.

"Why is it the programs that work are the ones they cut?" she asked.

But it is no mystery what the state is actually cutting.

"Somebody's health," she said.

Tom Corwin covers health issues for The Augusta Chronicle. He can be reached at (706) 823-3213 or tomc@augustachronicle.com.