Saturday, March 13, 1999
AIDS patients may lose a friend
Home program faces closure
BY TIM BONFIELD
The Cincinnati Enquirer
A home health program for people with AIDS may be forced to close as a result of a recent decision by the Health Alliance of Greater Cincinnati to discontinue its home nursing services.
The Red Ribbon Team was formed in 1993 to provide a blend of home nursing, home services and hospice services to people with AIDS. Although highly praised by the 30 to 50 patients it serves at any given time, the program has been bouncing from sponsor to sponsor since it started.
“We're talking with a couple of organizations. But there's a real possibility that the service will have to close,” said Dr. Susan Montauk, medical director for the Red Ribbon Team and a former Cincinnati health board member.
The team, which includes four nurses, four home health aides, a chaplain and a part-time social worker, has years of experience dealing with AIDS patients. No other home health service in the Tristate focuses exclusively on people with AIDS.
But the future of the Red Ribbon Team has turned cloudy after a cost-cutting move announced last month by the health alliance that included eliminating about 300 home health jobs.
At the time, health alliance officials said patients served by its home nursing programs would gradually be routed to other local agencies. Unless another sponsor can be found, that decision
includes the Red Ribbon Team.
“I think the (alliance) is making a terrible mistake,” said a 51-year-old Hamilton man with advanced AIDS.
“The Red Ribbon team is one of the best nursing agencies I've ever been around — and I've seen a lot of them,” he said. “I can tell you that a lot of their patients are freaking out right now.”
The patient, who asked not to be named, said the Red Ribbon Team saved his life at least twice. Then, after he survived tough chemotherapy treatment that helped him beat his cancer, team nurses took him out to lunch to celebrate.
“You don't get that from a regular nursing service,” the man said.
Sister Franette Hyc, S.C., said the team has about a week to find a new sponsor before it has to start placing its 32 patients with other agencies.
The Red Ribbon Team started with Hospice of the Miami Valley, which was acquired in 1996 by VITAS Healthcare Corp. By November, 1997, the team needed a new sponsor because VITAS had decided to drop its home health services to focus on hospice care.
The health alliance stepped in promptly to sponsor the Red Ribbon Team. But continuing cost-cutting pressures changed the picture.
“We recognize that the Red Ribbon Team is a very valuable community resource. That's why we incorporated them into our program two years ago,” said Tena Barker, executive director of Alliance Home Health Services.
“As we are currently doing with all our home health services, we are working hard to find another home health provider in the community to continue this program. We're very hopeful that we will be able to find another place for this team to continue its work.”
But finding a new sponsor has been difficult.
Unlike other home nursing patients, who are mostly elderly people covered by Medicare, Red Ribbon clients are younger AIDS patients covered primarily by Medicaid, the government program for low-income people.
The different billing patterns and the different needs of the AIDS clients make it complicated for more traditional home nursing agencies to absorb the Red Ribbon Team, Dr. Montauk said.
Yet running as a fully independent service isn't an option, said Sister Hyc and Dr. Montauk. The team does not have its own home nursing license and loses money on operations, even though its sponsors have absorbed the costs of computer equipment, billing, regulatory paperwork and other administrative burdens.
“If we can't get anyone to take us as a team, we'll take as many patients as we can wherever we end up as individu als,” said Linda Lee, a registered nurse for the Red Ribbon team. “We're still real hopeful that somebody will see the benefit of what we do.”
Char, a 53-year-old mother of four and grandmother to nine children who was infected with HIV nine years ago, said she “would do anything to help the Red Ribbon Team. If I didn't have the Red Ribbon Team, I wouldn't be alive today.”
The team nurses know how to work with the multiple medications AIDS patients take (as many as 60 pills a day for some). They know how to spot the first signs of opportunistic infections. The entire team is trained in hospice care.
But perhaps most important, they've chosen to work with AIDS patients.
“So many people with AIDS are still dealing with the stigma, the discrimination and the fear people have of the disease,” said Sue Butler, executive director of Caracole Inc., an agency that provides housing for needy AIDS patients.
“Even in the health care field, there are still providers who are afraid to deal with patients with AIDS,” Ms. Butler said. “I can tell you that the HIV community has come to rely on them (the Red Ribbon Team). I really hope they can find a home.”
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