Lack of Services Leaves HIV-Positive Patients Frustrated

Recession-driven budget cuts have all but eliminated health and social services programs around the country, leaving some of the most vulnerable populations to fend for themselves.

In Lewis County, that means the worst for HIV/AIDS patients, who have been left with no help at all.

“There's nothing left in this county,” Stephen Zauner said. “We're isolated as it is. Now there is no case management. There are no doctors. We have to go to Olympia for George for everything.”

Zauner and his partner of 22 years, George Miller-Zauner, moved to Glenoma in 1995 to settle down and start their business, the MZM Farm.

That decision was made in part because Miller-Zauner could no longer continue his career in project management in the Fortune 100 environment. He is HIV-positive.

Miller-Zauner sought treatment for the virus through the Lewis County Health Department and initially was able to receive case management services. He said the services weren’t really adequate, but health department employees at least tried to help.

He’d never before encountered insufficient services in any other city in which he lived. Refusing to accept the situation, he and Zauner became active in the community and lobbied in Olympia, although local legislators were not receptive to their message, they said.

“We boiled it down to one phrase: equity,” Zauner said. “It doesn't matter where you are, you should be able to get the same treatment anywhere.”

Now, however, what help the county did offer is entirely gone because of budget constraints.

John Abplanalp, an epidemiologist with the Lewis County Health Department, said funds had been shrinking over time.

“In 2010, the state made the decision to focus prevention dollars — which is what paid for counseling and testing and community education — on urban areas where more people test positive,” he said. “That took almost all funding away from rural areas.”

The county health department no longer even provides HIV testing.

Abplanalp said he refers people to other clinics, often the Valley View Health Center for those who have no health insurance.

Danette York, the director of the health department, said she doesn’t see a way of changing the lack of services in the future because state funding was the county’s only way of providing services.

“When that’s cut, there’s nothing else,” she said. “If we had the funding, we would love to provide services here. But our hands are pretty much tied at the moment.”

Currently only two physicians in southwestern Washington, who practice together, specialize in treatment for HIV-positive patients. They haven’t accepted new patients in about 10 years, Abplanalp said, so those seeking a doctor must travel to bigger cities like Tacoma or Seattle.

For other services, Lewis County clients were referred to the United Communities AIDS Network (UCAN) in Olympia. UCAN merged with the Pierce County AIDS Foundation (PCAF) late in February.

Several calls to administrators at PCAF, which is based in Tacoma, were not returned.

Howver, Megan Johnson, a medical case manager at PCAF, told The Chronicle that despite the merger, Lewis Clients clients will still be able to access most services, such as case management. But PCAF, too, is feeling the budget squeeze and some of its other services will no longer be available.

And still, other problems remain. HIV-positive people often cannot work and are on fixed incomes, so having to travel long distances can pose a challenge.

“I can do that, but how many others like me can do that?” Miller-Zauner said about having to travel out of the county for services.

Commissioner Bill Schulte said the county has discussed the possibility of having a Twin City Transit commuter bus which would allow Lewis County people to travel up to Olympia. But that idea is still being explored, so until it becomes a reality, HIV/AIDS patients have few other options.

Previously the county’s HIV/AIDS emergency fund was used to help HIV-positive clients with needs such as gas for a doctor’s appointment or paying a utility bill.

Much of that funding came from the annual Lewis County AIDS walk. Nancy Thomas organized the walk annually for 9 years until she stopped because the health department was no longer offering services and because of a lack of support in the community.

“My heart and soul went into the walks and other fundraisers I organized, such as World AIDS Day, and I was heartbroken due to the lack of support to continue these events to help those living in Lewis County living with HIV/AIDS,” she said.

She said the most money raised during the walk was $3,000 one year; the least was about $40.

In larger cities like Seattle, local businesses and major corporations alike support AIDS walks financially. That wasn’t the case in Lewis County where Thomas and other organizers had difficulty just getting people, especially local leaders, to attend.

Thomas said she believes the lack of support was in part due to the stigma surrounding HIV/AIDS.

“There are people here living anonymously among us,” she said. “And we no longer have something to offer them — not even a community. That was the most important thing to a lot of the clients, that they had a community.”

Thomas said she thinks HIV/AIDS is no longer at the forefront of public discussion because people are living longer due to better medications.

But people still test positive.

Abplanalp said the State Department of Health estimates that there are 28 people in Lewis County with HIV, but it’s likely there are more people who just don’t know they have it.

One in five people with HIV is undiagnosed, according to the Centers for Disease Control and Prevention.

Some patients have left the county altogether to move to cities with better services. The couple doesn’t believe people should have to leave their home for that reason, and so have continued to try to make changes within the community.

Morton General Hospital couldn’t provide quarterly testing for HIV-positive patients, until Miller-Zauner helped show them how.

“They now know how to serve folks with HIV,” he said. “And people don’t have to go all the way up to St. Pete’s.”

Miller-Zauner and Zauner said they will continue to fight on behalf of other HIV-positive people in the community.

“We are activists forever,” Zauner said. “We know there are a lot of people that cannot speak, that don't know how, or are frustrated and have given up.”

But they are disillusioned with a system that has worked against them for the last seven years.

“Without the support of the people in Olympia, who speaks?” Miller-Zauner said. “Who has the voice? It's hard on the outside to know what the inside is doing. We've already gone and tried. So where are we supposed to go, who are we supposed to talk to?”

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Bianca Fortis: (360) 807-8245