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A dramatic cut this year in federal Ryan White grants to the St. Louis area makes the region the biggest loser among the 51 metropolitan areas vying for the grants, which were announced March 4. The city's 14% cut from the previous year's level means the St. Louis region will receive just $4.3 million in Ryan White money this year, the St. Louis Post-Dispatch reports. The funding reduction comes despite the region's increase in new HIV cases, from 10-15 new HIV cases a month in 2002 to 35 per month in 2003. It is troubling that those who are newly diagnosed with HIV will enter the public health system, said David Salter, St. Louis's grants administrator, only to be placed on a waiting list for services. The Metro St. Louis HIV Health Services Planning Council had to cut $700,000 from services, including housing, food, drug cost reimbursement, child care, transportation, and emergency financial assistance. The council agreed to avoid cutting spending on primary care and insurance reimbursements. About $1 million of the Ryan White money granted to the St. Louis area goes to drug cost reimbursements. Other programs that will receive funding cuts due to the smaller Ryan White grants are mental health services, food banks, and case managers who help clients access services. Tightened financial eligibility requirements for housing, food, and mental health services also have been enacted to deal with the rising number of HIV patients and falling federal funding. The planning council restricted eligibility criteria to just $18,850 for a family of four in order to qualify for the programs. The cuts to services are "going to be a huge burden on people living with HIV and AIDS," David Lauber, director of development and communications for Doorways, the primary provider of housing for HIV-positive people in St. Louis, told the Post-Dispatch. "Without a place to live, they have no place to keep their food or medicine or for their doctor to call them."
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