New York has a good incentive to keep HIV drug fraud under control. State Medicaid costs overall are spiraling upward, driven primarily by long term care for the old and dying. Meanwhile, New York is threatened with a billion dollars in federal Medicaid funding cuts. The coming fiscal year will also see $1 billion chopped from the state budget, plus $1 billion in federal matching funds.
City Limits Magazine
_______
Back at the New York Diagnostic Centers, Binford recognizes that sometimes, regardless of how closely she monitors her clients, there isn’t much she can do. Rashid (not his real name) is one of them. Binford has been working with Rashid for a year. He is one of her favorite patients, and he is dying. He has sold his meds on and off, but more often than not he just doesn’t feel like taking them.
The rear entrance to the center on West 37th Street is a narrow wedge of black marble flecked with silver, jammed between an empty storefront and a discount clothing store. Waiting in the doorway is Rashid.
He is little more than a stack of bones and a cigarette slumped against a wall. The marble looks like a tombstone, as it props up Rashid’s body, full of 180 ml of Methadone and 12 ml of Xanax. His sunken cheeks inhale from under the collar of a huge black leather jacket; he shudders, winces and sinks deeper beneath his baseball cap.
Rashid has just resurfaced at the center after disappearing for two weeks in what Binford described as “a last hurrah.” When he turned up, he was barely conscious.
He says that his uptown SRO is “infected” with drugs. According to Binford, he has been repeatedly robbed and attacked by the local dealers. Rashid’s fingers are swollen and covered in bandages. It was his frustration with finding a safe home, says Binford that sent him on a two-week bender.
But Binford is thrilled to see him. She has just found him a place at a nursing home. Now all she has to do is help fold him into a cab and take him there. “His disease is so out of control I can’t manage him in the community,” she says. “This guy won’t make it through the summer on the streets.”
As the taxi creeps downtown to the bed that Binford has found for him at Rivington House on the Lower East Side, Rashid moans and his head lolls back against the seat as he slips in and out of consciousness. Virtually all that is visible of his face are the three blue teardrops tattooed under the corner of his left eye. “I’m going to lose every little thing I got,” he mumbles. “It’s chaos.”
