Have AIDS, Must Travel

A change in the way programs are funded affects local HIV/AIDS services

Over 50 New York City groups providing services to people with AIDS will see a reduction in funding from the city starting March 1. The Health and Human Services HIV Planning Council of New York—responsible for developing the city's HIV/AIDS funding priorities—has changed the ways in which providers will receive money earmarked for people with HIV/AIDS. Last year 67 awards were granted to groups that provide legal and counseling services, while this year only 32 contracts will be signed.

The consolidation means that many groups accustomed to receiving money under the Ryan White CARE Act of 1990 (which allocates money to cities to help people with AIDS) are now defunded. Small providers are being hit the hardest, and advocates say that the new preference for larger, more centrally located agencies will make it harder for the poorest and sickest to get help.

"MDs trust other MDs," says David Bryon of Brooklyn Legal Services, explaining that while some of the larger agencies, which usually employ more doctors, do a fine job, abandoning the neighborhood-based centers is a mistake. "They use counselors that come from the streets. Doctors cost more, and they can't hang out at a meth clinic to ask after people."

Services at Community Preventative Health
photo: Willie Davis/Veras
Services at Community Preventative Health

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    Last year four Brooklyn-based legal teams received funds; this year only one will get a contract. (Groups like Legal Aid are expected to make up the deficit.)

    The reorganization is the result of a comprehensive review, says Dr. Scott Kellerman, assistant commissioner of HIV prevention and control, in a written statement. The decision is expected to "improve accountability through improved monitoring and evaluation." Denise Miles of the Department of Health and Mental Hygiene told the Voice that some of the service categories were found to be redundant, adding that the city objects to the word "defunded": "It's a competitive process. Some proposals were accepted, some were not."

    Meanwhile, cash is hardly flowing from D.C. This year New York City received about $118 million under the Ryan White CARE Act, of which about 10 percent goes to legal and counseling programs. It may seem like a lot, but funding has failed to keep up with the number of new cases.

    The city has a list of Manhattan- and Brooklyn-based organizations expected to pick up the slack, but when it comes to counseling, many administrators seem unaware that they are meant to serve the entire city and not just their borough. Agencies that attempt to do so may not be able to reach many people in the outer boroughs anyway. Program director Joann Buttaro of the Man hattan-based New York Council on Adoptable Children, having just signed a $400,000 three-year contract, says her counselors can travel to the South Bronx or Queens. The trouble is, there are only three counselors on the job.

    The optimal situation is for people to get help where they live, says Chris Norwood, executive director of an AIDS service provider in the Bronx. A trip to Manhattan from the Bronx—which has a disproportionate share of new AIDS cases every year—can be arduous for a person with AIDS.

    In any case, many people benefit from the sense of community they can find close to home. Marisol Arenas, 38, discovered she was HIV-positive when she gave birth to her child, now eight years old. Two years ago she developed AIDS, and she currently works as a peer counselor at a now defunded neighborhood-based group. She likes giving and receiving assistance 20 minutes from her South Bronx home, and she believes, other mothers with AIDS who rely on her like the fact that she's close by as well. "I've never heard anyone say they want to leave our neighborhood," she says.

     
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