Tarrant AIDS agencies take a hit

Posted on 01 Sep 2011 at 7:55pm

AOC faced with nearly $300,000 in funding cuts as client load increases; Planning Council trying to track funds from defunct ARRT

Allan Gould

Tammye Nash  |  Senior Editor
nash@dallasvoice.com

Tarrant County largest AIDS service organization has found itself facing nearly $300,000 in federal funding cuts as it prepares to start its 2011-2012 fiscal year. And the area as a whole, while not seeing cuts as deep as had been feared, will be seeing fewer federal dollars than before.

Cuts at AOC
Tarrant County AIDS Outreach Center Executive Director Allan Gould said this week that his agency had been told in March that even though AOC was at that time receiving only part of the Ryan White Part A funds for which it had been approved, “we were told to go ahead and spend based on last year’s budget, and that we would get level funding [equal to the previous year] through Ryan White.”

But last week, Gould said, “six months into it, we found out that there would be some substantial cuts. That’s when we realized there is about $290,000 that we were expecting that we won’t be getting.”

And that, Gould said, is in addition to some $300,000 the agency had already known was being cut.

“We are adapting the budget, and we will survive. But it’s tough,” Gould said. “We are looking at what we’re doing, looking at what we feel are the absolute necessities and what areas can take the financial hit.

“Our fiscal year [started Thursday, Sept. 1] and we had a solid budget. Now we are having to reconfigure our budget and start over. We already knew we had to cut $300,000, and we did that. We had a solid budget. Now we have to cut another nearly $300,000,” he said. “It’s really going to hurt. We have been able to go back and balance our budget. But I can’t remember any time when we have had to try and do so much with so little.”

Under the reconfigured budget, Gould said that the agency’s case management programs would be cut by 40 percent, going from seven case managers to four. The three positions being lost will be cut through attrition, he said.

Despite the fact that proper nutrition has been proven to be pivotal in maintaining optimum health for people with HIV/AIDS, AOC is being forced to cut its nutritional therapy program by 50 percent, Gould said.

“Despite how important it is to the clients’ good health, nutritional therapy is not considered medically necessary,” he said.

AOC’s other programs, Gould added, are taking a 12 percent cut across the board.

At the same time funding is being slashed, Gould said, AOC has been taking on more and more new clients as other AIDS service organizations in the area have been forced to close.
“Over the last two years, we have absorbed quite a few new clients from other agencies,” he said, pointing to the Tarrant County AIDS Interfaith Network, which closed in 2009, to the Catholic Charities’ decision to end its Lady Hogan Project and to the closure last month of AIDS Resources of Rural Texas, which had offices in Weatherford and Abilene.

Jamie Schield

AIDS Outreach folded the TCAIN clients into its programs in 2009, taking over the network’s primary program, the Geisel-Morris Dental Clinic for people with HIV/AIDS. AOC also absorbed some of the Lady Hogan Project clients, and Gould said at least some of the ARRT clients have turned to AIDS Outreach for help as well.

He explained that when AOC took over TCAIN in 2009, “at the same time we were approached by ARRT about taking over their services in Weatherford and Abilene, too. But we were not in a position to be able to do that at the time.”

Although talks between the two agencies continued, Gould said, AOC officials had recently told those at ARRT that AOC probably would not be able to assume the other agency’s programs any time soon.

But since ARRT closed its doors at the end of August, Gould acknowledged, AIDS Outreach has been left with no choice other than to try and find ways to help those ARRT clients now left without resources.

“We immediately absorbed about 150 clients from ARRT’s Weatherford office,” Gould said, “on top of the 85 or so from the Lady Hogan Project and the 300 or 400 from TCAIN. We had about 1,600 clients before. Now we have around 2,000.

“That was a huge jump for us to make [in client load], and we only got a little extra money from those other agencies. We were able to make it work, but just barely. But with these recent cuts in federal funding, it’s going to be much more difficult,” he said. “There will be instances, I am afraid, when someone comes to us for help, and we are just going to have to say no.”

Gould acknowledged that he wasn’t surprised to see federal funds cut again, but he was surprised by how deep the cuts were.

“I am still in shock that they expect the programs to continue operating at current levels. It’s an almost surreal atmosphere,” he said. “We are constantly being asked to do more for more people, but do it with less funding and less manpower. And we have to do it under continual threats of even more cuts.”

Although he is “dismayed and frustrated” by the cuts — and by the level of political infighting and negativity he sees coming from Congress today — Gould said AIDS Outreach will continue to provide services to the HIV/AIDS community.

“The bottom line is, this is reality, and we are going to have to work with what we have. We have to be diligent in our expectations of help from the federal government, and we have to be prepared about what our next steps are,” he said.

“But we will not go away. And we won’t change our mission just to chase the dollars. We are prepared to make the adjustments we have to make to remain viable for the long run.”

N. Central TX HIV Planning Council

The closing of ARRT is also causing some headaches over at the North Central Texas HIV Planning Council, which allocates federal and state funding in Tarrant, Parker, Hood and Johnson counties.

Although the cuts there were not as drastic as had been expected, “it’s still a decrease in funds for the area,” Planning Council Coordinator Jamie Schield said.

“It’s not as bad as we thought. Originally, we thought we were looking at about $520,000 in cuts. But it turned out to be just $185,000” in Ryan White Part A funds, Schield said.

“And this is the first year that the federal government has given us the money in five different parts. It makes it hard for planning, hard for the agencies to work and to get the contracts out,” Schield added. “I guess they had some problems in Washington. The money is just not out yet.”

Schield and Planning Council HIV Grants Manager Margie Drake this week explained federal funding dispersed through the Ryan White HIV Treatment Modernization ACT — previously the Ryan White CARE Act — is divided into Part A, Part B, Part C and Part D funds.

Part A funds come directly from the federal government to the Planning Council to be dispersed among local AIDS service agencies. Part B funds go from the federal government to the state government and then to the Planning Council.

Part C funds are focused on medical treatment, and Part D funds are focused on women, children and youth with HIV/AIDS.

HOPWA funds are focused on housing people with HIV/AIDS.

The council also disperses money from the state to HIV/AIDS services, Drake said.

“All these categories have lots of overlap, but there are different amounts, different reporting requirements and different disbursement rules,” Drake said. “Tarrant County is one of the few places in the nation that actually has a planning council, and that gives us more knowledge, more control to make sure we are not duplicating services. It lets us focus the money where it’s needed most.”

However, the $395,000 in Part C funds that went to ARRT’s Weatherford and Abilene offices were not under the council’s control, and Schield said his agency is now left wondering what will happen to those funds.

“They got $395,000 total for the two service areas, and they got about half of that up front,” Schield said. “Now that ARRT has closed its doors, we don’t know what the feds are doing with the remainder of those funds that had been allocated for the current year. We want to apply for those Part C funds in the future, and the Tarrant County Commissioners [on Wednesday] gave us permission to do that.”

The problem is, Tarrant County is likely to be faced now with former ARRT clients seeking the services they lost, and money to provide those services is in short supply.

“We definitely think that there will be clients coming here [to Tarrant County] looking for help, especially those clients that went to ARRT’s Weatherford office,” Drake said.

“We can only serve maybe a third of those clients with the money we have. We don’t know what the federal government is going to do with [ARRT’s remaining Part C funds], and we’ve got clients right now that need care. We are doing the best we can to put a bandage on the situation and make sure no client goes without the services they have to have.”

Schield added, “Coordination of services and funding is really pretty good out here. We do that well. But the problem now is that we need to keep the money here where it’s needed.

“Our biggest thing now is to keep that [ARRT Part C] money here in the community. It’s a very urgent issue on our end to get some answers from the federal government about where that money is going, so we can plan on our end to make sure our clients here get what they need,” he said.

This article appeared in the Dallas Voice print edition September 2, 2011.

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