In Denial

As HIV spreads among blacks and Hispanics, agencies that serve those communities say they're being shortchanged

As for the central issue -- the perceived undermining of care and services in places where AIDS is on the rise -- Cooper says her hands are tied.

"I can't get into that argument. That's not my job."
Apparently not. Cooper was conspicuously absent from the recent "State of HIV in Houston" forum at City Hall. While the name implies universal participation, the event -- arranged by City Councilmembers Judson Robinson III and Gracie Saenz -- was clearly an opportunity for the Minority Caucus to air the plight of its community-based agencies. Cooper says she wasn't invited to sit on the panel, but planned to attend until "something came up at home."

In fact, the forum has sparked a backlash of sorts among the better-funded care providers, whose presence in the discussion was reduced to a few seats in the audience. Toward evening's end, however, their collective gripe was delivered by Sara Selber, executive director of the AIDS Foundation Houston.

Listening to Selber is itself like a trip in time, back to when early warnings about the HIV virus were widely ignored. The AIDS Foundation is one of the biggest and best at handling the consequences of that ignorance, offering case management services, emergency assistance, scores of volunteers and probably the best food pantry in the city to about 1,500 people a year.

"For the record," Selber says, the foundation will "fight" for the small minority agencies, despite being what she terms "grossly underfunded" itself. But that didn't appear to be her purpose during the City Hall symposium, when, clearly agitated, she wondered aloud how the Minority Caucus rated its own forum. And in a recent interview, Selber showed a less-than-empathetic side that would probably resonate with any gay man who has survived the denial of HIV that existed a decade ago.

"When I didn't get funding for something or another, I looked at my grant to see what I'd done wrong," Selber says. "Sure enough, it wasn't a good grant.

"I lost $75,000 from our food pantry, and no one's screaming about that. We took a $75,000 cut, and we never opened our mouth. I just looked elsewhere for it."

That's easy for her to say, counter Minority Caucus members. Despite the food pantry cuts, the AIDS Foundation's share of the 1996 Ryan White funds will be more than $500,000, 20 percent more than in 1995.

"If the process is flawed, and it's flawed to your benefit," says caucus chair Audrey Gassama, "then naturally you're going to be happy."

Less pleased are people like Lucy Reyna, vice chair of the Minority Caucus, who runs the HIV program at the Association for the Advancement of Mexican-Americans. Before the county attorney's ruling, AAMA had provided case management, outreach and transportation services to more than 500 people a year, 70 percent of whom were Hispanic. But in 1995, the agency's Ryan White funding was slashed by $425,000. This year, AAMA's in deeper straits: including supplemental funds, it will probably receive no more than $110,000.

As a result, Reyna has had to turn most of her HIV case load over to other agencies. Some of her clients were fortunate enough to land at AVES -- the Amigos Volunteers in Education and Services. Reyna can only hope the others will go to the referral agency, never mind being happy about it.

"It's money," Reyna says. "The minority and mainstream agencies are being pitted against each other because the mainstream saw that the minorities were gaining strength and getting more money."

The din has prompted Harris County Judge Robert Eckels to order an examination of how Harris County doles out Ryan White grants. The funding cycle begins each November, when care providers submit proposals outlining their services, projected clientele, experience and costs. An anonymous panel scores the proposals and sends them along to the county purchasing department, where everything that's transpired is inexplicably tossed out the window.

The purchasing department takes the scored proposals and weighs them against the ethnic breakdown of AIDS cases within the entire Ryan White funding area. Those demographics are roughly 40 percent white, 40 percent black and 20 percent Hispanic. No matter how an agency scores, the extent to which it proposes to serve a clientele that meets those exact demographics determines how much Title I funding it receives.

For example, AAMA predicted a clientele that is 69 percent Hispanic, and indeed scored highest in several funding areas. But because the county estimates that only 20 percent of HIV cases are Hispanic, AAMA received only 20 percent of the funds it requested for its Latino clients. Case management and volunteer funding was completely cut, and though its food pantry scored highest of all, AAMA received little more than half the $71,000 it requested to feed its clients.

According to an analysis by AAMA's executive director, Gilbert Moreno, all community-based groups have suffered similarly. On average, minority agencies that scored highest in various funding categories ultimately received just 50 to 75 cents of each dollar they requested. On the other hand, the so-called "mainstream" agencies -- such as the AIDS Foundation and the Family Service Center -- received an average of about 90 percent of what they asked for.

"To score highest and be told that you're serving too many of your population is a slap in the face," Reyna says.

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