Unembraceable You

When it comes to AIDS funding, process takes precedence over children in Harris County

The news that there would be no money came early last week, a few hours after Audrey Gassama arrived in New York City to observe how the AIDS community up there takes care of its own.

She had barely unpacked her bag when a phone call from Houston reminded her just how dismal things had become back home. She was told that the Harris County Health Department had made its Ryan White CARE Act allocations for 1997, and the Loving Arms Foundation, of which Gassama is executive director, had been stiffed. Not one dollar of the $8.1 million in federal grants distributed to local AIDS care providers was directed to the only daycare center in the city dedicated to families affected by the HIV virus.

No doubt Gassama had hoped for better, but she probably wasn't too surprised that Loving Arms was passed over entirely by its most critical source of funding. On August 1, citing a single act of contract noncompliance, Harris County had canceled Gassama's 1996 Ryan White grant, wiping out roughly $115,000 from the foundation's budget. Other grants and donations have kept the facility open, and Gassama and her staff are still able to provide medically managed care to 34 children a day, five days a week, in a cheerful two-story red-brick house in the Third Ward.

For how much longer, though, is anyone's guess. Gassama was counting on the '97 Ryan White grants -- the county has awarded more than $400,000 to the foundation over the last two years -- to carry Loving Arms through to spring. At that point, a smaller award from the state is expected, as well as a $1.5 million grant from the city of Houston for an expansion that will include 50 apartments for low-income families with HIV-positive children.

But now that Harris County has shut her out, Gassama fears Loving Arms will have to close.

"It's not looking too good," she says.
Loving Arms's situation may be the most dire, but the foundation is certainly not alone in its struggle to provide services to people with AIDS. The 1997 Ryan White allocations mark the third consecutive year that small, community-based agencies with a mostly black and Hispanic clientele have had their funding cut. As chair of the AIDS Minority Caucus, a group of about 15 organizations that coordinates services in minority communities, Gassama has been the most vociferous critic of that trend, which began in August 1994, when the County Attorney's Office ruled that targeting minority groups through the Caucus constituted an illegal setaside.

Just last spring, Gassama told the Press that Sue Cooper, director of the county's HIV-services division, had "sabotaged" the efforts of the Minority Caucus at a time when the rate of HIV had fairly exploded among people of color, especially women ["In Denial," by Brian Wallstin, April 25].

That may seem harsh, but the fact is, before the elimination of the so-called setaside, the Caucus got results: By 1995, the number of blacks and Hispanics partaking of AIDS-related services increased from about 45 percent of the reported HIV cases among those groups in 1992, when the Caucus was formed, to nearly 67 percent.

This was no anomaly. For years now, the U.S Department of Health and Human Services, which bestows the Ryan White grants, has urged local governments to support the community-based agencies, which are more easily and readily available to minorities. The feds even made a point of reminding Cooper of that following the county attorney's ruling.

According to an August 1994 letter from Eric Goosby, the director of the federal Division of HIV Services, Harris County was expected to "insure increased services to these communities through a variety of methods, including increased minority agencies' participation in service delivery."

In response, the county unveiled a new funding formula, the results of which have only exacerbated the conflict. Two years ago, Harris County awarded $5.1 million in Ryan White grants to about 50 agencies; in 1996, the county received $6.6 million, but funded only 40 care providers. In 1997, just 35 agencies will divvy up the $8.1 million allocation.

"Two years ago, the Minority Caucus had 11 members that received grants," Gassama says. "Last year, we had four."

This year, the county eliminated grants to two more Caucus members: Loving Arms and the Association for the Advancement of Mexican Americans, the city's largest community-based service agency for Hispanics. Despite the apparent trend toward a concentration of care, Cooper, the county's director of HIV services, says that there has never been evidence to prove that HIV-positive blacks and Latinos aren't being served.

"Our job is to make sure the clients are being taken care of," Cooper says, "not that individual agencies get funded. And the clients are being taken care of, there is no question about that."

That may be true -- for now. But minority care providers fear that many new HIV cases in their communities will go untreated because the county has made it harder for them to obtain everything from case management and medical services to transportation and counseling.

It is still hoped that the reduction in services in minority communities will be reversed, but no one's holding his breath. A year and a half ago, amid complaints that the funding process was unfair to minority care providers, County Judge Robert Eckels appointed a committee to study the issue. King Hillier, chair of the local Ryan White Planning Council, which sets the county's funding priorities, says progress has been made, but it's come slowly.

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