Clinic at Death's Door

Clinic chief Venator cleared out of his office last week.
Deron Neblett

Michael Venator slumped in a chair in his AVES clinic director's office in a medical high-rise just off the Southwest Freeway at Weslayan. Outside his door, staffers bustled about serving the mostly indigent Hispanic patients infected with HIV.

In March 1999 he helped launch the Amigos Volunteers in Education and Service clinic, the only center in Houston focusing on Hispanic and Latino AIDS patients -- particularly pregnant mothers.

"I've spent sometimes 16-hour days here, starting from patient one," Venator recalled. The 39-year-old clinic chief is proud of the center's accomplishments, including the delivery of 32 healthy, HIV-negative newborns, the children of clinic patients who are HIV-positive.

However, the strides made by his clinic only seemed to make Venator sadder on this day. The voice of the lanky, short-haired Venator was halting and softened by the knowledge that these were his final hours on the job. Weeks earlier, he had submitted his resignation.

"We put together one of the best medical teams I've ever worked with, and we're breaking up now. It's like the end of a relationship."

Patients remained unaware that they could be searching elsewhere for treatment in a matter of weeks. "They don't know yet," said Venator somberly. "This is happening pretty rapidly."

The 11-year veteran of work in AIDS treatment programs said he's getting out of that field and is headed to a secure post at Baylor. There, the checks don't bounce and top administrators don't lock themselves incommunicado in their offices.

"We've fought as much as we can," concluded Venator. He wasn't talking about the long, all-too-familiar struggle to defeat the ravages of the AIDS virus.

"We're essentially fighting him."

"Him" is 29-year-old Francisco Sanchez, the interim executive director of nonprofit AVES. Sanchez, a former aide to a state representative, has gone on to become secretary of the Harris County Democratic Party. Sanchez is touted in party circles as a rising political star, even as AVES plunges into chaos under his supervision.

Founded to fight AIDS in Houston's Hispanic community by local HIV service pioneer Angela Mora in 1988, AVES had steadily grown over the years. The nonprofit agency operates the two-year-old clinic along with several educational, counseling and treatment programs combating AIDS.

Nearly 500 patients monthly receive treatment at the clinic. Funded by federal, county and city grants, the overall program budget for this fiscal year is more than $2 million.

Last year Mora departed as executive director to become the HIV patient advocate for the state of California. She thought she had left her creation in good hands by asking Sanchez -- unpaid chairman of the AVES board -- to step in as interim director until board members had time to mount a search and hire an administrator.

"He was very supportive and he was very effective while I was the executive director," remembers Mora, who says Sanchez had been an AVES backer for years.

Since Sanchez took over, according to Venator, the AVES board has given him two pay raises, hiking his salary to $75,000 a year.

Staffers say Sanchez has been difficult to contact, often showing up for brief periods and secluding himself in his office. Both Mora and Venator blame him for allowing the organization to slide into a financial morass.

Repeated Insider calls to Sanchez's number elicited one return message. He explained he was traveling to Mexico for a funeral and would get in touch when he returned. As of press time, Sanchez had not called back.

"The agency is having management problems, and unless there is a change of executive director or a stronger board, the agency is most likely going to go under," says Mora by telephone from California. "It's a shame, because it's one of the most significant Latino agencies in the country and the largest in Texas."

Venator says Sanchez continues to pretend as if nothing's wrong.

"It's just his general lack of action," says Venator with a shake of his head. "For instance, I turned in my notice two and a half weeks ago. He hasn't even acknowledged it. He completely avoids phone calls from staff."

It is no exaggeration to describe AVES as in shambles. Venator says medical suppliers have cut off essential vaccines for AIDS-related illnesses like hepatitis and pneumonia, are demanding payments for back bills, and are threatening lawsuits. According to Venator, staff paychecks have bounced, employee insurance coverage has lapsed, and IRS withholding taxes have gone unpaid.

The clinic's doctor, Shannon Schrader, has given notice that he is resigning. Schrader had already resigned from the AVES board several months earlier, in part, says Venator, because he feared the disastrous state of the agency's finances could ensnare trustees in lawsuits. The head nurse clinician has also left.

A day after the Insider's clinic visit last week, Venator called to report that the building manager had delivered an eviction notice, and the clinic's lab contractor, Labcorp, had discontinued service because of unpaid bills.

Public Health and Environmental Services, the umbrella group that distributes and monitors AIDS funding routed through Harris County, sent Sanchez a notice on April 18 that AVES is "a high risk recipient."

"A high risk organization is one where management practices raise serious questions about its ability to assure proper programmatic use and financial stewardship of contract funds," wrote Patrick Richoux, project coordinator for AIDS services.

County officials cited AVES for failing to submit a required financial audit, filing contractor expense reports riddled with errors, and failing to implement programs for which the agency had been funded.

Richoux warns that if AVES is not in compliance by August 1, contracts totaling more than $1 million will be terminated and the funds redistributed to other AIDS providers. That would constitute a death certificate for AVES.

Asked whether he's been able to discuss the problems with Sanchez, Richoux replies, "It's very hard to track him down. He's always out of town."

Attendees at the annual Democratic Johnson-Rayburn dinner and party pep rally at the Westin Oaks Galleria last month had no trouble finding Francisco Sanchez. In front of a crowd of hundreds, there he was -- spotlighted at the podium introducing former Texas governor Mark White.

The thin, bespectacled South Houston resident is considered an up-and-comer in party circles, a future candidate deserving of greater responsibilities. He heads a consulting firm, the Sanchez Group, with an office in southwest Houston. People in his position generally court attention and publicity, rather than hide from it behind closed doors and phone-answering machines.

That was the same impression Angela Mora had as she prepared to leave AVES behind and head for California last August. Mora has since come to regard her decision as a major blunder.

"I think the mistake was that he has not had board support," Mora says, engaging in some Monday-morning quarterbacking. "The board should have been involved and micromanaged until they found a replacement, but I don't think the board was responsible enough to do that."

As a consequence, Mora says, the agency's daily billing requirements turned into a financial nightmare. AVES receives AIDS program funding allocations, but does not get the actual money. Instead, agencies for the county and city pay the AVES bills based on expense vouchers submitted by AVES. If the expenses are not filed in a timely and accurate manner, vendors go unpaid and programs quickly become paralyzed.

"I don't think there's any wrongdoing on [Sanchez's] part other than mismanagement," speculates Mora. "Being on top of billing is critical for the agency. But if you don't have a good manager, then he doesn't know what he's doing."

The seven-member AVES board has been anything but strong in recent months, says Venator. Meetings have been regularly attended by only two members other than Sanchez, lawyer and board secretary Michael Whitmire and treasurer John Gonzalez, a Wells Fargo Bank financial officer. Neither returned calls from The Insider. Schrader, who resigned from the board several months ago, could not be reached for comment.

Mary Champion Closner, a probation officer and the board's parliamentarian, says she has been inactive much of the last year with an injury. And after Mora left, she says, she gave notice she didn't want to be on the board.

"I got letters of concern from the employees, and I tried to get ahold of the chairman of the board," says Closner. She says she was told AVES did not have a contact number for Sanchez. Aside from one abortive attempt to set up a meeting with him, Closner says, she had no further contact with the agency.

When The Insider contacted county HIV project coordinator Richoux, he was unaware that the clinic director and doctor had resigned. Richoux is hopeful that if AVES contracts are withdrawn, replacement agencies can quickly be found to fill the void.

Angela Mora is not so sure. She says the agency she built is one of a kind and cannot be replaced so easily.

"The community is the one that's going to end up losing," laments Mora. "I don't think we'll see another AVES in the years to come."

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