San Francisco HIV/AIDS Providers Network To Undergo Reorganization Because of Funding Shortages
San Francisco's "acclaimed" HIV/AIDS Providers Network soon will undergo "its biggest overhaul since it was assembled" more than 20 years ago because of funding shortfalls resulting from federal budget cuts and decreases in private donations, the San Francisco Chronicle reports. The city in fiscal year 2004-2005 received $29 million in annual Ryan White CARE Act funding, a decrease of $4 million over the previous year that leaves the network "fac[ing] a year of reorganization, consolidation and learning to make do," according to the Chronicle. Private donations also have "falter[ed]" recently because of a "sputtering" economy and "compassion fatigue," in which private donors "grow weary of the relentless requests for cash," the Chronicle reports. San Francisco voters also rejected two propositions on the Nov. 2 ballot that would have resulted in tax increases "necessary to keep" HIV/AIDS services "afloat," according to the Chronicle.
In an attempt to "streamline" the network, San Francisco will begin directing federal funds into programs that provide "one-stop shopping" for HIV/AIDS patients -- a concept city health officials are calling "Centers of Excellence," the Chronicle reports. Although this model might "emerge stronger and more efficient," many service providers "fear they are witnessing the unraveling of a safety net that once set the standard for community response" to the HIV/AIDS epidemic, according to the Chronicle. "It feels very much like a slow death," Mike Smith, executive director of the AIDS Emergency Fund and president of the network, said, adding, "The system is withering." The current system uses both private and public funds to provide a wide range of HIV/AIDS services -- including prevention, treatment, nutrition, legal advice, housing and hospice care. Several programs already have been affected by the restructuring, including Shanti, the AIDS Legal Referral Panel, Project Open Hand and the University of California-San Francisco AIDS Health Project. However, the restructuring also might be an "opportunity to rethink what we are doing, across the spectrum," according to James Loyce, director of AIDS programs for the San Francisco Department of Public Health. He added that while the HIV/AIDS epidemic in the United States has "changed dramatically" since the early 1990s, the "system for dealing with it has not," according to the Chronicle (Russell, San Francisco Chronicle, 1/10).