HIV/AIDS service organizations in the area have been reassessing their options following last week’s announcement that a number of agencies would not receive funding from a federal prevention program.
The High Impact HIV-Prevention Services awards list was unveiled Dec. 19, with Action AIDS and The Colours Organization Inc. being zero-funded.
However, PGN learned this week that Colours will receive $135,000 from the program, funding that was put on hold in light of the death of the organization’s executive director.
The money for the program comes from the Centers for Disease Control and is distributed by the AIDS Activities Coordinating Office.
CDC revised its prevention funding for health departments this past summer, funneling dollars to cities and states most affected by the disease, with a focus on “high-impact” services that present the greatest opportunity to “significantly reduce new infection.”
CDC spokesperson Scott Bryan said the agency is “maximizing the impact of HIV-prevention funding and HIV-prevention efforts by increasing funding in areas with the greatest need. This new funding approach will help maximize the collective impact by directing resources to jurisdictions with the greatest needs and supporting interventions with the greatest, most lasting impact.”
The program allocated about 75 percent of the funds toward testing efforts, with the rest going to support risk reduction, education and other programs.
The funding program was last open in a competitive process in 2008, with grantees able to apply for continuation of funds on a yearly basis.
In this latest competitive process, Philadelphia received $570,000 less from the CDC, according to AACO, and the funding was distributed to 22 agencies, compared with 15 organizations in the last cycle.
AACO’s revised Request for Proposals took into account the new CDC guidelines and the National HIV/AIDS Strategy and was informed by the Philadelphia Community Planning Group, an independent panel that sets priorities for addressing the HIV/AIDS epidemic locally.
“It’s a fairly significant shift that starts with and emanates from the president’s strategy to address HIV/AIDS, which puts more of a focus on identifying and getting into care those who are already HIV-positive,” said Nan Feyler, chief of staff of the city’s Health Department. “For many years, there was a focus on testing negatives but there’s a lot of epidemiological evidence to show that many folks, in particular those in the African-American [men who have sex with men] community, are positive but have not been tested.”
For that reason, Feyler said the past success of a program in generating HIV-positive tests was integral when it came to where the funding was directed.
“Because of the shift toward focusing on positives, we had to look carefully at how effective the agency’s strategy was in identifying, locating and getting tested those who are positive,” she said. “It wasn’t just about the number of people who were tested but, to be consistent with the president’s priorities, the number of people who tested positive.”
The RFP was issued in mid-October with a bidders’ conference held at the end of the month, where interested organizations could garner more information, although individual conversations between service providers and city officials were prohibited.
The applications were due in mid-November and came before the Resource Allocation Advisory Committee, a group of 12 individuals appointed by the health commissioner — none of whom are allowed any conflict of interest, such as an affiliation with a service provider. The RAAC then made its recommendations for awards to the health commissioner, who gave final approval.
While there were six categories funded through the High Impact program, a seventh, Social Media Technology focused on the MSM population, was included in the RFP but no funding allocated.
“There was a very small amount of money earmarked in that category and, in light of the shift in the priorities and the $570,000 funding cut, it wasn’t cost-effective to use money for that category,” Feyler said.
While Colours, which had received $190,000 in the last cycle, was initially not included on the awards list, money had been allocated for the organization.
Feyler said executive director Robert Burns passed away the same time as the decisions were being made, and city officials wanted to meet with the agency’s board before finalizing the funding decision.
“They weren’t on the list that was sent out because we were waiting to talk to the board,” she said. “It would have been listed with every other agency but because this happened at the same time, we didn’t have information about what was going to happen to Colours so we wanted to meet with them first.”
Colours’ funding will be directed toward targeted testing for African-American MSM.
Action AIDS previously received $233,000 but did not receive any funding through the High Impact program this cycle.
Because of the cuts, Action AIDS last week laid off three staff members in its prevention department — one tester, one outreach worker and one comprehensive risk counseling and services staffer.
Action AIDS executive director Kevin Burns said one of the released employees had been with the agency for more than a decade.
After the layoff, the agency now has 84 full-time employees, with three staffers working in the prevention unit.
Burns said Action AIDS now has about $170,000 left for its prevention efforts, with a total agency budget of about $6 million.
Burns contended that, considering the funding shifts, there wasn’t enough time between the release of the RFP and the due date.
“When the new direction came out, AACO gave us little time to adjust what we were doing,” Burns said. “We were already in the cycle and weren’t able to shift things quickly enough to meet the goals. It’s hard for the priorities to be changed midstream and then have them expect people to meet those goals. I think this is a systems issue, not any issue with the AIDS services organizations.”
Feyler said the timeline was standard and that she believes the department “created a process that gave folks adequate information.”
Elsewhere in Philadelphia, Mazzoni Center was awarded $665,480, a jump from its previous $610,000. Mazzoni has a total budget of about $9.5 million.
Prevention Point Philadelphia received a total of $397,500, of which $150,000 will benefit its Trans-Health Information Project, in particular for comprehensive prevention with positives and health education/risk reduction.
Other awardees include The Attic, which received $50,000, and SafeGuards, which received $61,428 in the social-network category, an increase from the $50,000 it received in the last cycle. SafeGuards had applied for funding in five categories, which would have totaled $270,000.
“Considering that some agencies got nothing, I should feel happy we got funded at all,” said SafeGuards executive director Brian Green. “But overall, I wasn’t very pleased because I thought we presented a very good proposal that would have targeted MSM, specifically African-American MSM.”
Mazzoni executive director Nurit Shein noted that, while her agency saw an overall increase, it did lose funding.
In the category supporting its CRCS, its funding was cut, as Shein said the agency had been at about 65-70 percent of its goal for that category.
The loss resulted in the layoff of one CRCS staff member, Shein said, although other staffers will be cross-trained to alleviate any impact on consumers.
Mazzoni received increased funding in the testing category, and Shein noted the agency was about 130 percent over its goal for that contract, having tested 5,439 people with a projected goal of 4,288.
The added money will enable the agency to hire an additional HIV counselor.
The agency received level funding for its education and social-network contracts.
The first contract supports its Many Men, Many Voices program, an education workshop series for young, black MSM. The previous contract had a goal of 60 MMMV participants, and Shein said the agency surpassed that, with 81 participants and a combined 255 participant sessions.
Its social-network aims were also exceeded, she said, with the program operating at 178 percent over goal.
Shein said the agency has been generating a positivity rate on HIV tests of about 5-7 percent for young black MSM, and 3-4 percent among all MSM, rates that Shein said are higher than city averages.
The agency also generates a 2-4-percent positivity rate in its medical practice, which is not funded through this program. However, those numbers are used by the city, Shein said, when pursuing federal HIV funding.
While some in the community have criticized the amount of funding that Mazzoni received, Shein asserted it is important that funding be allocated to agencies that are meeting their goals.
“Funding for testing is based on the number of positives that are found. So given that, I think the 30-percent past performance [rating] in the RFP was a very important 30 percent,” she said. “What that means is that if the city does not adhere to its goals, in the next go-around if we weren’t able to show results, the city of Philadelphia could lose more money overall. Can we afford to lose more?”
Feyler cautioned that noninclusion in the awards list doesn’t signify an overall failing performance.
“Even though it’s difficult to get that news, agencies that were level funded or didn’t get funded aren’t necessarily poor performers,” she said. “It came down to whether their strategy for reaching HIV-positive individuals, in particular African-American MSM, was working. There is a strong commitment from the health commissioner, this administration and AACO to work in line with the president’s strategy. The prevalence of HIV in African-American MSM is really staggering and we need to be in line with the national strategy to get those who are positive tested, into care and receiving counseling around prevention.”
Among the agencies that had not received the dollars in the past and whose applications were not accepted were the Gay and Lesbian Latino AIDS Education Initiative, Philadelphia FIGHT and BEBASHI.
ASIAC did not submit an application, said executive director Kevin Huang, but he said he was disappointed that a number of organizations that serve communities of color have continued to be underfunded.
“The federal standards for a long time have been moving toward addressing populations at highest risk, which for some time has been MSM and, in particular, African-American and Latino men. And it appears that Asians are at a low risk for HIV but right now, we’re really at the early part of the curve in terms of the epidemic and, if we don’t get the resources we need, we will have the same emergency every other group has had,” Huang said.
Green contended that there was a disparity between the RFP and the programs that were eventually selected for the awards.
“I was glad to see that the city was focusing the RFP on MSM communities, but I don’t see that happening in the way this was funded,” he said. “I really question whether or not there’s going to be enough of a focus on MSM communities most at risk, and that’s African Americans and Latinos.”
Huang asserted that community collaborations could be helpful in dealing with the fallout from the funding.
“The only way we can end the spread of HIV is to be working together. We live together, we love one another and we should all be doing this together.”
Mazzoni is open to examining opportunities for collaboration, Shein said.
“We already subcontract with one organization that did not get funded and we will continue that,” she said. “No other organization that got defunded has come to us yet but I am most definitely open to that. We want to provide services to the whole community and, while we do provide services to the targeted population of MSM and MSM of color, we are definitely open to working with other organizations.”
Service providers are invited to meet with AACO officials to discuss this funding stream and other opportunities, Feyler said.
Meetings must be requested in writing.
“There’s a lot of vulnerability in federal and state funding these days but we’ve worked hard to have an objective process, and we’re going to work very hard with the providers to try to reach those who are HIV-positive.”
Jen Colletta can be reached at [email protected].