The disparity of directly provided HIV/AIDS services looms larger than ever before in southern Wisconsin. AIDS Network has made minimal efforts to address the issues we have raised through the opening of a one day a week food pantry, hiring Brett Brasher for 3.25 hours a week to provide mental health services and addressing the laundry list of internal agency failures uncovered during the DHS site visits. We are now getting a clearer picture of the agency’s inability to provide a level of service comparable to those provided in other areas of the state. It’s not a matter of whether or not they want to provide expanded services; it’s a simple fact that they can’t. Their hands are tied.
AIDS Network is functioning at full throttle and the engine is about to blow. Their inability to address the disparities we have uncovered are a result of a failed development department, failure to capture direct federal grants and inability to generate broad spectrum public goodwill at anytime other than the week of the annual ACT Ride.
A fundamental change in direction is called for.
Let’s look at the comparison in service levels of Wisconsin’s two state designated AIDS Service Organizations:
Medical Clinic
AIDS Resource Center of Wisconsin:
- The ARCW Medical Center is Wisconsin’s largest provider of HIV medical, dental and mental health care serving more than 1,500 patients in Green Bay, Kenosha and Milwaukee
- ARCW medical patient census increased 20% in the past year reaching a record high 1,003 medical patients
- 33% of ARCW medical patients are indigent with no health care coverage
- 97% of ARCW Medical Center patients rate their care as excellent or very good
- ARCW has embedded medical case managers into the clinic so that case management needs (from a medical context) can be addressed as a part of the patient visit
- ARCW will be opening a fully staffed medical clinic at their Green Bay office in early 2010.
AIDS Network:
- AIDS Network does not have a formalized relationship with the UW HIV Clinic. AIDS Network provides no financial support to the clinic through the use of subcontracts. UW’s HIV clinic has a shortage of HIV clinic nursing staff and one social worker provides social work services for over 800 patients. No case managers are embedded in the clinic
- AIDS Network anticipates 30 clients accessing their treatment adherence program during the twelve month period ending 3/31/2010
Dental Clinic
AIDS Resource Center of Wisconsin
- The ARCW Dental Clinic in Green Bay and Milwaukee is Wisconsin’s only HIV- dedicated dental clinic
- 1,110 dental patients made 3,557 visits for preventive and restorative dental care in 2008
- 42% of ARCW dental patients are indigent with no dental coverage
- Dental patients from as far away as Superior, Eau Claire and La Crosse travel to the ARCW Dental Clinic in Milwaukee and Green Bay to receive expert care
AIDS Network:
- AIDS Network has not announced any details of their plan to open a dental clinic. There has been no information forthcoming regarding the provisions for funding the ongoing operations.
- AIDS Network anticipates providing oral health services (or referrals) to 60 clients for the year 4/1/2009 through March 31, 2010.
Mental Health Clinic & AODA services
AIDS Resource Center of Wisconsin
- Operating in Green Bay, Kenosha and Milwaukee, the ARCW Behavioral Health and Wellness Clinic is Wisconsin’s largest provider of HIV behavioral health service
- The ARCW Behavioral Health and Wellness Clinic addresses issues such as anxiety, depression and post-traumatic stress and integrates health promotion practices with evidence-based mental health treatments. Additionally, AODA outpatient treatment services are provided.
- 280 patients made 2,726 visits to the ARCW Behavioral Health and Wellness Clinic in 2008
- 49% of ARCW behavioral health patients are indigent with no health care coverage
AIDS Network
- AIDS Network has hired a 3.25 hour per week mental health professional at a cost of $90.00 per hour plus payroll taxes. Additionally, AIDS Network refers clients to Lisa Baker, UW’s part time clinical psychologist. Brett Brasher has also been hired to facilitate a short term Substance Abuse relapse prevention group.
AIDS Hotline/Referral source
AIDS Resource Center of Wisconsin
- This resource is accessed thousands of times per year and provides information on testing sites, HIV related events, and referrals to various organizations throughout the state of Wisconsin. ARCW operates a toll free AIDS Information hotline.
AIDS Network
- Copies of POZ magazine and other HIV/AIDS publications are available in the lobby of AIDS Network
Food Pantry
AIDS Resource Center of Wisconsin
- The ARCW Food Pantry is Wisconsin’s only full time HIV-dedicated food pantry and operates in Eau Claire, Green Bay, Kenosha, La Crosse, Milwaukee and Wausau
- In 2008 the ARCW Food Pantry distributed 668,000 pounds of food to 1,303 ARCW patients and clients
- During the holiday season 1,591 holiday food baskets filled with Turkey or ham, dressing, potatoes, vegetables and pie were delivered to people with HIV throughout Wisconsin, including to the residents of Madison’s Rodney Scheel House.
AIDS Network:
- AIDS Network operates a food pantry three Wednesday afternoons per month (from noon until 6pm)
- Food bags were provided to eligible clients for Thanksgiving. (Rodney Scheel House residents that received food baskets from ARCW were not eligible
- AIDS Network provided nutritional supplements to 20 clients in the sixth month period ending 9/30/2009
Legal Services
AIDS Resource Center of Wisconsin:
- The ARCW legal services program provided representation and counsel to 817 clients in 2008 on issues of discrimination, health care directives, estate planning and entitlements
- In 2008 ARCW attorneys won 100% of social security disability status appeals for ARCW clients
- The ARCW legal services program is a national leader in protecting HIV patients from discrimination by health care providers who refuse to provide treatment based on HIV status
AIDS Network:
- The current workplan for the AIDS Network’s legal services department anticipates 100 clients accessing this service during the year ending March 31, 2010. Per AIDS Network “Legal services will cover the broadest range of legal issues as resources allow, including related to poverty and illness, as well as individual rights”
Housing facility and Rent/Utility assistance
AIDS Resource Center of Wisconsin:
- $739,385 in rent assistance was provided by the ARCW housing program in 2008; Approximately $120,000.00 funded housing and utility assistance in the southern region of Wisconsin
- 11,680 overnight stays were provided in 2008 at the two ARCW residential facilities in Milwaukee
- ARCW housing case managers provided housing counseling to 856 clients in 2008
- The U.S. Housing and Urban Development Department has twice designated ARCW housing programs as Special Projects of National Significance for innovative housing strategies
- ARCW also maintains a full-time housing office in Madison.
- In conjunction with Project Home, ARCW funds the operations of Madison’s Rodney Scheel House.
AIDS Network
- AIDS Network has funded the Community Action Coalition to provide housing counseling services for 15 clients
- AIDS Network has budgeted limited emergency housing assistance for 16 clients in 2009-2010
Social Work Case Management and Medical Case Management
AIDS Resource Center of Wisconsin:
- 1,586 people with HIV are enrolled in the ARCW case management program
- In 2008 ARCW case managers completed needs assessments and HIV service plans for 1,523 clients
- 42% of ARCW case management clients are African American, 41% are Caucasian, 13% are Hispanic, 1% are Native American, 1% are Asian and 2% are multiple races
- 365 case management clients received intensive medication adherence counseling in 2008
- 2,308 people with HIV disease received social services from ARCW in 2008
- 28% of ARCW social service clients are female, 71% are male and 1% are transgender
- Medical Case Managers are embedded in the ARCW medical Clinic and provide onsite medical case management services to medical clients
AIDS Network
- 267 southern Wisconsin residents were enrolled in AIDS Network’s case management program on 9/30/2009
- Per AIDS Network the agency will “continue providing psycho-social case managements, with emphasis on core medical, to individuals living with HIV in the thirteen counties of southern Wisconsin”
Transportation assistance
AIDS Resource Center of Wisconsin:
- 1,077 ARCW social service clients received transportation and financial assistance for medical appointments in 2008
AIDS Network:
- AIDS Network anticipates providing medical transportation services for 46 clients from 4/1/2009 through 3/31/2010.
Needle Exchange
AIDS Resource Center of Wisconsin:
- The ARCW Lifepoint program exchanged 713,849 needles in 2008 and reached more than 8,000 drug users in Wisconsin (Lifepoint Needle exchange in southern Wisconsin). ARCW’s needle exchange program in the southern region exchanged 123,017 needles. In addition, ARCW’s naloxone overdose reversal protocol was administered 96 times in 2008
AIDS Network:
- AIDS Network exchanged 86,540 needles in 2008 in the southern region of Wisconsin
It has become increasingly clear that AIDS Network is NOT cut out to be an AIDS service organization. They have failed to address the profound disparity in services. Through the opening of a food pantry, hiring Brett Brasher and seeking funding for a dental clinic they have acknowledged that ASO’s must provide direct client services if they are to retain (or regain) relevance.
The confluence of factors at play clearly leads to one conclusion. AIDS Network is not capable of rising to the level of service provision comparable to what is provided by ARCW in other areas of the state. Their refusal to avail themselves of technical assistance from the country’s best ASO (ARCW) is indicative of the state of chaos that has descended upon the agency. Their refusal to even consider the possibility of co-locating with ARCW in Madison is also indicative of the bleak future for AIDS Network.
If AIDS Network is to have any future it will be as a Community Based Organization (CBO) and not as an AIDS Service organization. Karen Dotson can call us every name in the book, but the facts speak clearly to the need for a fundamental change in the mission of AIDS Network.
Secretary Timberlake, Dr. Seth Foldy, Sandra Breitborde and Dr. Jim Vergeront have all stuck by AIDS Network as they have muddled through the past couple of years as they desperately attempted to find relevance. They have failed. AIDS Network has demonstrated that they are resolute in their desire to be a “homegrown” community based organization and are not ready, willing or able to rise to a level of service provision that comes close to the services provided by ARCW.
It is time for Secretary Timberlake, Dr. Foldy, Sandra Breitborde and Dr. Vergeront to put the politics of AIDS services on the back burner and cast aside the demands to preserve the status quo that Representative Mark Pocan and a few other “friends” of AIDS Network have imposed on the DHS.
It’s time for Secretary Timberlake to be the leader and not the one being lead. Anything short of this and she will surely go down in Wisconsin history as one of the worst Secretary’s of the Department of Health Services. Her legacy will be marked by her failure to lead.
Secretary Timberlake: Look at the facts presented above and compare the services provided by ARCW to those provided by AIDS Network and then tell us why it is a reasonable decision to keep funding AIDS Network as an AIDS service organization?
Short of defunding AIDS Network, the Department of Health Services must fund AIDS Network as a Community Based Organization (CBO). As a CBO AIDS Network could be funded to provide prevention and case management services. The funding of care and treatment services, those that are vital to the health and welfare of the HIV/AIDS community, should be shifted to ARCW. It’s time for Madison and the surrounding area to be provided services by the best ASO in the country.
AIDS Network and ARCW can co-exist in the southern region; just not as two AIDS service organizations.
It is time for the charade to end and for AIDS Network to take their rightful place as a Community Based Organization. To do anything else is jeopardizing the health and welfare of 1280 Wisconsin residents living with HIV/AIDS in southern Wisconsin.
The question is whether Secretary Timberlake will make the right decision or leave this mess for her successor to clean up.
