Background
Incoming Mayor Gavin Newsom, who was sworn in as San Francisco’s mayor on January 8, 2004, is reported to be considering eliminating an HIV/AIDS policy advisor to the mayor, also known as San Francisco’s “AIDS Czar.”

Newsom’s decision may have been influenced by one Jim Illig, the president of the HIV/AIDS Provider Network (HAPN), who couldn’t bring himself as a member, and chairman, of one of Newsom’s transition teams into recommending retaining the AIDS Czar position in a 12-page report delivered to the mayor-elect on January 5th.  Illig is fully aware of the CARE Council’s concern last summer that the czar position was needed, and needed to be filled; but as president of HAPN, Illig appears more concerned about the needs of provider organizations than he is about keeping this advisory position. As chairman of Newsom’s transition team focusing on healthcare issues, it was well within Illig’s scope of influence to have included a recommendation to keep the czar position.

Newsom’s decision to get rid of, or retain, this position may also be tainted by Mike Shriver, the most recent incumbent advisor to San Francisco’s Mayor on HIV/AIDS policy issues, who has been nowhere to be found for over two years ... unless, that is, he wants to see his name in print as being the mayor’s so-called AIDS Czar, and then he’s all too willing to momentarily stick his head out from under his disability blanket just long enough to manage getting his name placed in print.

———

AIDS czar position needed  Letter to the Editor, Bay Area Reporter, January 8, 2004
by Patrick Monette-Shaw  Reprint permission courtesy of the B.A.R.           

Anyone who questions whether the City can afford a single $50,000 AIDS czar position, (“AIDS czar position up in air,” Bay Area Reporter, January 1) even if Mayor-elect Gavin Newsom is facing a $160 million budget deficit for the fiscal year set to begin next July, needs their head examined.

In the two-plus years that San Francisco’s AIDS czar position has been vacant, the City has paid bonuses approaching $4 million to approximately 700 City managers. During the same two years, the 2,900-plus City employees earning in excess of $90,000 annually have been paid salaries totaling in excess of $660 million (at about $330 million annually). The City has 102 information systems project directors, IS managers, and other IS directors (job classes 1070, 1071, and 1072), paid $12 million annually. Another example: we have 32 hospital administrators and 4 medical directors for just two hospitals (SFGH and Laguna Honda) who, combined, are paid $4.5 million annually. Between this $16.5 million, surely the new mayor could cut some of the patronage fat to keep an AIDS czar. As well, recently DPH’s AIDS Office was bloated with 170 employees. Newsom has the tool to fund this position: Last November’s Proposition F, Targeted Early Retirement, passed by the voters. All he needs to do is offer some of these bloated positions early retirement to get them off the payroll in order to fund the czar position.

And in the past two fiscal years, the San Francisco AIDS Foundation has paid out, at minimum, $22.4 million in grants and grants payable to its African affiliate, Pangaea, even as SFAF receives City General Fund contracts. Surely San Francisco can afford a $50,000 to $75,000 AIDS czar.

While DPH keeps claiming that the AIDS czar’s job duties have been absorbed within DPH, I have filed repeated public records requests attempting to obtain the follow-up reports Mike Shriver was to have authored following the Mayor’s 1998 AIDS summit; DPH keeps telling me they have “no documents responsive to your request,” indicating that both Shriver and DPH have failed to author several policy papers for the Office of the Mayor.

Jimmy Lloyce, director of the AIDS office, was quoted in the June 12 B.A.R. that “[The czar vacancy] Is a huge hole. I don’t know that we can fill it.” Angela Alioto was quoted in the same issue that “[Shriver] would be the first person to say the job needs to be getting done.” Clearly, notable people believe the position should be retained. Personally, despite being a vocal critic of the former incumbent, I believe the position should be paid $75,000 (but no higher), as are the Board of Supervisor’s legislative assistants, and it should be a permanent position independent of DPH, not a contract position through DPH-UCSF.

Your “anonymous” source in the January 1 article has it completely backwards: Shriver did not do a “decent” job in the position; he may have had activist credentials, but he failed to complete an unabridged HIV Consensus Meeting report, and failed to issue the follow-on reports to “Promises Kept,” the report from the Mayor’s 1998 AIDS Summit. And “anonymous” has it further backwards about Mitch Katz: When Katz talks about cutting DPH programs, it is not “based on science and need,” it’s based on playing brinkmanship, the game he learned from Willie Brown, pitting the City’s most vulnerable one against another. Katz threatens cuts in order to scare up more General Funds for DPH’s bloated budget. I wouldn’t be the least bit sorry to see Katz replaced, even if he is gay; I would be sorry to see the czar position eliminated, because that position should, in part, be providing checks and balances to propaganda emanating from Katz’s bloated AIDS Office.

The controversy with the AIDS czar position rests largely with its last inept incumbent, not with the position itself. As reporter Matthew Bajko accurately noted in the June 12 B.A.R., the position is responsible for identifying budgetary requirements, sources of funding for the mayor’s AIDS initiatives, and monitoring of work of DPH and city-funded AIDS service providers, among other tasks. As well, the czar is the mayor’s liaison to the HIV Health Services Planning Council and the HIV Prevention Planning Council.

Newsom needs an independent-from-DPH AIDS czar to provide legislative and executive oversight of both the City’s AIDS non-profit and DPH bureaucracies. The White House has an AIDS czar, as do other major metropolitan districts. Eliminating the position would send the message that a czar-less “model of care” in San Francisco should be emulated elsewhere, and might lead to the White House dumping its czar.

If Newsom eliminates the AIDS czar position but keeps all of the bloated hospital administrators and information systems managers – and all 2,900 City employees earning in excess of $90K — people with HIV/AIDS in the City should take to the streets.
Top

It's time to clean up the San Francisco AIDS Foundation  Guest-Opinion, Bay Area Reporter,
4/22/99   by Criss Romero     Reprint permission courtesy of the B.A.R.

In July 1998, the Harvey Milk Lesbian, Gay, Bisexual, Transgender (LGBT) Democratic Club passed a resolution asking for the resignation of San Francisco AIDS Foundation (SFAF) Executive Director Pat Christen [emphasis added].  Last week’s Bay Area Reporter article, regarding numerous new work bias allegations, reinforces our lack of faith in the SFAF leadership.

Over the past five years, SFAF workers have come to our organization asking for help.

In 1994, workers came to the Milk Club to ask for support and to debate the issue of unionization with management.   At that meeting, the Milk Club discovered [SFAF’s] management was manipulating figures to hide that certain communities had little representation, including HIV-positive members on their own board of directors.

In 1998 workers came because the Vida y Movimiento program was cut without any input from the affected community. Latino clients were outraged and did not believe management’s rationale that it wanted to avoid the duplication of services.  Clients signed a petition demonstrating their dissatisfaction with the foundation.  A worker was actually fired for making the issue public at the California AIDS Ride [emphasis added].

The foundation has been duplicitous in their dealings with the LGBT community.  They hide client surveys from the public.  They place former managers on the board of directors that should include members of the community.  They’ve been oppressive in their labor management relations; new policies prevent employees from working with their communities for fear of retaliation.  It was only a matter of time before one of their own managers came forward with secrets regarding their management process, as was reported in last week’s story.

Of primary concern is that most of the management team at SFAF is not LGBT, nor do they live in San Francisco.  Yet they facilitate most of our AIDS policy on a local and nationwide level.  As president of the Milk Club, I spoke with an SFAF manager to let him know of our membership’s request for the current executive director to resign.  I related the frustration that members felt in that the foundation’s problems had been going on for years.   The Milk Club needed to share a message that SFAF leadership has failed our community.

His response: “If you have nothing better to do than pass resolutions about the foundation then go ahead.”  This patronizing response is demonstrative of the problematic relationship SFAF has with the LGBT community.

As a former SFAF employee, I’ve experienced the same harassment and disrespect they have shown to many in our community.  When I became active in voicing my concerns regarding much of the above, SFAF engaged in a calculated attempt to reduce my position and force me to quit.  The client services director made Erik Dubón (the former manager alleging workplace bias and my supervisor in the Vida Y Movimiento) lower my performance evaluations.  Program Director Rene Durazzo required Erik Dubón to change my job description in order to write me out of the Latino case management program.  Two other workers and I filed EEOC charges [against] SFAF for discrimination.  When I finally left SFAF, the foundation’s representative physician tried to force me to take an HIV test as part of a routine disability leave examination.  The SFAF human resources director had not informed him that it was against the law to do this.  I filed a charge at the Human Rights Commission to prevent them from doing this to anyone else.

During this time, the Harvey Milk LGBT Democratic Club was the only LGBT group that supported the workers’ efforts to receive decent treatment and respect at SFAF, including domestic partners benefits equivalent to the spousal benefits provided.  The Milk Club’s support brought me into political activism.  I’m honored to now serve as president of the Milk Club.

It is unlikely that things will change at SFAF unless the leadership does.  A lawsuit might be the only way to resolve the current conflict, but as an organization responsive to and working for the benefit of our community, SFAF should have never gotten to this acrimonious point.  The community’s concerns must come first.  The ongoing failure of SFAF management’s to do so deeply saddens us.

---

Criss Romero is President of the Harvey Milk LGBT Democratic Club [at the time this guest opinion piece was published].

Top

[Note: Repeated from the SFAF Bay Area Programs Cut page on this web site.]

The January 30, 2003 Bay Area Reporter reported that the San Francisco AIDS Foundation was going to slash its staff and reduce additional client services for the second time in the same fiscal year.
According to press reports, between June 2002 and January 2003, SFAF laid off approximately 48 employees, possibly chopping its staff by nearly 50 percent.  [Given an idiosyncratic IRS rule, SFAF’s tax returns will not confirm this until its tax return for the period ending June 2004 is released to the public in May 2005, which will show the number of employees SFAF had as of March 2003.]  The Carpetbaggers guest opion piece summarizes SFAF’s diversion of resources from the Bay Area — during the same time the Bay Area faced massive federal, state and city AIDS Service cuts — to launch SFAF’s so-called “global” program.  Potentially, SFAF carpetbagged — by diverting — $2 million, and possibly up to $4.4 million, of its own funds away from Bay Area residents in need of AIDS services in order to launch the Pangaea Global AIDS Foundation in Africa.   Learn more … 

Conceding many prevention programs geared at men who have sex with men are not stopping the spread of HIV in the gay community, the director of a San Francisco AIDS research center says it may be time to scrap those programs altogether [emphasis added].

Dr. Thomas Coates, director of the University of California at San Francisco’s Center for AIDS Prevention Studies, told Gay.com in an interview posted on its Web site Monday, November 26 that “maybe we should just stop” when asked what could be done to stem the spread of AIDS in the gay community.

“Maybe we should just make lots of condoms available, keep informing people where the STD centers are and just accept that every year there will be a certain percentage of people who will get HIV,” added Coates, who is also director of the UCSF AIDS Research Institute.

In the interview, Coates goes on to criticize “AIDS Inc.” — the many AIDS and HIV prevention and service agencies — for “almost beating on the community to get it to change its behavior.  They are not perceived as part of the community [emphasis added].”

The frank talk from Coates comes at a time when the funding and focus of HIV/AIDS programs throughout the nation are being scrutinized.  Health and Human Services Inspector General Janet Rehnquist is conducting a comprehensive investigation into how federal funding is being spent by these agencies.  The review is expected to be completed next year.

Already, two agencies, San Francisco’s Stop AIDS Project and Wisconsin-based AIDS Resource Center, have been targeted by Representative Mark Souder (R-Indiana) for being in noncompliance with federal Centers for Disease Control and Prevention guidelines that state programs must neither encourage sexual activity nor be “obscene.”

Souder chairs a subcommittee that has oversight of the Department of Health and Human Services and the Ryan White CARE Act programs. ACT UP/San Francisco activists and others have flooded committee aides and members with e-mails calling into question the practices and programs of HIV/AIDS prevention workers and agencies.

As representatives from the House and Senate meet this week to hammer out a compromise bill on funding for the AIDS Drug Assistance Program and the Ryan White CARE Act, the comments by Coates and ACT UP/SF could negatively impact those amounts, said one Washington source.

“It is hard for advocates to argue for more money in either bill when people either in the health department or political groups argue for less funding,” said Roland Foster, a Republican committee aide for the Subcommittee of Government Reform on Criminal Justice, Drug Policy and Human Resources.

When contacted by the Bay Area Reporter, Coates said his intent with the interview was to stimulate discussion and debate within the gay community.

“What I am calling for is simply to open up the discussion and think about the full range of options before us.  Stopping these programs is one of those options,” he said [emphasis added].

He acknowledged that his comments could be used by those looking to ax AIDS funding.  But he said the discussion needs to take place on which prevention programs are effective and which are not.

“It is scary to raise these questions because there are political enemies out there who want to take everything away.  I can’t be fearful of the outcome of that discussion.  One has to allow the discussion to go where it will go,” said Coates. “If we are fearful of discussion then we are fearful of open thinking and frank talk, and that is not what we are all about [emphasis added].”

Those contacted by the B.A.R. about Coates’s remarks said they were surprised by his statements.

“I was quite taken aback by it.  That is his million dollar advice to the taxpayer,” said Foster, referring to the millions of dollars UCSF receives in federal funding for the two programs Coates directs.  “It is AIDS complacency at its worst.  I certainly hope it is not reflective of other people’s attitudes.”

Foster, who used to work for a pediatric AIDS agency in Virginia and for former Congressman Tom Coburn (R-Oklahoma), said he doubts the federal government would totally cut off funding for prevention programs.

“We are investing $11 billion dollars at the federal level. I don’t think we are going to give up that commitment,” he said.

Nor is the city’s health department in a position to abandon its HIV prevention programs, said San Francisco deputy director of health James Loyce, Jr.

“In the Department of Public Health, we have a responsibility as long as there is an epidemic which is reportable to in fact try to create prevention strategies to reduce, and or hopefully eliminate, that virus, that disease through prevention strategies and further through the development of vaccines and vaccine trials,” said Loyce, who oversees the department’s AIDS programs.  “We are duty bound in the health department to continue to attempt to respond to this epidemic and create prevention strategies with the community that will hopefully have a greater impact on reduction of HIV infection.”

Dr. Ron Falcon, a board member of the Gay and Lesbian Medical Association, said he disagrees with the idea of eliminating prevention programs.

“It is interesting but I don’t think it is time to give up.  The prevention message has to reach people who are infected and are not infected,” said Falcon, director of the Minnesota Comprehensive Care Center in St. Paul.  “People with HIV are not going to come to hear the message how not to get infected.  But with every single patient I see with HIV, the last thing we talk about is how are we preventing you from infecting other people.”

As for Coates, he said he hopes the gay community begins to address what are effective prevention programs.

“I would hope that the community can hear the statements and engage in a broad ranging discussion on what it wants to do,” said Coates.  “Clearly the community wants treatment.  But what does it really want for prevention?”

The full text of Coates’ interview can be found on www.gay.com in the HIVlife section.