Allocating AIDS Aid
Last week, as World AIDS Day was being commemorated with candles and quilts, Vermont's AIDS-related nonprofits were contemplating recently announced federal HIV-prevention awards for 2005-2007. Faced with just $575,000 in Centers for Disease Control funds to distribute and $1.1 million in funding requests, the state allocated its block grant to programs serving "individuals at the highest risk of HIV infection in our communities," says HIV/AIDS Section Chief Kurt Kleier.
An estimated 600 to 700 Vermonters are living with full-blown AIDS or HIV. Around 41 percent of those individuals are believed to reside in Chittenden County. The state's most populous region is also where more than half of this year's HIV-prevention grants are going. Most of the big winners are based in Burlington: the Howard Center, Spectrum, R.U.1.2.?. Agencies left out entirely include two that specifically target minorities: the Women of Color Alliance and the Association of Africans Living in Vermont. The results have raised concerns that rural residents of the Northeast Kingdom and central Vermont and people of color will be underserved.
AIDS Community Resources Network (ACORN), a 14-year-old nonprofit based in White River Junction, applied for $109,000, or 50 percent of its HIV education budget. It received no direct aid. In a December 2 letter to Human Services Secretary Charles Smith, ACORN Executive Director Thomas Mock calls the situation a "crisis." He's trying to leverage political support to get the decision reversed. "Even if Tom Mock wrote a poor grant," he says in an interview, "where's [the state's] commitment to serve the people in Orange and Windsor counties?"
Although Kleier acknowledges the grants "won't serve every person who's at highest risk, or everyone who is at risk," he calls the application review process "one of the most comprehensive that has ever been used for HIV prevention in this state." Agencies that lost out either don't qualify as bona fide nonprofits or didn't meet the CDC's stipulation that supported programs be "evidence-based."
This new criterion is one reason the state's largest AIDS organization absented itself from this year's pool altogether. Vermont CARES -- which has been receiving around $100,000, or 8 percent of its annual budget, from the feds -- announced in September that it would seek those moneys from private sources rather than apply for federal grants. Among other issues, says Executive Director Kendall Farrell, was the CDC's reliance on treatment models that have worked well in large urban areas but wouldn't be appropriate in Vermont. "It would be ridiculous to give up the approach we've been honing and base it on something that worked in Los Angeles," Farrell suggests.
Kleier suggests, however, that the rules aren't quite that inflexible. The Howard Center's "Safe Recovery," for example, funded at more than $100,000, takes an approach that's proven effective in Vermont. "Not all states have been as responsive as we have to allow different models to reach rural populations," Kleier says.
To fill any coverage gaps, he says, the department will be "working to realign the work of public health nursing designees" in rural areas, and "looking for other ways to serve people of color."
Although Mock is still hoping for a piece of this year's grants pie, Kleier says the allocation numbers are final. He adds, though, that the state would try to compensate non- or underfunded agencies "if supplemental funding opportunities present themselves," And how likely is that? "Given the number of cuts in federal funding, and the fact that there is no state funding for HIV activities," Kleier says, "agencies need to be more resourceful in finding alternative ways to support their work." In other words: Follow Vermont CARES' example.