New York City AIDS Services Found Lacking

New York City AIDS organizations are beset by chronic understaffing, fragmented services and funding delays that threaten patients' services and medications, according to a study released Sunday. Published by the nonprofit Center for an Urban Future, "Epidemic Neglect: How Weak Infrastructure and Lax Planning Hinder New York City's Response to AIDS" was a six-month study of more than 60 HIV/AIDS service providers, consultants, public and private funders, and health experts. Researchers found that although community AIDS groups receive nearly $300 million annually in city, state and federal contracts, those funds are often delayed three months to a year by red tape, leading to staff cutbacks and client service disruptions.

"We have several groups in Brooklyn who are always waiting for money," said Divine Pryor, executive director for the Association for Drug Abuse Prevention and Treatment. "They can't afford things like MetroCards for low-income clients, they can't afford to duplicate literature. If I have social workers doing HIV test counseling and I can't order OraSure [HIV tests], that's hurting people."

Community groups were forced early in the epidemic to focus on treatment programs instead of building strong organizational structures, said study author Julie Hantman. More blame should fall on unrealistic administrative cost caps mandated by government contracts, she said. "Executive directors are distracted chasing checks or doing the work of absent administrators," said Hantman. "Some AIDS housing money sits unused because the contracts are so onerous, nobody has the staff to process them."

The report found the city health department is one of the worst offenders in late payments. According to the Mayor's Management Report for 2001, it ran behind in paying 97 percent of its contracts. The Bloomberg administration recently created an initiative to speed up the payment process. AIDS advocates said delays caused by the federal government are not being addressed.

The report found the city's AIDS groups offer fragmented services, forcing patients to hopscotch across organizations. The reason is that most organizations offer partial services based on whichever contracts they could obtain. At the same time, there is a severe shortage of substance abuse treatment, mental health and housing services. Citywide planning for AIDS is inconsistent and erratic, and there is no single government agency or official responsible for AIDS to identify system excesses and gaps.

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