San Francisco HIV care coalition reorganizes due to budget problems

San Francisco's HIV/AIDS Providers Network, a coalition of about 50 city AIDS service organizations, is planning the biggest overhaul in its more-than-20-year history because of budget problems resulting in decreases in both federal grants and private donations, the San Francisco Chronicle reports. The city is slated to receive $29 million in federal Ryan White funds this year, down $4 million from last year. Network officials also say private donations are falling off due to a still-uncertain economy and donor fatigue. Voters in November rejected two ballot initiatives that would have boosted some taxes in order to keep the city's AIDS services fully funded. To help stretch city AIDS dollars, San Francisco officials plan to streamline the HIV/AIDS Providers Network by directing more federal AIDS funds to programs that offer HIV patients "one-stop" shopping--providing several services, including case management, Medi-Cal services, housing assistance, substance abuse treatment, and more, at one centralized location. City health officials are calling these sites "Centers of Excellence." But many AIDS leaders in San Francisco fear that plan will lead to the demise of smaller AIDS groups that provide unique services or serve specific populations. "It feels very much like a slow death. The system is withering," Mike Smith, executive director of the AIDS Emergency Fund and president of the HIV/AIDS Providers Network, told the Chronicle. But James Loyce, director of AIDS programs for the San Francisco Department of Public Health, says the restructuring gives the city's AIDS service providers a positive "opportunity to rethink what we are doing, across the spectrum."