AIDS Service Organizations: Accountability Issue Surfaces in San Francisco
The major AIDS service organizations today started over 15 years ago as small, community-based activist groups--often created independently of older philanthropic and service organizations, which usually failed to address the epidemic because of public attitudes around AIDS. The need to build from scratch in response to a deadly emergency led to the creation of many thousands of separate AIDS organizations. Meanwhile, a few of the largest ones have become multimillion dollar agencies; and conflicts have arisen as they have tried to consolidate service delivery (either to increase efficiency, or to dominate the field, depending on one's point of view). In addition, some clients believe the larger organizations have become a remote, bureaucratic, self-serving "AIDS Inc.," setting their own priorities and agendas without meaningful public input or accountability.What is new in San Francisco is that some of the discontent is now coalescing publicly; many persons who have been unhappy about how AIDS services are prioritized, organized, and delivered are now learning about each other, when they did not know each other before. The San Francisco AIDS Foundation, as the largest service agency in the city, has been a primary target, but far from the only one.
AIDS Treatment News focuses mainly on treatment, and we are not close enough to the service agencies to form our own judgments of their programs. But for better or worse, this developing controversy is likely to affect the future of the AIDS community. Many of our readers may be interested, so we are listing some sources for more information.
On October 28, a public meeting called the Accountability Forum was sponsored by three well-known San Francisco organizations: ACT UP/Golden Gate (415-252-9200), the San Francisco Log Cabin Republican Club (415-522-2944), and the Harvey Milk Lesbian/Gay/Bisexual Democratic Club. Speaker after speaker related nightmarish experiences, and little was said in defense of the major AIDS agencies. For more information, contact the sponsoring organizations.
A new group, the Accountability Project, has started a Web site, (website no longer available). Besides press releases and other background material, this site includes controversial transcripts of client focus groups run for the San Francisco AIDS Foundation, with the names of speakers removed to protect their confidentiality. The transcripts, not intended for publication, were obtained by independent activist Michael Petrelis.
The Accountability Project also has a toll-free telephone number (888-583-3411) for people to call and tell their stories, good or bad, about experiences with AIDS services and organizations.
Defenders of the San Francisco AIDS Foundation have called for maintaining respectful discussion and debate. They note that there is not enough money to provide all necessary services--and that critics have often contradicted each other when demanding how services should be changed or prioritized (even when speaking in the name of the same organization). They point out that board members and senior staff of the Foundation have been willing to meet repeatedly with the critics, to explain what the organization is doing and why. They note that priorities of the Foundation are set by the board, which includes many people with HIV, some of whom are also clients of the Foundation--and that members of the public, with advance notice, can usually attend part of the board meetings (other parts of the quarterly meetings are often held in executive session), and can usually address the board. (They also note, however, that in many cases it may be more productive to talk with board members outside of the board meetings, which must focus on routine business -- or to meet with the senior staff responsible for the programs or policies at issue.)
A major dispute has concerned openness of board meetings of the San Francisco AIDS Foundation. The current policy is:
"If members of the public wish to attend a meeting of the board of directors, written notification must be received by the board chair at least 48 hours prior to the meeting. The request should contain the following information: name of individual who wishes to attend the meeting; purpose in attending the meeting; contact phone number where Board Chair can reach requester. The Board Chair will contact the individual at least 24 hours prior to the meeting to confirm receipt of the request and when appropriate, offer an invitation to attend the board meeting." Another procedure has been published for those who wish to address the board.
For more information about attending meetings, addressing the board, or bringing concerns to the San Francisco AIDS Foundation in other ways, call Joe Fera, San Francisco AIDS Foundation, 415-487-3053. For general information about the Foundation, see its extensive web site at http://www.sfaf.org.
