ILL WILL

LANCE CLEM, FORMER HEAD OF THE GOVERNOR'S AIDS COUNCIL, CLAIMS A DISPUTE OVER FEDERAL FUNDS COST HIM HIS JOB.

The real clout on the AIDS front--in other words, the money--lay in the hands of metro-area agencies, including the nonprofit Colorado AIDS Project (CAP) and the Denver Department of Health and Hospitals, which includes the public Denver General Hospital. These agencies received funding from the federal Health Resources and Services Administration for "demonstration projects," which qualified for the funds by providing unique examples of ways to care for people infected by the human immunodeficiency virus, the cause of AIDS. Administration of these HRSA grants fell to DHH, which used a large chunk of its share to support the salaries of clinic directors and other staff members involved in AIDS services.

"Basically, Denver health and hospitals was the only agency big enough to handle the administration," says Julian Rush, the founder and executive director of CAP, one of the original HRSA grant recipients.

The result was that DHH cut the checks for itself and other qualified agencies. Groups that didn't qualify--often agencies outside the metro area--were left begging.

"It was like AIDS didn't exist outside of Denver," says Shelley Nielsen, director of the Grand Junction-based Western Colorado AIDS Project. "Which made it tough, because there is a lot of denial on this side of the mountains, too. The lack of attention from Denver made it easier for people here to ignore what was going on."
By 1990 the Governor's AIDS Council had reached a crossroads. Groups such as ACT-UP accused the council of playing politics and dragging its feet on important issues. Gay activists picketed the April meeting, painting anticouncil slogans on the sidewalks outside the Kaiser building.

ÊThat's when a small group of councilmembers decided to get rid of Johnson, according to Rush. She was gone by June--and before the full council knew what was happening. (Now an employee with the AIDS Education and Training Center at the University of Colorado Health Sciences Center, Johnson did not return telephone calls requesting comment for this story.)

Councilmembers were upset by the secretive way three or four people had managed to remove Johnson, Rush remembers. As a result, the council drafted new bylaws stating that a majority of the councilmembers present at a meeting constituted a quorum "except with respect to...the installation or termination of the Director, which shall require a majority of the total number of members of the Council." The council started a search for a new executive director. Among those who applied was Lance Clem, a University of Denver graduate who had worked as a Colorado Department of Transportation public-information officer for twelve years. Clem, who is gay, had been volunteering at various AIDS agencies since the early 1980s, when he joined the fledgling CAP. "I had a lot of friends with AIDS," he says, "and volunteer work was sort of a family tradition--an example set by my mother and grandmother." Still, he soon discovered that his most useful talent was one he had picked up working for the state government: writing grant applications.

Among those supporting Clem's appointment to the director's job were Rush and Harmer, who had joined the council following the death of her husband from AIDS. "I started working for Denver health and hospitals after I was on the council," Harmer says. "But I didn't represent DHH at the meetings. I was there because of my husband."

Clem got the job in September 1990, unaware of how drastically the position was about to change. Earlier that year Congress had passed the Ryan White CARE Act, named for the hemophiliac boy infected with HIV who gained national attention when he battled to stay in his Indiana school. The money attached to the act came in two primary forms, Title I and Title II; the first category went to qualified metropolitan areas, the second to states. Unlike much of the HRSA funding, Ryan White money was earmarked for emergency-care services for people infected with the AIDS virus, including medical, transportation and housing expenses.

At the time, the Denver area didn't have the 2,000 AIDS cases required for Title I funding. But Title II money didn't have the same restriction, and the state health department quickly applied. But federal authorities rejected the department's application, and Colorado become one of only six states refused Ryan White funding. In March 1991, Clem says, he was shown the feds' letter rejecting Colorado's application. "Basically, they were saying that the application didn't indicate how the money would be spent, which was clearly required by the grant description," he remembers. "I looked at the application and thought that it was an embarrassment--a halfhearted attempt that told me that the health department really didn't want to take care of people with AIDS. Ryan White money was to take care of people who already had it."

At the urging of the governor's staff, Clem resubmitted the application, this time proposing that the Governor's AIDS Council be made the fund's administrator. The application was approved immediately, making Colorado the only state in which Ryan White Title II monies were controlled by a citizens' council rather than a state health department or social services agency.

The money arrived in May 1991. It totaled more than $770,000, of which a maximum of 10 percent was allowed for administrative costs. Clem was overjoyed. The council now had a significant budget, and the state had a major source of funds for dealing with the human effects of the epidemic.

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