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"We didn't have much of a staff back then," he continues. "But after we shook up the board, we started hiring people of color. Our emphasis in the next year will be in the African-American community, because we haven't reached them as much."
The PWA Coalition pairs clients with peer advocates, who help with everything from finding doctors to getting housing assistance. "If people are having a hard time getting what they need, they come to us," McKittrick says. "We find inconsistencies in every agency and every clinic. We serve many of the people who were disgruntled with the services at CAP or Servicios or POCCAA. Sometimes they have a legitimate complaint, and sometimes, because of their mental-health issues or substance-abuse problems, they're just difficult to work with. What it boils down to is the personality of the client and how they interact with the person who's helping them, more than whether they're black or Latino or white."
Ramirez and Lease, of the Empowerment Program, say the key to CAP's success in reaching out to an increasingly diverse clientele will be to collaborate with small organizations like theirs that focus on specific communities.
"You can't be successful without truly working with other organizations," Lease says. "Right now we are not collaborating. It's not in our Western culture, and it's not in the culture of community-based organizations to work together. Foundations encourage competition, and consequently, each agency spends time writing grants to the same foundations for the same money."
She offers a recent meeting of AIDS organizations as an example of what happens when agencies don't work together. People from CAP were talking about starting a back-to-work program for unemployed HIV clients, but the Empowerment Program, which has already been doing employment training for many years, wasn't consulted. "If you always think you have to do everything on your own and not work with others, fundraising is hard," she says, adding that she understands how the culture of isolation formed at CAP. "CAP got no government money until the end of the 1980s. The way CAP survived was through private donors and cocktail parties. They grew up as the scrappy kid on the block having to take care of themselves and being hated by everyone because of the stigma and fear around AIDS. So you can see how CAP has evolved; it makes perfect sense. But some of those early ways of doing things have left a legacy that might not be so helpful to them in 2001. CAP can't be the lone ranger anymore."
But Bruner, of the Cascade AIDS Project, believes having so many community-based AIDS organizations in one region could be part of the problem. "They spring forth in this never-ending way," he says. "It's as if every subset of a subset impacted by this disease needs their own organization, and that's just baloney. If every time a new demographic comes about we create a new agency, we'll be sunk. There's an American Cancer Society, not a cancer society for women, for black people and for homeless people.
"What you end up with is a pretty fragmented and sometimes duplicative field of service providers, and it's pretty cost-inefficient," he continues. "The other extreme is to have one mega-AIDS organization in every region that imposes a one-size-fits-all approach, and you don't want that, either. But is it reasonable for CAP to shift and try to respond to the changing face of AIDS? Absolutely. It has an obligation to."
Turnover and change within CAP have made that nearly impossible, however.
Thirty employees have left CAP since January 2000, many because they were disgruntled with the organization or burned out by the difficult work and low pay. Others were fresh out of college and never planned on staying long. There are now only nine case managers for CAP's 1,550 clients, and they get paid around $25,000 a year. Whatever the reasons for the rapid employee comings and goings, it's had an impact on public perception, Mauro explains; CAP conducted yearly client surveys when he worked there, and he recalls that high turnover was one of the top complaints.
CAP experienced further instability when longtime director Rush left at the end of February.
"I had decided that when I turned 65, I wanted to do something different," says Rush, who is now the executive director of the David Taylor Dance Theatre. "I made a pledge to myself when I left CAP to drop out of the AIDS community in order to be fair to the new director since I'd been there so long." (Although Rush agreed to talk to Westword about AIDS and the challenge of fundraising, he wouldn't address specific issues about CAP.)
The new director, T. Scott Pegues, who'd worked as community education manager at the Minnesota AIDS Project, lasted only five months. "The reason I'm not there anymore is that there was a significant difference between me and the board about how the agency should operate," says Pegues, who now works as a consultant on HIV-related research for the state health department. "The board and I wanted the same thing...an agency that was more financially stable, that reached out to a broader community and that created a continuum of care. My approach was to better involve the community, to empower people outside of the agency. I didn't understand what their style was.