While CAP's challenges include healing old wounds with donors and clients, coming up with new and creative ways to raise money, responding to changes in the epidemic without spreading itself too thin and collaborating with other agencies, the nonprofit's critics are also facing a challenge: to learn how to adapt along with the organization. Some understand that CAP simply can no longer operate as the grassroots agency it once was, but others continue to resist change.
"In the 1980s, the PWA Coalition was totally volunteer-based. We've had to become more professional, and that's been a struggle," McKittrick says. "All AIDS service agencies have struggled with going from grassroots groups to professional human-services case-management organizations."
The Cascade AIDS Project has also recognized the need to be more professional as the needs of its clients have changed. Bruner, Cascade's executive director, says complaints about agencies not offering compassionate services, such as grocery-store coupons and meals in the waiting room, are ridiculous. "I would never do that here. That's crazy. No health and human-services nonprofit operates as a drop-in day center. Some people feel that once an organization does something, it has to do it forever more, and that's crazy, too," he says. "Ten years ago, people who had AIDS were usually dead within a year. Look at the dramatic increases in life expectancy and life quality in the last few years. If people are only living for a few months and need a place to hang out, my God, let's do all those feel-good things, but why should the agency be a drop-in lunch place for people who are doing better? Get your own lunch!"
Agencies like CAP, Bruner continues, "can't consist of the same ten people who hug everyone who walks through the door; they have to become more businesslike. To bemoan the loss of the touchy-feely grassroots response of the past is outdated. We've fast-forwarded twenty years, and it's not just about HIV now; it's about homelessness and drug addictions and mental-health problems and on and on, and it's probably not going to feel like it did in 1984 anymore.
"The role of places like CAP is different now. They're about how to help people live with this disease and be self-sufficient," he says. "I'm more focused on those things than on the feel-good stuff of years ago. Back then, we did lots of things that were small, immediate gestures to ease people's pain, but we can't operate like we used to."
