4 GAY PEOPLE'S CHRONICLE OCTOBER 1, 1993
AIDS IN A 'SECOND-TIER' CITY
Service providers are there-for those who call
Continued from Page 1
lowing is a brief overview of three key service providers and the work they do. Health Issues Taskforce
The first call you place to the Health Issues Taskforce may be the most important one you'll make. As the area's largest provider of services to the AIDS/HIV community, demand for those services is great. Because of that, every Monday morning, the first five new clients to call in after 9 am are the only new clients taken that week. The roster is usually
filled by 9:10.
"We want to maintain quality service to our established cli-
ents," says Sylvia
Colón, Director of Cli-
ent Services. "It's an
option we've had to
explore." With 400 cli-
ents on active
caseload, divided be-
tween two full-time and one half time case workers, Colón isn't
eventual access. In addition to the "competition" for Health Issues Taskforce services, Colón feels the need for information and the link to services for future needs are the compelling reasons to seek those services. It's never too early to call. Proof of diagnosis is the only requirement needed to access HIT.
Once a client has been accepted, a case manager is assigned. There are three levels of interaction between manager and client. The first is generally a point of introduction to HIT and its services, more for future reference and referrals. A client may have little need for HIT
"People come to HIT with multiple issues. HIV is only one part of the problem. They have myriad needs. I
don't have any clients
kidding when she says with just HIV needs."
"We're not able to meet demands that are
coming in." But she
tempers the down side.
"I'm happy that we're
-Sylvia Colón
able to care for the people we have. I want them to feel that when they are here, they are what we're here for."
That initial phone call won't go ignored. Colón stresses the importance of that first call as the vital link to help. Callers are encouraged to leave their first name and told to call the following Monday. Logging the caller's name is the first step toward
at this point. The second level extends beyond information and referral and into some direct service, perhaps emergency monetary assistance, or a support group. The third level is an intensive inter-
action beyond divolving advocacy
rect services, in-
around a variety of
issues and health
needs. Simply put, "we are a kind of support system for people who need us." HIT services are vast because "people come to us with multiple issues. HIV is only one part of the problem. They have myriad needs. I don't have any clients with just HIV needs," says Colón. With the case management approach, a client can lock into HIT and access at will as the needs arise.
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are the food bank and the emergency financial assistance program. The food bank stocks nonperishables and necessary items. HIT actively purchases and stocks the bank and provides food certificates to area grocers to supplement perishable items. Because of the specialized dietary needs of clients and an increased need for food, the clothing bank has been eliminated in order to concentrate resources on food reserves. Clients' input on food selection is considered. Emergency financial assistance is provided to cover where insurance or Medicaid do not, maybe for rent or insurance premiums. Transportation vouchers are provided to assist clients in getting to doctor's appointments and HIT activities.
The Buddy program is one of HIT's oldest services. Volunteers are trained to provide emotional support, companionship, and basic daily help. Efforts are made to match client and buddy talents and needs. Often it's an important anchor in a client's life. "It's a rebirthing process for people, a re-evaluation. This relationship is often the only thing that propels them along." HIT offers two closed support groups, one on Thursday for men, and, in recognition of their own special concerns, a new Saturday group for women. Financial support for child care is provided.
HIT sponsors many activities throughout the year. Tickets to area concerts, movies and amusement parks are available. Financial assistance is made to attend Ohio Aids Coalition Weekends. Attorneys from the Legal Aid Society are available to help with things like wills, Social Security benefits and discrimination issues.
Advocating on a client's behalf is a major role for case managers. Colón stresses the point. "I really believe that there are some clients who have received help, like Social Security, because we have gotten involved and said, 'hey they really do need this.' The activities of daily living are better observed by HIT than a doctor or federal employee."
The bottom line at HIT is maintaining quality services, but remaining flexible enough to meeting changing needs and demands. The speakers bureau is being overhauled. While the case management approach works, "We are looking at decentralizing it, creating a network so people can
access our services at other centers, maybe
while others may arrive because they are physically unable to meet the challenges of their present environment (living on an upper floor of a walk-up apartment building). Public housing doesn't provide the answer since there is such great need for it across the board.
The AHC, established in 1987, provides a resource directory of affordable housing to anyone in the HIV spectrum, not always an easy job. Says Louise Valentine, Director of the AHC, "We have to beat the pavement just like anyone else looking for a place to live. There is a real lack of affordable housing out there in safe areas with amenities."
There are no qualifying criteria for clients beyond HIV status (Valentine notes the occasional attempt by someone outside the HIV community to obtain help, which is turned down). A client's needs and resources are accessed by a case worker who then places them with housing. Housing may take many forms, but the basic requirements are that it be safe, affordable and accessible to public transportation and services. Certain parts of town offer more success. The west side tends to be cheaper and "friendlier," due perhaps to its gay presence. While she must deal with the varied responses of a public that isn't always informed about the issue, Valentine says that "no business people have refused our requests for help." The AHC also provides donated goods such as furnishings, nonperishable food items and clothing.
The needs of clients with declining health have also been addressed by the AHC. Nursing homes have never been a viable option for anyone needing extra help with daily living. Homelessness has also played a rising role in the makeup of AIDS clients. Kamana Place was opened in 1991 to address these issues. Not a nursing home, Kamana Place is for people with full blown AIDS who are homeless, or need some amount of help with daily routines. It is staffed 24 hours a day because, "needs don't just happen between 8 and 5 pm, they happen all the time, particularly on Saturday," and provides visiting physicians and nurses to supplement care. It is full all the time and there's a waiting list of 2-3 people. Always.
community centers Kamana Place is full
where they feel comfortable. One stop shopping." Towards
that goal, HIT will pro-
vide a social work in-
tern at the AIDS Hous-
all of the time, and
there's a waiting list of 2 to 3 people. Always.
ing Council beginning October 1. A new case manager will be in place soon who will act as a "satellite," performing in-take at a variety of locations, thereby extending HIT's reach. Lakewood's meals-on-wheels program for the AIDS community will start to extend into the neighboring Cleveland border, thanks to HIT recommendations. The problem of new clients will continue to be addressed. "We are currently thinking of ways to solve the problem of new clients, without having to use waiting lists." Immediate needs are familiar. "I have to live in the present and be happy with what I have,” says a practical Colón. "It would be nice if we could get to the point where we could provide more financial assistance. We need more staff. I have one family with three adult sons who are HIV, all are clients. We just are not keeping up."
AIDS Housing Council
Because the services of the AIDS Housing Council are so specific, clients arrive as a last resort. Some seek aid because they have lost housing due to financial reasons, (unable to work because of poor health),
Valentine knows the serious need for Kamana Place. "There are always enough
people who need Kamana Place. We need to expand, provide another Kamana Place. But it must be without jeopardizing the stability of our first home." Part of that stability can be seen when Kamana Place is measured against the nursing home alternative. "Kamana Place is cost effective because of volunteer support. Without volunteers we wouldn't be possible. In the past, people who just needed housing were having to resort to nursing homes, costing hundreds a day. What we do and what we try to do we could not do without volunteer support."
As the face of AIDS has changed, new challenges and problems have arisen. Sometimes people find themselves in need of temporary assistance, an in-between place. "We want to establish Hebron House," says Valentine. "It will be a transition place that will help people mainstream. They may be in need of somewhere to stay temporarily while looking for employment. Or maybe a temporary place while we look for permanent housing." A resident will be able to stay up to 90 days. The project was recently greenlighted with the necessary funding and will be in place by the first of the year. Like most other local AIDS organizations, the AHC does not operate in a vacuum, relying on referral services to fill in the