GLAA/Stein testimony on Agency for HIV/AIDS

Testimony of Jeff Coudriet
GLAA Ryan White Planning Council Representative
Vice-President, Gertrude Stein Democratic Club

Oversight Hearing on DC Agency for HIV/AIDS
DC Council Committee on Human Services
Sandy Allen, Chair

Thursday, June 18, 1998

Good morning Madam Chair and Councilmembers Ambrose and Catania. My name is Jeff Coudriet and it is a privilege for me to be here today to testify on behalf of GLAA and the Stein Club. I am joined on this panel by the current GLAA President, Rick Rosendall, who I think will have a few comments and observations of his own later.

I have been testifying on behalf of GLAA on AIDS issues for over 10 years. Sadly, some of the same problems and issues we were talking about 10 years ago are still with us — problems of management. Before I go any further, we all want to thank you for having this oversight hearing today, which we specifically asked you to do at the last oversight hearing in February and applaud your commitment and compassion in getting to the heart of some matters and hopefully working towards some solutions with us.

The last time I was here I talked about the good news about protease inhibitors and about how they are helping so many people stay alive and stay healthy. They are still doing that for many people. But the recent deaths of Commander Hank Carde and Steve Michael should remind us all of how much more we have left to do.

One of my top concerns today is what I'll call the spinning "wheel of misfortune" at the Department of Public Health — Directors come, directors go, etc, etc. In fact, several years ago I stopped bothering to learn the name of whoever the Director of Public Health happened to be at the time — it just didn't seem worth it. I always hate to see my hopes go up and then down and then we have a long interim period with no director, and then maybe an acting director, and so on and so forth. The last DOH head I had an emotional attachment to was Dr. Mohammed Akhter. It's really starting to remind me of the Department of Housing in its glory days! Directors in and out, in and out. Who knew what was really going on? Nobody! And that's my point. It is incumbent upon this Committee to know what's really going on, regardless of the chaotic situation at the Department.

Now I wasn't particularly saddened to see Drs. Noonan and Saunders get fired by Camille Barnett, in fact, we hardly had time to get to know them. I was heartened by Ms. Barnett's comments in the Blade — "the changes we're making are aimed at improving services. We're here to make things work for people." I, of course, couldn't agree more that we need to keep that focus on improving services precisely because they do affect people, people who are oftentimes poor, and most certainly very sick. That is the work of the Agency in question today and we need to look at the work that it does do in a critical fashion — something which wasn't done by the appropriate Council committee over the many years that the Department of Housing was allowed to slide into complete disrepair and ultimately federal receivership, even before the Financial Authority came to town.

We are all in touchy territory these days as we have a multilayered government — a control board here, a council there, a Mayor here, a chief management officer there. It's hard to know who's in charge! I heartily agree with Sabrina Sojourner's observation that Ms. Barnett might want to do some consulting with the members of the Ryan White Planning Council, and with the members of this very Committee here today, when looking at some of these personnel issues because there are so many very knowledgeable people in this community who can give good sound advice, advice that will be needed to make some of these decisions. I am glad that Ms. Barnett is planning a nationwide search to fill these positions and only hope that that can be accomplished soon. We have had too many leadership voids over the last decade at DOH and at AHA to delay these things any longer. The continual spinning of these personnel wheels of misfortune have indeed, to quote Jim Graham "adversely affected our efforts to address the AIDS epidemic."

All of that being said, there is perhaps one thing that can help us through such difficult times, which hopefully will be over once we install new leadership at DOH, and that is a good road map. Personnel may come and go in various capacities, which is bad enough, but if we don't even have a sense of where we are and where we need to go we will have nothing to make our plans by and no means of measuring our progress. We think that a comprehensive plan for each of the next 6 months, 1 year, 3 years, and 5 years, or something to that effect, is in order and very much necessary. There are recurrent needs that probably needed to be looked at every month — the AIDS Drug Assistance Program is one — does it have a waiting list in general, or for protease inhibitors specifically. There are other needs that have been long neglected which need to be jump started — such as prevention programs targeting populations that haven't gotten all the information that they need to protect themselves — women, young gay/bi men, gay/bi men of color.

One thing that the Ryan White Planning Council does every year — in part because we have to by law — is that we look at all these different service areas, such as primary medical and transportation and whatnot, and we have to look at the needs out there, the populations affected, and we have to take a good long look at where our spending is going and what we are trying to accomplish. Then we all sit down in what are usually a few long, painful, serious, involved meetings, and hash out our spending priorities for the next year. Categories of spending can be moved around — and usually are. Every year sees more tinkering, more refiguring, more responsiveness to changes in the epidemic. In short, we are doing what we need to do to continue to respond to this epidemic in a constructive fashion. This process, however, involves just the federal money we are gettting. What I would like to propose today is that we do something very much like this with our local dollars, some sort of process that forces us to reevaluate and reassess our efforts on a very regular basis — not just the dollars in a budgetary fashion, but the "why's" behind the dollars — at the very least once a year, which might be the most practical thing given our fiscal year structure. In that process, there also must be a very genuine commitment to involving the communities affected by this disease and not just involving service providers who might or might not have vested interests in their funding streams. I don't mean to bash service providers, in fact I have a very high opinion of most of the people involved in these difficult and trying efforts, but the voices of the people trying to stay alive every day with this disease need to be heard and this process must be designed to bring their opinions into consideration.

In conclusion, I would like to take this time to invite everyone on the Commitee to come visit one of the meetings of the Ryan White Planning Council, in fact there is one tonight, and hear some more of the voices of people living with this disease and the many people struggling to provide services to them — it makes for some interesting and informative, not to mention sometimes very moving, interactions among a diverse group of people. Beyond all the heated rhetoric of the the current political campaigns going on this year are real people, with real needs, and the best thing we can do for people is to disregard the rhetoric and get to work on making ours a government that actually functions and meets their needs. We must uphold and champion home rule by ruling!

Thank you again Chairman Allen and the members of the Committee for having us here today. I am of course, happy to answer any questions you may have and I think Mr. Rosendall has a few comments to make as well today.

[Rick Rosendall joined Jeff Coudriet in praising Councilmembers Allen, Catania, and Ambrose for their tough grilling of Department of Health and AHA officials during the hearing. He raised questions about the status of the condom availability program in the District's prisons, in particular whether AHA was still providing the condoms. He also expressed support for the agency's announced plans to expand the number of needle exchange locations, and — while respecting the quality-of-life concerns of constituents of Mrs. Ambrose in Ward 6 who did not want needle exchange sites in their neighborhoods — he stressed the practical necessity of reaching drug users where they are. He urged the agency during the community input stage to seek input from street-wise activists, such as local needle exchange pioneer (and GLAA member) Michael Singerman. Afterwards, AHA official Ivan Torres thanked Rosendall for the suggestion and indicated that he would be contacting Singerman.]

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