by Nathan Schaefer

A new study by the AIDS Taskforce of Greater Cleveland highlights �serious signs of financial and operational vulnerability� among AIDS service organizations across the United States, due to a combination of government funding cuts and lags, larger patient loads, and the increasing complexity of tasks they are being asked to undertake.

The study, primarily authored by Krissy Ferris, was released November 27 in a national teleconference sponsored by the organization Funders Concerned About AIDS. The complete report is available online at www.aidstaskforce.org.

The report examined IRS financial records from 100 AIDS service organizations in the U.S. over the period of 2001-2005, and conducted follow-up interviews with executive directors. Participating organizations represented each region of the country, organizations with small and large budgets, and both general and more specialized (such as faith-based or women�s) agencies.

Among some of the key findings:

Over the five-year period, most organizations experienced increasing financial difficulties. In the entire sample, only nine organizations reported a budget surplus�that is, not �losing money��in all five of the reporting years. The other 91% reported a loss in at least one of the years between 2001-2005. Half of the organizations had a budget deficit in three, four or all five of the years.

Regionally, organizations in the southern United Stated reported the greatest difficulties, and organizations in the Northeast were more likely to report �breaking even� or small surpluses.

When asked about programming, 72 percent of AIDS service organizations responded that they had cut or restricted programs in the last five years.

Nearly all organizations reported being deeply concerned about the uncertainty of future government funding, and only seven percent said they thought the current method of funding ASOs is sustainable.

A significant number expressed a sense of what can only be called �relief� to realize that theirs was not the only organization facing challenges�that in fact, the problems were fairly common.

In Ohio, the challenges are similar. In 2007, AIDS Resource Center Ohio, the primary ASO for 35 counties, will have assisted 2,100 people living with HIV and their loved ones�a 32 percent increase over 2006, according to executive director Bill Hardy.

�Needless to say,� says Hardy, �support for programs is nowhere near keeping pace. Our situation is further complicated because we serve so many counties without large population centers, where resources are already spread thin. In addition, for many of these regions, HIV/AIDS was never a �real� issue, or one that received community assistance. Meeting the needs of thousands of clients, while weighing financial �solvency� considerations, has become a never-ending tug-of-war.�

The report points to opportunities as well as challenges. It applauds the groups� work: �That ASOs have managed so well to grow, adapt, and evolve is a testament to the thousands of professionals and volunteers who staff them.�

It also recognizes that increased collaboration and strategic partnerships can help strengthen the system of AIDS care and treatment, ensuring greater stability in the future.

Kevin Sullivan, Ohio AIDS Coalition executive director, noted, �What this study tells me is that Ohio�s HIV/AIDS organizations must become more aggressive in reducing our operating costs. We need to think seriously about mergers and alliances as a means of continuing to provide services and advocacy for the HIV-positive population.�

The report ends with a series of recommendations, including a call to �seek out every opportunity to consolidate, build bilateral resource- and program-based partnerships, or merge with other ASOs.�

The report also recommended that funders support investments in consolidations, that consumers continue funding and supporting human rights advocacy; and that researchers investigate �best practices� and �model programs� in the development of sustainable networks that can provide comprehensive services.

�It�s clear that many, many ASOs across the U.S. have done an extraordinary job in mobilizing professional and volunteer talents to provide services and prevent new infections,� Earl Pike, executive director of the AIDS Taskforce of Greater Cleveland, concluded. �But we also have to stop thinking about what we do in the context of a �state of emergency,� and start thinking about the long haul.�

Nathan Schaefer is director of education and public policy at the AIDS Taskforce of Greater Cleveland.