Douglas County (Oregon) AIDS Council: HIV Resource Center

 

 

Portland Shame

I think of Portland as a huge economic sponge that sucks the life out of the rest of the state. It's not an original thought. Activists in Southern Oregon have been struggling with the excesses of the Portland leadership for the better part of a century, and the Portland leadership is at its worst when it comes to hoarding tax dollars designated for HIV funding.

Throughout this commentary, when I refer to the "Portland leadership", I am speaking of the close-knit camaraderie of state and county human services employees and other mid- and low-level program managers from the various Portland services organizations that share in HIV prevention funding.

After a series of actions in 1992, including two demonstrations lead by Coos Bay and Roseburg activists, the two Federally mandated Statewide planning committees began distributing resources fairly throughout the State. This was facilitated by a fair-minded administrator at the HIV Program. Some communities fared better than others, but every county received some funding.

Things started changing in 2000, leadership at the State had changed and more and more decisions were simply made by the Portland elite and presented to the statewide planning groups in the form of slick presentations including huge amounts of data to support whatever rationale they were proposing.

Numerous disagreements over HIV/AIDS funding occurred. Tillamook, Coos, Josephine and Douglas County AIDS Service Organizations were continually at odds with the Portland leadership. We accused them of manipulating the data to support their preconceived outcomes and usurping the Statewide planning process by strategizing between sessions to insure that their agenda is the one that always prevails.

Coos Bay and Roseburg activists used the Oregon version of the Freedom of Information Act in an effort to access information we felt Portland was manipulating. We wanted to see the raw data. It was a losing battle. They overwhelmed us with charts and records. A Portland based advocacy group was also struggling with the Portland elite, and while we didn't work closely together, we shared information. We got lucky when the guru of Portland's elite accidentally sent an email to a Portland activist meant for his cohorts. In the email, he advised a colleague to "generously flood" this activist with "huge stacks of EXISTING data" in hard-copy form and to intentionally include redundant and irrelevant statistics. "Let him try and sort it out, and if he is overwhelmed and he wants US to do the analysis, we can kindly refuse." This fiasco was reported in a January 2003, Willamette Weekly column appropriately called "Rogue of the Week." The disgraced bureaucrat quickly resigned and his Portland cohorts laid low for a while. For the next two years funding flowed smoothly again to the three surviving AIDS Service Organizations outside the Willamette Valley.

But the prosperity was short-lived. In late 2003 the State committee that proposes the formula that determines how funding is distributed in Oregon, CLHO-HIV (Conference of Local Health Officials-HIV), started reversing the trend. Claiming adherence to a (Centers for Disease Control & Prevention) mandate to reduce the number of new cases by half nationally by 2008, the committee cut funding for most injection drug user HIV prevention programs outside Portland. This caused two of the three remaining needle exchange programs outside the Willamette Valley to cease operation. The surviving program in Roseburg merged with the Grants Pass site in an effort to maintain services along the I-5 corridor in rural Oregon.

Prior to this coup d'état, the Portland leadership presented the groundwork for this formula change to the Statewide Planning Group in a day-long presentation I refer to as the Spotted Dick Affair. It centered around a map using individual red dots to show the number of living cases in Oregon by county. Multnomah, with its 2,377 red spots reminded me of Spotted Dick, a favorite British confectionary. Referring to the rest of the State as "low incidence" areas, the presentation hammered home the need to divert funding to troubled Portland. The Spotted Dick map was impressive, but lacked context. Oregon is a low incidence State. While Portland fleeced the rest of Oregon citing it's perceived great need, New York reported 7,641 new cases that same year. New York had more than twice as many new cases in 2004 as Oregon had total cases. Florida reported 5,822 new cases, California, 4,679. Applying Portland's rationale nationally, why should Oregon get any funding? What happens in Oregon won't affect the CDC mandated outcome to reduce new cases by half.

After months of confusing suggested scenarios ( 4, 5, 6, 7, 8, 9, 10, 11, 12) smoke and mirrors the State adopted a funding formula in early 2006 that delivered a serious blow to the remaining AIDS Service Organizations outside the Willamette Valley. Again citing the CDC mandate, The Portland leadership generously increased Portland's level of funding by $100,000, over $75,000 of which was pulled from Southwest Oregon. They shifted funding around the rest of the State willy-nilly, in every case penalizing counties that had the capacity to deliver prevention services in favor of counties that have little or no capacity. Besides making the richest part of the State a little richer, they disrupted HIV prevention services to their rural neighbors.

In its rationale, the State claims that it has made "it's (SIC) first big step towards meeting this federal mandate with an HIV Prevention formula change in late 2004." That formula change crippled programs in Benton, Tillamook and Josephine Counties. The rationale claims to be retargeting resources for HIV counseling, testing, treatment, and referral services and other prevention services in order to meet the federal mandate and program needs. No one, including the drafters of this rationale believes that the mandate to reduce new cases by half by 2008 will happen. The State's rationale is just a ruse to divert more funding to Portland. And the cuts won't end here. They'll need to cut another $180,000 for the upcoming funding cycle (FY-08). The State, joined by other mid- and low-level managers from Portland organizations, which share in this funding, are planning ways to insure that they won't suffer from the upcoming cuts.

Douglas County Public Health, which has a seat on CLHO-HIV, opposed the formula change. In an effort to play down the dissension, the Portland leadership, suggested that the rationale include a "Majority" and a "Minority" Report, which they promptly wrote. Douglas County rejected Portland's version of their position and submitted their own Minority Report. In the end, the Portland leadership scrapped the Majority/Minority concept and submitted the rationale mentioned in the previous paragraph.

Disregarding all objections, the Portland leadership pushed the formula change through. In a token effort to quiet our angry voices, they agreed to spread the devastating cuts over two years, allowing us to die slowly.

While not exactly a silver lining, there is a bit of good news in all of this. The cuts which have disabled other rural programs, have not reduced services in Southwest Oregon's rural counties. Douglas, Josephine, Coos and Curry Counties will continue to receive services through the HIV Resource Center; however, if Federal funding isn't restored, the HIV Resource Center will also wither and die by the beginning of the next decade.

There just aren't enough private dollars in rural Oregon to sustain HIV/AIDS services, and we need your help to restore public funding. Send an email to [email protected]. Put "Portland Shame" on the subject line. I'll keep you posted on our progress and suggest ways you can support our activism

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Billy Russo
Executive Director
HIV Resource Center

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