Life support

Toothless. Skeletal. Homeless. Rock-cocaine addict. HIV positive. That’s how Richard Hamilton describes himself seven years ago when he finally hit bottom and sought help from the Minority AIDS Project in Los Angeles.

Hamilton, who works as a program coordinator for MAP, is now billboard handsome with a brilliant smile. He’s living proof of the agency’s effectiveness in serving its primarily African American and growing number of Latino clients who either have or are at risk for the virus that causes AIDS -- including some of the sickest, poorest, most desperate and hardest-to-reach men and women in South Los Angeles.

His bank account reveals, however, all is not well.

The paychecks are late. MAP -- the first black AIDS organization in the United States -- is in danger of dying.

“We’re in danger of the doors being closed,” Executive Director Victor McKamie says recently at the MAP headquarters on West Jefferson Boulevard near South La Brea Avenue. The nonprofit agency is about $500,000 in debt due to shortfalls in public and private funding.

Archbishop Carl Bean, who founded MAP in 1985 and remains chairman of the board, fears the agency will go under without a substantial cash infusion. MAP’s demise would put an end to an organization whose very existence was revolutionary for the minority community.

In the early days of the disease, the public face of AIDS was a gay white man. Services, support and all kinds of help poured into those neighborhoods. African Americans at risk or infected had nowhere to turn in the black community, where the deep stigma of homosexuality caused the traditional oases -- home and church -- to turn their backs.

Bean -- black, gay and a minister -- stepped up. With a single phone line and missionary zeal, he started the Minority AIDS Project. As word spread, he and members of his Unity Fellowship of Christ Church, a haven for gay worshipers, provided outreach, support and succor.

“Carl Bean took the initiative to respond to the need when people were being discriminated against, stigmatized and being abandoned, dying by themselves,” says Cynthia Davis, one of Los Angeles’ best-known AIDS activists.

The agency soon moved into a nondescript building, but Bean didn’t put up a sign that proclaimed “Minority AIDS Project.”

“If they’d had one, when they first opened it 20 years ago, people would have burned it down. You know how black people were about AIDS,” says a woman who requests that her name not be used because she is married to a prominent African American.

That building remains the agency’s headquarters and still doesn’t have a sign spelling out MAP’s name.

No one is turned away.

“Everyone gets a hug,” the Rev. Russell Thornhill says. “We ask, ‘When’s the last time you’ve eaten,’ and we give them something hot.” If the cupboards are bare, Thornhill and others reach into their own pockets and give money for food and bus fare.

MAP provides services such as case management, counseling, treatment adherence, health education, testing, a needle exchange and a food pantry, for about 1,200 clients a month, three-quarters of whom are men.

“Bottom line, they reach a population that a lot of other minority CBOs [community-based organizations] don’t have the expertise to reach,” says Davis who runs education and prevention programs for women, youth and other high-risk groups. “The population they target has the highest rates of infection: gay men of color, bisexual men and men in the closet.”

African Americans represent the majority of people getting HIV, living with the virus and dying of AIDS-related causes today, according to the national Centers for Disease Control and Prevention.

Race can matter regarding treatment. A Rand Corp. and Oregon State University study, released in February, found a significant number of African Americans distrust the healthcare system and believe in conspiracy theories, among them that a cure for AIDS has been found but that the information is being withheld from poor people.

“Black people still have suspicions about the system, about the police, about government,” says the Rev. Charles Lanier, MAP’s chief financial officer. They are more likely to trust MAP, he says, because, “when I come to MAP, I see somebody who looks like me. I can connect because we have a shared experience.”

Funding cuts

MAP’s financial problems run deep and aren’t easily solvable. According to Lanier, MAP lost $2 million -- about half of the annual budget -- in the most recent rounds of public funding.

Not because of mismanagement or malfeasance, say government officials and AIDS activists, familiar with MAP’s situation, but because Washington now favors direct services for people living with HIV or AIDS over outreach, prevention, education and testing.

High ratings don’t guarantee dollars, McKamie learned, when the CDC approved one of MAP’s programs but didn’t have the money to fund it.

“They’re doing good work, and their performance level has increased significantly in the past couple of years,” says Teresa Wallette, a consultant paid by the Los Angeles County Office of AIDS Programs and Policy (OAPP) who is in her second year of working with the agency.

MAP lost about $1 million when OAPP allotted the federal dollars sent to areas with the highest HIV rates. That killed a women’s outreach program at a time when, according to the CDC, 72% of the newly reported HIV and AIDS infections among women are in black women.

“Straight women, we’re not thinking about HIV, but when my husband says he’s going to play poker, do I really know where he is?” asks Carolynn Martin, MAP’s program manager. She describes a woman who thought she was losing “all this weight because of the cabbage soup diet. A married woman, she’d had sex with one man in her whole life, and now she had full-blown AIDS.”

MAP client Betty Knox learned she had the virus three years ago after taking a physical. “I’m here in Los Angeles, no family members here,” the Chicago native says. “Once I was referred to MAP, they got me set up with housing, a bus pass so I could get to the doctor, and food.”

She’s attends one of MAP’s weekly support groups for men and women who are living with the virus. Most are black.

“MAP means the world to me. First because it is the Minority AIDS Project, and also because it is very loving, very down to earth,” Regina Brandon, another regular, says. “It makes all the difference in the world to see a reflection of yourself. There’s a sense of belonging.”

MAP’s mental health director, Dr. Roberto Olivas, also runs two Spanish-speaking groups. The co-ed group, he says, brings both perspectives to parenting issues, such as how to tell the children that Mami or Papi has SIDA.

The other is for women only.

“In the Latino community, there is a difference,” he says. “Women would not be able to express themselves openly if men were there.”

The Spanish-speaking groups meet in Dignity House, a home MAP used as a hospice before new medicine, like protease inhibitors, prolonged lives. AIDS rarely kills quickly now, but there still is no cure, and the virus continues to spread, especially among young black men -- gay or not.

The agency’s caseload is rising 13% a year, McKamie says, and more clients have multiple diagnoses, such as mental illness and substance abuse, which make them harder to serve.

If MAP dies, what will become of the services the agency provides at the Twin Towers jail, or the program for women in residential drug treatment programs deep in South L.A.?

“The real issue with MAP is that they are being asked to do more with fewer dollars. They have always stretched themselves,” notes Gunther Freehill, director of public affairs for OAPP. “They are an agency like many others that are fiscally challenged. They are real troupers and have done a lot with very little for a number of years. Their situation is not unique, but it may be a little more critical.”

Already, budget cuts have caused McKamie to eliminate programs for women; men on the “down low,” who have sex with men but may not consider themselves gay; homeless men and women; IV drug users; people on Skid Row; and food vouchers, transportation and housing. He has closed offices, laid off 22 employees and accepted resignations from an additional 15, losing essentially half the staff, and has relied on volunteers to answer the phones and for clerical help, custodial work and bookkeeping.

He has also cut executive pay, including his by 10%, and maxed out his credit cards at $15,000 to make payroll, keep utilities on, buy food vouchers and help staff waiting for late paychecks.

$10 as incentive

Short-STAFFED and underpaid, MAP remains on a mission.

Late on a Friday night, Richard Hamilton stands in a nearly empty parking lot behind a rental hall on Western Avenue near King in South L.A. His long dreadlocks loosened from his usual low ponytail, Hamilton is looking good, but he is not here to party.

Tonight, he’s an evangelist.

By 10:30 a dozen MAP employees and volunteers are placing packets of HIV information and red packages of condoms on the cocktail tables.

They are here for the “Love Is a Message Ball,” a glittery extravaganza, part fashion show, part “voguing” contest for gay men, transvestites, transgenders and a few lesbians who will compete for trophies. Depending on the category, they walk the “runway” in designer labels, business suits, evening gowns as the standing-room-only crowd, largely black and largely male, shouts “Sex-y! Sex-y!” and snaps its fingers in approval.

Before the vocal house music gets louder, the MAP folks, the oldest in the room, go table to table, offering a $10 incentive to take a rapid AIDS test and get the results in 20 minutes. Hamilton makes safe-sex announcements throughout the night.

As the gala ends around 4:15 in the morning, champagne glasses and leftover cocktails cover most tables. Hamilton and Carolynn Martin, the two remaining MAP staffers, walk away from the only table filled with empty Starbucks cups.

They expect no overtime nor comp time, though they put in a full day at the agency before working this event. They haven’t had a raise in five years, and they are asking for help.

So far, county Supervisor Yvonne Brathwaite Burke’s office has speeded up government reimbursements for services, such as AIDS testing, that the agency has already provided. But, because the funding priority favors individuals with HIV, MAP gets paid only for positive results, which are far fewer than the negative results.

The city’s AIDS coordinator, Stephen David Simon, has funded two of the agency’s efforts and promises to do whatever he can to prevent MAP’s collapse. But his budget is small.

The big money, nearly $37 million for fiscal 2005, is controlled by the county OAPP. MAP took a huge hit from that source. However, OAPP is paying for Wallette, the consultant, and a professional grant writer for two months, who is contacting foundations and seeking unrestricted money, the kind needed to keep the lights on.

MAP should have a permanent professional fundraiser, but public dollars can’t be spent in that manner, Wallette says. Because the agency is addicted to federal funds, the pressure to come up with large donations is even greater.

Government grants typically pay 70% of program costs, and that other 30% has to come from somewhere.

Lanier, MAP’s CFO, says that last year the agency raised about $70,000 in donations from the Elizabeth Taylor Foundation, a consistent supporter, individuals such as singer Mary J. Blige, and small fundraisers.

“What’s the board doing?” wonders Davis, who serves on the board of the AIDS Healthcare Foundation.

The board meets quarterly and is not scheduled to gather again until July. Bean, the chairman, is addressing the crisis by making phone calls.

With Wallette’s help, the nonprofit agency is revamping the board, bringing on new members, like community activist Willis Edwards, who joined in April and persuaded the AIDS Healthcare Foundation to donate $50,000.

Meanwhile, McKamie is reaching out to celebrities and politicians who supported MAP at one time and are still listed on the letterhead as well as a website that in some areas is five years out of date.

He is also asking companies to lend executives, provide in-kind services or donate movie tickets, gift certificates, DVDs and CDs that can be used as incentives to encourage more individuals to get tested.

Netting the kind of private money MAP needs is becoming tougher, AIDS activists says, because some potential donors no longer consider the virus a crisis.

There’s no denying the crisis, from MAP’s viewpoint: the lobby.

“I just can’t see another girl walk in that door, who at 16 or 18, and after her first sexual encounter, tests positive,” Carolynn Martin says in the MAP office.

So on a recent Saturday, she carries an AIDS 101 display into a building near Vermont and Manchester in South L.A. She is here to speak to a group of girls, ages 12 to 15, who are taking part in a mentoring program sponsored by the Century City Alumnae Chapter of Delta Sigma Theta Inc., a black public service sorority.

“As she discusses symptoms, tests, and the difference between being HIV positive and having full-blown AIDS, one 15-year-old knows many of the answers.

“My mother and grandmother told me about it,” she volunteers. Her uncle has AIDS.

Like thousands of others, Hamilton was in a crisis when he came to MAP, but with help, he’s rebounded.

Will MAP rebound?

“We can’t afford to have MAP’s doors closed,” Davis, the veteran AIDS activist says. “Who’s going to fill the void?”