Head of AIDS Agency Outlines the Scope of the Battle : Q & A

Stephen Bennett, 42, outgoing chief executive officer of AIDS Project Los Angeles.

Claim to fame: Presides over the second-largest AIDS service provider in the country. He is credited with putting APLA--at the brink of bankruptcy nearly three years ago--back on firm financial ground.

Background: A graduate of Pepperdine University, he has spent much of the last two decades working for charities and nonprofit organizations. He has headed the United Cerebral Palsy/Spastic Children’s Foundation of Los Angeles and Ventura counties, and is a board member of the Los Angeles AIDS Hospice Foundation. Bennett will soon return to full-time work at a management consulting firm, where he is a partner.

Interviewer: Free-lance writer Duke Helfand.

Q: What is AIDS Project Los Angeles?

A: APLA is an advocacy organization consisting of three parts. One involves direct services to those who are sick. Another deals with prevention and education. The third concentrates on public-policy issues. We are the second-largest agency in the country that provides services to people who are HIV-positive and to those with AIDS. Only Gay Men’s Health Crisis in New York is larger.

Q: What are your direct services?

A: We provide 650 bags of groceries a week to clients. We also offer free dental care and a limited amount of housing for people who are HIV-positive and drug users. We take emergency walk-ins and try to get people into shelters. And we’ve created a hot line in English and Spanish, which is up to 8,000 calls a month. A translator machine offers the information in eight languages, including Japanese, Chinese, Thai and Korean.

Q: Do your clients have to meet any requirements?

A: Yes. To be a full-fledged client, you have to have an AIDS or an ARC (AID-related complex) diagnosis. Then you are eligible for our case management, our mental health support, and the food and dental programs, among other things. But our public-benefits programs--insurance seminars, legal assistance, education forums and self-care manuals--are directed at the whole HIV community.

Q: How many people do you serve in Los Angeles County?

A: The numbers keep growing. Right now, we have more than 3,200 clients. We estimate, however, that we will serve 150 new people each month in the next year. By mid-1993, we expect the total to reach 6,000.

Q: How do the numbers break down along racial and ethnic lines?

A: It’s about 17% Latino, 16% black, 1% Asian, and the rest white. Those numbers have changed dramatically over the years. People have said that this is becoming a minority issue. Yes and no. Although the percentages in the black and Latino communities are growing, the white community thus far has the largest actual numbers. We had a 17% increase in Caucasian men last year.

Q: What are you doing to reach the Latino community?

A: For starters, we have a very high-pressure program to hire people who speak Spanish. We pay a premium to those who are bilingual, and we have Spanish classes here for staff. Then we have a bilingual educational specialist who does nothing but write all of our materials in Spanish. And we have added Latinos to top management.

Q: That’s all internal. What about working in Spanish-speaking communities?

A: We have tried to develop liaisons. Our arrangement with AltamedHealth Services Corp. is a good example. We come to the table knowing a lot about the gay and lesbian community and about HIV care. Altamed, one of the oldest health care agencies in East Los Angeles, comes to the table having dealt with the Latino community. They’re interested in HIV-positive drug users. So we have started integrating what we each know.

We have a panel of doctors that trains their doctors in HIV care. That’s the first step--learning to work together. The second step involves us talking about opening pharmacies and infusion clinics together. The third step involves perhaps opening the clinics. We like the alliance with Altamed because it enters the field as an equal. It is a legitimate agency with a $12-million budget.

Q: How do you reach the black community?

A: The black community has really empowered itself politically over the years. You have to deal with it from a power base by working through black politicians. But first, you’ve got to start inside your own organization by breaking down racism. It is very important for us to hire people who are geographically based in the black community.

Q: Are black activists open to your solutions?

A: It is very difficult when you are meeting with them, and they’re reminding you of the oppression they have experienced and of the fact that they don’t want to be patronized by white folks spending white donor-dollars to serve them. We are seen as a white, Westside, gay-oriented agency.

Q: How do you respond?

A: (We acknowledge that) they are talking mainly to an agency that is typified as white, but they are talking to members of an oppressed community as well. I’m gay, a lot of our staff and leadership are gay, and most of our donors are gay. We have dealt with an issue--AIDS--that no one else would deal with originally because of homophobia.

Q: So you do find common ground?

A: By essence of our size, we are part of the black community. We’re the largest provider of services to black people who are HIV-positive in Los Angeles. That’s who we are.

Q: AIDS is projected to rank fifth as a cause of death among women 25 to 44 by the end of this year. Are you doing anything new to help them?

A: As a practical matter, we have added tampons, diapers and other necessities to our food bank. We also now have the Women and HIV Task Force, a kind of cross section of people from different departments who come up with proposals for new programs. One of the things the task force is concerned with is the education of gynecologists. The participants are trying to teach doctors that HIV symptoms manifest themselves differently in women than they do in men, often showing up as chronic yeast infections or pelvic inflammatory disease.

Q: The introduction of anti-viral drugs like AZT and earlier detection of the HIV virus are helping to prolong the amount of time before the onset of AIDS symptoms. That is a positive development. Is there a down side to longer life spans?

A: What we’re seeing is a parallel of poverty with the disease. Let me give you a stereotype for a minute--a 32-year-old gay white male. He used to enter the system but would be dead within six months. Now he will enter the system and live for 2 1/2 years. Meanwhile, his friends are all dead or dying, and in 18 months his COBRA (health insurance) runs out. His disability benefits add up to crap, so he sells his furniture and car, and he gets a roommate. Within a year, he’s lost all his resources. His income is welfare, and he’s totally broke.

Q: What impact is that having on service providers like APLA?

A: Our direct-assistance demands skyrocket. Instead of having 10% of our clients using the food bank, all of sudden we have 40% using it. We believe that the average client entering the APLA system today consumes seven times more services than that same client did four years ago.

Q: Let’s turn to education. APLA holds a number of speakers’ forums. One of the newest, I believe, is called “Speaking of Sex.” What would I learn if I attended?

A: It’s a negotiation class. It is one thing to know about safe sex, but it’s another to have enough personal power in a sexual situation to come out on the safe side. The question is, how do you make the right decisions?

Q: The terminology surrounding AIDS is confusing. I believe you cover this subject in your AIDS 101 forum: What are the differences between HIV-positive/asymptomatic, symptomatic HIV infection, and full-blown AIDS?

A: People who are HIV-positive but asymptomatic might not ever know they have been infected. They don’t feel sick. They simply have been exposed to the virus. If you have symptomatic HIV infection, you are HIV-positive, and you start to show symptoms of an opportunistic infection. You have full-blown AIDS when your T-cells drop below 200 and you have one or more of the symptomatic diseases as defined by the federal Centers for Disease Control.

Q: Isn’t the definition about to change?

A: Yes, I believe April 1. The requirement of showing symptoms will be dropped. If your T-cells fall below 200 you will be defined as having AIDS. With the new definition, the number of AIDS cases will expand tremendously.

Q: Is APLA prepared for the influx of clients?

A: Yes. We have just restructured our intake process, making it more thorough, to determine each client’s needs. Traditionally, you would be assigned a case manager, who got you services through us or through referrals. We have found, however, that there are a number of people who do not require this--they are qualified to manage themselves.

So our goal is to refer 30% of our new clients to our case managers and allow the rest to manage themselves. We’ve designed a support system for them with a client resource center and specialists to deal with insurance, diet, legal issues and other things. In addition, we have a group of volunteers who contact each of these individuals regularly to check on them.

With the new system, we will be able to accommodate 200 new clients a month. Right now, we can accommodate about 50.

Q: I think there is still confusion about how the HIV virus is transmitted. Can you clear that up?

A: The main way that people get AIDS today is still through unprotected anal or vaginal intercourse, or through the sharing of needles between drug users. One of our real concerns, to be blunt with you, is that there are a number of subcultures in Los Angeles that practice anal intercourse as a form of birth control. That’s a problem.

Q: Can I get the HIV virus through contact with tainted blood?

A: If someone is HIV-positive and their blood is splattered all over you, it is nearly impossible to contract the virus. They say that if you prick your finger with a needle that has been exposed to the virus, the odds are about 44,000-to-1 that you might get something.

Q: Why then so much concern among doctors over wearing gloves when they treat patients?

A: If you’ve got a cut, an open sore or wound, and it comes into contact with HIV-positive blood, then you’ve got a concern. You just want to be protected.

Q: Will Magic Johnson’s announcement that he has tested positive for the HIV virus help agencies like APLA educate the public?

A: I think Magic’s announcement has made an incredible impact on AIDS awareness across the nation. It has made the disease a more personal cause and presented us with a valuable opportunity to reach communities who previously thought they were immune to this horrible disease. An added benefit comes in the potential increase in funding from individuals and corporations that have been afraid to support us in the past.

Q: APLA established a public-policy office in Sacramento last year. Why?

A: As AIDS becomes a part of the mainstream, our work lies in helping government accommodate it within the system. That doesn’t mean that you stop holding demonstrations and things like that. But we need a stronger, more professional, effort in Sacramento. This last year, for example, we fought for a bill to put AIDS education in junior and senior high schools. We look back at what we have accomplished for people with AIDS, and we realize that our public-policy work in some ways has probably had more of an impact than all the services we ever provided.

Q: How is APLA funded?

A: We have a $14-million budget this year. Nearly all of it comes from private sources. We have to raise about $1 million a month through our own efforts. Only about $2.5 million comes from the county, state and federal governments.

Q: Have there been cutbacks in public funding recently?

A: AIDS has been somewhat protected to this point. We have not felt specific cutbacks. What has happened, however, is that the numbers of people impacted by AIDS has grown, while the funding has not. So in essence, the demand is outpacing the money. Remember, we’re seeing people live longer, become poorer and consume more services. It’s a disaster.

Q: Am I right that APLA was near bankruptcy when you arrived 2 1/2 years ago?

A: It had a $6-million budget, but it was $1 million upside down. It wouldn’t be able to make payroll in a matter of weeks. One of the outstanding issues has been to reposition this agency and make it viable. In other words, put it back on track financially. We now have a balanced budget with a 7% reserve, and we have a sophisticated accounting system. I can tell you how much money we expect to have in the bank on April 27, 1992.

Q: The fact that APLA has grown so much goes to the heart of the major criticism I hear, namely, that it has become too big and impersonal. Is that so?

A: It’s the smallest agency I’ve ever run. When I was at United Cerebral Palsy, we had 600 employees. Here we have 137 employees and 2,300 volunteers.

Q: The criticism, as I understand it, comes from within the gay and lesbian communities. Why?

A: I think the root of it has to do with misdirected anger, frustration and Angst relating to AIDS. I also believe that in our community there is an oppression-sickness. We have a very difficult time with institutions and leadership. That was true long before AIDS. The fact that we have an APLA is something we should be damn proud of. If we were all itty-bitty agencies, we’d have no power.

Q: APLA is nearly 10 years old. What does it still need to accomplish?

A: APLA needs to become an organization that can change easily. For example, we were very oriented toward gay white men in the beginning. Over time, though, our clients have increasingly been people of color. I think that the internal organization--the board of directors, management, case managers and others--has needed to reflect that change faster and with less tokenism.

Q: What else?

A: We also need to focus more on client satisfaction. Too often in social service agencies, clients get the message that they are charity and that the agency is poor. We would like our clients to feel like they’re at Nordstrom’s. We try to keep our lobby friendly. We put in comfortable furniture, and we have a host or hostess to serve coffee and to make sure that clients don’t wait too long.

Q: You’ve headed some of the largest charities in the area. You’re a successful businessman. Why did you leave that for your stint here?

A: I am a gay man who intends on living to a ripe old age. When I am sitting in my rocker on my front porch and thinking about what happened when my friends started dying from AIDS, I will ask myself one question: “What did I do?”