Community Outreach & Advocacy Committee Mission Statement: To ensure that
the voice of the community and consumers are part of the work of the Council.
The committee will ensure that consumers and other community members have the
opportunity to give input to the Council, be educated on the issues that affect
the HIV/AIDS community, and are empowered to be a voice for the needs of the
HIV/AIDS community that can affect positive change and ensure public policies
that enhance the lives of people living with HIV/AIDS.
Committee Members Present: Wilfredo Ortiz (co-chair); Devin Anderson (co-chair)
Committee Members Absent: Darnell Durio, Kim Pickens, Robert Oropeza
Other Council Members Present: Ayisha Benham; Ken Pearce; Dorothy Kleffner;
Walter Miller
Council Support Present: Jack Newby, Richard Bargetto, Skot Jonz
Others Present: Service Providers: Sarah (ALRP); Gwen Smith (SE Health Center);
Dr. Dan Wlodarczyk (SE Health Center); Tracy, RN at SE Health Center; Abner
Bowes of Westside Community Mental Health; 2 representatives from Black Coalition
on AIDS; 2 representatives from Legal Services for Children; Dean Goodwin;
Marshia Herring; Michelle Long (HIV Health Services – AIDS Office); 2
members of the public
(26 total in attendance).
Item 1. Greeting & Refreshments
The Committee was greeted by Dr. Dan Wlodarczyk and Gwen Smith of the Southeast Health Center. Refreshments were made available to those in attendance.
2. Welcome & Introductions
Co-Chair Ortiz called the meeting to order and welcomed everyone. Those present
introduced themselves.
3. Open Discussion
An open discussion on HIV services, upcoming changes in services and client
needs, particularly those of the Bayview community. Neighborhood service
providers, if present, will have an opportunity to discuss their services.
Co-Chair Ortiz opened the meeting for discussion.
Mr. Bowes from Westside Community Mental Health discussed the new SE Bayview COE facility and that there have been efforts to collaborate with other agencies, including Black Coalition on AIDS, Positive Health Project; and others. The discussed the goal of the COE, to work with individuals and families with HIV/AIDS to connect with primary care for African American males and females. He discussed collaborative efforts with the Maxine Hall Health Center and the care coordination, intensive case management, brokerage of services and linkages to services, and building a model that helps individuals pursue a healthy lifestyle and to connect with community support. He discussed that there will be wrap-around services with an extensive marketing campaign, easy access, long-term access, breakdown of barriers, and flexible funds to address needs of clients.
A representative from Black Coalition on AIDS discussed that they will be holding an event on World AIDS Day, and discussed various services available for education and support. He asked if there were any questions. One person asked how BCA is funded. The response was that BCA is funded mostly by city and federal funds, with 20% private funding.
Dr. Dan Wlodarczyk discussed that he has been the Medical Director at SE Health Center for more than 20 years. He discussed the history of the clinic. His main question to the group was why there was not more of a presence from the community. He discussed that it is difficult to get people to come to the events to talk about HIV. Many people are not open about their diagnosis/status because of the taboo or stigma around HIV. Dr. Dan stated that he is excited about the COE, which will make available more support and counseling, and make it possible to discover those HIV+ people who are out of care.
In the Bayview, regarding HIV, it is difficult to get people to keep taking their medications and keep their appointments. He discussed the critical issue of late presenters. He added that there is additional difficulty of hiring and retaining qualified staff, especially when there is a hiring freeze in effect. He discussed that he is not sure how great the need is, but believes many people are not getting any care, or the level of care that they need.
Representative from SE Partnership for Health discussed the lack of education and the need to link services, the population is more relational. The motivation for positive behavior is related to a person they can trust and feel comfortable with. He added the SE area of the City contains a non-traditional population troubled with substance abuse, mental health issues, and legal matters including incarceration. All of these activities translate into risky behaviors leading to HIV infection.
Dr. Dan Wlodarczyk added that he feels the area has been neglected for a long time. Other parts of the City have better and more services. He added that this neighborhood is plagued with crack and heroin, and less speed than others parts of City. He discussed that incarcerated individuals may get health care and medication while in jail/prison but upon release everything falls apart. There needs to be some transitional services to keep people in care.
Representative from Black Coalition on AIDS discussed that there are three major housing projects in the Bayview and few service providers spend much time there. He suggested that to turn around this epidemic it is necessary to go to the people with what they need. In addition to the concerns of HIV, there is a great need to discuss the violence, diabetes, housing, and other matters.
Andre Roberts of BCA mentioned that he sits on the HIV Prevention Planning Council as a community liaison, to look at Bayview and Visitacion Valley. He discussed that HIV and other health issues are not even on the radar because there are other issues that are too important. He stated that if you really want to serve the folks there, you need to go where they are at, because many do not travel far from their home; and many people spend their entire lives confined to a very small geographical area rarely traveling outside. He expressed the need to hire residents of the neighborhood to work in the service providers.
Someone asked if the churches in the neighborhood are involved.
A member of the public responded negatively, and discussed how there are problems
with churches getting involved.
Representative from BCA mentioned that there is information and literature in about 10 churches, and stated that this is a big step. He emphasized vigilance in changing the mindsets in church, and it is certainly not where it needs to be.
Member of Public stated that her pastor will not talk about AIDS, and that there is a stigma, especially among women. She discussed the difficulty in finding a women’s support group.
Others suggested a Thursday night support group at BCA or Glide church, or Jones United Methodist.
Ronald Gutierrez from Legal Services for Children discussed their Hope Project and permanency planning for children, and caregiver with children who are HIV+. He discussed their support groups available for children in preschool, middle school, and high school, as well as a parents group. He discussed that the current population does not seem to have the same interest in HIV or support groups, and believes many families need services in primary care and housing. He discussed that there is a level of apathy and it is difficult to get people involved.
Representative from BCA suggested that there have been too many promises made
that have been broken. The people are disenfranchised, and the community feels
they have no power, and they do not expect to receive anything. He added that
people are afraid to out themselves because of the stigma, and this is intertwined
with other issues, such as food, clothing, housing, violence.
The fear and stigma of being seen in a HIV clinic contributes to many undiagnosed
cases in the Bayview.
There was discussion that support groups would be helpful but there are no funds for this.
Someone indicated that they had facilitated a support group for four years without ever receiving any funds and asked why money was needed for a support group and whether people who needed it could just gather and create their own support group.
It was discussed that funds are needed to help the oppressed and depressed members of the community. The community has no reason to be hopeful. It was added that money is needed for childcare, transportation, food, room rental, advertising, and other expenses of organizing and maintaining a support group.
Member of Public discussed that she feels people just won’t come, whether there is funding or not. Many people are not aware of the services available. She discussed that with or without a support group it is the responsibility of individuals to check up on each other on a daily basis, and not wait for a support group meeting.
Someone discussed that it is not necessarily about having a support group, but having “structure” in individual lives throughout the day. There needs to be a social network to attend meetings and a sense of community to feel comfortable.
Sarah, staff attorney from AIDS Legal Referral Panel (ALRP), discussed the legal services provided by her agency and mentioned that they provide assistance for civil legal matters (not criminal) with the use of 400 volunteer attorneys. She expressed that ALRP wants to be accessible to the Bayview Community.
CM Kleffner discussed her participation in WORLD, a women’s group that
discusses HIV issues.
Member of Public discussed that many African American women will not go to
WORLD because they are too afraid to talk about AIDS, and additionally women
do not like to go to a specific AIDS building.
Dr. Dan and Gwen Smith discussed that Southeast Health Center is an all-purpose clinic, ,including psychiatric and health needs from prenatal to geriatric., and it is not a specialized HIV clinic.
Representative from BCA discussed that in order to end the stigma, people need to stand up.
Question regarding the COE structure and what is the point of entry? The response was that there are multiple points of entry, and that the advertising and marketing is not out yet, but there will be contacts at SFGH and other providers who will refer through care coordinators.
CM Kleffner asked about the issue regarding child care and how much of a need there is for child care.
There was discussion that children may be neglected, and infected parents may not have custody of their children. There are both male and female parents infected, and childcare is definitely a concern.
Someone stated that this issue is compounded by the fact that taxis will not come to that area of the City.
CM Ortiz discussed the safety issue and violence being discussed are not necessarily the purview of the Planning Council, and asked how the organizations in the neighborhood are working with the Mayor, and what is being done to address these issues?
Someone addressed the question by stated that there are a few small groups dong some work separately, but not a coordinated effort. He added there are no resources to solve this issue and it is like “gnats hitting the side of an elephant.”
Comment: Someone dies from gunshots every day in San Francisco. During Halloween weekend, there were 11 shootings and 6 deaths.
Comment: There is an inability in the community to work and collaborate with the police in solving crimes. There needs to be more violence prevention programs, housing, employment, community development.
Comment: The solution needs to come from the community, not outside or from downtown. The people here are oppressed and depressed. After so many years of being oppressed and depressed and the long-term violence, the residents of the Bayview do not have the energy to fight the current environment.
Public Comment: Asked “What is the plan?” He added that it was great that all these people were meeting here to discuss these issues, but was concerned about what would occur next after this meeting. He asked why people in the room didn’t already know each other. He expressed concern about how to solve problems in the neighborhood and it discussed how it is “touch-and-go” each day whether you will survive. He added that people talk about it, but nothing ever gets done, and he would like to see changes made. He added that he doesn’t have the answer, but knows that there is a need to get something done.
Tracy, a nurse at Southeast Health Center added that she also lives in the neighborhood, attends a local church, and attends meetings related to solving the violence. She expressed that there is a need to do more outreach. She discussed how some people NEVER leave the housing project because of fear of violence.
Comment: What will be done about HIV and violence?
CM Pearce added that the Bayview has been disproportionately given a large amount of money to service providers in that neighborhood. The work has already been done, and the money has been given. He stated that the Council Members are now here, listening to what else needs to be done.
CM Miller added that the Council will continue to defend the issue of keeping funds in Bayview and will justify and protect the money in the Bayview.
Comment: Suggested that there needs to be regular meetings in the Bayview to hear different voices. People want to be heard. He added that the Health Commission got blasted because they had never been to the neighborhood in 30 years. There is a need to GO TO the projects and hear the voices. This includes not only the subcommittee, but perhaps the Full Council should meet there.
Co-chair Ortiz added that the COA Committee has the mandate to go to the various communities in the entire 3-county EMA, and reviewed the other meetings that have been held to focus on the Asian-Pacific Islander community, the Hispanic community, and the transgender community, among others. He added that the Committee will return to the Bayview. He added that this meeting is very similar in attendance to the other meetings.
Comment: Feels like denial is as big or bigger problem than HIV itself. He added that no matter how much money is allocated, it is inadequate.
CM Pearce commented that he sits on both the CARE and Prevention Councils, and mentioned that Gwen Smith of SE Health Center also sits on the Prevention Council. He repeated that a disproportionately large amount of money has been allocated to this community, and an effort has been made to get people into care. He added that the two Councils DO care, but with limited funds it is necessary to take away from other areas of the city in order to accomplish this. Those areas of the City being cut in funding naturally want to hear justification about why so much is being spent on the Bayview, especially if people are not accessing the care. He concluded that the Council members are here today to find out what more can be done.
4. Explanation of Community Outreach & Advocacy Committee and
the HIV Health Services Planning Council
Basic explanation of purpose to this committee, our working groups and the
Advocacy Project. Short explanation of the reasons why the Council exists and
what we do.
5. Future HIV Services Funding
Explain CARE Act reauthorization process.
Where we are.
Jack Newby, Council Director, discussed that he has learned a lot today and
served to open his eyes to the issues and struggles affecting the neighborhood.
He discussed in detail the funding issues and the pending reauthorization of
the CARE Act and discussed the various Titles of the CARE Act.
6. Practical Tips for Advocacy: Let’s write our Congressional Representative
Jack Newby discussed practical tips for advocacy and encouraged people to contact
their elected representatives. He provided several poignant examples of the
impact of a phone call or letter can have.
7. Thank You- Evaluation
Thank members of the community for attending and encourage their future participation
in our community processes (attending Council meetings, Council membership
and/or other HIV advocacy).
Gwen Smith added that she has been at the Southeast Health Center for 14 years
working with Dr. Dan. She stated that she was angry that 20 years into the
epidemic there was no funding to this area of the city. That is why she joined
the Prevention Council and thanked the CARE Council for finally directing funds
to the COE.
Co-Chair Anderson thanked everyone for attending and encouraged people to apply for membership to the Council.
CM Kleffner thanked everyone for attending and for the valuable feedback and
information, which will aid the Council in continuing funds to this area and
the different issues of concern.
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