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Gotham Gazette

The Place for New York Policy and politics

Advocates Contest AIDS Caseworker Cuts

Photo (cc) 2010 William Alatriste

Robert Doar, commissioner of the city Human Resources Administration, testifies Tuesday on proposed cuts in programs for people with HIV/AIDS.

Valida Henry sat over a bowl of plain pasta in the cafeteria of Bailey-Holt House, a supportive AIDS housing residence she has called home for the past four years.

Henry, who contracted HIV 10 years ago, has lived longer than she ever anticipated -- in part thanks to services from both the city and the 44-unit facility long settled on Christopher Street.

"A lot of these places were set up for us to come and die," said Henry, who is 62 and legally blind. "The people with HIV and AIDS are living longer than they anticipated, and now they have to rethink the medical [care] and rethink the budget. And rather than rethink it, they want to cut it."

Henry is referring to the Bloomberg administration's executive budget proposal, which includes a $75 million cut to the city's Human Resources Administration, the agency which oversees social services for those living with HIV and AIDS. That cut will sever 248 caseworkers from the HIV/AIDS Services Administration to save the city about $4.2 million in fiscal year 2011 and $8.5 million the year after.

The city argues the reduction of caseworkers will not only save money, but also reduce service redundancies. Meanwhile advocates and those living with HIV and AIDS contend it will not only drive up caseloads, but also violate city law.

"Who is going to represent [us], if we only have one to 100," Henry asked, looking toward two fellow Bailey-Holt House residents beside her. "How will we be taken care of?"

An Illegal Move?

To cut back on costs, the city has proposed to include contracted caseworkers from outside groups, such as Bailey-Holt House, in calculating its client to caseworker ratio. City law requires one caseworker for every 34 cases for individuals and one caseworker for every 25 families. According to one HRA official, the administration has 850 caseworkers serving about 31,000 clients -- or one for every 36 clients and above the legal threshold.

The administration would not disclose how many caseworkers it contracted with in community based organizations and nonprofit groups. It did say both the city's caseworkers and its contractors do the same job and eliminating some of those positions would save taxpayers cash.

"We have reached a point in this difficult economy in which it is no longer tenable to have two case managers assigned to one case when both their salaries are paid for in whole or in part with scarce public resources," said Human Resources Commissioner Robert Doar yesterday at City Hall. "We are acknowledging the important role played by the long-standing contracted supportive housing programs and including their case management staff in the HASA staff ratios."

The administration will also hire 18 liaisons and two supervisors to work with caseworkers in contracted social service organizations to help streamline the process.

From the get go, advocates have argued contracted caseworkers and city caseworkers do not do the same job and should not be counted toward the ratio requirement. Advocates say the city's caseworkers focus on fundamentals, such as making sure those living with HIV and AIDS get housing and welfare. At a contracted social service agency, like Bailey-Holt House, staff focuses on mental health and social support.

"They might as well count farmers in Poland," said Armen Merijan, a senior staff attorney at Housing Works, another social service organization that deals with the HIV and AIDS population. "It's so preposterous that it's insulting to anyone's intelligence. The law says it has to be staff at the agency."

When Gotham Gazette asked Human Resources Administration staff for a response to Merijan's claim, they did not return phone calls or emails.

For now, some council members appear to be siding with advocates.

"You're going to tell me that every one of the HASA case managers is equipped with psycho-social case management and [can] deal with health issues and able to manage clients?" asked Councilmember Domenic Recchia, the chair of the council's Finance Committee, at a hearing at City Hall Tuesday.

"Without question," responded one administration official.

"So, you're going to tell me all these years you wasted taxpayers' money by contracting case managers?" Recchia boomed, his voice reverberating throughout the packed council chamber.

Administration officials said "robust case management" was needed at the beginning. Now, the commissioner countered, the administration has to "properly scale" its workforce.

Caseloads Up, Services Down

Regardless of the cut's legality, those caring for or living with HIV and AIDS fear they reduction in caseworkers will have other consequences.

Raul Plasencia, the director of supportive housing services of Bailey House, predicted an increase in homelessness if the caseworker cuts go through. Clients at Bailey-Holt House all have HIV or AIDS and have been homeless, incarcerated or suffer from drug addiction. If it takes longer to get them into supportive housing should caseloads increase, they will have nowhere to turn to but the streets.

Above Plasencia's office, Henry was attempting to enjoy her lunch -- one of three meals Bailey-Holt House gives her gratis every day. Instead of focusing on her pasta, she was focused on the city budget.

"You've cut the pools, the parks, HIV, AIDS," said Henry. "Just have to go along humbly with what they say. ... If they can do that now, what else can the government do?"

Moments later, a caseworker from the Human Resources Administration walked through the door of Bailey-Holt House. She was there to see her client.

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