Henry J' Kaiser Family Foundation

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Henry J. Kaiser Family Foundation

• Congressional Staff Briefing
• on Financing HIV/AIDS Care
• October 27, 2000

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Challenges Faced by ASOs/CBOs

• Thank You and Good Morning --
• Whitman-Walker Clinic has a long history of
  rising to meet challenges. For more than 25
  years we have provided community care to gay men
  and lesbians in the metropolitan Washington area.
  And since 1983, we have served those who are
  challenged every day by HIV and AIDS. I am proud
  to stand here before you this evening
  representing an institution that serves as a
  model for other health care organizations serving
  their communities in urban areas across the
  country and around the world
• Our challenges are the challenges of our sister
  organizations across the country. Today, because
  of advances in HIV medical care and treatment, we
  help most of our clients find a way to live with
  this diseaseto dream again of the next monththe
  next yearand the next decade. But while we work
  every day to help our clients live healthier,
  longer, fuller lives, we are facing our own
  strugglea struggle for the very life of our
  institution.

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Washington Leads the Nation -- in AIDS Cases

• We live in a city that has a deplorable rate of
  AIDS diagnoses that is 9 times the national
  average. That is unacceptable.
• A recent survey of community representatives
  found that substance abuse and HIV/AIDS were the
  top two health care issues for this city to
  address. But in the predominantly
  African-American areas of this city served by
  Whitman-Walker Clinics Max Robinson Center,
  there are only a total of 300 hospital beds and
  only 1 in 13 doctors in the District have medical
  practices in those Wards.
• 25 of the people who come to us are women, many
  with children

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More Clients -- Greater Needs

• Like most other ASOs, Whitman-Walker Clinic today
  serves more clients than ever before. The vast
  majority of our patients are the poor those who
  have traditionally been underserved in Americas
  health care system. Many present themselves with
  a multitude of problems ranging from substance
  abuse, to mental health needs, to an acute need
  for medical treatment because they have not had
  adequate access to health care.

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HIV/AIDS and Poverty
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Public and Private Funding -- Organizational
Survival

• We look to the private sector for assistance and
  find that Americans are becoming complacent about
  AIDS because our brothers and sisters arent
  dying in the same numbers they once were.
• We look to already overburdened local and federal
  governments for assistance. And, we become
  dismayed with the picture of a health care system
  that cannot begin to address the myriad health
  care needs of the thousands of people who
  desperately need help.
• We cannot continue to be the safety net for the
  single largest health care threat to the Nations
  Capital!
• The process of finding the money is complicated
  the tracking and reporting is extensive and, the
  grants are becoming more restrictive.
  Increasingly, grants do not include any support
  for overhead or administration, including quality
  assurance, financial reporting and management.

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Federal, State and Local Funding is Complex
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Fundraising Not Keeping Up With Demand for
Services

• Over the past few years, while our client base
  has continued to grow at a record pace, our
  funding has by and large remained steady. That
  cannot continue. The Whitman-Walker family is
  about tapped out. We are constantly trimming our
  expenses to wring out every dime we possibly can
  for client care, but theres just not much more
  room for cuts without looking at programs and
  services.
• If Whitman-Walker continues to acquire new
  clients at the same rate as it has in the first
  10 months of this year alone, our case load will
  more than double in 5 years.
• Medicare and Medicaid do not begin to reimburse
  the Clinic for the costs of services provided to
  community health care providers

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Client Case Load ProjectionsBased on Current
Clinic New Client Trends
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Projected Budget Needs (in Millions of Dollars)
at Current Service Levels
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Without Help, Its Getting Worse...Fast

• From Fiscal Years 1997 to 2001, our budget grew
  by an average annual rate of 12.25
• This year we have 25 more clients than we did
  last year.
• We need helpat current rates of new client
  intake, our budget will have to double in five
  years to nearly 60 Million
• Federal funding and its importance...

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Federal Support is Critical