A San Francisco-based nonprofit that works to help Asians and Pacific Islanders, including those who are HIV-positive, has ceased its operations in Oakland and Daly City.

Lance Toma, executive director for API Wellness Center, said the cuts – which took effect January 15 – come after reductions in funding. He said the center remains committed to preserving services in San Francisco.

In an e-mail, Toma wrote that the funding reductions reflect how, across the country, Asian and Pacific Islander communities aren't being prioritized.

"HIV infections are rising in our communities and we continue to fall through the cracks," he wrote. "API Wellness Center will continue to advocate on behalf of our communities" so that their needs are no longer made invisible, he continued.

In 2008, the Centers for Disease Control and Prevention reported that the largest proportionate increase in the number of HIV/AIDS diagnoses from 2001 to 2006 among men who have sex with men in 33 states was among Asian and Pacific Islanders aged 13-24 years. Their numbers more than doubled. California was not among the states studied.

Over the past three years, public and private funds to the center's programs and services for HIV-positive APIs have been reduced by over $350,000 annually.

The center will be losing about 45 clients between its Oakland and Daly City services. Three full-time positions have been cut, including one case manager in each of the two cities. Two part-time positions were also eliminated.

The agency works to provide culturally and linguistically competent services. Toma indicated that is important for reasons that can include community members' mistrust of service providers who don't share their culture.

He said in a phone interview that API Wellness had started its office in Oakland in response to the rise of HIV in the Burmese community.

Struggle to maintain services

Despite the cuts, the center has carried a financial deficit for several years in order to maintain services, Toma said in a statement posted on its Web site.

In Oakland, API Wellness Center received funding for several years from the California Endowment, which provides grants to community-based organizations. However, Toma said the endowment's funding priorities have shifted, and API Wellness hasn't received any money from them since the beginning of 2009.

Some clients are being transitioned to AIDS Project East Bay in Oakland, from which the center had rented space.

Kevin Bynes, the AIDS Project's program director, said the agency would be absorbing about 25 of the center's clients. He said his agency's services include an HIV specialty care clinic and housing assistance.

Bynes said his organization doesn't have staff that speaks any Asian or Pacific Islander languages, but they do have access to translation services.

The Daly City cut comes after other funding reductions. The San Francisco Department of Public Health had provided about $45,000 annually in Ryan White Part A/Minority AIDS Initiative money to API Wellness, but the center stopped receiving that funding in February 2008.

API Wellness Center's case manager in Daly City had collaborated with a San Mateo County medical provider and social worker to provide culturally specific case management to any HIV-positive Asian or Pacific Islander resident of San Mateo County, according to Matt Geltmaker, the county's STD/HIV program director. Services provided to all HIV-positive residents of San Mateo include medical care, financial assistance, and other services. 

Geltmaker said the services will continue, but they won't be culturally specific. He said the center's work had been "a wonderful addition" in the county and he called the loss "unfortunate."

In an e-mail, Bill Blum, interim director of HIV health services for San Francisco's health department, wrote that the city could no longer afford to care for San Mateo clients on top of the proportional allocation of Ryan White Part A money that's passed through to San Mateo.

San Mateo and San Francisco counties are part of the same Ryan White funding area. The allocations are based on counties' percentage of living AIDS cases.

Blum noted API Wellness hasn't received any Minority AIDS Initiative money from San Francisco for at least the past three years. The AIDS initiative money is embedded in all Ryan White Care programs.

In addition to other cuts, Toma said a number of smaller private foundations "have shifted away from direct services programming" over the past three years, helping lead to the cuts in Alameda and San Mateo counties.

Toma has also taken a temporary salary cut, from $105,000 to about $89,000, through the end of March. With all the changes, the center's overall budget is about $3.7 million annually.

He said all through the last year the agency had been "doing what we could to raise funds" specifically for the Alameda and San Mateo County services, but he finally decided to make the cuts in December. He said staff and clients were informed the first week of January.

SF operations continue

In San Francisco, HIV-positive clients will still be able to access services at the center's offices at 730 Polk Street. Those services include mental health and intensive case management.

API Wellness Center's San Francisco HIV care services currently has 135 unique, active clients accessing its case management services.

The center will also continue to provide HIV and hepatitis testing services, in addition to health education programs for the transgender community, gay and bisexual men, and LGBT youth.

Mike Rabanal, API Wellness Center board chair, said in the center's statement that a "wealth of services delivered by our San Francisco-based staff will continue, and we encourage our clients outside of San Francisco to access these resources to the extent they can."

At least one client of the center's San Francisco services is concerned, though.

Charles Siron, 46, is living with AIDS.

"I think it's been decided already that San Francisco is next" for cuts, and that a planned town hall "is after the fact," Siron said.

Siron said he thinks the center's mission, which includes service to people living with HIV/AIDS "just went out the window."

Told of SironÕs remarks, Toma said, "The mission and vision of API Wellness is about making sure we protect all our HIV services across the board. ... These decisions that we made are to ensure that we can continue our services in San Francisco."

API Wellness Center is hosting a community town hall to discuss the organizational changes being implemented and its vision and plan for the future. The meeting will be today (Thursday, January 28), from 4 to 6 p.m. at 730 Polk Street in San Francisco.