PiCASO struggles to survive
amid funding cuts

Leaders of an 18-year-old organization dedicated to HIV/AIDS prevention and patient assistance are contemplating closing in the face of a budget shortfall greater than 30 percent.

The loss of about $25,000 from the United Way of Pitt County has the Pitt County AIDS Service Organization scrambling to find new dollars to fill in the gap, so far a difficult task because several other donor agencies also have cut funding or rejected their grant applications.

“I think we are running a pretty tight ship, and when you run a pretty tight ship, it doesn't take a lot to put you in crisis,” Aaron Lucier, president of PiCASO's board of directors, said. “As a board we are looking at whether we still will be able to keep the agency open.”

The organization operated with a $130,000 budget in 2008. This year the group expects to receive less than $90,000, Lucier said. The board will decide by month's end if the agency must close unless a significant portion of the $40,000 deficit can be raised, he said.

PiCASO, incorporated in 1991, provides rapid HIV testing, counseling and educational services and assistance with drug costs, housing, nutrition and other needs.

Last year the organization performed 460 tests, Teneisha Hardison, the group's executive director, said. Out of that group, five people learned they were HIV positive. The rest were counseled about how to reduce their exposure risks, she said.

There have been 743 HIV cases and 443 AIDS cases reported in Pitt County over the last 25 years, Dr. John Morrow, Pitt County Health Department director, said. Since 2005, 20 to 40 new cases of HIV are reported annually. The county ranks 17th in the state in reported HIV cases and 18th in reported AIDS cases, according to a 2007 state report, Morrow said.

People can have difficulties accessing services that will help them live with HIV/AIDS, Morrow said. PiCASO helps solve the problems.

Those services range from finding transportation so people can make medical appointments, finding assistance to cover drug costs or securing housing. PiCASO has 68 clients receiving active case management. Hardison said another 175 people are classified as inactive clients who don't need case management but use services such as the group counseling programs.

PiCASO already is cutting back. It hasn't been able to fully stock the food pantry it runs to meet the special nutritional needs of HIV/AIDS patients, Hardison said. It also hasn't been able to provide emergency financial assistance in recent months.

Community-based groups such as PiCASO fill in the gaps left by state and federal HIV/AIDS assistance programs, said Evelyn Foust, communicable disease director of the N.C. Division of Public Health. Her organization oversees the state's drug assistance program that helps low-income HIV patients without health insurance pay for medicine. PiCASO directs people to her program. People who can remain on a regular drug regimen remain healthier longer, she said.

PiCASO has three full-time employees, an executive director, a health educator and case manager, and a part-time case manager.

None of the positions can be eliminated as a cost-saving measure because federal rules require case managers to have a supervisor not directly involved in assisting clients, Lucier said.

PiCASO lost the bulk of its United Way funding because the fundraising organization has changed its model for distributing funding. PiCASO received about $4,500 in United Way donor specified funding since July, Lucier said. It's unclear if any more donor specified dollars will come their way, he said.

Morrow said PiCASO's fundraising problems reflect a disinterest the general public has exhibited toward HIV/AIDS in recent years. New drug regimens are significantly extending the lives of patients so it has become a chronic disease.

“There isn't a public perception of the acute need that there was when so many more people were dying from the disease,” Morrow said. “AIDS and HIV isn't as popular to support as it was even 10 years ago.”

Lucier said PiCASO's board learned this lesson when the group recently sent out 1,000 fundraising letters to people identified as previous givers. They got two checks totaling $50, not even enough money to cover the postage, Lucier said.

After that, discussions about closing were no longer hypothetical.