Clinical Depression

Hounded by budget crises, unflattering audits, and general gripes about management, the Economic Opportunity Family Health Center circles the wagons

To scores of other Dade County residents who've been fighting on the same fronts, a chronicle of Lucinda's life for the past eight months sounds like deja vu. They've all been battling the AIDS virus; many are single parents, and more are struggling to stay drug- or alcohol-free. On top of all that, they've been in constant combat with the Economic Opportunity Family Health Center to get their rent paid.

"From month to month I don't know if I have a place to live," says "Lucinda," who doesn't want her real name used because she swears if the people at Family Health Center (as most refer to it) knew she was complaining they'd drop her from the rental assistance program altogether. "The problem is the landlord doesn't get any rent check. Now I've received several eviction notices. We kept telling Family Health, 'You gotta pay the bills,' and people were getting evicted. And they said they didn't have the money. But I know they do."

Last fall the center received almost two million dollars in federal funds to help about 280 AIDS patients pay their rent for a year. The money, supplied through a program called Housing Opportunities for People with AIDS (HOPWA), is doled out by the City of Miami to agencies throughout Dade. Family Health Center, a large segment of whose clients are HIV-positive, was awarded more HOPWA money than any other agency in the county. But long before the year was up, unbeknownst to City of Miami officials, the center had spent more than $500,000 in excess of its twelve-month allotment and had accepted more than 550 AIDS patients for HOPWA rental assistance. It had even secured a $340,000 line of credit to help make the monthly payments.

But who was getting the money? Every day Family Health Center caseworkers were bombarded with complaints from anxious tenants and angry landlords -- all of them wondering what happened to their rent checks, which the center is supposed to mail directly to the landlord. Many clients faced imminent eviction and had to be referred to other agencies for emergency assistance. Others demanded meetings with Family Health Center officials and managed to get their checks mailed, one or two months late, while landlords tacked on late fees. Word of the disarray spread quickly through the AIDS community, and people flocked to HOPWA advisory board meetings to seek assurance that they wouldn't find themselves abandoned and homeless. Exclaimed one former client who currently receives HOPWA rent assistance through another agency: "It's the talk of the town."

The talk died down some in July, when the HOPWA board voted to recommend that $1.2 million in unallocated HOPWA funds be granted to Family Health Center. That was the sum Frankie Swain, vice president of the center and a member of the HOPWA board, estimated it would take to satisfy the commitments they'd made. "We made the decision not to have anybody homeless, so we enrolled people in excess," Swain declared to the board.

The past year has been one of the most difficult in the distinguished history of the Economic Opportunity Family Health Center, which since 1969 has provided medical, dental, psychological, and social services to poor and marginalized residents of Liberty City and parts of Brownsville, Little Haiti, and Hialeah. Some 70,000 clients annually avail themselves of one or another of the nonprofit corporation's health clinics, drug-abuse treatment facilities, and in-school programs. Family Health Center is one of the largest minority employers in Dade. Jessie Trice, its president and chief executive officer, has been honored with innumerable local, state, and national awards for her innovative work. A 67-block stretch of NW 22nd Avenue, the western border of the center's main office, was named Jessie Trice Boulevard in 1994. In a community that has faced challenges and setbacks of vast proportions, from devastating riots to unsettling influxes of immigrants, Family Health Center has come to stand as a monument to accomplishment and pride. "But it's not what it appears," contends former board member John Aldrich, who also worked at the center.

Indeed, like monuments that have weathered decades of bitter storms and blazing sun, the center is showing cracks. Without restoration work, crises such as this past summer's -- in which at least a few hundred AIDS patients were threatened with eviction or were actually evicted -- will continue to undermine the institution. A controversial $2.3 million housing complex for people with AIDS, which the center is building with federal funds, is behind schedule. Recent audits have brought to light lax or nonexistent controls on accounting and record keeping. Payroll funds were so short last winter that some employees say they drew lots for checks; dozens of staffers have been laid off or fired during the past year. Two of the agency's well-regarded drug-abuse treatment programs were cited in a 1996 state Health and Rehabilitative Services (HRS) evaluation as having "inadequate" success rates.

These troubles have arisen during troubling times. Publicly funded health centers, which once were considered noble and effective weapons in a nationwide battle against poverty, have fallen victim to governmental retreat. Already some have closed because they couldn't adjust to newly competitive conditions in the health-care industry -- conditions unheard of when they came into being.

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