HIV 101














San Antonio AIDS Foundation

The San Antonio AIDS Foundation - also known as SAAF (pronounced like the word "safe") - was founded in 1986.

"Our founder was a local bar owner, Robert Edwards, also known as 'Papa Bear,'" said Jill Rips, Deputy Executive Director of SAAF. "One of the bars he owned was a gay bar. People were showing up at his bar who were sick with AIDS. No one wanted to treat them, they were being thrown out of their houses, and they were desperate. So Papa Bear opened up the back of his bar as a makeshift hospice, with round-the-clock volunteer nurses. That's how SAAF started. It was the first community response organization in San Antonio."

As the needs of those in with HIV and AIDS in San Antonio became greater, Papa Bear purchased a house and moved the hospice into it from the back of the bar.

"Then, in 1991, we moved into our current facility," said Jill Rips. "It had been a nursing home, so it was ideally suited to our needs, but it was in terrible condition. Community members, particularly from the gay community, came in to rewire, re-plumb and refurbish the building, and it opened in April 1991."

From the beginning, because there were always residents in the program, there was always a hot meal program, even when it was in the back of the bar. "It has always been open to anyone with HIV or AIDS," Jill says. "So in the beginning, we were a hospice and hot meal program, and they both continue today."

In 1995, with the advent of effective meds, the need for hospice care decreased. But there was still a need for skilled nursing care.

"We changed to a skilled nursing facility and hospice," Jill says. "We are a "Special Care Facility," licensed by the Texas Department of Health, which gives us a much broader license to treat than a nursing home or assisted living facility. We can treat someone who just needs a little nursing care all the way up to someone who is very seriously ill. It's a great licensure because it addresses the full range of nursing needs of people with HIV or AIDS."

"We're licensed for up to 41 in-patients, but we generally have 26 or so," Jill says. "During Katrina we had 36 at one time, which was absolutely our total capacity. There was a comparable facility in New Orleans that had to close, and we took their patients in. Twenty-seven is really about all we can handle long-term, because many of our patients are so sick. Many have been living with HIV for a long, long time, they're on salvage therapy, and there's not much more that can be done for them. In Texas, unfortunately, many people find out they're HIV-positive very late - 25% have an AIDS diagnosis within a month of testing positive. People are showing up with pneumonia in the hospital and find out they have AIDS - it's a lot like the early 1990s. Because of this tendency to late diagnosis, there are still AIDS wards in the hospitals here. These AIDS patients usually start in a hospital, and then once they're somewhat stabilized they're released to our care."

"Our hot meal program is a really big deal," Jill said. "We serve breakfast, lunch and dinner, 365 days a year, free to anyone who is HIV-positive. Last year we served 45,000 meals. Our facility is located in an urban, low-income area with lots of low-cost rental housing, as well as bridges where homeless people live. It's a huge savings, obviously, for someone who is living on Social Security Disability Income, to get their meals for free. For the homeless, it's a chance to get into the air conditioning, or out of the rain, at mealtime. And for those in our nursing facility who are well enough to come to the dining room, it gives them a chance to have a little community."

"We also provide both medical and social case management," Jill said. "Within the case management department, we're the primary provider of HOPWA in this area - we provide about $250,000 of long-term rental assistance to people with HIV every year."

"We have a brand new program started last July," Jill said. "There was one dedicated HIV homeless shelter in San Antonio, and they lost their funding. We decided on two weeks notice to start our own program. We found a house right around the corner that had been converted to assisted living. It was going into foreclosure, and we bought it. By the end of July we opened our transitional housing program that can accommodate up to 20 male, female or transgender clients. It's been very successful. We get a lot of people discharged from prison or discharged from our nursing program. Because it is just a block away, all those residents can access our free meal program."

The San Antonio AIDS Foundation has two missions. The first, of course, is to provide compassionate medical and social services to people with HIV or AIDS. But the other is to help prevent transmission.

"Our prevention outreach program is called 'You're the Cure,'" Jill said. "We go out to the schools and provide prevention education. Our program is unique because we not only talk about HIV and testing - all of our engagements include a person with HIV or AIDS who tells their story. We try to get speakers as young as possible so the kids can relate to them. We do presentations to about 17,000 people a year. We also do prisons, the police department, medical students - basically anybody, it's a free service."

"We do HIV rapid testing, both on-site and off-site. Last year we tested over 3,000 people."

The San Antonio AIDS Foundation has a staff of 50 to 55 full-time equivalent paid staff.

"We're about 50% government funded," Jill said. "The other half comes from private grants, United Way funding, private donors and fundraising special events. We also get funding through subcontracts with local hospitals that discharge patients to us. We get all kinds of little bits of money that all put together add up to a $3.2- to $3.3-million annual budget. All of our services are free to our clients."

"While we need government funding we're not reliant upon it," Jill said. "So that allows us to provide services to anybody, even if they don't quite qualify for Ryan White or HUD eligibility. We can use our own fundraising dollars to cover them."

"We're a dynamic agency," Jill said. "We're positioned to be responsive to changing needs. For example, last summer when the local HIV homeless shelter was closing we didn't say 'Isn't that a shame.' We stepped up to the plate. We said, 'This is a critical need in the community,' and we did it. We had to write a lot of little grants and go to the city council, but we did it. And I think that's what's special about us - to be able to change to meet changing needs."

Hats off to the San Antonio AIDS Foundation for the great work they do!

For more information on this outstanding ASO, check out their website at San Antonio AIDS Foundation.



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