The Whitman-Walker Clinic will pull out of the Northern Virginia and Maryland suburbs, lay off nearly one-fourth of its staff of 260 and reduce, consolidate or end a host of other programs to stabilize the organization's finances and future.
The measures will be permanent, interim Executive Director Roberta Geidner-Antoniotti said yesterday, and presage a much-altered future for the region's oldest and largest provider of services to people infected with HIV. They amount to the most severe retrenchment in the 32-year history of the clinic, which began as a gay men's health center and built a national reputation for its AIDS programs.
"We will look different tomorrow than we did yesterday," Geidner-Antoniotti said.
Severe cash-flow problems, which caused a crisis when Whitman-Walker could not meet its payroll two weeks ago, forced the nonprofit organization's board to scrutinize every aspect of its $30 million operation. But the $2.5 million in cuts approved Tuesday night are only part of the solution.
"Because the heart of the clinic . . . has been so big, often we've expanded programs beyond their funding," Geidner-Antoniotti said. No more. The new imperative is to bring Whitman-Walker "back to the core services that we know are the most sustainable," she said.
More than one-third of the expected savings will come by terminating its work in Arlington and Takoma Park, locations where the organization serves more than 600 people with HIV or AIDS. The two sites will shut down within 120 days unless other nonprofits in those jurisdictions step forward to keep them open.
Also slated for closure as early as July 1 is the clinic's District food bank, which assists 300 people. A residential treatment program for men and women who battle substance addiction will be discontinued, as will a second housing program for individuals who have overcome their addictions.
Clinic research will be cut back, contributions to a prevention program suspended and budgets pared for case management and administration costs, the board voted. Some properties might be leased or put on the market to shore up cash reserves. A foundation that annually helped more than 500 AIDS clients in dire circumstances will cease to exist, freeing $50,000 in past memorial donations.
If no groups fill the breach, the impact could be substantial, Geidner-Antoniotti said. The District has one of the nation's highest rates of HIV/AIDS, with an estimated one in 20 adults infected. "The epidemic will get worse," she predicted. "AIDS is still a killer disease."
Other organizations are hoping to devise interim plans, and possibly to do more.
"I think the chances of another agency picking up the slack are good," said Andrew Oatman, deputy director of the Northern Virginia AIDS Ministry. "I'm not prepared to say who, but the money is there and there is a need. . . . I don't think any agency in Northern Virginia will let this fall by the wayside."
Still, he added, Whitman-Walker clients there likely will feel "some chaos, some confusion, some fear" in the months ahead. "There are no easy answers to this."
The short term will not be easy for the clinic itself. Despite the board's action, the crisis has been averted only temporarily. The organization will make payroll tomorrow, Geidner-Antoniotti said, but its bank account remains shaky month to month. Its $1 million line of credit is tapped out, she said, and fundraising continues to lag.
Although the clinic apparently was living beyond its means in recent years -- "we may have needed to make these decisions [about cutbacks] sooner," Geidner-Antoniotti conceded -- its fiscal problems were not all of its own making. The D.C. government's perpetually late reimbursement for services rendered, sometimes delayed by more than three months, was a substantial factor. Key federal grants have been flat since 2000 despite escalating costs, which the clinic said equates to a 16 percent decrease in funding.
"I credit the board with taking responsible action to save the institution," said D.C. Council member David A. Catania (I-At Large), who chairs the council's Health Committee. Yet he said he fears the consequences, not just for the city but for the region. He doubts that lawmakers in Maryland or Virginia will respond with new or additional resources.
"This gives me pause, real pause," Catania said. "In an era where the epidemic is still with us, to see this kind of retreat is disheartening."