After 25 years, a Baltimore organization that once attracted international acclaim for its efforts to help people with AIDS is set to close its doors for good.
Even now, as the Health Education Resource Organization prepares to shut down Wednesday, people from all across Baltimore keep making their way to the group's Maryland Avenue building to find assistance, and some local leaders are begging the city to do more to save its oldest and largest HIV and AIDS service provider.
In a city with the nation's second highest rate of HIV, more than 16,000 known cases, this organization is where the most vulnerable part of that population finds solace. At least 400 people are using its services, and employees think as many as 3,000 come to the drop-in resource center each year.
"It's sad because there are politics involved. There's mismanagement involved," said Marvin "Doc" Cheatum, president of the Baltimore branch of the NAACP, who is calling on city leaders to intervene. "But we're talking about people's lives."
Better known as HERO, the organization began in a Johns Hopkins doctor's office as a buddy system and evolved into a comprehensive provider offering everything from clinical and counseling services to a place to do laundry and collect mail. It evolved into a respected, multimillion-dollar nonprofit that AIDS groups across the country looked to as a model.
The money, and its good reputation, are now gone.
Private donations slowed as AIDS became less lethal. Where HERO was once "the only game in town," as its founder put it, now a dozen or more clinics and organizations have sprung up. A financial scandal five years also left questions about the organization's management practices, further impeding its ability to raise money.
About a year ago, HERO stopped providing clinical services, and employees - lawyers, counselors - have been leaving at a steady pace. This summer, deeper problems surfaced as HERO sometimes failed to make payroll and pay its subcontractors.
The city Health Department reviewed HERO's books and concluded early this month that the organization was in such dire shape that its federal grant money should be pulled, leaving it all but penniless. HERO's grant money and its clients will be diverted next month to places like Total Healthcare, Women Accepting Responsibility, Chase-Brexton medical clinic and Johns Hopkins Hospital.
"The concern was that HERO would just shut down one day and leave clients with nowhere to go," Baltimore Health Commissioner Dr. Joshua M. Sharfstein said. "We had to get people into other programs before that happened."
But there's more to consider than simply whether another organization has the capacity for HERO's former clients, said Alta Cannaday, president of HERO's board of directors.
"I want to know, do they care?" she asked. "The clients we serve are often homeless. Some are recovering from substance abuse. Everybody doesn't do a great job of handling this population. There is no other agency in place to provide that kind of service to people."
Twenty-five years ago, AIDS was quickly fatal and deeply misunderstood. Dr. Bernard Branson, now with the Centers for Disease Control and Protection in Atlanta, saw some of Maryland's first AIDS patients as a doctor at Hopkins.
In the spring of 1983, about a dozen of those patients met in his waiting room, just to talk and keep each other company, and HERO was born. It had no budget.
Those meetings spawned a buddy system and a hot line. Volunteers began delivering meals and ferrying sick patients to doctor's appointments. Small grants came in. The group started an outreach and education program and added a legal component. It moved to the Medical Arts building at Cathedral and Read streets and its budget grew to well over $1 million - then to $4 million.
The group's AIDSWalks attracted 10,000 people and hundreds of thousand of dollars in pledges. By the late 1980s, the World Health Organization was turning to HERO as a consultant as it worked to set up similar groups across the globe. "HERO has gained a reputation that few others can match," a May 31, 1987, cover story in the Sun Magazine stated.
"In the early years, this was the only big community organization doing this kind of work," said Dr. John Bartlett, chief of infectious diseases at the Johns Hopkins School of Medicine and another doctor involved early on in the AIDS fight.
Dr. Peter L. Beilenson, the city health commissioner from 1992 to 2005, called HERO "an icon." Federal Ryan White grant money, a program that began in 1990, flowed to HERO.
The mid-1990s saw huge gains in AIDS research, as well as an explosion in other AIDS providers. As the prognosis for HIV-infected people grew brighter, the disease faded from the national spotlight. Fewer and fewer people attended AIDSWalk.
In 2001 Maryland Association of Nonprofit Organizations gave HERO a "seal of approval" for complying with standards of accountability and governance. It might have been harder to attract money, but HERO maintained its pristine reputation.
And then that, too, changed.
In 2004, a deputy director, Indira Kotval was fired days after telling HERO's board that she suspected the director, Dr. Leonardo Ortega, was misusing money. Her memo to the board said she found that Ortega had paid a personal trainer with checks entered in the ledger under the heading "community relations." Kotval, who'd been with the organization since its early years, also said she found checks that awarded him bonuses of "$1,000, $2,000 and even $3,000 over the period of time that we have had a fiscal crisis."
Ortega had been director for about 11 years at the time and was earning a salary of more than $120,000. Beilenson asked the FBI to investigate; however, Ortega was not charged with wrongdoing. Other investigations showed that he had properly obtained board approval for the bonuses and other benefits.
"Legal or not, it did not look good that a nonprofit with financial trouble was giving its director huge bonuses and perks," Beilenson said. The Maryland Association of Nonprofit Organizations revoked its seal of approval.
Ortega continued as HERO's director until last year. But there's no doubt that the questions raised about his salary and bonuses - and about the nonprofit board's lack of oversight - had a lasting impact on the donations.
In a statement announcing the organization's demise, Cannaday wrote that the "negative and devastating press" caused contributions to dwindle. "HERO never recovered."
It received more than $2.4 million in grants in 2006, the latest income tax data available online, but public support paid other expenditures, such as utility bills and some employee salaries. That shrank to about $227,000 in 2006. HERO went more than $500,000 over budget that year.
This year, the losses piled up even more. In April, the organization threw a fundraising bash at the Engineers Club to celebrate its 25th anniversary. "The message was that this organization has really turned a corner," said Anthony McCarthy, who worked for HERO at the time. But the $100-per-ticket party failed to raise any significant money.
Sharfstein said the city began fielding late-payment complaints from HERO's subcontractors. It became clear that reassurances by top HERO officials and board members were unfounded, Sharfstein said.
On Friday morning, people milled around the reception area of HERO's building, called the Maryland Resource Center. Many people with HIV rely on it as a place to shower, eat, wash their clothes and get help. A large white sign on the door announces the closing and says, "It has been a pleasure serving Baltimore."
Regulars found out three weeks ago. "I've cried twice about it," said Debbie Hamilton, 46, a client for three years. "I don't know what I'm going to do."
Albert Davis, who is homeless, said he had been coming to HERO since 1997. When he heard about the closing, he said, he was "totally heartbroken."
Both of them plan to keep coming until the last day.
There's also anger about the demise. Several clients said they wish the staff had shared more information with them. "We have so much love for this place," said Brian, 43, who's been coming to HERO for 18 months. "If we had had any inkling, maybe we could have done more."
Cheatum of the NAACP and others place much of the blame with the board, which he said should have kept better track of finances and sounded the alarm earlier. "It is real clear from our vantage point that the board failed," he said.
Some clients also suspect dubious motives on the part of the city, which gave the organization $500,000 last year, a loan secured by the Maryland Resource Center. State tax records indicate the 22,104-square-foot building was assessed at $2.3 million in July. The loan to HERO is in good standing, said Cheron Porter, a spokeswoman for the housing department. "But we are aware of their financial difficulties. We're assessing our options."
Clients attended a town hall meeting Thursday night at the Baltimore NAACP office. Cheatum compared it to a church service, with tears flowing, people hollering and "so much hurt."