On April 1, David Munar began a new chapter at Howard Brown Health Center ( HBHC ), as president and CEO, taking over an organization rocked by scandal for the past many years. His entrance is a marked and, for many in the city, hopeful change; he will be its first leader in many years to actually have any experience in healthcare. Munar began his career in healthcare in the field of HIV/AIDS policy and advocacy, and his training and experience came about at AIDS Foundation of Chicago ( AFC ), where he began in 1991.
John Peller has taken over as interim head of AFC until the board finds a replacement for Munar; he has not yet decided whether or not to include himself in the list of candidates. Peller joined AFC as a state lobbyist and then made his way up to vice president of policy.
Speaking to Windy City Times about the changes ahead, Peller said that the organization would miss Munar, but that it was working to make sure there was a continuity between his departure and the new leadership, and that it looked forward to his expertise and working with him at Howard Brown. He also emphasized that AFC was "not sitting still" and was a "nimble, quick" organization that could adapt to the times. He spoke about the changes and challenges ahead as the Affordable Care Act ( ACA ) rolled out.
According to Peller, AFC's strategic plan is about its primary goal, "making sure people with HIV have continued access to care." AFC is not a direct service provider, but has three primary roles: advocacy, fundraising, and maintaining government contracts to do prevention services. The last includes making sure that people diagnosed with HIV get their first medical appointments but also get back into and stay in care. The organization also provides case management through the Ryan White act. This can include assistance with housing rentals and providing supportive housing for people struggling with homelessness and/or HIV or chronic diseases.
As to the Ryan White Act, "which has historically been the backbone of HIV care for low-income people," Peller said that "its focus is going to shift from when it was the only payer for people with HIV to one that provides coverage completion, filling in the gaps that insurance or Medicaid leaves out." Smaller, community-run organizations may also see their roles shift. Peller emphasized their continuing importance, pointing out that they know the communities they work in and are also culturally sensitive. However, under ACA, filing for Medicaid can take up a lot of resources, and the challenge will be to work with them to see how they might change their infrastructure to accommodate paperwork and other structural issues.
But Peller was also enthusiastic about a new project with Harvard Law School, funded by the Mac AIDS Fund, which would help monitor implementation of the ACA, primarily through reporting by social service agencies.
Peller said he feels the ACA offers tremendous opportunities in healthcare, but also acknowledged that there are significant challenges. He said, "There's a continued need for advocacy to make sure people with HIV get the services they need. And there are very high out of pocket costs for medications, which dramatically affects low-income populations. If curing HIV was as simple as giving someone a pill we would have ended AIDS 15 years ago. The reality is that people need a tremendous amount of support to get into care in the first place. They need housing assistance, transportation, food, nutrition, and help overcoming the stigmawhich is still with us to a degree that really continues to shock me."