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PaperclipPerfector  2mo ago (text post)   35696 thread views

Culture War Roundup for the week of February 3, 2025

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Reuters: Health clinics grapple with US funding squeeze

It seems funding hasn't been fully restored and a lot of affected clinics don't have sufficient cash reserves:

Three community health centers near Richmond, Virginia, were forced to shut down after federal funds used to pay staff salaries remained inaccessible since last week, said Virginia Community Healthcare Association spokesperson Joe Stevens.

As of Friday, another nine centers across Virginia also could not access federal funds but continued to see patients by tapping into reserve funds.

"They will need money in the next week," said Stevens. "We don't know why some centers can access funds and some cannot."

In Virginia, community health centers provide medical, dental, behavioral health, pharmaceutical and substance use services for approximately 400,000 patients. For much of the state's rural areas, the centers are the only option for primary care, said Stevens.

One center that was still unable to access federal funds is in southwestern Virginia, where the next closest option for medical care is more than an hour's drive, he said. Most providers were able to access Medicaid and grant monies once the spending freeze was rescinded. However, some say they are still cut off from payments used for essential care, including medical, dental, prescription drugs and behavioral health.

And, of course, problems with transgender-serving clinics and federal grants for STI prevention and treatment:

Late last week, some healthcare centers that provide HIV prevention services and care for transgender patients received notices that grants issued by the U.S. Centers for Disease Control and Prevention would be terminated. The letters cited the Trump administration's orders on diversity and gender identity, according to three recipients of the notices.

A spokesperson for the U.S. Centers for Disease Control and Prevention referred questions about the grants to the Department of Health and Human Services.

St. John's Well Child and Family Center, a network of public health centers in South and Central Los Angeles, cannot access $746,000 remaining from a $1.6 million grant used to provide prevention, testing and treatment for about 500 transgender people at risk of HIV, sexually transmitted infections, tuberculosis and hepatitis C.

"We have made a decision not to cut back any programs because of any threats from the federal government," said St. John's President Jim Mangia.

St. John's has joined a lawsuit filed by California's attorney general contesting the funding cuts. Mangia says he will seek private funding to make up the loss.

The LGBT Life Center in Norfolk, Virginia, received a letter stating $6.3 million of the organization’s funding, or 48% of its annual budget, would be terminated, said spokesperson Corey Mohr. The center provides medication and monitoring to 400 patients with HIV.

I'm curious what the LGBT Life Center's grant was for, given that St. John's had 25% more patients. Maybe it was specific to HIV-positive patients and treatment is genuinely more expensive than prevention? But I had thought PrEP, PEP, and ART were the same medication at different doses, and that progression of HIV to AIDS is very uncommon, so that wouldn't make much sense.

https://lgbtlifecenter.org/events/

"Youth matter LGBT+ affirming youth groups" and drag shows, mostly. They also run a housing grant ring. Basically a gay church but paid for entirely by taxpayers.

Very common media trick, noting a single uncontroversial thing and pretending it's the whole thing.

But the question is what the grant was for. Youth groups and drag shows don't cost $6.3 million.

Youth groups and drag shows don't cost $6.3 million.

The administrative salaries of the people running youth groups and drag shows, the venues for youth groups and drag shows, the consulting fees for ensuring that your youth groups and drag shows are totally compliant with all applicable rules and regulations, well... that costs $6.3 million, easy.

I have seen universities pay $100,000+ to consultants to give single day seminars on grant writing. Sometimes these consultants have a history of writing successful grants, so the expertise is definitely there. And some of the grants that result can be worth millions of dollars to the university, so the expense is justified on paper. But no one--absolutely no one--is doing controlled experiments in which they determine whether these consultants actually make a difference, or whether there are cheaper alternatives with similar (or better) results. It's all part of the higher education grift; if you know the right people, and have the right friends, you can quit your underpaid research post and instead make millions telling other underpaid researchers to try harder.

I strongly suspect it is the same in every grant-driven industry everywhere. (Indeed, the whole "Effective Altruism" grift has largely consisted in insisting that EA is totally different, it's definitely going to make real change, instead of just creating new jobs and generous salaries for charismatic people who would rather attend conferences in exotic locales, than do the hard work of producing meaningful work.)

I strongly suspect it is the same in every grant-driven industry everywhere. (Indeed, the whole "Effective Altruism" grift has largely consisted in insisting that EA is totally different, it's definitely going to make real change, instead of just creating new jobs and generous salaries for charismatic people who would rather attend conferences in exotic locales, than do the hard work of producing meaningful work.)

EA is meaningfully different. The average charity spends 20% on overhead, and for arts and culture charities the "sweet spot" is apparently a whopping 35%.

Look at the recommended charities on GWWC (GWWC is recommended as the best overall resource for charities on ea.org). GiveDirectly spends 95% of its money on charitable expenses. For AMF it's 99.4%. Malaria Consortium is at 12% and HKI is at 16%.

Look at the recommended charities on GWWC (GWWC is recommended as the best overall resource for charities on ea.org). GiveDirectly spends 95% of its money on charitable expenses. For AMF it's 99.4%. Malaria Consortium is at 12% and HKI is at 16%.

If I'm understanding your links right, you flip what the numbers mean in mid-paragraph here - the first two (in the 90s) are the amount spent on actual charitable expenses while the last two (in the teens) are the amount they spend on overhead. This makes it look like the last two are really terrible wheras I take your intended point to be that they're nearly as good as the first two.

Sorry, yes, that is what I meant.

EA is meaningfully different.

I'm sure there are charities, including EA charities, that are better than the "average" charity along the relevant axis, sure.

But according to your own link, the managing director of GiveDirectly pulls down almost $500,000 per year. That's a hell of a grift, and perfectly analogous to my university consultant example. I'm sure the managing director has the relevant expertise, and probably is directly responsible for a healthy chunk of charitable cash transfers that would otherwise have gone elsewhere (or nowhere). But no one--absolutely no one--is doing controlled experiments in which they determine whether that $500,000 actually makes a difference, or whether there are cheaper alternatives with similar (or better) results. Personally, I know several very competent administrators who are happy to make $100,000 managing sums similar to those laid out by GiveDirectly.

Charity in America is Big Business(TM), and even EA is no clear exception.

perfectly analogous to my university consultant example

I admit that there was no A/B test to figure out if this guy should be paid 450k or 500k or 550k.

However, is anyone actually doing the math on how much grant consultants increase grants received? I kind of doubt it. I suspect that those guys have some marketing and the university spends money on them because they have to do something, and everyone sits through the info session because they have to.

At least with EA there is at least some external validity. The money goes in, and 95 cents on the dollar goes out. Autists are working around the clock to see if you really are as effective as you claim. Ironically, this means EA charities operate more like a business than your average grants consultant, because they've got people keeping an eye on their bottom line and the business doesn't exist just to enrich the guy who runs it (unlike the grant consultant). They have to actually deliver shareholder value, where the shareholders are the recipients and the donors.

So I guess what I'm trying to say is, yes, charity is big business, and that's a good thing.

Add in promotion and 'awareness campaigns' and security expenses.

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