The AIDS Healthcare Foundation has signed a two-year, $903,294 contract with Marin County to provide services for residents living with HIV/AIDS.

Services include medical case management, benefits counseling, health insurance premium and cost-sharing assistance, emergency financial assistance, transportation, emotional support services and delivered meals. Much of the work was previously done by the Corte Madera-based Spahr Center, which ceased operations in February.

“AIDS Healthcare Foundation has been awarded the Ryan White grant and recently hired several staff, including former Spahr Center employees, who were temporarily employed by the county of Marin to ensure continuity of care during this transition,” Lisa Warhuus, director of the Marin County Department of Health and Human Services, said in an email.The services are funded by a federal program that is a continuation of the Ryan White Care Act enacted in 1990. Marin receives about $450,000 annually as part of a larger allocation to the San Francisco area.

This week, the AIDS Healthcare Foundation opened a branch office at 851 Irwin St. in San Rafael. The foundation began as a network of hospices but has expanded, turning the hospices into health care centers. The foundation is a global nonprofit that provides services in 45 countries and 17 states. It provides HIV-related services to more than 14,000 clients in 20 locations throughout California, including Oakland and San Francisco.

Warhuus added, however: “It’s important to note that Ryan White services focus on individuals living with HIV but do not cover behavioral health or social support services for the broader LGBTQ+ community in Marin.”

Efforts are underway to fill that gap.

Two organizations, Spectrum and the Marin AIDS Project, merged in 2015 to become the Spahr Center. The center was named after the Rev. Janie Spahr, a former San Rafael pastor, who played a major role in founding both Spectrum and the Marin AIDS Project.

Warhuus wrote that after the Spahr Center closed its doors, Spahr, now 82, and other local LGBTQ+ advocates, including Bobby Moske, a former Spahr board member, and Rick Hess, who was recruited to the board after the organization began experiencing financial difficulties, initiated efforts to establish a new nonprofit, the Marin LGBTQ+ Center.

“Last week, Marin Public Health facilitated a meeting between Janie Spahr’s group and AHF to explore potential collaboration and financial support, including the possibility of shared space at AHF’s new office at 850 Irwin Street,” Warhuus wrote.

“While there’s still a lot of work ahead, we are optimistic about the direction Janie and her team are taking,” Warhuus said. Spahr said Wednesday that it is unlikely the new nonprofit will share office space with the foundation. She said her group has been seeking public input to determine what type of services the new nonprofit should provide. “We’re listening to the LGBTQ+ people in our county,” she said. “The community in Marin is very diverse now.”

Hess, who played a key role in recruiting the AIDS Healthcare Foundation to the county, has recently decided to go it alone and try to found a nonprofit that would focus on the mental health needs of Marin’s LGBTQ+ residents.

In addition to the Ryan White services it was providing, the Spahr Center was also sponsoring support and discussion groups. Two Marin middle schools, Kent and Miller Creek, and eight high schools — Archie Williams, Novato, Redwood, San Andreas, San Marin, San Rafael, Tamalpais and Terra Linda — were paying the nonprofit $5,000 a year to host “Q groups” during school hours on school grounds.

“We were disheartened when Spahr closed because they provided important and valuable services to our LGBTQ+ community,” said Lisa Miller, assistant superintendent of the Marin County Office of Education. “We hope another qualified entity emerges to fill these gaps.”

For Hess, the work is personal. He recounted during a Sept. 10 Board of Supervisors’ discussion of suicide prevention efforts that he is a survivor.

Hess grew up on a farm in Lancaster, Pennsylvania, and his parents were Mennonites. “I overheard my mother and my aunt talking when I was 16 saying they’d rather have a child be dead than be a homosexual,” Hess said. Nevertheless, he went on to have a successful career working 19 years for the Oracle Corp. in Silicon Valley. It wasn’t until he retired that he fell into a deep depression. “This is very common with older men, which we see is a very big percentage of suicides in this county and nationwide, where we got our meaning from work,” Hess said during the supervisors session.

Hess’s depression was intense, driving him to the brink of suicide. “I will tell you,” he said, “when you want to end your life, it’s the most excruciating pain that anybody in this world will ever feel.” Hess said he ultimately found the motivation to go on living after a therapist reminded him that if he killed himself, his husband would spend the rest of his life questioning whether he had failed Hess. “The regrets that would have been left are what helped me move forward,” he said. “With exercise, medication and a purpose, I’m back. I really have a personal mission now to get help for folks in mental health crisis.”

Spahr said she doesn’t view Hess’ initiative as competing with the effort to create a new Marin LGBTQ+ Center. “If some people want to do one part and somebody else wants to do another then we can collaborate together,” she said.

Said Hess: “The bottom line is this: There are multiple initiatives underway to restart those services.”