HIV/AIDS funding delay causes problems for D.C. agencies

August 19, 2011

Congressional delay in passing a federal budget and internal glitches at the agency responsible for awarding HIV/AIDS safety net funds have held up critical dollars that pay for basic medical care and essential support for more than 500,000 people living with HIV/AIDS, officials and advocates said Friday.

A spokesman for the U.S. Health Resources and Services Administration, part of the U.S. Department of Health and Human Services, said that a significant portion of the funds had been awarded by last month and that nearly $700 million more will be sent out as soon as possible.

Officials said they were not aware of any services cut off as a result of the months-long delay.

But some advocates in the District, which has one of the highest rates of HIV/AIDS in the nation, said the holdup has complicated their work and is putting individuals at risk.

“In these tough financial times, we would not be able to sustain the program very long on our own without this funding,” said Adam Tenner, executive director of Metro TeenAIDS, which provides HIV testing and sexual and reproductive health education to about 30,000 youths, primarily in the District. The organization relies on $5,000 a month in federal AIDS funds.

The funding is provided under the Ryan White Act, which pays about $2 billion every year to cities, states and local community-based organizations for primary medical care and essential support services to individuals who are HIV-positive or have AIDS and don’t have health care coverage or resources to cope with the disease.

The funding, which comes in the form of reimbursements, is made up of several parts. About $640 million is awarded annually to metropolitan areas most severely affected by HIV/AIDS, including the Washington area, and is supposed to cover the 12-month period that began in March. An additional $1.2 billion provide annual grants to the states and the District, beginning in April.

But Congress failed to pass its fiscal 2011 budget until early April, which delayed the federal agency, HRSA, that calculates the grants. That, in turn, made it difficult for local officials and community organizations to do their planning, officials said.

In addition, HRSA had staff turnover that led to some errors in calculating awards and a backlog at its office in charge of grants, adding to the slowdown, agency officials told advocates and providers in a conference call in early August, according to participants in the call.

“A very large part of the delay was created by Congress,” said William McColl, political director for AIDS United and co-chairman of a working group that monitors Ryan White funding. McColl organized the conference call after hearing from city officials on the East and West Coasts who were looking for their money. “It’s a terrible way to do budgeting.”

The D.C. region receives about $31 million annually of the funds awarded to areas most severely affected by the epidemic.

Federal and city officials gave conflicting accounts Friday about the status of funds.

Federal officials said all but $1.7 million due the region has been paid, mostly in July. The remainder will be sent next week.

But Greg Pappas, senior deputy director for the D.C. health department’s HIV/AIDS administration, said only 36 percent of the funds have arrived.

In the District, more than 3 percent of residents older than 12, about 16,000 people, are stricken, high enough to be categorized as an epidemic.

Pappas said there has been no impact on services. “We are making plans to make sure that services continue,” he said.

But the funding delay has already affected at least one organization.

Tenner, of Metro TeenAIDS, said his group has sought to take over the work of another organization that provides mental health services to HIV-positive children and youths. That organization shut down last week, he said, for reasons unrelated to the funding delay.

But city officials have told Tenner that they can’t move forward on his request until the federal funding becomes clear. “It’s ridiculously complicated,” Tenner said.

In the meantime, about 100 youths with HIV-positive parents or caregivers who were receiving mental health services are in limbo, he said.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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