By Debbie Cenziper
Washington Post Staff Writer
Sunday, December 13, 2009; A01
They are cheering and clapping and calling his name, but the boy in the corner won't budge.
In front of him, eight children stand elbow to elbow on a rainbow-colored carpet. The adults at the group therapy session in Northwest Washington say: Tell us what makes you celebrate. The boy stares at his khakis, refusing to look up, even after a friend tries to coax him into the giggling fray.
On this chilly night early last month, the 9-year-old has traveled across town to the District's only community-based program for children affected by HIV and AIDS. Some have lost a parent. Others were infected by their mothers at birth and are living with the disease themselves.
After a day in fourth grade, the boy is tired and drawn. He comes from a family where two generations have been infected with HIV.
Soon, he will leave Pediatric AIDS/HIV Care's bustling townhouse filled with finger paints and dinosaur books and trek home to a desolate area east of the Anacostia River that has become the epicenter of the AIDS epidemic in the nation's capital.
Among District residents known to have HIV/AIDS, one in four lives in the squat rowhouses and aging public housing complexes of predominantly African American wards 7 and 8. But since 2004, the city has awarded just 6 percent of $100 million in AIDS funding to specialized nonprofit groups east of the river, forcing families to scramble for care in other parts of the city, a Washington Post investigation found.
Four years ago, the city launched the East of the River Initiative, a widely touted effort to address the disparity. Pressed by D.C. Council members, the city Health Department has earmarked about $3.5 million to bolster neighborhood groups focused on AIDS housing, counseling and case management.
But the city spent more than $1 million from the fund on grants to nonprofit groups in other neighborhoods. Much of what was left was awarded to programs that had little lasting impact east of the river, hobbling a well-intentioned effort to drive money into an area that has long lacked a network of established nonprofit groups to help slow the spread of the disease.
The Health Department used the fund to pay for a high-end study instead of services, a neighborhood AIDS office in Ward 7 that closed within months and grants to nonprofit groups tainted by financial and operational problems, records show.
One counseling program that received $60,000 from the fund was run by a woman whose counseling certification was revoked by the city last year. City investigators determined that she had listed false academic credentials on her application, including a purported doctoral degree from an online enterprise that sold degrees for $599.
Another group that promised medical care and support received $50,000, despite a long and troubled history with the Health Department's HIV/AIDS Administration, whose monitors had cited lapses in services and questionable budgets. The group has since moved to Maryland.
"We threw money at the problem," said Terrence Young, manager of HIV testing and field operations at the Community Education Group, an established AIDS group that recently moved into Ward 7. "I don't think the [initiative] actually benefited the community. We need infrastructure."
HIV/AIDS Administration spokesman Michael Kharfen said the city has taken steps to provide more oversight of nonprofit groups and to better track the money.
Kharfen defended the agency's decision to direct some of the East of the River money to other neighborhoods. Although priority was supposed to be given to groups in wards 7 and 8, the program was open to nonprofits in other hard-hit wards, he and other city officials said.
As a whole, the District has the highest AIDS rate in the nation, with numbers that surpass those in some countries in West Africa.
Kharfen also said the city decided to spread the money around because some families don't want to seek care in their neighborhoods.
"People don't necessarily want to go around the corner to the place with a big HIV sign," he said.
But D.C. Council Chairman Vincent C. Gray (D), who helped launch the East of the River Initiative, said the goal was to shore up services in the city's most vulnerable areas. Of the $1.9 million in grants from the fund given directly to specialized nonprofit groups, less than $900,000 went to programs east of the river, records show.
"It would be a real disservice to what the intent was for this program in the first place," Gray said when The Post told him about the pattern. "I have no problem with building the capacity of others in the community . . . but the reality is that the epidemic is growing fastest east of the river, and you have an inverse relationship between the presence of the epidemic and the capacity of the neighborhood to be able to fight it."
Gray is considering a challenge next year to Mayor Adrian M. Fenty (D), who has been criticized by some AIDS advocates for failing to take more aggressive steps to fight the disease.
D.C. Attorney General Peter Nickles said that under Fenty, the city has invested more heavily in health services east of the river.
"The intent and design [of the East of the River program] were fine. . . . The follow-up [early on] was not acceptable to me," he said. "If you're trying to build capacity in an area that doesn't have it, it's very difficult."
Forty percent of the 75 children who come to Pediatric AIDS/HIV Care in Northwest Washington live in wards 7 and 8. They catch a bus or take Metrorail to the agency's townhouse to participate in the nonprofit group's tutoring and therapy sessions.
Executive Director Khadijah Tribble said she hopes to find money to open a satellite office east of the river. Her nonprofit group has received $60,000 from the East of the River fund.
Early last month, after a group dinner of fish and salad, Tribble watched the children in therapy -- so used to talking about death and disease -- chat about Christmas trees and Redskins games. The 9-year-old boy, who had refused to participate for most of the session, was asked once again to name something that makes him happy.
From a chair in the corner, he finally answered: "I'm alive."
Later, Tribble grew angry. In the past two years, she has attended three funerals.
"We're in one of the most powerful cities in the world," she said. "It's not fair to these kids that we didn't get it right."'The absolute quintessential insult'
City leaders have long known about the disparity in AIDS dollars in the District, but year after year, efforts to deliver money east of the river have fallen short.
Gray began to study the flow of AIDS dollars in 2005 soon after his election to the D.C. Council.
In the beginning, the disease had spread in the largely white gay community in neighborhoods northwest of the Capitol. But over time, AIDS infiltrated other parts of the city, affecting ex-offenders, drug users and the heterosexual community.
The impact was particularly acute in wards 7 and 8, already struggling with staggering rates of unemployment, homelessness, poverty and violence.
Ward 8 has the highest rate of new HIV/AIDS cases in the city. The rate is slightly lower in Ward 7 but still surpasses rates in many other District wards, as well as those in comparable-size cities, records show.
Gray calculated how much money had been sent to agencies in the neighborhood, particularly in his home base of Ward 7. He was stunned by what he found.
"There was not one grant that had been awarded to an organization indigenous to Ward 7," he said. "It was almost as if no one had thought about fighting this at the neighborhood and community level."
At the end of 2005, the D.C. Council began to push the East of the River Initiative to prop up nonprofit groups and churches focused on housing, counseling and other services.
Instead of immediately expanding services, however, the Department of Health paid about $500,000 to a consultant for a "needs assessment" in Ward 7. Vision Consulting was also assigned to open an office in the neighborhood and award small grants to nonprofit groups.
But the office, intended to become a hub for local groups, closed a year later when the contract ended. The grants also had little impact in the neighborhood: The largest one didn't even go to a local organization. Vision awarded $120,000 in city AIDS money to the Balm in Gilead, a nonprofit group that works with churches on AIDS and other diseases. The group is based in Richmond.
"It was the absolute quintessential insult," Gray said. "Not only was the District not investing money in its own communities to do this work, but now we were going to take money and give it to entities outside the city. And for what purpose?"
Vision Consulting's president, Celeste Garcia, said she was directed by then-HIV/AIDS Administration Director Marsha Martin to give money to the Balm in Gilead without a competitive bid. After receiving the award, the Balm in Gilead opened up a local office, in Northwest Washington, records and interviews show. The office has since closed.
Garcia said she raised concerns at the time with Martin but opted to follow her orders. Neither Garcia nor the HIV/AIDS Administration provided records to account for the Balm in Gilead's work.
The group's founder, Pernessa Seele, said the Balm in Gilead worked with local churches but declined to provide details. She said she could not recall how she had heard about the grant.
"Funding opportunities come to my office all the time," she said.
Seele said she had met Martin years earlier through AIDS circles. Before joining the District government, Martin worked as a special assistant on HIV/AIDS policy to then-U.S. Health and Human Services Secretary Donna E. Shalala in the late 1990s.
Martin, who runs an HIV-testing program for Oakland, Calif., did not return calls seeking comment.Corrective measures are often ineffective
In 2007, the HIV/AIDS Administration took a next step: encouraging nonprofit groups east of the river to form AIDS collaboratives. With tens of thousands of dollars in funding, the groups would host HIV-testing events, workshops and health fairs.
In Ward 7, eight agencies banded together, including two churches, a large medical clinic and Young's Community Education Group. Nine groups rallied in Ward 8.
Both collaboratives fell apart after two years, however, when the HIV/AIDS Administration stopped providing funding. The Web site for the Ward 7 for Life collaborative hasn't been updated in months. Its phone has been disconnected.
In 2007, the city introduced a formal grant program for nonprofit groups to develop and expand services, the centerpiece of the East of the River initiative. The program had a well-known leader: Effi Barry, former wife of D.C. Council member Marion Barry (D-Ward 8), the city's former mayor. Effi Barry was working as a special projects director at the Department of Health, with a focus on communities east of the river.
There were some immediate successes. Antioch Baptist Church in Ward 7, which received a $50,000 grant, paid for a series of AIDS workshops and began to hold on-site HIV testing.
"There are so many people walking around with it, and they don't even know they got it," said the church's pastor, William Gibbs.
The grant program, however, raised concerns early on among some AIDS groups because Effi Barry was awarding the money without competitive bidding, records and interviews show.
Barry also awarded grant money to groups that had been criticized previously by the HIV/AIDS Administration, including the Abundant Life Clinic, which had been cited for shoddy patient and financial records and other problems, records show.
Abundant Life's medical director was Abdul Alim Muhammad, who has served as the minister of health for the Nation of Islam and as the personal physician of its leader, Louis Farrakhan. Muhammad told The Post that the clinic, which has since moved to Maryland, had successfully served hundreds of patients. Muhammad said he no longer has any professional involvement with the care of AIDS patients.
Records show Effi Barry also awarded $20,000 to Hill's Community Residential Support Services, one of the most troubled AIDS groups in the city.
Monitors had repeatedly cited the housing group for staff turnover, bad building conditions, double billing for salaries and questionable expenses on invoices for such things as jewelry and suede gloves, records show. In 2007, the year Hill's Community was awarded East of the River money, clients complained that there was no staff, telephone or food.
After those allegations and others were detailed in a Post series in October, the D.C. attorney general's office launched an investigation.
Hill's founder, Marilyn Hill, could not be reached through calls and letters. In a report to the HIV/AIDS Administration, Hill reported using the East of the River money for computers and office furniture.
Barry awarded $50,000 to Concerned Citizens on Alcohol and Drug Abuse, run by longtime family friend Samuel Foster.
The Southeast group was the subject of a federal report in the 1990s when the U.S. Public Health Service found that Concerned Citizens maintained sloppy or nonexistent records and did not provide clients with access to a social worker.
Foster defended his program, saying he has long provided AIDS services to the community.
Last year, the HIV/AIDS Administration stopped funding Concerned Citizens because the group does not have a business license.
Although most of the grants administered by Effi Barry ranged from $20,000 to $50,000, one was much larger: $425,000 to Trinity Development. Trinity was chaired at the time by former D.C. Council chairman Sterling Tucker, one of Marion Barry's political allies. Tucker had served as council chairman in the 1970s and later was the city's drug czar during Barry's third term as mayor.
Tucker said he received no compensation from Trinity. He said that he could not recall how the grant was obtained but that Effi Barry played no role.
"I didn't even know that she was in government," Tucker said.
It is unclear whether the grant was officially part of the East of the River program; city records on its origin are inconsistent and vague.
Trinity officials said they used the AIDS money to open six "conversation centers" in churches for literature and discussions. Records show each church was paid $500 a month plus expenses, with Trinity Development Corp. drawing an overhead fee of $38,000. Only two of the churches were in wards 7 and 8.
Trinity officials said they reached thousands of people.
"It opened up a dialogue in the churches," said former Trinity executive director Sullivan Robinson.Lingering questions about grant recipients
Effi Barry died of leukemia in 2007, prompting the D.C. Council to rename the East of the River program in her honor. Gregg Pane, then-director of the Health Department, declined to comment on the program.
After Barry's death, the HIV/AIDS Administration took over the grants, setting up a formal selection process, records show. But funding continued to flow to some troubled groups.
The city awarded a total of $60,000 to the Institute for the Prevention and Eradication of Violence, a nonprofit group run by Corrine Simons.
The money was awarded even as another arm of the Department of Health, the Board of Professional Counseling, reported that Simons had made a series of false statements about her college credentials and degrees on her counseling and social work applications to the city.
In one case, investigators reported that Simons submitted a transcript listing a doctoral degree received from an online enterprise in 2007. Investigators reported that the program "will sell a doctorate degree in social work for $599. [The program] indicates on its Web site that no class attendance, study or exams . . . are required for a degree."
Last year, the Department of Health revoked Simons's counseling certification and put her social work license on hold. Simons said that her statements were truthful and that the city has scheduled a hearing on the matter next month. A Department of Health spokeswoman, however, said the city stands by its findings and called the hearing only because notices to Simons had originally been sent to the wrong address.
The HIV/AIDS Administration also awarded $10,000 to Germon "Mama G" Miller, who describes herself as a math educator, international motivational speaker, cultural historian and "female pathfinder in the martial sciences." Miller's group does not have an office or business license and is not registered as a nonprofit group with the IRS, records show.
The Community Education Group served as Miller's fiscal agent. But the executive director, A. Toni Young, said she grew worried because the program had produced no tangible results.
"It wasn't working," Young said.
Miller said she used the city's money to take six college students on trips around the region for discussions about HIV.
"I'm a bridge person," Miller said. "I take people out and show them how to communicate with somebody who may not have a place to live and now has HIV or AIDS and people are shying away from them."
Kharfen, with the HIV/AIDS Administration, said Miller's group did not compete successfully for new funding this year.
AIDS advocates say even nonprofit groups that appear to have sound finances and programs are struggling to maintain services launched under the program. The city's grants, $10,000 to $50,000, are often not enough to support fledgling agencies.
"Once the training wheels fall off, the bike just falls down, and you are on the ground," said Terrence Young, the testing coordinator at Community Education Group.
D.C. Council member David A. Catania (I-At Large) said the initiative was a learning experience, with successes and failures.
"I don't doubt for a second you're going to see some of these new organizations have issues that are going to cause us to shudder. But by and large, I think it's been successful. This hasn't been done before in the District. You're not going to get it right right out of the gate, and I don't believe we did."
Staff researcher Meg Smith contributed to this report.