Red tape holds up federal funding for local AIDS programs

By Sandhya Somashekhar
Washington Post Staff Writer
Tuesday, March 30, 2010

A bureaucratic bottleneck holding up federal funds in Prince George's County has forced some local medical clinics and nonprofit groups to delay or cancel services for people with AIDS.

Donald Shell, health officer for the Prince George's Health Department, said he is aware of the difficulties experienced by some of the groups. He said the delays were the result of the county's lengthy, exhaustive contract review process.

Federal and local monitors have repeatedly expressed concerns about the problems, noting that they affect groups across suburban Maryland and that small providers could be forced to shut down. The financial issues, stemming from the county's administration of funds from the federal Ryan White program, come as the District is trying to rein in an epidemic whose effects can be felt beyond city borders.

Groups have had to limit emergency food vouchers or postpone nonessential dental work for as long as six months. One organization temporarily halted a program that provided rides to HIV/AIDS patients who needed to get to doctor's appointments. The small, church-based nonprofit ended that program last year.

"They really need to work this out so there is some continuity of care for residents," said Douglas Morgan, who oversees the Ryan White program nationwide for the federal Health Resources and Services Administration. "This is the one disease where you don't want major disruptions in the continuity of care."

The Ryan White program provides money for medical and other needs of low-income people with AIDS and HIV who lack insurance. In this region, the money flows from the federal government to the D.C. Department of Health, which in addition to managing its own program oversees the distribution of about $12 million annually to the suburbs and two counties in West Virginia.

The District contracts with the Prince George's Health Department to distribute about $7 million to government agencies, hospitals and nonprofit groups in suburban Maryland, including in Charles, Frederick and Montgomery counties.

The District also sends about $4.7 million to agencies in Northern Virginia, but local and federal monitors have singled out suburban Maryland for concern.

"Our hands are tied. We can't do anything until they have their ducks in a row," said Shannon L. Hader, director of the District's HIV/AIDS Administration.

Last year, monitors for the Health Resources and Services Administration complained that Prince George's had not signed its contract with the District a full four months after the grant year had begun, leaving the AIDS groups without the ability to get reimbursed for the services they were providing.

Shell said Prince George's officials have asked the District for help in addressing the problem.

"Our staff has had some dialogue with the District on ways we could begin this process five months earlier," he said. "We want to make sure that our residents have every opportunity to receive care."

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