Bureau of HIV/AIDS director explains Drug Assistance Program crisis, ignores federal report

That Florida’s AIDS Drug Assistance Program has been in a funding crisis since 2010 is no secret, but how the state helped make that crisis possible has been largely ignored.

Tom Liberti, director of the state’s Bureau of HIV/AIDS, told National Public Radio on Wednesday that a combination of a deep recession, flat federal government funding, flat or reduced state funding, massive unemployment, 4 million Floridians without insurance and more early treatment for HIV explains the AIDS Drug Assistance Program’s funding crisis. (Full audio below.)

What Liberti didn’t say is that a federal report issued in March said there are unresolved and unanswered concerns from prior Office of Inspector General, Office of Performance Review and Health Resources and Services Administration audits and visits.

The U.S Department of Health and Human Services’ Health Resources and Services Administration report alleges that Florida’s Bureau of HIV/AIDS failed to use “available resources in the best interest of people living with HIV and AIDS” while administering its Drug Assistance Program, which provides HIV/AIDS medications to low-income citizens.

The report adds, “the Florida Department of Health’s inability to manage the Ryan White grant has resulted in the current deficit, which jeopardizes access to HIV services and medications.”

The federal report acknowledges the successes of Florida’s management of the Drug Assitance Program, but lists 19 fiscal recommendations and 17 administrative recommendations the states HIV/AIDS bureau should implement.

Concerns and recommendations highlighted by this report include:

• The Bureau of HIV/AIDS has used AIDS Drug Assistance Program money to pay the salaries of officials with little or no role in administering the program. The report cites the example of program coordinators, and one “Senior Health Program Specialist” whose salary is paid through the Ryan White program despite having a “primary duty” with no relation to Ryan White.
• The Bureau of HIV/AIDS was awarded $3.05 million to take 357 clients off the waiting list, but these funds do not show up in financial reports provided by bureau. The report recommends that the bureau provide documented expenses for the use of those funds, with a list of the 357 clients taken off the waiting list.
• The program developed an ineffective cost-containment strategy. The report lists at least five cost-containment strategies that need to be implemented to continue to reduce the number of patients on the waiting list.
• The Florida Department of Health’s inability to manage the Ryan White grant has resulted in the current deficit, which jeopardizes access to HIV services and medications. The reports calls on the department to ensure that Ryan White funds provide access to comprehensive high-quality community-based care for low-income individuals and families living with HIV.
• Despite reports of quarterly meetings between state HIV/AIDS officials and local patient care staff, there is no documented proof of communication, collaboration and coordination.

Tom Liberti has not responded to The Florida Independent’s inquiries about how the Bureau of HIV/AIDS is implementing the federal report’s recommendations.

From NPR:

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