AID Atlanta is chiming in on the problems within Georgia's HIV Unit, including major red tape when it comes to distributing funding to HIV-positive patients who need help to pay for their medications.
In an Atlanta Journal-Constitution story published Sunday and headlined "HIV aid pipeline clogged by state," reporter Chris Joyner talks to one patient, Alpha Goodshepherd, who was recently cut off his HIV meds after his insurance was canceled.
"Goodshepherd applied to the Georgia Department of Public Health on May 16 to have his $510 monthly insurance premium paid through a program called the Health Insurance Continuation Program. Although his request was approved, the state didn’t mail the check by the payment due date, and Goodshepherd’s coverage was dropped," the report states.
HICP currently serves 364 people from across the state with its annual budget of $2 million from the U.S. Department of Health & Human Services, according to the AJC.
Georgia’s HIV Unit faces severe problems distributing medicine funding
The AJC reports that local AIDS activists say “dozens of their clients have been put at risk of losing their health insurance because of paperwork snafus by the health department.”
Tracy Elliot, executive director of AID Atlanta that serves HIV and AIDS clients, expressed frustration with the HIV Unit, saying there is no clear reason why it takes so long for the Department of Health to deliver insurance checks.
“According to time lines provided by both departments, checks for HICP were cut by Community Health on June 30 and delivered to the HIV Unit in Public Health on July 1 … public health employees stayed late to make sure the checks made it out and were postmarked by the end of the day,” the AJC reported.
But the first of the month is the payment deadline for many health insurance policies, Elliot said.
“That time line is just too close in any case,” he said.
The HIV Unit originally was part of the state Department of Human Resources and was then rolled into the Department of Community Health. On July 1, the HIV Unit became part of the new standalone Georgia Department of Public Health.
“Now there is a third standalone department, and I’m willing to give them a chance to do their job,” Jeff Graham, executive director of Georgia Equality and a veteran HIV/AIDS activist, said at the time.
“There are good people in the unit, but they’ve been shackled, they’ve had to answer to so many people. There’s the standard problem with bureaucracy. The staff doesn’t have leadership or support. And you have had this constant turmoil for past the three years.”
Red tape at the HIV Unit also makes it difficult for agencies to receive federal funding for prevention programs from the federal Centers for Disease Control & Prevention. Georgia ranks sixth highest in the nation for its cumulative reported AIDS cases, based on the most recent data released in 2009, according to state records. And in 2009, there were 2,250 newly diagnosed HIV/AIDS cases in the state — 61 percent were HIV (that had not progressed to full-blown AIDS) and 39 percent were AIDS.
Bringing down these numbers is crucial to stemming the epidemic in the state. It is the HIV Unit that is responsible for distributing CDC funds to state health departments and HIV/AIDS agencies for prevention efforts, such as outreach, support groups and free HIV testing.
“The bureaucracy just takes forever. There are delays [in getting grants]. Sometimes it takes six months or more. That’s my biggest complaint,” said Mark Douglas of Savannah’s My Brothaz Home, an AIDS service organization. “And that makes it hard on us to deliver contracts.”
My Brothaz Home was to receive funding in September 2010 as part of the CDC initiative to test more people and link them to care. But the agency did not receive the funding from the state HIV unit until January 2011. That means the agency lost three months of providing services.
“We got a one year grant that we now had to conduct in nine months,” Douglas said. “The paperwork just goes through so many people. It impacts my work locally, changes my timeline, I have to adjust my budget, change personnel. We’ve had to lay off — it just messes everything up,” he said. “And it shouldn’t be that way.”
And when an agency cannot spend all of its money, the money goes back to the state, which in turn must return it to the CDC.
“From fiscal year 2007 through fiscal year 2009, the Georgia Department of Public Health averaged an annual award of approximately $7.93 million and requested to carryover funds an average of 8 percent [or about $634,000] per year,” said CDC spokesperson Scott Bryan.
“Essentially, if a health department has unspent funds at the end of the year, that money is returned to CDC. The state health department can request those unspent funds be carried over and added to the following year’s budget (funds),” he added.
Simply put, Douglas said, that is “government waste.”
“We don’t need to give any money back. This money needs to hit the streets,” he said. “It should be going to local on-the-ground community based organizations.”