After 12 years and lots of ups and downs, the Department of Health HIV/STD/TB program has been left by its fiduciary to steer its own financial course.
Roger Dewey, St. Croix Foundation president, said Thursday that after several personnel changes and all the years with the Foundation as fiduciary, the Department was doing a good job keeping HIV medications on the shelves and stabilizing its other programs.
In 1999, the Centers for Disease Control and Prevention helped set up the relationship between the HIV/STD/TB program and St. Croix Foundation to ensure that the medications and programs flowed smoothly.
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, enacted in 1990, established funding for low-income people and families living with HIV/AIDS who could not bear the enormous costs of medication, which can be as much as $30,000 a year or more.
Despite the partnership, in the V.I. HIV drugs dwindled to nothing four times during those years leaving participants in the Ryan White program living with HIV without drugs for weeks and months in some cases.
Bureaucratic bungling and glitches in the government’s financial management system accounted for three of the four crises. In the fourth case, the federal funding component dropped the ball.
But Dewey said he is fully confident that the department is ready to handle the grants that amount annually to more than $1 million to the program.
“Despite the organization’s exit as a third party fiduciary for the VIDOH, the Foundation will continue to support issues surrounding HIV and AIDS in our community, by working with donors like Denali Asset Management who generously established a fund at the foundation to address HIV/AIDS programmatic service gaps,” Dewey said in a statement Thursday announcing the end to St. Croix Foundation’s involvement.
Despite Dewey’s optimism, the statement says that the foundation loaned $100,000 to the program to cover the still sluggish movement of the money through the various government channels this year.
In a meeting Friday between the Health Department, Government House and the northeastern branch chief for the HIV/AIDS Bureau of the U.S. Health Department, it was decided that another fiduciary would be needed.
“We’re just not there yet,” Gritell Martinez, territorial director of the HIV/STD/TB program, said in a phone interview Friday afternoon.
Given the current state of the local government’s finances, Martinez said, it is impossible to turn money around fast enough to meet the requirements of the program’s vendors.
As the fiduciary, St. Croix Foundation, along with donors such as Denali Asset Management, have been able to fill the gap while the governments – both local and federal – gradually grind out the money.
Martinez was optimistic that a new fiduciary will be found. The search will be handled through formal Property and Procurement procedures.
Meanwhile there are drugs on the shelves at the moment, according to Martinez, and another order will be placed shortly.
She said the agency will also try to work with vendors to make temporary stopgap arrangements while the search for and transfer to a new fiduciary goes on.
The arrangement with St. Croix Foundation ends on Sept. 16, Martinez said.
There are 144 people on AIDS Drug Assistance Program (ADAP), of 600 known to be living with HIV/AIDS in the territory.
Some of them may have to seek financial assistance elsewhere soon. Martinez said there are several people on medical assistance, Medicaid and Medicare, who are eligible to get their prescriptions covered by those programs. “We know who they are,” she said. Ryan White funds are the payee of last resort and therefore these recipients need to go to the other programs for their prescriptions.
Right now Martinez is waiting for the second half of the federal funds. The program is in the second half of the grant year that goes from April 1, 2010 to March 30, 2011. “We’ve received 49 percent,” she said.
She said they were assured in Friday’s meeting that the process of securing the other 51 percent was underway.
Meanwhile, she said, there is some local government money still available.
The program was appropriated $669,000 in federal funds for this year, leaving a balance needed of about $500,000. Last year, the local government kicked in $423,000 to take care of the shortfall. But that was last year.
A $250,000 revolving fund set up by the V.I. government in 2006 remains in place at St. Croix Foundation and will move to whatever new fiduciary takes over. Meanwhile the huge gap between what is committed and what is needed remains unfilled, needing to come from “somewhere,” Martinez said.
