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Velazquez Calls for Federal Investigation of HIV/AIDS Crisis in Puerto Rico

Velázquez Calls for Federal Investigation of HIV/AIDS Crisis in Puerto Rico
June 8, 2007
Press Release

WASHINGTON – Today, in light of the recent accounts regarding the HIV/AIDS crisis in Puerto Rico, Congresswomen Nydia M. Velázquez (D-N.Y.) and Hilda L. Solis (D-CA), submitted the following letter to Comptroller General David M. Walker, calling for a thorough investigation and report of the state of affairs of treatment for HIV/AIDS patients in the Commonwealth.  Below is the letter:

Dear Ms. Walker:

The Ryan White Comprehensive AIDS Resources Emergency Act, as amended by the Ryan White HIV/AIDS Treatment Modernization Act of 2006, enables programs aimed at people living with HIV/AIDS who have no private health insurance or other source of health care.  Over the past several weeks, our offices have learned through media accounts and meetings with various Community Based Organizations (CBOs) and HIV/AIDS patient advocacy groups in Puerto Rico that there is a lack of services available to these patients due to the mismanagement of vital funds.

This reported lack of care seems to be the result of, among other things, the inability of CBOs to acquire equipment, prescription drugs, etc., from suppliers due to the inefficiency in the reimbursement processes of federal funds of one grantee under Title I and the grantee under Title II of the Ryan White Act in Puerto Rico.  CBOs and government facilities may not be providing quality, timely, adequate or dignified services.  This is unacceptable in any circumstance, but especially if lack of oversight and guidance of how these grantees have used federal funds to treat patients is the problem.  People’s lives would have been placed at risk needlessly as a result of this lack of proper federal oversight of federal funds.

Title I provides grants, which fund medical and other health support related services, to 51 Eligible Metropolitan Areas (EMAs) across the country which are disproportionately affected by the number of HIV/AIDS cases they have in their respective jurisdictions. Title II provides grants to states and territories to improve the quality, availability, and organization of HIV/AIDS health care and support services. Title II also provides access to medications through the AIDS Drug Assistance Program (ADAP).  The federal agency vested with the duty to manage these federal funds and provide guidance, oversight to grantees is the Human and Health Services’ Health Resources and Services Administration (HRSA).

In order to fully understand the actions taken by HRSA to respond to the current situation and to investigate how this situation has been allowed to deteriorate to the present state of affairs, we request that you conduct a study to provide us with answers to the following questions:

  1. How many HIV/AIDS persons in Puerto Rico eligible for Ryan White funds assistance are on waiting lists to receive: 1) medications; 2) treatment; 3) health care support services?
  1. What are the primary causes for delays in the processing of disbursements of Ryan White federal funds to CBOs in Puerto Rico under Titles I & II?
    1. When did HRSA become aware or receive reports of these problems?
    2. What were HRSA’s actions, recommendations and oversight plan in response to these reported problems?
  1. Given the current apparent crisis in health care services for the Ryan White population in Puerto Rico, what immediate remediate steps is the agency taking to ensure that patients begin receiving the care and drug treatment necessary to treat their condition?
    1. Has HRSA considered naming a third party to administer the Title I or II or both programs in Puerto Rico?
    1. What recommendations has HRSA provided to current Titles I & II grantees to address the issue of their accounting and disbursement practices of funds to the community based organizations?
    1. When where those recommendations promulgated and did the agency offer to provide the technical, economic and resources necessary for grantees to implement recommendations?

We would ask that the final Report provide a short term and long term strategy for making sure those HIV/AIDS residents of Puerto Rico get the immediate access to health care services and treatment drugs that keep them alive. The Report should also assess what changes are necessary in HRSA that would facilitate more effective oversight of Ryan White funds.

Also, we want to know what corrective or oversight actions the agency took in the past to address misuse or inefficient administration of federal funds by Titles I & II grantees in the Commonwealth of Puerto Rico, if any, and an explanation of how the situation deteriorated to the present crisis.

Given the urgency of the situation and the lives that are at stake, we ask that GAO provide our staff information about the progress of this request.  Please contact Maximiliano Trujillo, office of Congresswoman Nydia M. Velázquez, at (202) 225-2361 with any questions about this request.