Norfolk, Va., Officials Fail to Spend $1 Million in Ryan White CARE Act Funds

Norfolk, Va., officials have learned that the region's Ryan White CARE Act program failed to spend $1 million of its $5 million grant for the fiscal year that ended February 29, despite the fact that 900 eligible HIV-positive individuals did not receive care during the fiscal year, the Virginian-Pilot reports. The Health Resources and Services Administration, the federal agency that administers Ryan White funds, plans to send a team of consultants to help Norfolk officials revamp the program, which is responsible for serving more than 2,100 uninsured HIV-positive people. Norfolk's program has accumulated $2.6 million in unspent Ryan White funds, which is enough to cover health care costs for the region's Ryan White beneficiaries for one year, according to the Virginian-Pilot. In 2002, only one region nationwide -- San Antonio -- spent a smaller percentage of its Ryan White funding than Norfolk. The federal consultants will spend a few days each week in Norfolk for at least six months to assure that the program is in compliance with federal guidelines, Douglas Morgan, a HRSA official who oversees the Ryan White program, said, according to the Virginian-Pilot. HRSA and Norfolk officials hope to develop a plan to allow the unspent money to be released for patient care. "We believe we will be able to have those monies sooner than later," LaVerne Parker Diggs, Norfolk's assistant city manager who oversees the local Ryan White program, said. The program last month was informed that its Ryan White grant for fiscal year 2004 will be renewed at $4.8 million, a $300,000 decrease due to federal budget cuts. HRSA has not yet released the FY 2004 funds because of outstanding compliance issues. However, Parker Diggs said that the program has met the requirements and is sending verification to HRSA this week, according to the Virginian-Pilot (Messina, Virginian-Pilot, 3/17).

Past Criticism
Norfolk officials in the past have been sharply criticized for their management of Ryan White funds. HRSA in October 2003 refused to approve a contract with a local pharmacy to provide antiretroviral drugs to HIV-positive individuals who are eligible for the local Ryan White program. In addition, a contract dispute between Norfolk officials and clinic doctors regarding billing practices last year resulted in the revocation of the clinics' Ryan White funds. Eastern Virginia Medical School clinics used a billing method in which doctors received a set fee for each patient, a practice that is reportedly not allowed under federal government regulations. As a result, the clinics had to cease operations (Kaiser Daily Reproductive Health Report, 10/20/03). Dr. Edward Oldfield, director of EVMS' infectious disease program, said that he has been "frustrated" by the local Ryan White program, adding, "The difficulty of the care gets lost in the difficulty of the bureaucratic requirements. With the new direction, with the new assistant city manager, with the rejuvenation of the planning council and with all the providers working for the same goal, it's just night and day. I see a very good group of people ... with a real focus on getting the job done" (Virginian-Pilot, 3/17).

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