Subject: WTP: Federal AIDS audits, Ryan White, PR's Rossello
From: [email-masked]
Date: Fri, 23 Apr 1999 14:22:06 EDT

*******************************************************
FASTFAX #226, April 23, 1999
published by We The People Living with AIDS/HIV of the
Delaware Valley, Inc.
[http://www.critpath.org/wtp]

*******************************************************
News That Matters to People Living with HIV/AIDS
*******************************************************

GOP LEADERS SEEK 'AUDIT' OF FEDERAL AIDS $$

        U.S. Representative Tom Coburn (R-OK), House Majority Leader Dick
Armey (R-TX) and Commerce Committee Chairman Tom Bliley (R-VA) have sent a
letter to the United States General Accounting Office  requesting a
"performance audit and evaluation of all federal AIDS/HIV programs and
services."
        "Congress has a moral obligation to those suffering with AIDS/HIV to
ensure that the nearly $9 billion directed to federal AIDS programs is
spent for purposes for which it is intended," Coburn, a practicing
physician, said in a statement.  "Over the past five years I  have
encountered too many instances where federal AIDS/HIV funds have been
misused.  There have been instances in which AIDS dollars have been used
for political campaigns, programs that condone illegal drug use, and
programs that fail to fairly distribute funds to women and minorities," he
said.
        Coburn's statement cited a number of recent news reports as the
basis for his concern.
        In a story reported this month in U.S. News and World Report and the
New York Blade, the head of an AIDS group in Puerto Rico testified that more
than $2 million of U.S. funds for AIDS services were diverted to the
political campaigns of Puerto Rico governor Pedro Rossello and other
officials.  A trial is underway and several individuals involved in the
case have already pleaded guilty.  Governor Rosello denies any knowledge of
the embezzlement.
        In May 1998, the Associated Press reported that the head of a North
Carolina program "Drug and AIDS Prevention Among African-Americans" wrote
checks to himself and kept books that were "unauditable".  Similar charges
have been levied against several Philadelphia-area AIDS service
organizations; two former AIDS agency heads, Fran Stoffa and Carmen Bolden,
were convicted of embezzlement several years ago.
        Coburn also cited an October 1996 Washington Post article which he
said described a program that "condoned illegal drug use in a housing
facility
funded with federal AIDS dollars."
        "I am concerned that these examples may represent a widespread
pattern of abuse." Coburn said.  "This audit is designed to spotlight lapses
in
accountability and restore integrity and compassion to federal AIDS/HIV
programs.  As a practicing physician, I have seen first-hand the effects of
this horrible disease.  As a congressman, I am dedicated to guaranteeing
that AIDS/HIV dollars are spent to alleviate that suffering."
        Coburn has come under fire from AIDS advocates in the past for
proposing federal legislation which would mandate HIV testing for prisoners
and other populations, and aggressively seek out partners of HIV-positive
people.
        Specifically, the GOP leaders requested an update from the GAO on
its report, initially issued in January of 1995, which examined the
allocation
of federal AIDS funding in terms of whether it was being fairly distributed
in terms of "race, gender and/or other demographics."  The congressmen also
asked the GAO to determine the "average cost per client served nationally,
regionally and in urban versus rural settings" of Ryan White CARE
Act-funded programs.
        They have also asked the GAO to determine what criteria determine
federal AIDS Drug Assistance Program (ADAP) distributions and whether these
criteria "advantage or disadvantage" any state or region.
        Coburn and his colleagues also asked if the Department of Health and
Human Services routinely requests from grantees information pertaining to
what
percentage of the funds directed towards care and prevention programs are
spent on overhead or other non-care related activities, and if so, what
that information dhows.  The also want to know if there is "evidence of
abuses or misuses of federal AIDS funds."
        Recognizing growing complaints that Ryan White funds are supporting
a wide variety of social support services rather than primary medical care,
the
congressmen asked the GAO to "provide an estimate of the percentage of CARE
program funding which directly supports treatment and medical care for
HIV/AIDS patients."  The also asked for an estimate of the percentage of
Ryan White funding which supports "services and welfare not directly
related to treatment, such as housing, counseling and other services, with
a special request to determine how much is estimated to be spent "directly
or indirectly on housing."
        The GOP leaders also want to know the salary levels of top
administrators in AIDS service organizations that administer substantial
federal grants, which they define as $250,000 per year or more, and how they
compare with state and federal civil service compensation in their regions.
        Linking their request to Coburn's partner notification agenda, the
Republicans also ask, "Are funds routinely being spent to ensure that those
who test positively are made aware of their treatment options and how to
access them and their personal responsibility to notify past, present and
perspective partners of their HIV status?  Is there any evidence of a
failure to enforce federal laws- such as spousa1 notification or tolerating
drug abuse in housing programs-  within any of the programs?"
        The GOP request immediately generated an angry response from Daniel
Zingale, executive director of AIDS Action, the lead Washington AIDS
lobbying group.
        The legislators' request is "nothing less than a politically
motivated
attempt to raise doubts about the fight against AIDS and the
community-based service organizations leading that fight," Zingale said.
He said he hoped that if the audit is conducted, "we expect the [GAO] will
conduct it fairly, equitably and free of the political influences of those
who are beginning the process."

===========================================================

From: [email-masked]
Date: Tue, 20 Apr 1999 22:12:13 EDT
Subject: Rep. Coburn to GAO: Audit all federal AIDS programs

> Tom A. Coburn, M.D.
>
> News Release
>
> For immediate release
> Contact: John Hart
> (202) 225-2701
> April 20, 1999
>
>   COBURN, ARMEY,  BLILEY CALL FOR AUDIT OF ALL
>    FEDERAL AIDS/HIV PROGRAMS
>
>       (Washington, D.C.) - U.S. Representative Tom Coburn (R-OK), a
> practicing physician who has treated patients with AIDS/HIV, Majority
> Leader Dick Armey (R-TX) and Commerce Committee Chairman Tom Bliley (R-VA)
> today sent a letter to the United States General Accounting Office
> requesting a performance audit and evaluation of all federal AIDS/HIV
> programs and services.
>
>       "Congress has a moral obligation to those suffering with AIDS/HIV to
> ensure that the nearly $9 billion directed to federal AIDS programs is
> spent for purposes for which it is intended.  Over the past five years I
> have encountered too many instances where federal AIDS/HIV funds have been
> misused.  There have been instances in which AIDS dollars have been used
> for political campaigns, programs that condone illegal drug use, and
> programs that fail to fairly distribute funds to women and minorities,"
> Coburn said.
>
>       In a story reported this month in U.S. News and World Report and the
> New York Blade, the head of an AIDS group in Puerto Rico testified that
> more than $2 million of U.S. funds for AIDS services were diverted to the
> political campaigns of Puerto Rico governor Pedro Rossello and other
> officials.  A trial is underway and several individuals involved in the
> case have already pleaded guilty.  Governor Rosello denies any knowledge
> of the embezzlement.
>
>       In May 1998, the Associated Press reported that the head of a North
> Carolina program "Drug and AIDS Prevention Among African-Americans" wrote
> checks to himself and kept books that were "unauditable".
>
>       In October 1996, the Washington Post described a program that
> condoned illegal drug use in a housing facility funded with federal AIDS
> dollars.
>
>       "I am concerned that these examples may represent a widespread
> pattern of abuse.  This audit is designed to spotlight lapses in
> accountability and restore integrity and compassion to federal AIDS/HIV
> programs.  As a practicing physician, I have seen first-hand the effects
> of this horrible disease.  As a congressman, I am dedicated to
> guaranteeing that AIDS/HIV dollars are spent to alleviate that suffering,"
> Coburn said.
>
> ______________________________________
> April 20, 1999
>
> The Honorable David M. Walker
> Comptroller General of the United States
> United States General Accounting Office
> 441 G Street, NW
> Washington, DC 20548
>
>
> Dear Mr. Walker,
>
>       We are writing to request that the General Accounting Office conduct
> a performance audit and evaluation of all federal AIDS/HIV programs and
> services.
>
>       Specifically, we would like an examination of the following:
>
> 1.    GAO issued a report in January 1995 examining the equality in
> funding regarding race, gender and/or other demographics.  Could you
> provide an update of this report to determine if any disparities exist?
>
> 2.    In terms of Ryan White CARE Act programs, what is the average cost
> per client served nationally, regionally and in urban versus rural
> settings?
>
> 3.    What criteria determine federal AIDS Drug Assistance Program (ADAP)
> distributions and do these criteria advantage or disadvantage any state or
> region?
>
> 4.    Does the Department of Health and Human Services routinely request
> from grantees information pertaining to what percentage of the funds
> directed towards care and prevention programs are spent on overhead or
> other non-care related activities?  If so, could you provide that
> information?  If not, would it be possible to make such a determination or
> estimation?
>
> 5.    Is there evidence of abuses or misuses of federal AIDS funds?
>
> 6.    Could you provide an estimate of the percentage of CARE program
> funding which directly supports treatment and medical care for HIV/AIDS
> patients?
>
> 7.    Could you estimate the percentage of care program funding supports
> services and welfare not directly related to treatment, such as housing,
> counseling and other services?  How much funding would you estimate is
> spent directly or indirectly on housing?
>
> 8.    What are the salary levels of top administrators in AIDS Service
> Organizations that administer substantial federal grants ($250,000+) and
> how do they compare with state and federal civil service compensation in
> their areas?
>
> 9.    Are funds routinely being spent to ensure that those who test
> positively are made aware of their treatment options and how to access
> them and their personal responsibility to notify past, present and
> perspective partners of their HIV status?
>
> 10.   Is there any evidence of a failure to enforce federal laws- such as
> spousa1 notification or tolerating drug abuse in housing programs-  within
> any of the programs?
>
>       Thank you for your consideration of this request.  If you have any
> questions, please contact Roland Foster at (202) 225-2701.
>
Sincerely,

Dick Armey,
Majority Leader
U.S. House of Representatives

Thomas J. Bliley, Jr.
Chairman
Committee on Commerce

Tom A. Coburn, M.D.
Vice Chairman
Subcommittee on Health and Environment