GAO: Major HIV/AIDS funding program improperly monitored


A pharmacist pours Truvada pills back into the bottle at Jack's Pharmacy on November 23, 2010 in San Anselmo, California.


Justin Sullivan

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The Health Resources and Services Administration (HRSA) has failed to oversee nearly half of all grant recipients under the Ryan White CARE Act, according to a government report released Wednesday.

Under the Ryan White CARE Act, first passed in 1990, the Department of Health and Human Services distributes grants to local governments to provide uninsured HIV/AIDS patients with funds for medication and health services. In fiscal year 2012, $2.3 billion has been dedicated to CARE Act programs, according to the Government Accountability Office. HRSA is tasked with ensuring that these funds are spent properly.

Only the agency didn’t do that, it seems.

The Government Accountability Office report found that HRSA has consistently broken its own monitoring rules.

As FRONTLINE pointed out, the agency failed to visit 44 percent of grant recipients, including Washington, DC, where HRSA is based.

Required documentation of monitoring was also incomplete. Of a sample of 25 grantee files, only four had records of quarterly calls with grant recipients.

Four of 25 grantees said they were not given technical assistance because they were told there were budget constraints, and, the report added, HRSA did not follow its own policies for selecting which grantees to visit.

Washington, DC received $21 million from HRSA in 2011 and has a 3 percent HIV prevalence rate, higher than the rate of five PEPFAR countries.

Instead the agency visited Puerto Rico 12 times, and the Virgin Islands six times. HRSA’s response to FRONTLINE was that both destinations have much bigger challenges than other grantees, and the agency has a limited budget.

But whether those challenges merited eighteen site visits while other places received none remains unclear. After all, the drive from HRSA’s office in Rockville, MD to Washington, DC takes 36 minutes, according to a Google Maps estimate. Sure quicker (and cheaper) than a plane ride to Puerto Rico.

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