May 19, 2004 Darlene Carty, the new commissioner of the V.I. Department of Health, met with federal officials from the Center for Disease Control early this week. Advocates for Virgin Islanders suffering from HIV and AIDS, like the rest of the public, were not clear on what the topics of discussion were, but they were guessing the primary subjects would be funds for the administration of AIDS programs here.
Just a week ago the U.S. Department of Health and Human Services awarded a grant worth over $1 million to fund testing, provide medication and support services for the sick in The Virgin Islands.
However, a disagreement on what direction the Health Department's AIDS program should take led to a partial suspension of a previous grant to the Virgin Islands. Two community-planning groups oversee how programs are run and funds spent one is on St. Croix and the other represents residents of St. Thomas and St. John.
The V. I. groups declared the V.I. Health Department to be in non-concurrence with the federal Health Department. The federal authorities responded by not releasing one quarter of a grant worth more then $600,000 to the V.I. Health Department.
According to Pat Odoms, of the St. Thomas/St. John group, the approach adopted by the V.I. Health Department differed with the group's approach to HIV issues.
Last week the St. Croix group changed its position and voted to accept the department of health's position. But a lack of a quorum prevented a vote Monday night in the St. Thomas-St. John district.
Odoms said Tuesday the process would have to wait a little longer. She explained, "It is only now that the Department of Health is responding to that (declaration of non-concurrence) and attempting to get the community planning group … to change their position from non-concurrence and move it to concurrence so they can get that restricted money released."
Odoms said the money cannot be released until the community planning groups in both districts give the go ahead.
Odoms suggested the differences lie in which groups of Virgin Islanders should get the focus of public health efforts to treat and educate about AIDS and HIV.
Federal health experts say the Virgin Islands has the fourth highest incidence of new HIV infection of any state or territory in the United States.
Odoms said the focus should be put on heterosexual women and teenagers because that's the group experiencing the fastest growth of new infections.
Now, in what appears to be a change in strategy, Odoms said the department of health is shifting its focus on target populations identified in grant requests dating back to the year 2000. Those groups include youth ages 13 to 19, drug abusers and men engaging in homosexuality.
"As a result of us voting non-concurrence, they are now reverting back to the old plan and designing interventions with those target populations," she said.
The funds provided through the community planning grants are largely earmarked for HIV testing, prevention and some support services. But last month on St. Croix some similar funding was reportedly diverted to pay for medications for persons already suffering from HIV disease and AIDS.
Medications are usually paid for through Ryan White Title II federal funding programs, which are supposed to be disbursed through a fiduciary agency working under contract with the V.I. government.
Carolyn Forno, at the nonprofit agency, V.I. Care, called the situation worrisome and a sign of other problems in the government's administration of the local AIDS program.
The fiduciary agency was appointed after hundreds of thousands of federal AIDS dollars went unspent by the V.I. government in 2001. That situation led to stocks of AIDS medications drying up on the shelves of pharmacies. At that time, it took intervention by the executive branch to release some of the money and restock life-saving drugs.
Local AIDS advocates say they are worried because any situation that would force indigent patients to go without their medicines for as little as a few days could render those patients unresponsive to a continuing course of medication. If that were to happen, they say, patients could get sicker than they already are or even die.
The executive director of the fiduciary, Roger Dewey of the St. Croix Community Foundation, declined comment on the situation. He cited a contract agreement with the V.I. government that prohibits disclosures to the media.
But in an interview last week, Forno said it was uncertain whether that contract was still in effect, leaving the possibility that there may be no entity with the legal authority to disburse Ryan White Title II funds to pay for HIV medicines.
Forno said Friday that she was advised by health officials that some federal funds her agency relies on to pay for HIV test kits would not reach the St. Croix V.I. Care offices because the money had to be used to fund other priorities.
Commissioner Carty was not available to comment about recent developments in the territory's HIV program on either Friday or Monday, but she did invite the submission of questions regarding the program on Tuesday.
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