July 11, 2005 – Bureaucratic bungling has prevented more than 150 HIV/AIDS patients in the Virgin Islands from receiving the medicine necessary to keep them alive. According to information obtained by the office of Senate President Lorraine Berry, the patients have been without their medicine for more than eight weeks.
Berry wrote Health Commissioner Darlene Carty Friday demanding an answer to the situation, which she termed "unacceptable" and even "criminal."
"This is not the first year that this situation has occurred," Berry wrote. "Unfortunately, this has become the norm … to obstruct any progress in the administering of medications to severely ill human beings is criminal."
Berry said her office has been investigating the situation for three weeks. "We have consistently been led astray [by] members within the Department of Health, and on several occasions [were] given erroneous dates on when the money would be available."
Berry asked Carty to respond before Friday with a list of challenges the department has faced regarding the program, and solutions for an expeditious disbursement of the funds.
Health Department spokesperson Eunice Bedminster said Monday that Carty had received Berry's letter, but that she would respond directly to the senator because of confidentiality issues. Bedminster also said Carty had found "inaccuracies" in Berry's letter, but that she could not elaborate on them.
On June 10, the Source was made aware of the situation when a patient with HIV, who spoke only on condition of anonymity, said he had been waiting for weeks for his medication. (See "AIDS, HIV Patients Still Without Medication.")
The territory receives federal funds from the AIDS Drug Availability Program known as ADAP, which is part of the Ryan White Foundation funds.
Specifically the ADAP money provides drugs to people who have no other means — such as insurance or membership in any kind of health program — to obtain the costly medication.
The drugs can cost anywhere from $10,000 to $20,000 a year, per patient.
In June it came to light that a contract between the V.I. government and the St. Croix Foundation — the third-party fiduciary agent that distributes the funds — had not been signed. However, Berry said that the contracts were all signed by late June, and the DOH "refused to issue a priority to the Department of Finance for the immediate draw down of this money."
Berry reminded Carty that this is not the first time such bureaucratic inefficiency has occurred. She wrote, "Since implementation of a third-party fiduciary several years ago, there has been a lag in administering federal monies for this program. The implementation of a third-party fiduciary in no way should impede the rapid response to draw down federal money."
The checks were received by the St. Croix Foundation on Friday, it was revealed on Monday.
Berry said Monday afternoon that was "great news," but it should not have been "eight weeks late."
Berry said to Carty that the situation is unacceptable, "especially when federal money was available since January 2005, and that the DOH was made duly aware of the potential shortage of medications to these patients by mid-May 2005."
Although the Combivir-HIV medications ran out in mid-May, Sen. Berry noted that DOH officials failed to "move rapidly in processing contractual agreements for the $600,000 in federal funds."
According to HIV specialists, it is not a particularly threatening situation for patients to be completely off the "cocktail" (as the drugs are known) for limited time periods. However, patients' fears about not having their medication can affect their emotional well-being.
One expert said it was important for the patients to understand that short periods off the drugs that keep the virus at bay were not dangerous. As soon as patients go back on the medication, they will respond normally to the drugs. However, other expert opinions say that it isn't known how long an HIV/AIDS patient can be off the drugs with no ill effects.
In the letter, Berry also asked Carty when a Ryan White II ADAP state coordinator would be hired, since "the program is out of compliance.'' She said she also was very concerned about how the St. Croix Foundation would be paid. "If the payment is made out of the ADAP money," Berry wrote, "patients will run out of medication by early March 2006, if not before."
She suggested to Carty that the indirect cost fund, which has paid the foundation over the years, remain the sole source of payment for administration of the funds.
James Francis, Berry's chief of staff, said late Friday afternoon that no correspondence had been received from Carty's office. Berry was presiding Monday over a full session of the Legislature, and wasn't available for comment Monday afternoon.
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