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HIV/AIDS Patients Without Meds Because of New Finance System, Official Says

Dec. 21, 2006 – Thirty-one HIV/AIDS patients, out of the approximately 160 eligible for federally funded drugs, have been without their medication for as long as six weeks, according to Taetia Phillips-Dorsett, the director of the Health Department's STD/HIV/TB program.
Phillips-Dorsett said the department has been unable to access available money caught in the financial tangle of the local government's new financial management system.
She says the department is between a rock and a hard place when it comes to getting federally funded HIV/AIDS medications to patients.
She said that Doctor's Choice pharmacy stopped dispensing prescriptions the week of Dec. 4.
However, the problem was alleviated Thursday morning when the Health Department paid Doctor's Choice pharmacy the $37,752 it was owed for HIV/AIDS drugs dispensed to patients on behalf of the Health Department.
Health Commissioner Darlene Carty said in a news release issued late Thursday that full service has been restored to clients.
"We are happy that our clients will have their much-needed medication and will work to ensure that these lapses in medication availability do not re-occur," Carty said.
Phillips-Dorsett said that another $33,387 worth of HIV/AIDS drugs will be shipped to Doctor's Choice to fill future prescriptions.
Anna Benjamin, manager at Doctor's Choice on St. Thomas, refused comment on the situation. Calls to the St. Croix store were referred to Benjamin.
Phillips-Dorsett said that the funding holdup occurred in the Office of Management and Budget. OMB Director Ira Mills did not return a phone call requesting comment.
Phillips-Dorsett said that the Health Department and OMB are trying to iron out the problem. Finance Commissioner Bernice Turnbull also did not return phone calls requesting comment.
Phillips-Dorsett said that not all of the Health Department's eligible patients were without drugs because some had private insurance and others were on Medicare Part D, which pays for prescriptions.
Health Department spokeswoman Eunice Bedminster said that other local government departments are also having problems accessing funds caught in the transition to the government's new financial management system.
The system of getting federal HIV/AIDS medications to eligible patients is complicated.
The Health Department receives a total of $1 million a year under the Ryan White grant program. Of that figure, $684,242 is earmarked for medications and fiduciary management through the St. Croix Foundation.
After the federal government allocates the funds, they must pass through the St. Croix Foundation. From there, the funding heads to the local government's newly computerized financial management system.
Phillips-Dorsett said that previously the transfer was handled with paperwork.
She said that the funding is available for low-income patients with no other means of getting them. "We're the payer of last resort," she said.
Bruce Smail, director of the HIV/AIDS advocacy organization VICARE, said Wednesday that several people haven't received their HIV/AIDS medication for up to two months. "Administrative problems are directly impacting the lives of individuals in the program," Smail said. He said that he knows of three people on St. Croix who are not getting their drugs.
Smail called the snafu "mismanagement" on the part of the Health Department.
Phillips-Dorsett said that the Health Department has tried to address the issue of getting medications to HIV/AIDS patients in a more timely manner for the past two years. Last year, bureaucratic bungling was to blame as more than 150 HIV/AIDS patients went without their medications for more than eight weeks (See "HIV/AIDS Patients Still Without Medication").
She said the department has requested local funding because often there is not enough federal funding to meet the needs of all eligible patients. Additionally, she said the department has shifted the amount it charges for operational costs from one category to another to reduce that cost. This allows more money to go to help patients.
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