Federal rule change rocks HIV programs

Print Friendly and PDF By: Andy Miller Published: May 28, 2012

HIV/AIDS service programs say a rule change by a federal agency would squeeze their budgets to the point that they may not be able to serve as many patients.

The Health Resources and Services Administration is now requiring that rent, utilities and insurance costs be classified as administrative expenses under parts of the federal Ryan White HIV/AIDS program. As such, these costs will be charged to the administrative cap of 10 percent of the total amount awarded.

That means many HIV service programs will have to seek other ways to cover those expenses.

“All agencies are scrambling to find ways to shore up their budgets,’’ says Larry Lehman, executive director of the nonprofit AID Gwinnett/Ric Crawford Clinic, which serves HIV patients in Gwinnett, Newton and Rockdale counties.

The rule change means AID Gwinnett will have to find an extra $47,000 for its budget, Lehman says.

The AID Gwinnett clinic receives more than 90 percent of its clinic funding from the Ryan White program, named for a young Indiana hemophiliac who was diagnosed with AIDS at age 13. Ryan White and his mother helped educate the nation about the disease. He died in 1990 at age 18.

A national organization of HIV service providers has asked HRSA’s administrator to reverse the accounting change.

“With this new policy, the agency has acted in a manner that is reducing the availability of services and harming [agencies],’’ said a letter from Ernest Hopkins, chairman of the Communities Advocating Emergency AIDS Relief Coalition (CAEAR).

The coalition surveyed 21 agencies, and 15 report the policy change has been a burden for grantees. One grantee predicted that small agencies could close, and others would reduce the number of patients they can treat. Four other agencies said they were not sure of the effects of the policy change.

HRSA issued a statement recently to Georgia Health News saying the agency “is working to address the concerns CAEAR expressed in their letter.’’ HRSA, the statement adds, “has and will continue to provide technical assistance to any and all grantees who seek it on this issue.”

For 20 years, expenses such as rent and utilities were classified as direct services expenses, Lehman says. “It’s causing a huge problem for anyone that’s a safety-net provider.‘’

AID Atlanta, which serves most of metro Atlanta, reports no impact so far from the change. But Tracy Elliott, the organization’s executive director, says the HRSA switch “has the potential to have a very significant effect.’’ At worst, it could create a $250,000 hole, he says.

At AID Gwinnett, 70 percent of patients have no insurance, Lehman says. The rest have Medicare or Medicaid, or in a few cases, private insurance.

“The only reason this agency exists is to support the people it serves,’’ Lehman says. The money, he adds, “goes to prevention and care.’’

With the rule change, he says, “you’ll see a lot of clinics go to a waiting list.’’

HIV/AIDS service programs say a rule change by a federal agency would squeeze their budgets to the point that they may not be able to serve as many patients.

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  • Concerned POZ

    This demonstrates how ASO’s & State agencies have been cooking the books for years. Full accountability needs to be shown for every dollar spent. This rule actually forces the entities to do what they should have been doing all along.


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