HIV prevention funding cut after it was discovered the state health
department had mismanaged a grant, leading to the $8 million refund
in HIV and AIDS money.
in spite of the dramatic increase in the number of residents
diagnosed with HIV – women especially.
to the Colorado Health Department, 455 people will be told they have
HIV before the end of 2019… an increase of nearly 40 people. The
news comes after the 10+ years of promises in HIV prevention that
includes a brand new drug that is going to change public health.
Colorado, clinics offer HIV testing and PrEP, a daily preventative
pill, but are now seeing their budgets cut with no notice whatsoever.
Colorado Department of Public Health and Environment reached out to
clinics and other agencies, letting them know about the cut in
funding from 25 percent, starting in January. This ignited a clash
between a community group that has counseled the state about AIDS and
HIV and state officials.
are three reasons why the cuts are happening:
- Multitude of grants are expiring
- Legal view on how dollars should be spent
- Previous mismanagement of federal dollars (which led to $8 million being returned to the government)
2017, the U.S. Health Services and Resources Administration awarded
the state with $13.1 million under its Ryan White program, which is
developed to help people who have HIV and AIDS. However, due to not
spending the minimum 75 percent of the fund, Colorado officials had
to return $7.9 million over the last four years.
- 2015 - $757,000
- 2016 - $4.3 million
- 2017 - $2.5 million
- 2018 - $357,000
alliance members say the waste of funds is reckless, even more so
now, because clinics are being hit hard even though they are trying
to stem the HIV spread. It’s unclear if the cuts will impact care
or mean a loss of jobs.
state health department said there are over 14,000 Colorado residents
who have HIV.
Cardell was diagnosed with HIV in 1991 and is a current Colorado
Alliance for HIV Prevention, Care and Treatment member. The alliance
has had a positive standing with Colorado public health officials
until recently. The alliance has been asking for some transparency in
how the state is spending its money and an answer as to why money
given to HIV and AIDS work is being sent back to the federal
community members and activists, Cardell said, it’s concerning that
the illogical activities are going to have a negative impact on
people who have HIV or those at risk of acquiring it.
the federal money going back, the Colorado Attorney General’s
Office informed the health department back in September that it was
no longer allowed to use supplemental rebate dollars for any HIV
prevention. Rather, this money under the same rules applied under the
Ryan White program – for people who already have HIV or AIDS. It
does not go for the prevention of it.
White is the Indiana body who attained AIDS in 1984 after getting a
blood transfusion. He died in April 1990 from pneumonia.
was using the rebate money to help with prevention, but state
officials have designated it only for treatment.
still, it gets worse, the four-year, $1 million a year-grant given
from the U.S. Centers for Disease Control and Prevention is also
Executive Director Jill Hunsaker Ryan said she asked the staff to
look over the financial controls to ensure the state was following
the grant rules and ensuring contracts were released to community
agencies to offer an array of services in a timely manner.
said she wanted to make sure the money wasn’t being reverted,
remarking about the previous accounting failures several years ago
and before her appointment. She said she was looking into other funds
the department could use to help with HIV prevention until a more
sustainable funding source could be found.
said clinic support comes from various sources such as grants with
different timeframes and pharmaceutical rebates.
on the advice Colorado officials had on the Ryan White program – to
not spend money on HIV and AIDS prevention – Ryan said the topic is
not closed. She said many other states are using the funds to pay for
the PrEP drugs in at-risk HIV communities. Ryan said it was something
she’d like looking more into, but the more discretion these
programs have for the money, the easier it’ll be for the agencies
to address community needs.
2012, the everyday antiviral, which sells under Truvada, became
available. And, without any insurance, the drug can cost nearly
$2,000 a month. When Congress wrote the Ryan White program rules, the
drug hadn’t even been introduced, which is why many think it’s
time for the law to be updated.
Ryan said preventing HIV is one of the state health department’s most crucial priorities. She said it is imperative that prevention responses are kept up to ensure people don’t continue to get this disease.