Jul 132012

Department of Health and Human Services workers responsible for overseeing a program that administers grants to programs that help impoverished HIV/AIDS patients occasionally take trips to ensure the money is being spent effectively.

An investigation by the Government Accountability Office found, however, that these government overseers have taken almost 20 trips to such sunny destinations as the Virgin Islands and Puerto Rico, while neglecting places where the disease has hit the hardest.

The GAO report said officers from Health Resources and Services Administration, an agency of HHS, spent more time traveling to the Caribbean (especially during the fall and winter) than checking in on places where there are far more AIDS cases. Under the Ryan White Care Act, enacted in 1990, the federal government gives out about $2 billion a year in grants to programs that provide medical care to low-income HIV/AIDS patients.

The U.S. Virgin Islands, for example, receives $1 million annually in Ryan White Care funds, but HRSA program officers made six visits there from 2008 to 2011, and 12 visits to Puerto Rico, which received $31 million in funds.

Less exotic locations received much less attention, according to the GAO report. HRSA officers visited New Jersey, which received $47 million in Ryan White Care grants, only once from 2008 to 2011. And Maryland, which received $40 million, wasn’t visited a single time. No other location in the United States received as many oversight visits as Puerto Rico and the U.S. Virgin Islands.

The GAO report criticized the Department of Health and Human Services for ” lack of oversight” when it came to selecting site visits and overseeing grants made under the Ryan White Care Act.

Sen. Tom Coburn, R-Okla., who asked GAO to look into the issue, had a harsher assessment.

“It is troubling that a few exotic locations with little grant funding saw far more visits than more mundane locations that received significant funding,” Coburn, who is also an M.D., wrote in a statement.

Coburn demanded that the agency “should be setting travel priorities based on dollars, risk and need, not any other factors.”

The HHS oversight trips add up. It spent more than $50,000 on the 18 trips to Puerto Rico and the Virgin Islands over four years. Most of the excursions were made during the winter months, when it can be chilly in Rockville, Md., where the 20 HRSA officers are based.

When contacted about the report, Martin Kramer, director of communications at the Health Resources and Services Administration, issued the following statement:

“The Ryan White program is a valuable program that provides care, treatment and life-saving medications to more than 500,000 men, women and children living with HIV/AIDS across the U.S. That’s why HRSA is committed to improving and strengthening the Ryan White Program and has developed a detailed action plan to address the recommendations in the GAO report. In fact, prior to the GAO report, HRSA was already making improvements to strengthen the program.”

The agency justified the multiple trips by pointing out the Puerto Rico’s HIV rate is nearly twice that of other parts of the U.S., and the death rate is three times higher.

Jonathan Karl and Avery Miller