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END THE AID$ GRAVY TRAIN
THE RYAN WHITE CARE ACT HAS BECOME A CA$H COW for high paid executives and red tape loving bureaucrats, while patients continue to suffer and die. AIDS activists demand accountability, oversight, and the end of trickle-down AIDS funding that merely subsidizes the lavish lifestyle of AIDS industry executives.
The following are some reform proposals supported by ACT UP Washington, DC. (202) 547-9404
CAP SALARIES, NOT SERVICES
AIDS service providers receiving Ryan White funds may not provide a compensation/benefits package greater than the salary of the Chief Elected Official of the Emergency Management Area.
The six figure salaries for the Executive Directors of AIDS organizations often exceed the compensation paid to the mayors of large US cities, governors, and members of Congress. A review of the 990 tax forms of AIDS providers (available at www.accountabilityproject.com) reveals a nationwide trend of rising salaries, particularly among larger, well-established organizations.
While people living with AIDS are forced to live at a subsistence level, placed on waiting lists for essential survival services like emergency assistance, or food banks, it is unconscionable that the executive directors subsidize their lavish lifestyles using funds intended for AIDS care.
FEEDING AT THE TROUGH
RW Title I Planning Councils should be composed of no more than 49% voting members who are employed or board members of organizations receiving RW funds.
Planning councils were first created to ensure client participation in local priority setting, and to provide community oversight in the allocation and spending of federal AIDS care dollars. Title I Planning Councils are currently mandated to reflect the AIDS demographics of the Emergency Management Area (EMA), and must have a minimum % of members identified as living with HIV/AIDS.
However, an overwhelming majority of voting planning council members are directly employed by AIDS service providers. (In the Washington DC EMA, there are only three 'non-aligned' members, out of over 60).
The domination of service providers extends to nearly every aspect of Ryan White Planning Council functions, including: the nominations process for new members, selection of the Chair, quality assurance protocols, priority setting, and fiscal oversight.
Conflict-of-interest rules are rarely enforced and public disclosure statements poorly maintained. The result has been a community planning process hijacked by providers, advocating for their own service categories, and, ultimately, salaries, often at the expense of client needs.
Mandating that a majority voting membership of Planning Councils be 'non-aligned' will help expand community and client participation when federal AIDS funds are allocated. In addition, financial oversight over federal AIDS spending can be enhanced at the community level by empowering clients, and not just employees, in the monitoring of AIDS services.
HHS ASLEEP AT THE WHEEL
A random sample of contractors, grantees, and sub grantees from all Ryan White CARE Act programs would be audited annually with any financial irregularities forwarded to the Justice Department for legal action.
As far back as 1993, a member of the Puerto Rican legislature alerted Health and Human Services Secretary Donna Shalala to the fraud and misuse of AIDS funds at the San Juan AIDS Institute, outlining substantial evidence of corruption resulting from his office's investigation. Donna did nothing. HHS official Lawrence Poole testified that millions of federal AIDS dollars were funneled to the SJ AIDS Institute without ever receiving an accounting of the funds.