Some Puerto Rican clinics limiting HIV/AIDS services following suspension of reimbursements from Ryan White progra

Mar 11 2007

Some clinics in San Juan, Puerto Rico, have begun rationing drugs for hundreds of HIV-positive people, while other organizations have reduced food supplies and services, since they stopped receiving reimbursements from the Ryan White Program, the AP/AOL News reports.

Puerto Rico receives about $58 million annually under the Ryan White Program, according to the AP/AOL News.

Ryan White Program invoices from Puerto Rican health agencies have received extra scrutiny since 2005 because of previous management issues, according to Tina Cheatham, a spokesperson for the Health Resources and Services Administration.

In addition, FBI agents in December 2006 raided four San Juan government health offices that manage Puerto Rico's Ryan White funds as part of a broader fraud investigation, the AP/AOL News reports.

The agency has not made any arrests and will not comment on the investigation. According to Maria del Carmen Munoz, director of federal affairs for San Juan, FBI agents conducting the fraud investigation seized documents in the December raid that were needed by the local government to obtain Ryan White reimbursements for the clinics -- a claim that the FBI has denied.

Munoz said that Puerto Rican health officials have had to request new invoices from the island's clinics and verify their authenticity.

She added that officials have proceeded more cautiously because of the investigation. "We are hopeful that within this month, all the ... invoices will be paid," she said.

FBI spokesperson Harry Rodriguez said the agency "takes the appropriate measures to ensure the public is not affected in any way."

According to health workers at 21 San Juan clinics, which are privately run under the administration of the city's government, they stopped receiving Ryan White payments late last year, but the rationing began in recent weeks as their budgets started to run low.

Health workers at some clinics already have scaled back their hours, staff levels and antiretroviral distribution, and others say they will have to do so within days.

About 2,000 HIV-positive people in the San Juan area currently face drug rationing and are receiving enough treatment to last up to five to seven days each month, according to Anselmo Fonseca, co-director of an AIDS advocacy group.

Some patient advocates have said that San Juan city government officials and other agencies are at fault for the funding suspension, saying it is a result of mismanagement and longtime corruption in the program.

Clinics in other parts of the island are receiving funds from the Ryan White Program and operating normally, the AP/AOL News reports.

According to Cheatham, issues in distributing Ryan White funds are not uncommon, and HRSA is offering San Juan officials technical assistance. Some advocates have said that they question if such delays would be tolerated on a similar scale in the U.S., according to the AP/AOL News (Mitchell, AP/AOL News, 3/7).