June 10, 2005 – More than 120 persons with HIV or AIDS have been without medication for three weeks while a contract crucial to the release of the funds to purchase the drugs was caught up in the quagmire of V.I. bureaucracy.
The contract isn't even about the money — that's a done deal. A grant has been written and approved for the money to purchase the drugs.
It's the contract for fiduciary services that has not made it through the proper channels. The contract is with St. Croix Foundation, which is tasked with managing the funds – taking in the money and writing the checks. They get 4 percent of the grant for the administration, which is all federally funded.
A patient with HIV, who spoke only on condition of anonymity, said he has been waiting for weeks for his medication. And he's nervous. "It's not right. Doesn't anybody care?"
According to HIV specialists, it is not a particularly threatening situation for patients to be completely off the "cocktail" (as the drugs are known) for limited time periods. However, patients' fears about not having their medication can affect their emotional well-being.
One expert said it was important for the patients to understand that short periods off the drugs that keep the virus at bay were not dangerous. As soon as patients go back on the medication they will respond normally to the drugs.
"It isn't good for people to take a holiday, but it doesn't cause damage to the immune system," one expert said.
The AIDS Drug Availability Program, known as ADAP, is part of the Ryan White Foundation funds.
Specifically the ADAP money provides drugs to people who have no other means — such as insurance or membership in any kind of health program — to obtain the costly medication.
The cocktail drugs can cost anywhere from $10,000 to $20,000 a year, per patient.
Other funds are available under the Ryan White program to help people meet their insurance co-pay obligations or other shortfalls where they do have some form of insurance.
Meanwhile, no one in the government has been able or willing to say where St. Croix Foundation's fiduciary contract is in terms of the paperwork process.
However, late afternoon on Thursday, the Source was able to trace the contract to the V.I. Justice Department – where it had been for a month while the bureaucratic bouncing ball had been going between the Health Department and Justice.
And no one was willing to speak on the record about any of it.
One source inside Justice said the paperwork from Health was improperly handled, which began the back and forth wrangling. "They didn't provide the request in the normal way," the source said. Health used a miscellaneous disbursement voucher, which is normally used for requesting money from the local General Fund.
It is anybody's guess how long the wrangling might have gone on if the situation had not been uncovered. One person said the paperwork might even have been sent back to the Health Department for re-submission if the crucial nature of the situation had not been brought to light by the Source.
"In fairness to the Justice Department," one person said, "no one at Health told us this was holding up drugs for people."
James O'Bryan, spokesman for Government House, said Friday afternoon that he was sure the contract would be expedited once it arrived at Government House, which is expected to happen by Monday or Tuesday.
"Nobody appreciated the human lives that were behind the paperwork," one knowledgeable source said.
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