TESTIMONY SUBMITTED BY CARL SCHMID
VICE PRESIDENT OF GOVERNMENT AFFAIRS
CAPITAL AREA LOG CABIN CLUB
D.C. COUNCIL COMMITTEE ON HUMAN SERVICES
OVERSIGHT HEARING ON THE DEPARTMENT OF HEALTH
FEBRUARY 25, 1998
By way of background I would like to inform you that not only have I been watching our city's performance when it comes to AIDS with great concern, I was deeply involved in the successful Congressional reauthorization of the Ryan White CARE Act in 1995, and worked hard to defeat anti-gay and other negative amendments.
Government Not Spending Funds & Contracting DelaysEven though the federal government has taken over the responsibility of paying D.C.'s Ryan White vendors, the D.C. government still must issue proposals and award grants to service providers. Unfortunately, the Agency for HIV/AIDS (AHA) continues to fail by not issuing proposals and awarding contracts in a timely basis. Proposals are often issued at the last minute, if at all, vendors are left to continue services for their clients without valid contracts, and in order to reach deadlines, contracts are rushed through at the last minute. As a result of this poor management AIDS providers and their clients suffer. And, on top of it, both D.C. appropriated and federal funds are left unspent. In fact, according to the Human Services' Chief Financial Officer, in FY97 AHA did not spend almost $6 million of its $34 million federal AIDS funds-or over 17% of its funding. In a city that is scraping for money, and has the fifth largest concentration of AIDS cases in the Nation it is unconscionable that our government can't even spend the money that the federal government is providing to us.
Since AHA has not released a detailed accounting of its own spending it is hard to determine just how D.C. is spending its own funds. While the CFO reports AHA spent all but $128,000 of its budget, many question how AHA spent its over $6 million of D.C. funds. In the past, some of these funds have been deceitfully transferred to other city agencies; the same could have been true last year, but without a detailed budget we will never know. In response to the AIDS community's concerns, AHA began under its last Administrator to periodically release its budget. But under current AHA management, I understand this practice has not continued even though the Ryan White Title I Planning Council has requested this information. Maybe the City Council will have better luck in obtaining this information.
Lack of Leadership and PersonnelIn a city in which its elected officials often speak passionately about the critical importance of AIDS treatment and prevention, judging by their actions it seems for many they are merely empty campaign promises. What we need is leadership, better management, better procurement and personnel systems, and better trained employees. Just look at the lack of consistent leadership at AHA. I can not remember all of its Administrators, but off the top of my head I recall one was fired over a dispute over the awarding of a contract, the next one lasted roughly six months, and the last was there for about 2 years before he was transferred for poor performance. In between each of these administrators there were long periods of time without a permanent director, sometimes for over a year. A December 1997 organizational chart for AHA indicated that all of the top management positions, which there are 12, were being filled on an interim basis. Again, we find ourselves with an Interim Administrator, who has been in the job since late November, 1997. How long will it be before we have a permanent Administrator?
With so many top level positions being filled on a temporary basis, I understand there are very few people left with the institutional knowledge who are familiar with the programs, and the contracting and reporting processes. Many of the staff positions go unfilled, and, in fact, in October of last year it was reported that 20 out of 103 positions were vacant. The competency of the staff that is there is unclear, and it would be worthwhile for the management to conduct a performance review. Because of all of these problems AHA has had to rely on a number of consultants to ensure that its work is completed.
ConclusionThere are a number of other problems that also need to be examined, such as the AIDS Drug Assistance Program (ADAP), and adequate prevention and testing programs that I hope the Committee will also examine. Finally, I would like to remind the Committee that despite an almost tripling in the number of AIDS cases in the District, local AIDS dollars have remained constant since FY91. As our friend Hank Carde wrote in a note to me last year, "These numbers further understate the demands on the system, since in the past six years the demographics of AIDS in D.C. have shifted heavily into the indigent, mentally ill, addicted, and homeless populations, who require considerably more services to stabilize. The entire service delivery system is under heavy stress."
On behalf of the estimated 20,000 District residents who are living with HIV/AIDS, and those we must protect against HIV infection, I believe it is clear our government must do a better job. I thank you for the opportunity to participate in this hearing, and would encourage the Committee to conduct periodic oversight hearings in the future specifically on HIV/AIDS. As a suggestion, I believe it would be useful for the public witnesses to be heard from first so that the government witnesses can hear the public's concerns and address them in their testimony. Again, thank you for allowing me to present our views today. I will be happy to answer any questions you might have.