AIDS Healthcare Foundation (AHF), the largest global AIDS organization and largest provider of HIV/AIDS care in the United States, has filed a lawsuit against the King County Department of Public Health over what AHF asserts is the flawed Request for Application grant application process and its subsequent award of Ryan White grants for HIV/AIDS care and services in Seattle. Through its lawsuit, filed Friday, March 17, 2017 in the Superior Court for the State of Washington in and for the County of King, (Case #17-2-06620-6 SEA), AHF seeks the court’s intervention to overturn recent Ryan White grant awards made by King County in several categories, including the ‘non-selection’ of AHF in at least two categories in which AHF was the sole bidder or respondent to the County’s Request for Application (RFA) process. Ryan White grants are largely pass-through grants from the federal government that provide funding to community-based organizations such as AHF to support the provision of medical and support services to low income people with HIV.
In its Motion for a Temporary Restraining Order against the Department of Public Health, AIDS Healthcare Foundation asserted that:
“… local administrative agencies may not burden or restrict competition in the award of federal funds under the Ryan White program by ‘[p]lacing unreasonable requirements on firms in order for them to qualify to do business, … [o]rganizational conflicts of interest,’ or through ‘[a]ny arbitrary action in the procurement process’.”
AIDS Healthcare has a well-grounded fear of an immediate invasion of its rights to an objective, impartial, and fair review of the proposal it submitted under the September 2016 RFA due to several material irregularities that provided substantial advantages to competing bidders.”
AIDS Healthcare also added in its TRO Motion that:
“…two of the four reviewers in the Psychosocial Support Services category [in which no grants were awarded—and in which AHF was the sole applicant] stated that they had conflict of interest due to professional relationships with competing applicants.”
In its accompanying Complaint for Injunctive Relief, AHF formally petitioned the Court:
“ … for an order directing the Department of Public Health (‘Public Health’) to (1) enter into contracts with AIDS Healthcare Fund (‘AIDS Healthcare’) for the six categories of HIV-Related Care Services for the Seattle Transitional Grant Area dated September 15, 2016 for which AIDS Healthcare submitted applications or (2) enter into contracts with AIDS Healthcare for the two categories of HIV-Related Care Services for the Seattle Transitional Grant Area dated September 15, 2016 for which AIDS Healthcare was the only applicant to submit applications. Alternatively, AIDS Healthcare requests that this Court grant both preliminary and permanent injunctions to prevent Public Health from entering into any contracts with applicants based upon Public Health’s Request for Applications (RFA) for HIV-Related Care Services for the Seattle Transitional Grant Area dated September 15, 2016.”
Background on AHF’s Ryan White (RFA) Grant Application Experience in King County
On September 15, 2016, King County announced and opened its request for application (RFA) process for its latest Ryan White grant cycle, which began March 1, 2017.
By October 11, 2016, AHF submitted applications to the King County Department of Health for Ryan White grants to provide HIV/AIDS care and services in six program categories: psychosocial support services; medical transportation; Minority AIDS Initiative (MAI) early intervention services; non-medical case management services; outreach services; and outpatient ambulatory medical treatment adherence. The approximate value or amount of these six grants was $169,000.
On December 29, 2016, King County’s Ryan White Program Manager Kate Briddell informed AHF that the health department’s grant review committee rejected all six of AHF’s applications.
King County Health Dept. Audited, Fined $2M by HRSA Over Earlier Mismanagement of Ryan White
In addition to its current lawsuit, AHF is also accusing the Department of Public Health of being a poor steward of federal HIV/AIDS funds. For the period between 2011 and 2013, the Public Health Department was audited by HRSA (the overseer of Ryan White funding), which found $5 million in questionable costs that had inadequate documentation supporting its Ryan White expenditures. While it appears that these issues compelled King County to return approximately $2 million to HRSA, the health department has yet to account for the entire period in question.
Background on AHF and its Involvement with Ryan White
Established in 1987, AIDS Healthcare Foundation (AHF) is the largest HIV/AIDS service organization in the world. Domestically, AHF operates medical clinics, HIV specialty pharmacies, HIV managed care programs, and HIV prevention, testing, and education services in 16 States and the District of Columbia, including over 24 metropolitan areas like Seattle receiving funding under the Ryan White CARE Act.
Since 2012, AHF has served thousands of clients in King County, and has partnered with local community based organizations to augment the local response to HIV/AIDS and reach many more in need of services. After making substantial local investments as well as commitments in staff, facilities and partnerships, AHF responded to the RFA with a series of modest proposals to further strengthen the local response to the epidemic.
In the United States, the HIV/AIDS epidemic is predominantly driven by people who are unaware they are infected, or are aware of their status but are not in regular care. Without access to regular care and antiretroviral medication, people with HIV/AIDS are sicker, and unwittingly infectious. Getting people aware of their status, into regular care, and adherent to a medication regimen are the keys to reducing new infections and stopping the epidemic. The purpose of the Ryan White CARE Act is to expand services and points of access to care, which makes the health department’s decision to unfairly exclude AHF so bewildering, especially in light of the recent HRSA audits of the Department of Public Health.
“As it does when AHF begins providing services in a new area, we built our services in King County a number of years before Ryan White contracts were available for bid. We did so in order to first establish relationships and alliances with other service organizations, to determine need and augment existing services, and to become part of the network of care providers in the area,” said Jonathan Petrus, AHF Chief/National Bureau & Investment, who supervises domestic operations in regions that include King County. “Just as we have done in other geographies, AHF invested substantial amounts of our own resources locally. Our goal is to reach those people and areas of King County still in need of services, which, of course, is the primary purpose of the Ryan White CARE Act.”
According to the 2016 Epidemiology Report for Washington State and Seattle/King County, at the end of 2015 there were 7,071 people living with HIV or AIDS in Seattle/King County and 13,021 people who have been diagnosed with HIV in the state of Washington.
AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 707,000 individuals in 38 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare
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