AIDS 2002

P.S.P.S. Inc.



"Dollars & Death"



DOLLARS AND DEATHS
By Patricia Nell Warren
Published in June 2002 A & U Magazine
Recently several readers took me to task for spotlighting AIDS corruption in this column. One insisted that AIDS corruption doesn't exist. Said he: "Nobody other than [Michael] Petrelis and [David] Pasquarelli [from San Francisco], plus the right-wing Congresspeople they notified, has found any misspending."

What planet do these people live on? For several years, AIDS misspending and outright larceny have been making the news, owing to little accountability and oversight of spending. A number of Democratic and Republican Congressmembers sniffed the wind and realized that AIDS spending doesn't always pass the smell test. In 1999, acting on demands from whistleblowers, legislators asked the General Accounting Office for an audit of federal AIDS programs and services. In 2000, Congress included stepped-up accountability in the renewed Ryan White CARE Act. But getting compliance may be hard with people denying that there's a problem.

Some cases have already been through the courts, notably trials in Puerto Rico two years ago. It took several years of effort by Jose Fernando Colon and other local activists to get the government's attention on crimes being committed. But finally, in 1999, five directors of the San Juan AIDS Institute were found guilty for embezzling $2.2 million dollars from patient care between 1988 and 1994. Court testimony showed that Ryan White funds were stealthed into offshore accounts and political campaigns. Today the FBI and a grand jury continue to investigate -- as I write this, several new arrests were made.

The ongoing Puerto Rico scandal raises a big human question: How many individual PWAs have died or suffered injury as a direct result of AIDS fraud and misappropriation? These are not your typical white-collar crimes. People who steal or misspend AIDS funds can do devastating injury to others -- by preventing care, treatment, housing, etc. Jose Colon charges that numbers of Puerto Ricans died because money meant for medical services and treatment was unavailable. During our telephone interview, Colon broke down and cried, stating that among the alleged victims were people he knew personally, including his own partner of 17 years. "Aramis had Kaposi's," Colon told me, "but there was no funding for medication, so he died." Many of the victims were poor.

Colon finds it ironic that, during the San Juan trials, the U.S. federal government was deemed to be the victim. "The real victims here have been forgotten," Colon says.

When I asked Colon if he could estimate how many Puerto Rican deaths might be linked to the fraud crimes, he said that the Institute's old case files from 1988-1994 should be scrutinized and matched up with death records. "But the victims may be in the hundreds," he added, pointing out that statistics show some 17,000 Puerto Ricans as having died of AIDS, while the embezzlements spanned six of the epidemic's 20 years. Colon also alleges that some still-living patients from this period also suffered injury as a result of unavailable care.

Last year Colon testified at a House hearing and demanded federal audits. His testimony helped get Ryan White accountability requirements passed. But, as far as I know, Congress is not yet moving to investigate these alleged deaths. Colon's watchdog group, Pacientes de SIDA pro Politica Sana, continues to fight ongoing abuses. At the Barcelona AIDS Conference this month, PSPS will be circulating a declaration calling for international support of full fiscal accountability and concern for patient welfare, among other things. Colon says: "What happened to us must never be repeated."

I agree with Colon. It's time to look beyond the dollars, and put a human face on how AIDS fiscal crimes may impact lives. Legal experts need to look at how those responsible might be held criminally or civilly accountable for any deaths or injuries that occur.

Last year, in [the San Francisco , [ACT UP DC's] Wayne Turner's roundup of mainland AIDS scandals suggests that the bad smell hanging over Puerto Rico hangs over the U.S. mainland as well. Turner commented: "The San Juan case is, tragically, not isolated." He added: "The FBI is currently probing an AIDS clinic in Dallas, Texas, after local authorities uncovered tens of thousands of Ryan White dollars had been spent on shopping sprees to Neiman-Marcus and psychic phone-in calls. A bookkeeper in Florida pleaded guilty to stealing $500,000 in AIDS money, and spent the funds on trips to Disney World. Los Angeles auditors discovered three years of federal AIDS housing funds in a hidden bank account. In Indiana, a statewide agency diverted funds intended for emergency patient assistance, to help cover its own operating costs." So -- did any patients die, or have their health damaged, as a result?

Funds for AIDS housing seem to be a problem area. Housing is a life-and-death issue for PWAs who are homeless or in danger of losing their homes. Living on the street makes it difficult for them to follow treatment, and exposes them to killing stresses, unsanitary conditions and new infections that might aggravate their condition. The poor and homeless -- many of whom are people of color -- have little lobby power and media access to fight AIDS housing-money abuses. Yet often funds go flagrantly unspent. In the Los Angeles example cited by Turner, the mayor's office ignored protests by local activists who learned that $17 million earmarked for housing went unspent by HOPWA (Housing Opportunities for People With AIDS). Yet this action affected two thirds of L.A.'s PWAs. Meanwhile, in New York, a State Supreme Court Judge recently found the Giuliani administration in contempt of court for failing to place homeless people with AIDS in housing, even though funds were available. The city had ignored angry activists protesting its failure. What impact do these sordid practices have on actual death rates of homeless PWAs in different cities?

Across the country, local AIDS investigations are sparked by an array of individuals like Colon, who get heartsick at seeing funds being stolen or misspent, and people's lives put at risk. In [Asheville] North Carolina, for example, activist Kevin Nuttall [State & Federal Affairs Director of the NC AIDS Policy Center] is demanding answers about $125,669 that the Asheville Housing Authority was supposed to spend on AIDS housing, while sick people needing housing were turned away. Some whistleblowers complain bitterly about the widespread belief, in the LGBT world, that the corruption issue is just a red herring invented by right-wing legislators who hate gays.

How can this be happening, when "winning the war on AIDS" is supposedly such a national goal? Why so little outcry about from PWAs themselves? One reason: some PWAs see the abuses, but keep quiet because they know that whistleblowers are often targeted for what Nuttall drily calls "consumer disenfranchisement." Nuttall, who is HIV+, says he was punished for his activism by being denied services at his local ASO. Similar cases of punitive service denial, or of barring whistleblowers from conferences and meetings, are on record across the country. Jose Colon told me: "I was openly threatened because of my activism. If I hadn't been vindicated by the trials, I might have had to leave the island."

Another reason: though PWAs are the ones most directly harmed by AIDS corruption, they have little leverage on AIDS spending. Their under-representation in AIDS agencies and ASOs has become a central issue. Funding decisions tend to be made by employees of bodies receiving funds, which creates a conflict of interest. There is evidence that sunshine laws may often be violated, with spending decisions made behind closed doors. The amended Ryan White Act now requires that at least a third of Title I council members be conflict-of-interest-free consumers of CARE services. But Title I covers only certain U.S. cities. Nuttall is lobbying Congress for 33-percent representation of consumers in ALL spending decisions.

Some responsibility for ongoing investigation has been shuffled to the Dept. of Health and Human Services. Some federal audits have already been done; more audits were promised for this year. Is anybody at HHS going to investigate the obvious question of how corruption affects the U.S. AIDS mortality rate? To put it another way, how many of the 448,060 people said to have died of AIDS by the year 2000 died needlessly because of funding-related crimes? And where is HRSA, who is supposedly responsible for reaching people who aren't receiving care?

We got no clue of government concern from AIDS czar Scott Evertz when he was in San Francisco recently. During an interview with , Evertz soothed the local AIDS establishment's fears about federal audits, saying: "I really don't think that people should be overly concerned. I believe that the Secretary of Health and Human Services' office felt compelled to respond to the folks on The Hill that were pushing to take a look at this." Everts also spoke at a meeting of the S.F. HIV Prevention Planning Council, according to , and dismissed activists demanding audits as a "small group of people" who are "ginning the issue up."

If AIDS corruption were ended everywhere in the U.S., I'll bet my bottom taxpayer's dollar that there'd be plenty of money for legitimate human needs. Puerto Rico's new governor, Sila Maria Calderon, has pledged an end to corruption in the island commonwealth. But Jose Colon's burning question for Puerto Rico must be answered for the whole country.

Further reading:

ACT UP DC's Wayne Turner wrote: http://www.aegis.com/news/bar/2001/BR010110.html Wayne Turner/ACT-UP DC

Pacientes de SIDA Pro Politica Sana: http://www.geocities.com/aidsanepolicies

Report on L.A. housing mismanagement: http://www.aegis.com/newsbar/1999/BR990503.html
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