U.S. News

Washington, D.C., Health Dept. Director Announces Plan to Assure City Pays Not-For-Profits Serving HIV/AIDS Patients on Time

May 27, 2005

District of Columbia Department of Health Director Gregg Pane on Wednesday announced a plan to prevent further problems that cause delays in reimbursements for organizations that serve the area's HIV-positive population, the Washington Times reports (McElhatton, Washington Times, 5/26). Washington, D.C., City Council member David Catania (I) had called for a proposed plan after the Whitman-Walker Clinic, which provides HIV/AIDS testing and related health services to mostly low-income area residents, announced that it is facing financial constraints that might force the group to consider program cutbacks. The clinic -- which serves about 7,000 HIV-positive individuals in the Washington, D.C., area and has a $29 million budget for 2005 -- earlier this month failed to meet its payroll for the first time since it opened in 1974. Whitman-Walker Interim Executive Director Roberta Geidner-Antoniotti said that a series of budget and funding problems have contributed to the organization's financial problems, including more than $700,000 in late reimbursements owed to the clinic by the district health department and the housing agency of Prince George's County, Md. The district health department's failure to pay reimbursements on time also has led the Carl Vogel Center, which provides case-management and counseling services to about 700 HIV/AIDS patients in the city, to reduce staff and cut back services (Kaiser Daily HIV/AIDS Report, 5/23).

New Payment Process
The current "cumbersome, bureaucratic" system for reimbursements will be "drastically pared" and bills expedited to assure that not-for-profit groups receive reimbursements within 30 days or less, according to Pane, the Washington Post reports. The plan will reduce the number of steps in the invoice process from eight to four and full audits will be required quarterly instead of monthly. In addition, payments will be sent out prospectively each quarter so groups no longer will have to advance money to provide medical, legal, housing and social services to HIV-positive people (Levine, Washington Post, 5/26). The plan also calls for the department to move to an electronic payment system -- rather than using the current paper-based system -- to assure that payments go out each quarter. In addition, Pane said health department officials will conduct "enhanced site visits" to not-for-profits that receive city funding, according to the Times (Washington Times, 5/26). The plan did not include a request by Catania that the department turn over its reimbursement functions to an outside company because Pane said such a move is "not necessary," according to the Post. Pane said the payment process, not the personnel operating the system, was at fault for the delayed reimbursements, according to the Post. However, Pane said he later would announce additional steps to the plan, according to the Post.

More Questions
The city's HIV/AIDS Administration will face additional scrutiny over coming months, as the D.C. Inspector General plans to conduct an audit of the administration, according to the Post. City Council member Jim Graham (D) on Wednesday raised questions about potential "doctored paperwork" showing a series of monthly payments dating to October 2004, according to the Post. A printout submitted to the City Council showed that an unnamed not-for-profit that was seeking reimbursement submitted all invoices for that period on May 9, which would make the delayed reimbursement the not-for-profit's fault rather than the administration's and would give the administration one more week to reimburse the funds. "I want you to do an audit of HAA," Graham told city Administrator Lydia Watts, adding, "Let's see just what the truth of this is."

Catania and other council members "reacted positively" to the plan, and Council member Vincent Gray (D) called the plan "an exciting framework," according to the Post. However, the not-for-profit groups waiting for reimbursement still are "waiting for proof" that the plan will work, according to the Post. "I think it's only fair to give (the administration) an opportunity" to succeed, Sharon Bakerville, executive director of the D.C. Primary Care Association, said, adding, "It's amazing to me how quickly a solution can be found" after the council gives an ultimatum (Washington Post, 5/26).

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