It came from the email box ( big government works)

Just think of this next time some one wants some big government

The Miami Herald
October 12, 2005 Wednesday FL EDITION

SECTION: A; Pg. 1

Report: AIDS funds wrongly diverted;
Florida social service administrators took $200,000 from an AIDS program to pay the bills of a Broward child with autism, a state report said. Favoritism may have been a factor.; HERALD WATCHDOG

BY CAROL MARBIN MILLER; cmarbin@herald.com

Faced with a long waiting list and short on dollars to meet the needs of disabled Floridians, state administrators ''went shopping'' for the money elsewhere, an inspector general's report says.

Apparently, those with AIDS paid the price.

In 1999, the politically connected parent of a disabled Broward County youngster threatened to sue state social service officials who refused to pay for the youngster's care. The report, by the Agency for Health Care Administration's inspector general, says that state authorities diverted about $200,000 in federal AIDS dollars to pay for the child's care.

The report raises several concerns. Among them: whether state social service administrators routinely pilfer money from one pot to cover shortfalls in another, and whether they play favorites when deciding whom to serve among a 15,000-name waiting list of disabled Floridians in need of care.

To Florida AIDS advocates, the conclusions of the 200-page report confirm their long-standing fears that people with AIDS suffer particular neglect in a state known for its meager spending on social services.

''It is completely immoral and unethical to take money away from people with AIDS,'' said Sheri Kaplan, executive director of the Center for Positive Connections, an HIV and AIDS resource and support center in North Miami.

So who approved the diversion of funds?

According to the report, at least two high-ranking state administrators told investigators that former AHCA Medicaid Bureau Chief Shelly Brantley -- and perhaps others in the agency -- approved the funding. One of the administrators told investigators that when he questioned Brantley about the propriety of the diversion, she responded: ''Find a way to pay it. Do what you're told to do.''

Brantley, now director of Florida's Agency for Persons with Disabilities, declined to comment for this story.

Lindsay Hodges, a spokeswoman for Brantley in Tallahassee, declined to discuss the report in detail, saying Brantley had not read the report, and was not interviewed as a part of the investigation. Hodges said, in an e-mail, the Broward family's settlement with the state ''was resolved prior to [Brantley's] employment with AHCA.''

Yet two high-ranking administrators told inspector general investigators that Brantley was involved in the decision to divert the money. It was not clear from the report what role Brantley had at the agency at the time, and her spokeswoman could not furnish a copy of Brantley's resume to The Herald on Tuesday.

At the center of the April inspector general's report is a Broward County couple described by agency administrators as politically connected. When the couple threatened to sue the state over the costs of their child's care, officials diverted about $40,000 per year -- or more than $200,000 since 1999 -- from a program for people with AIDS to pay for expensive therapies for the child, who suffers from autism.

The investigation began in August 2004, when an AHCA program analyst, Colm McAindriu, filed a formal complaint with the agency's inspector general a few weeks after he retired. In his complaint, McAindriu alleged several ''violations of state and federal laws'' by his former bosses, including the misspending of hundreds of thousands of AIDS dollars.

'ALTERNATIVE FUNDING'

The inspector general's report confirmed McAindriu's claim that high-ranking administrators of the healthcare agency approved the use of AIDS money to pay for the Broward youngster's behavioral care. The report recommended the agency ''consider an alternative funding source'' for the child's therapies.

Jonathan Burns, a spokesman for AHCA, which regulates healthcare providers in Florida, declined to specify whether the child's therapies still are being financed by the AIDS program, citing federal privacy laws.

The state rules that govern the Project AIDS Care program say only those diagnosed with AIDS are eligible for services.

UPSET OVER DIVERSION

McAindriu, a seven-year employee of the healthcare agency, told investigators the diversion of funds bothered him because he has a 30-year-old cousin with AIDS.

''I don't know if I'm ever going to see her before she dies,'' he said. ''To my knowledge there is no cure for this thing. . . . There are a lot of people like my cousin who need as much help as they can get.''

McAindriu told investigators he asked other AHCA administrators, including the supervisor of the AIDS program, whom he did not name, whether officials commonly robbed Peter to pay Paul. 'And [the] frequent comment was, 'We do lots of things like that,' '' he said, according to the report.

The mother of the Broward child, who is not being named to protect the family's privacy, declined to discuss the report.

SOME LEFT AGENCY

Brandi Brown, an AHCA spokeswoman, said in an e-mail that few, if any, of the employees involved in the case were still working with the healthcare agency, and so ''disciplinary actions have not been taken.''

Burns said the agency would not reimburse the Project AIDS Care program for the money removed to pay for the child's treatments since 1999.

Like Floridians with AIDS, the families of disabled people also have struggled to obtain state aid. Martha Creel, who worked in AHCA's Medicaid office in the early 2000s, told investigators her agency succumbed to ''political pressure'' in the Broward family's case.

''Usually, people are told, 'I'm sorry, we can't help you. Get on the waiting list with everybody else,'' Creel, who is now director of a community program for disabled people at the state Department of Elder Affairs, told investigators.

EARLIER REPORT

It's not the first time the issue has been raised. A 2004 report by the Department of Children & Families' inspector general concluded that the family of a disabled Tampa Bay child ''received special consideration'' from the state following phone calls from the aide of a powerful lawmaker.

The 2004 report quoted a doctor who worked for DCF's developmental disabilities office as stating ''that politics play a part in the daily operations'' of the program.

UNEVEN FIELD?

State Rep. Susan K. Goldstein, a Sunrise Republican who has championed the cause of disabled children, said parents have expressed concerns that the playing field is not even.

''People really, truly believe it's who you know,'' Goldstein said.

Officials interviewed by the inspector general said one of the Broward child's parents was friendly with a Broward County commissioner, who was not named, and a former state Cabinet official.

Karen Alday-Henderson, a program analyst with AHCA, told inspector general investigators: ''I believe that [the parent's] political clout has something to do with how this happened.''

AN ADOPTED CHILD

The Broward couple, now divorced, adopted the youngster in the 1990s from the Department of Children & Families' foster care program.

In the spring of 1999, DCF's adoption program announced it would refuse to continue paying for the child's care, including costly ''intensive behavioral treatments,'' beginning that June. The therapy was intended to combat the effects of autism, an often debilitating neurological disorder that can leave children extremely difficult to manage.

Desperate for help, the family appealed DCF's rejections and threatened to sue the state. The family also threatened to give the child back to the state, Creel told the inspector general investigators.

1999 AGREEMENT

What resulted was a settlement agreement in 1999 between the family and AHCA, which agreed to pay about $40,000 per year for the child's care.

But DCF, which administered Florida's disabilities program until lawmakers created a separate state disabilities program, called the Agency for Persons with Disabilities, last year, insisted it did not have the money to pay for the treatments.

Alday-Henderson, the AHCA program analyst, testified she thought the decision to pay for the youngster's treatments with AIDS dollars originated with Brantley and Nicola ''Nicky'' Moulton, who was a Medicaid program administrator until she left the agency in late 2000, the inspector general's report said.

NOT ENOUGH FUNDS

Alday-Henderson said the state's developmental disabilities program lacked ''adequate funds'' to pay for the child's treatment, so officials ''went shopping'' among other state programs to come up with the money.

McAindriu told investigators that in about 2002 or 2003 he asked Brantley -- AHCA's second-highest ranking Medicaid official as bureau chief -- whether it was right for the state to use AIDS money to pay for the child's therapies.

''Find a way to pay it. Do what you're told to do,'' he quoted Brantley as replying, according to the report.

Creel described to investigators a similar conversation with Brantley: ''I was told that this had been set up to happen; it was set up above her and that I would just let it go.''