Cleveland Health Officials Admit Problems Administrating HIV/AIDS Grants

Cleveland’s public health officials on Wednesday took responsibility for not meeting the state’s expectations as set forth in grants totaling $1.5 million for HIV/AIDS prevention and treatment.

At an emergency Health and Human Services Committee hearing called by Chairman Blaine Griffin, the Cleveland Department of Public Health (CDPH) and other city officials attempted to address City Council’s concerns about grant management following the state’s decision last week to cancel the grants and look for another provider for the programs.

“I do think that it’s this body’s responsibility to make sure that the public has clarity, and it’s clear that we understand what happened so that we can try to prevent it from happening again,” Griffin said.

CDPH administered the funds for 24 years in a similar program for the city and Cuyahoga County. But in January 2019, the state expanded the grant’s coverage area to include a six-county region of Ashtabula, Cuyahoga, Geauga, Lake, Lorain, and Medina counties.

The timeline of the expansion was problematic for CDPH, said Persis Sosiak, Cleveland’s health commissioner, and external factors prevented the city from moving forward and completing the grant’s requirements by the deadline.

“Could we have started contracting six months earlier, hiring six months earlier? Perhaps. And some might argue that we should have,” Sosiak said. “However, many of those operations could not even begin until we had a notice of award from the state, so we can’t enter into a contract until we know we have the dollars.”

The expansion isn’t to blame for the loss of the grant, said Cleveland Chief of Public Affairs Natoya Walker Minor, and the department is taking responsibility for not meeting the grant requirements.

“We’re not pointing blame,” she said. “At this table, we owned our challenges and we welcomed oversight. We made progress with oversight, and we look forward to working with whomever is awarded the grants.”

The state is in the process of re-bidding the grant and plans to have a new local service provider in place by Feb. 1, so there is no gap in providing services. The city is ineligible to reapply for the grants in 2020 but CDPH officials said they hope to rebuild trust with the state and re-apply in the future.

The state cited a myriad of performance problems that led to the decision to pull the grants, including failure to meet contract deadlines, failure to fill staff vacancies by deadlines, and having below-standard performance measures. CDPH also failed to connect newly diagnosed people with partner services within 30 days of the confirmed HIV-positive test date, according to the Ohio Department of Health (ODH).

“I believe the state, rightfully so, was holding us accountable, to what they put in the contract with us,” said CDPH Director Merle Gordon.

ODH addressed some of the city’s previous performance deficiencies in a correction plan established in February 2019, but CDPH did not make sufficient progress, according to the state, and the grants were cancelled.

Concerns For The Future

In 2019, Cuyahoga County had 131 new cases of HIV. Cleveland had 89 new cases.

“We cannot stop the work,” Sosiak said. “The communities will continue to be served by whichever agency is awarded the new grant.”

Getting HIV and AIDS education and treatment where it’s needed remains the most important concern, said Councilman Kerry McCormack.

“I don’t know that they necessarily care about the bureaucratic agency in which this goes through, they need to get the services,” McCormack said.

Of the current staff of ten working in CDPH’s HIV/AIDS prevention and treatment program, eight of those positions were funded by the grant, according to Walker Minor.

“We are quite concerned about our staff because without these funds, we do not have the funding presently to maintain the employment of our staff,” Walker Minor said.

Councilman Matt Zone wants CDPH to prioritize funding to retain program staff, if at all possible. HIV and AIDS prevention, education, and treatment is particularly important to Zone because his brother died of AIDS in 1993, he said.

“There’s so many organizations that are serving people with this disease that we can’t turn our back on it,” Zone said.