According to an investigation published by The Guardian Wednesday, Florida blocked or returned more than $70 million in federal grants to fight HIV during a three-year span of Gov. Rick Scott’s administration.
During that 2015 to 2017 period, after five years of declines, HIV diagnoses soared in Florida, increasing by nearly 11 percent as the state recorded the highest number of new HIV diagnoses in the country with 4,783 cases in 2017 – 13 percent of all cases nationwide – according to the Centers for Disease Control (CDC).
“I think Rick Scott fueled the epidemic in Florida,” Marlene LaLota, the Florida Department of Health (DOH) HIV/Aids section administrator from 2014 to 2016, told The Guardian. “How many infections could have been prevented with that money? How many lives could have been saved? Shame on them.”
LaLota said she “wrote a plan to end the epidemic” by tapping into the U.S. Health Resources & Services Administration’s (HRSA) 340B rebate program to purchase federally subsidized medications for lower-income HIV patients under the state’s Aids Drug Assistance Program (ADAP).
ADAP money is allocated from HRSA’s Ryan White program, specifically its Part B funding stream. HRSA requires states first spend all annually allocated ADAP-related 340B funds before accessing Part B grant money.
To secure the Part B allocation, the DOH needed to submit a routine request to the state’s Joint Legislative Budget Commission (LBC).
Multiple DOH employees told the Guardian they were prohibited from doing so by a Scott policy that considered the receipt of the federal funds as a budget increase, requiring legislative approval. Only DOH executives were permitted to discuss the funding with lawmakers under the Scott administration, LaLota said.
“Rick Scott had us all on lockdown,” LaLota said. “It didn’t used to be like that with previous governors.”
LBC members also told Florida Politics they were never made aware of the federal HIV grants. In addition, multiple legislators who served on the LBC also told Florida Politics that they were never asked to approve the grant request.
“We were stopped at every turn,” LaLota told The Guardian. “I could not give that money away to save my life. It was so criminal and so egregious.”
By Wednesday night, Scott had not responded to The Guardian’s investigation, which quoted an unnamed Scott spokeswoman who blamed lawmakers for not approving the grants.
“The state could only spend the money that it had the budget authority to spend,” the spokeswoman said, even after The Guardian confirmed the allocations were never referred to the Legislature from 2014 to 2017.
According to HRSA, Florida returned $23.9 million in unspent Part B HIV grants in 2015, $29.2 million in 2016 and $767,364 in 2017 — $53.8 million in prescription drug reimbursements for low-income HIV patients that was reallocated to other states.
In addition, according to The Guardian, the Scott administration also blocked $16 million in grant applications from Miami and Broward counties — which have some of the nation’s highest HIV diagnosis rates — to the CDC for HIV prevention and treatment programs in 2015.
Two CDC grants were available to health departments in cities with the highest infection rates to support HIV prevention, including pre-exposure prophylaxis (PrEP), and improved care and treatment for those with the virus.
Miami qualified for $7.6 million in grants over four years while Broward was set to receive $8.7 million.
However, when the counties submitted their grant applications to the DOH for required endorsement, they were rejected on the last day of the deadline because, the department said, it did not have the budget authority to spend such new money, officials from both counties told The Guardian.
Scott, elected to the U.S. Senate in November after serving two terms as governor, is the former chief executive and co-founder of healthcare conglomerate Columbia/HCA with a net worth estimated to exceed $230 million.
He campaigned in 2010 on his opposition to the Affordable Care Act (ACA) and opposed Medicaid expansion under the ACA during his tenure.
Scott initiated a pattern of leaving federal dollars earmarked for Florida on the table made available under President Barak Obama’s administration by nixing a $2 billion grant for high-speed rail.
LGBTQ civil rights organization Equality Florida condemned Scott’s decision not to follow through with the HIV grants.
“This is outrageous and irresponsible. This reporting indicates that Sen. Scott purposefully worked against public health, directly endangering Floridians and keeping Florida among the highest states for HIV transmissions in the nation,” Equality Florida HIV Advocacy Project Director Alejandro Acosta said in statement. “We cannot afford silence when it comes to HIV. Florida should be using every tool at its disposal to combat its HIV epidemic, both through the state budget and state policy.”
Gov. Ron DeSantis, responding Wednesday to The Guardian investigation, said he has met with federal officials to boost funding for Florida HIV prevention and treatment.
“Not only are we taking a look at it, I met personally with the director of the CDC in my office within the past couple of months,” the told reporters in Naples. “They are interested in providing a lot of funding for the effort. As soon as they figure out how much money they can give, then we can go ahead and announce it.”
DeSantis said increased funding may actually cause a spike in reported infections “because we’ll be finding ways to bring people out of the shadows who just aren’t getting seen.”