September 26, 2019

Florida Returned Federal HIV Funding… and HIV Incidence Rose

On September 11, the Guardian (a British paper) broke the news that former Florida Governor Rick Scott “left millions of federal dollars unspent to fight HIV” during his tenure, including CDC funding offered to the state for HIV prevention and Ryan White funds offered for treatment.

Marlene LaLota, after decades of working in the Florida Department of Health, was appointed Administrator of its HIV/AIDS section in 2014. Although her predecessors had no difficulty getting essential budget authority increases allocated to them by the department, LaLota found herself completely blocked. She was forbidden from talking about her section’s budget with anyone in the governor’s office, the state legislature (which approves the budget) or anyone else outside of her section.

LaLota resigned from the Health Department in 2016. Recently, she told the Guardian that “the Scott administration forbade anyone on her team from discussing budget concerns directly with legislators… Rick Scott had us all on lockdown.” She added, “I wrote a plan to end the epidemic. But we were stopped at every turn. I could not give that money away to save my life.”

Her colleagues confirm that they were not permitted to discuss the situation with anyone, including members of the Florida legislature, at risk of being fired. The legislature, for its part, seems to have been largely unaware of the damage being inflicted on Florida’s HIV response.

During fiscal years 2014-2015, the Guardian reports, “Florida was forced to return to the federal government $54 million in unspent grants for combating HIV” because they “did not engage in the routine practice of asking the federal agency for permission to carry over unspent Part B funds.” In 2015, Scott’s administration also “directly blocked two US Centers for Disease Control and Prevention (CDC) grant applications” that totaled $16 million. This funding was earmarked for Miami and Broward counties, both afflicted with very high HIV rates, so the applications would likely have been approved.

Decisions to pass on these opportunities removed access to over $70 million from the budgets of the Florida Health Department’s HIV/AIDS and STI sections. In 2017, Scott ran for and won a US Senate seat. Governor Ron DeSantis has taken his place but the financial situation of these two sections of the Health Department has yet to change dramatically. In 2017, Florida had more new HIV cases reported (4700) than any other state.

Scott’s successor, Governor Ron DeSantis also made a statement on the situation on September 11. He said he had already met with federal funders to “boost the support for HIV prevention and treatment.” With regard to HIV infection rates he said, “If we do it right, you will actually see an increase in infection rates at first, because we’ll be finding ways to bring people out of the shadows who just aren’t getting seen.”

He added, “I actually hoped we could do it by now, but we just haven’t gotten the sign-off from the feds.” Other state officials note that the number of HIV diagnoses in Florida declined by 18% overall between 2008 and 2018. Nevertheless, the number of new infections in the state began trending upward in 2013.