Tennessee health chief addresses shunned CDC HIV grants

Tennessee Health Commissioner Ralph Alvarado told a state Senate committee Wednesday that two federal HIV prevention grants worth up to $8.8 million that the state decided to scrap this year will be replaced with $9 million in state dollars.

Alvarado, who took the helm of the state health agency in January, provided few details of the plan.

He also didn't fully explain why the state decided to reject federal dollars and replace them with those from Tennessee coffers — or not double funding for the prevention of a disease that affects Southern states like Tennessee far worse than other regions of the country.

"What we're going to do in the upcoming governor's budget amendment is, it's going to include $9 million in recurring state dollars to provide upfront funds for nonprofit and for community partners in this regard," Alvardo told members of the Senate Health and Welfare Committee.

Alvarado said the federal grants provided by the Centers for Disease Control and Prevention were "cumbersome," in that they required agencies to seek reimbursement for expenses. Because of that, agencies only ever spent a maximum of $7 million, Alvarado said.

"I think this is going to allow a bit of innovation, a little bit of liberty and space for our partners to have the money upfront (and say,) 'Let's try some different methods of trying to reduce this," Alvarado said. "I think it's going to help vulnerable populations: people who are in human trafficking populations, mothers, children, first responders."

Those last comments echo those made by Gov. Bill Lee and have been criticized by many in the Hiv-prevention community, who note that those groups are the least at risk for contracting HIV.

The Foundation for AIDS Research, one of the world's leading HIV/AIDS advocacy and fundraising organizations, notes that the highest-risk group remains men who have sex with other men.

State Sen. Jeff Yarbro, D-nashville, noted as much and questioned Alvarado if future state funding would focus on the highest-risk groups. Alvarado responded:

"I think we're going to continue to partner with a lot of our metro health departments. We've approached a lot of them, had discussions," he said. "I think this proposal has been well-received. We've also spoken with a lot of our partners that are currently doing work in this space. And, again, I think this has been well-received."

He added that: "I imagine that the same populations they've been approaching will continue to receive benefits from this."

The Tennessean requested any correspondence the Tennessee Department of Health has made to HIV/AIDS agencies about the plan. TDH spokesman Dean Flener responded Wednesday evening by saying that "work and planning are ongoing and underway."

"Accordingly, we will announce the specifics of any program as soon as it is appropriate," Flener added.

The Tennessee Department of Health notified HIV/AIDS prevention agencies in January that Tennessee had decided to reject the two federal HIV prevention grants.

"These arrangements were made under prior administrations, and this administration is examining areas where it can decrease its reliance on federal funding and assume increased independence," the letter stated. "The State has determined it is in the best interest of Tennesseans for the State to assume direct financial and managerial responsibility for these services."

The notice came shortly after Alvarado took the helm of the Health Department. The department has refused to say who made the decision to nix the grants.

At the time, it even refused to say how much the grants were worth and which agencies they funded. The Tennessean later determined they were worth up to $8.8 million and received a list of affected agencies through the state's open records law.

Frank Gluck is the health care reporter for The Tennessean. He can be reached at fgluck@tennessean.com. Follow him on Twitter at @Frankgluck.