Whistleblower Alleges Retaliation

By Denise Penn

Federal officials with the Department of Health and Human Services Health Resources Services Administration (HHS/HRSA) have demanded that Orange County repay nearly $150,000 after an audit revealed that county officials could not document that the services had been provided to minority clients with AIDS.

At the Orange County Board of Supervisors meeting on March 14, Orange County Health Care Agency officials informed the board that they would return to the federal government $143,328 in misspent HIV/AIDS grant funds, pending an appeal, in order to avoid any additional penalties or interest if they do not prevail. Representatives from the County's HIV Planning Council insisted, however, that there was no improper conduct and that any management deficiencies have long ago been corrected.

Not true, said a Health Care Agency whistleblower. "The claim that this is old news is the product of the fact that the Health Care Agency has concealed and denied this problem for the past three years," Chris Prevatt, who disclosed problems in the administration of the AIDS grant in March 2003, told IN Los Angeles Magazine.

The controversy began in 2001. After discovering deficiencies in services provided by New Millennium, a faith-based agency responsible for providing services for African Americans affected by HIV, Prevatt, a longtime AIDS activist and Health Care Agency program monitor, reported his concerns to his superiors. The first formal review of New Millennium found problems, such as a lack of documentation on clients. They had not provided services for even half of their caseload and clients complained that their calls were never answered. Prevatt said he kept warning officials to monitor the group more closely and withhold payment for services not rendered.

Despite this, New Millennium's funding was renewed in 2002. At this point Prevatt filed a written complaint with the supervisor of the program monitors. The county continued to fund the program and took no action. Finally, in 2003, Prevatt filed a formal complaint with the Health Care Agency's Office of Compliance about potential fraud in the county's AIDS program.

The next day, Prevatt, who is HIV-positive, was transferred to the county's tuberculosis (TB) program. The transfer was immediate: " I was required to return my office keys and directed that I would not be allowed back into my office without supervision and would not be allowed access to the files on my computer," recalls Prevatt. "The actual cause of my reassignment was not due to an agency need to fill a vacant supervisory position, but was a deliberate act of retaliation for my challenging improper actions."

Prevatt said he was terrified every day he went to work, lest he come into contact with a TB carrier. Worldwide, TB, an airborne disease, is the primary cause of death in HIV-infected people. In regions with a high burden of both diseases, health-care clinics are overwhelmed with patients carrying both M. tuberculosis and HIV. Each of the two infections has a negative impact on the other, and drugs that treat TB and HIV medications may adversely impact each other's safety and effectiveness when taken together, according to the National Institute of Allergy and Infectious Diseases National Institutes of Health.

Prevatt alleges that agency head Dr. Penny Weismuller had previously threatened him with reassignment to an area that would "make Siberia look good." Weismuller has since taken an early retirement.

While county officials concede that there were some problems, they blame the 2000 federal mandate that required AIDS minority funds be managed by minority-run community-based nonprofit organizations, such as New Millennium. Meanwhile, the number of African Americans affected by HIV/AIDS skyrocketed, accounting for 49.3 percent of the estimated AIDS cases while being only 12.8 percent of the U.S. population in 2003. According to HRSA, of all males living with AIDS in the United States at the end of 2003, more than one-third (37.2 percent) were Black. Nearly 60 percent of all females living with AIDS at the end of 2003 were African American as well as 62.7 percent of children under age 13 who were living with AIDS at the end of 2003.

In an effort to fund culturally sensitive programs, the federal Minority Aids Initiative had required local health officials to contract with African-American agencies. Orange County, with a population of from 2-3 percent African Americans, had difficulty finding such an agency and was relieved to eventually find the faith-based group, Pastor Aubrey Keys and the New Millennium Community Coalition. The group was funded without submitting an initial written proposal and problems were overlooked, according to Prevatt. Their contract has since been terminated.

"In all of their talk in today's meeting," Prevatt said, "the Board of Supervisors has missed the serious underlying problem that has been revealed: County managers are willing to commit fraud, lie to federal grant managers, coverup misconduct, and permit retaliation against anyone who speaks out about management misconduct in order to conceal the truth."

Prevatt, who was a candidate for Garden Grove City Council in 2000 and 2002, served as a member of the Sanitary District Advisory Commission from January 2001 to November 2005 and as chair for one year. In February, the Garden Grove City Council recognized him with a Community Spotlight Award for his work as a volunteer commissioner.

Prevatt is also the current chair of the Eleanor Roosevelt Democratic Club and was an openly gay and HIV-positive delegate at the 2004 Democratic Convention. He has been confirmed as a guest presenter at the Institute of Internal Auditor's Orange County Chapter seminar on "Fraud Waste & Abuse" on May 31, 2006.

The Ryan White CARE Act provides more than $2 billion for AIDS each year. Established by Congress in 1990, it was named in memory of a young hemophiliac who inspired many. Ryan White Funds are up for reauthorization by Congress, and some fear that scenarios such as this, which demonstrate a lack of accountability by local health-care officials, could jeopardize reauthorization.