Health commissioner declines to answer reporters’ questions on HIV funds

Health Commissioner Ralph Alvarado got a hall pass in his first appearance before the Senate health committee, then dodged reporters Wednesday inquiring about the state’s new policy to end federal funding to nonprofits for HIV services.

Alvarado, who came to Tennessee in December after serving in the Kentucky legislature and running for lieutenant governor there, broached statements by Democratic Sen. Jeff Yarbro but didn’t provide new insight into the Department of Health’s recent decision to pull the federal money.

The committee’s chairman, Republican Sen. Rusty Crowe of Kingsport, had asked members to make Wednesday’s gathering an introductory moment and refrain from questions until Alvarado presents his budget March 15. 

But Yarbro, D-Nashville, took the opportunity to query Alvarado about the “abrupt” decision to stop funds from flowing to groups that have been providing HIV services for decades with bipartisan support. Yarbro noted that the decision came two days after Alvarado took the post.

“I’m not sure whether that’s a decision you signed off on or inherited. But in any event it’s a decision that in the aftermath is going to be one that you have to deal with and we have to deal with,” Yarbro said.

Yarbro added that lawmakers from both sides of the aisle want to know how the state plans to proceed with HIV care and urged the commissioner to have a “broader conversation” before March 15.

Alvarado didn’t shed any new light on the matter.

Echoing a letter sent to nonprofit agencies a week ago, Alvarado responded that current arrangements for HIV services were made by other administrations.

“This administration is examining areas where it can decrease its reliance on federal funding and assume a lot more increased independence in that realm. The state’s determined right now that the best interest of Tennesseans is for the state to assume direct financial and managerial responsibility for these services,” Alvarado said.

The funding will last through May and then the state will take a different course, he said. The new policy does not affect HIV treatment through the Ryan White Program, Alvarado added.

“The state’s examining how an effective program will be implemented at the state level and will notify the community of the specifics as soon as that’s appropriate,” Alvarado said.

The new commissioner left the meeting room followed by staff and reporters but with Health Department spokesman Dean Flener shouting that no questions would be allowed because Alvarado had another meeting to attend.

Yarbro was miffed afterward, saying neither the governor nor the commissioner have given enough information about the funding shift to legislators, the public or community providers. He called their decision “reckless.”

Yarbro contends the state won’t be able to set up the same level of service as community-based organizations with a record of success.

“And, frankly, that puts people at risk,” he said.

HIV funding is to be directed primarily through the state’s six metropolitan health departments.

Gov. Lee said last week some nonprofit organizations will receive money from the state to provide HIV services, but he also said those will target human trafficking, first responders and pregnant women, which aren’t considered the most likely groups to get HIV.

Reports show the state targeted Planned Parenthood before notifying every nonprofit organization that it would end participation in the federal HIV program.

“I don’t know who it’s targeting,” Yarbro said Wednesday. “I’ve read the media reports saying there’s issues around LGBT organizations or Planned Parenthood. … But why do we care who’s helping Tennesseans not get AIDS and not transmit HIV?”

Yarbro contends the state should be looking for comprehensive access to HIV testing, for instance, not handcuffing groups that provide those services.

Metro Nashville Health Department’s PrEP Clinic, which provides confidential testing, counseling services and pre-exposure prophylaxis prescriptions, has 134 clients, according to spokesman Matthew Peters. 

The department’s clinic manager had not received any information this week about potential changes to funding for PrEP services.

The money funds Planned Parenthood’s free condoms distribution and HIV testing. Planned Parenthood sent out a letter stating that the United Way of Nashville, which handles the CDC money for the Department of Health, told its affiliate that “because of state politics,” the department tried to remove Planned Parenthood from the program.

“We asked our attorneys to remind the state that they cannot target us because they disagree with our free speech right to oppose the state’s abortion ban. The response from the state? They’re going to stop participating in the entire federal program and defund all of us,” the communication states.

The program’s end also affects Alliance Health Services in Memphis, Cathedral of Praise in Memphis, Cherokee Health Systems, Choice Health Network, Friends for Life in Memphis, OutMemphis and St. Jude Children’s Research Hospital in Memphis, according to the release.