The depth of the mess that is Fulton's HIV prevention efforts sank to a new low. Not only did mismanagement result in losing $9 million in funding, the county's health director blocked efforts to fix it.
That disturbing report comes from WABE in the wake of Patrice Harris, director of the county's health department, announcing her retirement. Her quitting, in turn, came after WABE exposed that Harris oversaw HIV prevention programs so dysfunctional that the county squandered millions in funds from the Centers for Disease Control & Prevention for HIV prevention efforts in Fulton and DeKalb counties.
In June, WABE reported that the Fulton health department returned $8.7 million in HIV prevention funds – nearly 30 percent of its budget since 2012. This week, WABE dropped another bombshell: Harris blocked CDC efforts to intervene and ignored an offer to embed a staffer to fix the issues.
That's why in 2012 the CDC refocused prevention efforts on cities where HIV rates were exploding. So far, the shift has meant more than $28 million coming to help Fulton County fight the epidemic here.
But in June of that year -- just six months into the five-year grant cycle -- the CDC raised a red flag about Fulton County's bureaucratic red tape. According to documents obtained by WABE, the CDC believed the problem could drastically slow, or even stop, HIV prevention money from getting into a community that desperately needed it.
Despite the CDC's concerns, which were repeated in several biannual reviews, Fulton County's top officials remained unaware.
According to multiple sources and internal CDC documents obtained by WABE, that's because the director of the Fulton County Health Department kept the CDC away from county commissioners.
Harris put up roadblocks to any CDC intervention. Her reason? Protocol.
"I do remember email communications or phone communications” related to the incident, Harris told WABE during an interview last Friday. She also remembers turning down the request.
But a June 2014 interoffice CDC email paints her answer differently. It reads, in part, that Harris "made very clear that we are not to contact the board of commissioners for any reason."
Harris said it made more sense to follow protocol and "build a case" for making the changes.
"I knew the CDC wanted to be helpful,” Harris said. “But I felt the best way to handle that was to go through the chain of accountability."
After the WABE interview, Harris offered a statement expanding on why she stopped the CDC from helping – and bragging that she's "collaborative, collegial, cordial and service oriented."
I do recall some discussion with CDC about talking with the Board of Commissioners about inefficacies in County processes and the challenges they presented for our timely compliance. A former CDC staffer also told me that, in his opinion, that request was highly unusual. I didn't think that was the appropriate way to handle the situation. I also worried that it might look like I had put the CDC up to it. I felt it would make more sense for me to work through the chain of command to build a case for making the needed changes and that I would work internally to institute changes and that's what I've been trying to do and/or schedule a meeting with the County Manager—staff to staff communication.
I think the changes we made last year by bringing Leisha McKinley Beach on board as the Health Program Administrator as well as having her report directly to me since April and the biweekly grants management meetings with Purchasing, Finance, Personnel and Program staff are testament to my proactive efforts and the County’s proactive efforts to address the problems. Certainly if I had to do it all over again I would be more aggressive, but hindsight is always 20/20. Nevertheless, I did and do believe that since the beginning of the year we have made important progress in improving the processes and we are on the right track now.
To your inquiry re my demeanor, first, let me say that I never discount anyone’s perception of interaction. What I can always accurately speak truth to is my intent in any interchange. I am upfront, direct and responsive. In fact, recently someone at the County said to me , “Dr. Harris, your reputation for responsiveness precedes you.”
I consider myself collaborative, collegial, cordial and service oriented. Those are the principles that drive the culture on the Health Services’ Teams. Also attached is a document that Senior Leadership on my team has adopted to guide our interactions and work with one another.
WABE also reported that when Harris refused to allow the CDC to embed a staffer in her department to help address the problems, the federal health agency wouldn't do an end run around her to alert county commissioners. The reason? Protocol.
When WABE shared its findings with Fulton Commission Chairman John Eaves, he became equally upset. He said he was unaware of the attempt and that he found Harris’ efforts to keep the commission out of the loop “incredibly disconcerting."
Eaves also questioned why the CDC needed to ask the health department’s director for permission to talk to the board.
Dr. Eugene McCray, head of the CDC's Center for HIV Prevention, said doing so without Harris' permission would cross the boundaries of the agencies’ cooperative agreement.
"Our goal is to work with [local health departments] and provide them with the information we think they need,” McCray said. But it's up to the local health department to act.
So while metro Atlanta has one of the highest rates of HIV infection in the county – fifth actually – and faces a host of other HIV-related problems, local and federal health officials with the funds to help are more concerned with protocol. Harris, though, wants to brag on her way out the door.
Despite all this, Harris hopes the missteps won't overshadow the many good things the county health department has achieved in the fight against HIV.
"There have been some successes,” Harris said. She even uses the HIV prevention spending issue as an example. After three years of problems, she said the county is now on track to spend all of its HIV prevention funding. And, Harris notes, the health department is meeting more quality benchmarks.