AHF—which cares for approximately 30% of Baton Rouge’s HIV/AIDS patients at two AHF clinics— asserts that the City of Baton Rouge/Parish of East Baton Rouge acted in an arbitrary, capricious and illegal manner when it refused to renew AHF’s Ryan White Part A Contract, an action that threatens the delivery of care and treatment to vulnerable, underserved, largely minority populations.
Baton Rouge’s action also makes AHF ineligible to participate locally in the federal 340B drug discount program. AHF seeks Declaratory and Injunctive Relief from the Court to overturn denial of the renewal of AHF’s Ryan White Contract as well as restoration of AHF’s local eligibility for the 340B program.
BATON ROUGE, LA (April 10, 2017) AIDS Healthcare Foundation (AHF), the largest global AIDS organization and largest provider of HIV/AIDS care in the United States—including two AIDS clinics in Baton Rouge that care for approximately 30% of the city’s HIV/AIDS patients—has filed a lawsuit against the City of Baton Rouge/Parish of East Baton Rouge (through the City of Baton Rouge Division of Human Development and Services) after the Mayor’s Office arbitrarily defunded AHF from a federally funded, locally administered program known as the Ryan White program, an action that now threatens the delivery of quality care and treatment to vulnerable, underserved, largely minority populations in Baton Rouge.
AHF’s lawsuit focuses specifically on the Parish of East Baton Rouge’s arbitrary, capricious—and AHF asserts, illegal—denial of renewal of a Ryan White Part A Contract to AHF for its delivery of HIV/AIDS care and services in Baton Rouge, an action by the Mayor’s Office and Parish which also made AHF ineligible to participate in the 340B Drug Pricing Program, a crucial federal, but locally-administered drug discount program in Baton Rouge.
In its lawsuit, filed Monday, April 10, 2017 in the United States District Court, Middle District of Louisiana, (Case # 17 cv00229 BAJ-RLB), AHF filed motions for Declaratory and Injunctive Relief against the City of Baton Rouge/Parish of East Baton Rouge through the City of Baton Rouge Division of Human Development and Services. AHF is seeking the court’s intervention to overturn the denial of Ryan White Part A grant awards for the 2017/2018 grant year.
“At the heart of AHF’s lawsuit is the Parish of East Baton Rouge’s illegal demand as a condition of AHF’s Ryan White Contract renewal that AHF provide documents concerning our participation in the 340B drug discount program, documents which under the law they are not entitled to. The 340B Program is an entirely separate program from Ryan White,” said Michael Kahane, Southern Bureau Chief for AHF. “In denying renewal of our Ryan White Contract, the Mayor’s Office and the Parish of East Baton Rouge have taken an action that directly threatens the delivery of quality HIV/AIDS care and treatment to a vulnerable, underserved and largely minority population of patients. Through this lawsuit and by other actions we will vigorously advocate on behalf of these patients.”
Denial of Ryan White Contract Halt’s AHF Eligibility for Crucial Drug Federal Discount Program
In denying AHF renewal of its Ryan White Contract, Baton Rouge also made AHF ineligible to participate locally in Baton Rouge in the 340B Drug Pricing Program.
According to the Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs (OPA), the drug-pricing program “…requires drug manufacturers to provide outpatient drugs to eligible health care organizations/covered entities at significantly reduced prices. The 340B Program enables covered entities to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.”
After some back and forth with the City of Baton Rouge/Parish of East Baton Rouge in February and March of 2016, AHF was awarded a Ryan White Part A Contract. Under the Contract, AHF provides, among other things, outpatient medical care to people with HIV/AIDS, medical case management services that help people remain in care, and early intervention services that help people know their HIV status and get quickly linked to medical care. The Contract provided for an initial term of March 1, 2016 – February 28, 2017, and the RFP provided that “[u]p to two additional 12-month renewal awards may be made based upon the availability of funds and acceptable contract performance.”
However, in a letter dated March 2, 2017, Baton Rouge notified AHF that it would not renew its Ryan White contract for the 2017 – 2018 grant year, despite the fact that in previous written communications, Baton Rouge officials wrote that were no areas of performance by AHF that rose “to the level of a breach of contract or non-compliance.” Instead, Baton Rouge officials had repeatedly—and AHF asserts, illegally—been demanding access to documents related to AHF’s participation in the separate, federal 340B drug discount program.
“As the largest HIV care provider in Baton Rouge, AHF treats almost 1,300 HIV/AIDS patients. We have a high patient retention rate, something that is crucial both for the wellbeing of patients themselves as well as key to helping break the chain of new infections in the community,” said Dr. Waref Azmeh, Medical Director for AHF in Baton Rouge. “Despite the fact that Baton Rouge has the highest rate of HIV and AIDS in the nation, the city has only 4,000 or 5,000 individuals in retention medical care. For AHF to be denied renewal of our Ryan White funding and for our patients to be ignored is very unjust and we will do what we can to ensure patients and the community receive the care and services they need.”
In its lawsuit, AHF asserts:
EBR (East Baton Rouge) has violated 45 C.F.R. § 75.328(a) by its actions, which include, but are not limited to:
a) arbitrarily deciding not to renew AHF’s Contract, despite AHF’s adequate performance under the Contract;
b) including in the Contract a provision that purports to give it the authority to demand 340B documentation;
c) impermissibly and arbitrarily using AHF’s participation in the 340B Program as leverage to compel AHF to comply with contractual conditions that relate to a separate program (340B); d) not renewing the contract due to AHF’s justified refusal to provide 340B documentation.
First in the Nation: Background on HIV/AIDS in Baton Rouge, the Ryan White Program
According to the Advocate newspaper, “Baton Rouge is ranked first in the nation for estimated HIV and AIDS case rates per 100,000 people, while New Orleans is ranked third for HIV and fourth for AIDS, according to newly released 2014 Centers for Disease Control and Prevention figures.”
In a separate Advocate article on February 18, 2016, the newspaper also reported:
“Baton Rouge already leads the nation in diagnosed HIV and AIDS case rates, but an additional 900 to 1,000 people in the capital region are living undiagnosed with the disease, a local civic group was told Wednesday.
René Taylor, executive director of Family Service of Greater Baton Rouge, told the Rotary Club of Baton Rouge on Wednesday that the city needs more HIV testing if it hopes to shed its No. 1 ranking in HIV and AIDS cases per 100,000 people.”
In the United States, the HIV/AIDS epidemic is predominantly driven by people who are unaware they are infected, or are aware of their status but are not in regular care. Without access to regular care and antiretroviral medication, people with HIV/AIDS are sicker, and unwittingly infectious. Getting people aware of their status, into regular care, and adherent to a medication regimen are the keys to reducing new infections and stopping the epidemic. The purpose of the Ryan White Act is to expand services and points of access to care, which makes Baton Rouge’s Division of Human Development and Services’s decision to illegally defund AHF so bewildering.
In Baton Rouge, AHF operates the following two Healthcare Center locations: 1) Baton Rouge Healthcare Center, 8281 Goodwood Boulevard, Suite D, Baton Rouge, Louisiana 70808; and, 2) Baton Rouge Azmeh Clinic and Pharmacy, 4890 Bluebonnet Boulevard, Baton Rouge, Louisiana 70809.