Sunday, February 25, 2018
Health

U.S. Rep. Kathy Castor calls for federal review of Florida's shifting HIV statistics

U.S. Rep. Kathy Castor, D-Tampa, is calling for a federal investigation into the "dramatic" changes made to Florida's HIV statistics.

Earlier this year, the state department of health changed the number of new HIV cases reported in 2014 from 6,147 to 4,613. State health officials said the 25 percent adjustment was routine.

But the revision was significantly larger than any revision made in recent years, a Tampa Bay Times analysis found. What's more, it was made as state lawmakers grilled Florida's top health official over a reported spike in new HIV infections.

The health department's "significant amendment has prompted widespread questions over the accuracy of the HIV/AIDS numbers in Florida, especially as most local agencies report a significant increase in the number of new infections," Castor wrote Tuesday in a letter to U.S. Health and Human Services Secretary Sylvia Burwell.

"I respectfully request a review by the Department of Health and Human Service, Centers for Disease Control and Prevention and/or the Office of National AIDS policy to help determine accurate numbers and whether or not the state manipulated crucial HIV data," she added.

The state health department declined to comment on the letter.

State health officials have said they changed the data to account for infections that had already been counted in other states or were inadvertently logged twice. The process, known as de-duplication, is done regularly in collaboration with the Centers for Disease Control.

But the Times analysis, published last month, found that Florida made larger-than-usual adjustments to the 2014 figures, as well as major revisions to the annual counts dating back to 2005.

The health department has since declined to provide a breakdown of how infections were either reclassified or removed — or any public records fully explaining why this year's process turned up more duplicates than previous years.

The department has also failed to make interim state Surgeon General Dr. Celeste Philip available for an interview, even though Philip released a statement last month saying "we welcome the opportunity to discuss with the Tampa Bay Times the entire data gathering and de-duplication process to clear up the misconceptions presented in the article."

Last week, the department released a report issued by the CDC after a routine site visit to Tallahassee in early January. The report praised Florida for "continued excellence and high levels of achievement in meeting all of the national HIV case surveillance process and outcome standards," and called its program for training field staff "impressive."

The report mentioned a backlog in entering information that could help determine duplicate cases. But it did not explain why so many changes were made dating back a decade. What's more, it was unclear if the CDC's visit took place before of after the state adjusted the HIV data.

The health department declined to clarify, issuing only the following statement from Philip: "As the CDC report shows, Florida's HIV data program is a national leader in helping health officials better understand and treat this terrible disease. We are also proud to have the opportunity to train professionals from other states on the best practices for collecting and interpreting HIV data."

Florida's spiking HIV statistics were thrust into the spotlight in late January, when state lawmakers blasted then state Surgeon General Dr. John Armstrong for the original tally of new infections from 2014.

The dramatic increase — and the fact that the original figure made Florida the national leader in new infections — were key reasons Armstrong lacked enough support in the Senate to be confirmed this spring. He resigned from the position in March.

During the confirmation process, Armstrong did not state publicly the number of HIV cases diagnosed in 2014 had been revised downward, or that the new count put Florida behind published counts for two other states.

In her letter to the federal health department, Castor said Florida has "an unfortunate history of purposely ignoring or in some cases deliberately failing in its duty to provide adequate care to its citizens."

She noted the state health department had recently "screened out" thousands of children from a program for kids with profound special needs, only to have the new evaluation process invalidated by a judge.

"Florida may have the largest increase in the rate of new HIV cases," Castor wrote, noting that federal funding is based on state counts. "Floridians deserve to know the public health facts."

Times Staff Writer Michael Auslen contributed to this report. Contact Kathleen McGrory at [email protected] or (727) 893-8330. Follow @kmcgrory.

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