We noted earlier this month that D.C. Mayor Adrian Fenty planned to overhaul the D.C. Department of Health in his first 100 days, and the Examiner reports that this is well under way. Earlier this week the pyramid underneath reappointed Director Gregg Pane got a little narrower, as the eleven agencies were consolidated into seven, and a number of senior deputies and chiefs of staff were let go.

Notably, pregnancy prevention and care and school health programs will be consolidated into the new Maternal and Primary Care Administration. On Fenty's now neglected e-Transition blog, a report was posted in early December that signaled pre-natal health care would be a major focus of the DoH overhaul. Dr. Michael Zeilinger, a USAID chief, highlighted D.C.'s alarming infant mortality rate, well above the national average, and painfully noted that Ward 7's rate rivals that of some third world countries. We assume this means Fenty plans to make maternity health care a major priority, but there's no information yet on how the agency plans to go about dealing with this situation. Compiling some updated statistics might be a good start, since the report footnotes that the most current numbers are almost five years old.

The HIV/AIDS Administration (HAA, formerly the Administration for HIV Policy and Programs, or AHPP) and the Addiction Prevention and Recovery Administration will be freed from their grant reviewing responsibilities, as that will be moved into an agency of its own. We noted earlier that Fenty decided not to reappoint former AHPP Director Marsha Martin, but as the 100 days tick by and the agency is completely reworked, a new director has yet to be named. Director Pane continues to do extra-duty as its interim director, though his attentions must be regrettably stretched by now.

David Mariner, the blogger at the comprehensive Fight HIV in DC, laments Pane's seeming disinterest and/or lack of time to invest in reworking one of the most vital agencies within DoH — in a region that still finds infection rates at ten times the national average. Mariner reports that Pane has been absent at recent community meetings and is either holding up or failing to process applications for the HIV Prevention Community Planning Group (CPG), with some people waiting over six months now to find out if they can serve.

Some good news may come in the form of $400,000 in government grants to Ward 7 organizations committed to HIV prevention, through the newly formed Ward 7 Collaborative, which includes community groups such as the Antioch Baptish Church and Planned Parenthood of Metropolitan Washington. However, Raymond S. Blanks, a member of the CPG, writes in the report on Fenty's blog:

The City Council last year appropriated a half-million dollars to establish HIV services in Ward 7 where no services are provided although it has the second highest rate of infection in the city. Today, there are still no services in that ward although a local consulting firm was hired to assist in developing new services. More distressing, nearly 25% of the Council’s award was spent illegally in other sectors of the city and for other purposes.

So we'll continue to hold our breath to find out if Fenty's new grant use system eliminates this unconscionable use - and lack of use - of funds. This time around "each grantee will receive training in fiscal management, social marketing, grant writing techniques, board development, strategic planning, enhanced HIV/AIDS education and cultural competency training."

While we sincerely hope that this leads to increased community involvement — one of the major factors in bringing down infection rates — and while we know Fenty may be hard at work on other important city agencies, we still have serious concerns that everyday without a permanent director of this division will continue to increase the major problems that person is going to face on their first day, much less trying to move forward with new initiatives. The streamlining of DoH will serve to alleviate this, but the city will continue to have to wait to find out just how much.