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Whitman-Walker posts $2.6 million surplus

‘One of the most successful years in history’

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Don Blanchon, Whitman-Walker Health, gay news, Washington Blade

‘By adopting a greater emphasis on community, caring and quality, we produced results for the community that would have been unthinkable just a few short years ago,’ said Whitman-Walker director Don Blanchon.

Whitman-Walker Health, a D.C. community health center with special expertise in LGBT and HIV care, announced last week that its revenue in 2011 exceeded its expenses by more than $2.6 million, marking the second year in a row that it has sustained a budget surplus.

In a statement released on March 5, Whitman-Walker said it cared for 15,515 individuals in 2011, an increase of nearly 20 percent over the number of clients it cared for in 2010. It said its patient base has nearly doubled since it began the process of becoming a primary care community health center in 2006.

“2011 was one of the most successful years in Whitman-Walker’s history,” said Executive Director Don Blanchon.

“By adopting a greater emphasis on community, caring and quality, we produced results for the community that would have been unthinkable just a few short years ago,” he said. “And we show no signs of slowing down in 2012.

Blanchon has been credited by Whitman-Walker’s board and community supporters with changing its direction at a time when it faced near financial collapse in 2006 and its ability to continue operating was in question.

The budget surplus, which Whitman-Walker refers to as an “operating gain,” was used to pay off its outstanding line of credit and reduce its accounts payable, the statement says.

“We can attribute our financial success to three factors,” said Blanchon. “First, more patient care produced higher revenues, largely from third-party health insurance payments and prescription drug sales. Second, our fundraising efforts exceeded our projections for the first time in at least five years. Third, our new operating culture emphasizes the importance of living within our means.”

Whitman-Walker’s statement did not include the health center’s total revenue and expenses for 2011.

In its IRS reports filed in 2009 and 2010, Whitman-Walker reported 2010 revenue of $16.7 million and expenses for that year of $15.6 million, yielding a surplus of just over $1 million.

Its 990 report for 2009 showed total revenue of $15.3 million, total expenses of $15.9 million, with a deficit of $660,567.

Whitman Walker spokesperson Chip Lewis said that due to IRS filing requirements, the health center’s 990 reports don’t reflect its income it receives through its pharmacy. He said when pharmacy income is included Whitman-Walker’s total revenue came to $16.8 million in 2009, $20.8 million in 2010, and $26.3 million in 2011.

In its statement released last week, Blanchon said Whitman-Walker Health’s current patient base is represented by all eight of the city’s wards and the diversity of its patients “reflects a tremendous diversity across the entire metro D.C. community.”

The statement included this demographic breakdown of Whitman-Walker’s patients/clients:

• Gender: 68 percent male; 29 percent female; three percent transgender, “with the number of transgender patients increasing by 185 percent since 2006.”

• Race/ethnicity: 48 percent black; 37 percent white; 15 percent “other or unknown;” 14 percent Hispanic

• Age: Four percent younger than 21; 33 percent between 21 and 30; 25 percent between 31 and 40; 20 percent between 41 and 50; 13 percent between 51 and 60; and 5 percent older than 60

• Sexual orientation: 50 percent “self-identified as lesbian, gay or bisexual;” 50 percent self-identified as heterosexual.

“The number of LGB patients has increased by 77 percent since 2006,” the statement says. Twenty percent of all patients were HIV positive, said Lewis.

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Monkeypox

Monkeypox vaccination effort shifts towards maintaining demand

‘Thousands of shots’ administered at gay events across country

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White House National Monkeypox Response Deputy Coordinator Dr. Demetre Daskalakis (YouTube screenshot)

As ensuring adequate supply and distribution of the monkeypox virus vaccine becomes “less of an issue,” efforts have shifted toward maintaining demand, Dr. Demetre Daskalakis, White House national monkeypox response deputy coordinator, said on Sept. 7. 

This will mean, “making sure that people know that a effective and safe vaccine is available for those that could benefit,” he said, during a press briefing that also featured National Response Coordinator Dr. Bob Fenton and White House Press Secretary Karine Jean-Pierre. 

The officials said they were pleased with the impact of their targeted allocations of vaccine doses to events with large numbers of gay and bisexual men who have sex with men, populations considered high risk for MPV infection. 

“Thousands of shots were administered” at Southern Decadence in New Orleans, Black Pride in Atlanta and Oakland Pride in the San Francisco Bay Area, Fenton said. These efforts “were, frankly, wildly successful,” Daskalakis said. 

During a Q&A with reporters that followed the briefing, Daskalakis addressed questions about the racial disparities that have begun to emerge with respect to infection and vaccination rates. 

According to the Kaiser Family Foundation, “Black people have received 22 percent vaccines, while they account for 36 percent of cases. In contrast, White people have received 63 percent of vaccinations but account for 42 percent of cases.”

Daskalakis explained the events that were targeted this summer were a major part of addressing the disproportionately higher rates of infection and lower rates of vaccination among people of color. 

“It’s not about just the vaccine allocation,” he said. “It’s about that intense community engagement that happens on the ground because, ultimately, public health is a local event.”

From the beginning of the outbreak, those engaged in the federal response were in touch with community organizations, Daskalakis said: “Giving the tools that people need to be able to sort of reach health goals is what we’ve been doing. And the support of organizations that serve Black and brown people have been pivotal in really turning the tide in what I think you’re going to see, the new vaccine numbers emerging over the next few weeks.”

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Health

Percentage of gay D.C. monkeypox cases rises slightly

Latest data show category of ‘unknown’ sexual orientation at 41.9%

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The latest weekly release of monkeypox case numbers by the D.C. Department of Health shows there were a total cumulative number of 431 monkeypox cases in the District as of Wednesday, Aug. 31, an increase of 26 cases since 405 cases reported one week earlier.

This week’s DOH data for the category of cases based on an individual’s sexual orientation show there were a total of 14 cases (3.2%) listed as straight/heterosexual, up from 11 cases (2.7%) from the previous week;  212 (49%) gay, up from 172 (42.5%) from last week; 24 (5.6%) bisexual, up from 18 (4.4% last week; and 179 (41.5%) in a category listed as “unknown” for the person’s sexual orientation, which was up from 172 (42.5%) from the previous week.

Officials at DOH, which is also known as D.C. Health, have said since the start of the monkeypox outbreak earlier this year that the overwhelming majority of cases in D.C., similar to across the nation, have been among gay, bisexual, and other men who have sex with men.

One DOH official speaking at a monkeypox town hall event last month placed the number of D.C. cases among all men who have sex with men at more than 90 percent. Officials have said the lower percentage of “gay” cases and the rise in the “unknown” category reported over the past two weeks is most likely due to a change in the data gathering policy.

In an effort to lessen the stigma associated with monkeypox infections, officials have said they do not want to appear as if they are applying undue pressure on people to disclose their sexual orientation when they apply for a monkeypox vaccination or seek a monkeypox test or treatment.

For the category of “lesbian” and “other,” the DOH this week included an asterisk instead of a number and a percentage.

“To help protect confidentiality, small numbers (between 0 and 4 are shown by an asterisk,” DOH states as an explanation for not including a number for the “lesbian” and “other” categories.

In last week’s data release, DOH said there were 0 recorded monkeypox cases for lesbians and one case in the “other” category.

In its category of “gender identity,” the DOH data released on Wednesday show that as of this week, out of the total cumulative cases of 431,423 (98.1%) were male. An asterisk is shown instead of a number for the categories of female; female-to-male transgender; male-to-female transgender; and gender nonconforming.

 A full breakdown of the latest monkeypox case number for all categories, including race/ethnicity, age group, and residential ward can be accessed at the D.C. Health website.

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Health

Biden health officials defend approach to monkeypox as cases grow

Contradictory information emerges on vaccine administration

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Biden officials defended their approach to monkeypox as contradictory emerges among health experts.

Top health officials in the Biden administration defended their approach Thursday to the monkeypox outbreak as cases continue to grow and contradictory information has emerged on appropriate vaccine administration.

Members of the White House monkeypox task force, in response to a question from the Washington Blade in a conference call with reporters, held fast to their new guidance on the JYNNEOS vaccine, which seeks to change the method of administration of the shot in an effort to expand use of the existing supply by fivefold — despite objections and even threats to cancel the supply from the vaccine manufacturer, according to a report this week in the Washington Post.

Meanwhile, cases of monkeypox in the United States are escalating — and beginning to extend outside the community of men who have sex with men — as the total number of confirmed cases has reached 13,517.

Bob Fenton, the White House monkeypox response coordinator, was first to respond to the Blade’s question on how the public can trust guidance from health officials amid the contradictory information by asserting “anytime that you have change, you’re going to have the need to update and educate the community on those changes.”

“The day…the FDA made that decision, we need signaled a week that this was being undertaken by FDA there already were a number of jurisdictions that started the training in anticipation of that decision,” Fenton said. “And that day, there were jurisdictions actually delivering intradermal shots that day [to] fivefold the number of shots and did that to areas of high risk and did that to areas that made equity a factor in those decisions where they vaccinated. So it is happening; it is being successful.”

The context of the Biden administration’s change in guidance last week — which shifts from injection through the subcutaneous route (delivery of the vaccine under the fat layer underneath the skin) to the intradermal route (delivery of the vaccine into the layer of skin just underneath the top layer) — is an announcement from localities, including the D.C. government, shifting from two doses to one dose to make up for limited supply. Biden officials discouraged the one-dose approach, pointing to data suggesting it was not effective in protecting against monkeypox.

In essence, contradictory information is coming from health experts on monkeypox on all levels localities offer on the vaccine, which in turn is criticized by the federal government as ineffective in favor of different approaches, which is in turn criticized by the vaccine manufacturer as untested and inappropriate.

Rochelle Walensky, director of the Centers of Disease Control & Prevention, responded to previously articulated concerns about the one-dose approach from localities by saying the Biden administration is working “really hand in glove in really fluid communication through this outbreak.”

“As I articulated we don’t yet know how well this vaccine will work in this outbreak,” Walensky said. “And as those data are evolving, as we had some resource constraints early on with the vaccine, we were working close with health departments so that they could maximize their coverage. We’ve met with them to talk about what data might be available for one dose, which are really limited [and] concerning in terms of how well it would work. And so when the strategy for intradermal dosing, which we anticipate will work just as well as subcutaneous dosing, we again met closely with the health departments…so that we could provide the data to them.”

Defense of changes in guidance in vaccine administration ended up overshadowing the announcements top officials were seeking to make, such as making an additional 1.8 million doses available for ordering starting Monday, a pilot program setting aside 50,000 doses for jurisdictions hosting large LGBTQ events, such as Black Pride in Atlanta and Southern Decadence in New Orleans; and making available next week 50,000 patient courses of TPOXX monkeypox treatment.

Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health & Human Services, said when asked by CNN about expanding the supply the administration may look elsewhere aside from the JYNNEOS vaccine manufacturer, Bavarian Nordic in Denmark, calling the company a “small manufacturer.”

“They currently have one active line and in the Copenhagen area that we’re relying on for 2.5 million doses to be filled and finished, but when we ordered that second 2.5 million to be built and finished, we made it a requirement that they work with a domestic U.S. contract manufacturing organization and we continue to partner with Bavarian Nordic as they solidify that relationship,” O’Connell said. “We are also helping them in other ways consider manufacturing capacity increases, potentially working with a larger pharmaceutical company.”

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