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Despite efforts, worries about ADAP remain

by Seth Hemmelgarn

Despite efforts, worries about ADAP remain

Advocates for people living with HIV and AIDS are still worried about clients' access to medications as California officials continue fixing the state's AIDS Drug Assistance Program.

Problems with the system emerged after contractor AJ Boggs was brought on to handle eligibility and enrollment about a year ago. After several months of trouble, including clients being turned away by their pharmacies or even being dropped from ADAP, the California Department of Public Health terminated Boggs' contract.

The state extended eligibility for all ADAP clients to ensure that nobody's eligibility would expire before July 1.

But with that date getting closer, there are fears that problems with the program, which helps 29,000 people, still won't be ironed out.

Martha Ayala, an enrollment worker at APLA Health, said, "My main concern of what can happen is that based on our past experience" with the state's Office of AIDS, "they're not prepared for this type of contingency. When something like this happens, they're not prepared, and clients fall through the cracks."

That could mean people being "turned away" from their pharmacies and interruptions in insurance payments, among other problems, said Ayala.

"Clients have not been notified of any of this," she added. "Clients come and they have no idea that they've been extended. ... I'm the one that tells them."

In response to the Bay Area Reporter's emailed questions, CDPH spokespeople said, "All client eligibility end dates are staggered based on client birthday, so only a certain number of clients whose birthday or half-birthday is in July will need to renew eligibility in July."

That's about 5,000 people, according to the agency.

"CDPH has reminded ADAP enrollment workers to re-enroll and recertify clients in a timely manner so their eligibility is extended," spokespeople said, adding, "CDPH will continue to emphasize this important reminder. To assist enrollment workers with this important task, by the end of May, the ADAP enrollment system will have a new feature that allowing enrollment workers to see a list of their clients and their clientsÕ eligibility end dates."

Courtney Mulhern-Pearson, director of state and local policy at the San Francisco AIDS Foundation, said in an interview, "The good thing about them extending the eligibility is that clients shouldn't have been impacted too much by the transition in the contracts ... but once that extended eligibility ends, that's when we'll be able to see if the system is really working or not."

Clients notified, state says

CDPH spokespeople said that it does notify people of what they need to do in order to extend their eligibility.

"Enrollment workers across the state also work with clients to ensure they remain enrolled and do not lose access to their medications," the agency said. "Clients must meet with their enrollment workers before their birthdays each year to re-enroll in ADAP," and people with birthdays in July should have received postcards in mid-May "reminding them to meet with their enrollment workers before their birthdays."

Spokespeople also said that clients have to "self-attest to their ADAP eligibility before their half-birthdays via a form that is mailed to them from CDPH."

People with half-birthdays in July should have received the forms in mid-May. Clients who have questions about the forms should get in touch with their enrollment workers or call ADAP at (844) 421-7050.

Mulhern-Pearson, who encourages people to check their mail for anything from CDPH, said, "We really need more transparency around what the functionality is now, what systems improvements they're working on, and what the timeline of those improvements is going to be."

She said she wants to see at least a page on the state's website devoted to the information. The way it is now, "You hear slightly different things depending on who you talk to."

CDPH spokespeople said that on April 27, the agency posted "a list of past, current, and future features planned for the ADAP enrollment system."

The list is "being updated every four weeks and will be shared with enrollment workers and posted to the ADAP website each time it is updated," the agency said.

 

Contact the author at s.hemmelgarn@ebar.com.

 

 

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