February 2017 Report from SFAN

The South Florida AIDS Network (SFAN) functions as the networking and advisory body for the Florida-Department of Health (FL-DOH), Ryan White Care (RWC) grant in Broward County. It has monthly public meetings.

Joey Wynn, Chair of SFAN, made a valiant effort to present in an upbeat manner the latest news from DC. Wynn said, “We have work ahead of us, but it’s not impossible.” Nonprofit staff can provide education to public officials about the issues related to their work. The cost-effectiveness of the AIDS Drug Assistance Program (ADAP) and RWC could be very persuasive.

Bureaucratic inertia will have a protective effect in the short-term. Agencies could use that time to diversify funding. Due to looming budget cuts, HIV service programs will have to prioritize where to cut. “This could become ugly,” Wynn cautioned.

Wynn urged people not to write off Republicans. He cited Congresswoman Ileana Ros-Lehtinen, of Miami, as an example. She has been a major ADAP supporter and has a transgender son.

Continuing resolutions have flat-funded RWC and Housing Opportunities for People with AIDS (HOPWA). As the authorizing acts for these programs have expired, these critical programs could be at risk, if people fail to educate their representatives about the value of these programs.

Medicaid faces great risk. Wynn referred to the threat of Medicaid Block Grants. Medicaid functions as a health insurance program for the very poor. When recessions occur, more people fall into poverty. Medicaid funding then automatically increases to meet the increased need. A block grant would set funding at a fixed amount, regardless of the need for the program.

RWC programs, including ADAP, function as a Payers of Last Resort. If health insurance is available, RWC will pay its premiums and copays. If not, RWC will pays for HIV-related health care. In 2015, Medicaid paid for HIV meds of 7 percent of all RWC clients. A Medicaid-Medicare Partnership paid for another 2 percent. If Congress cuts Medicaid funding, RWC will absorb the difference. Simultaneously, RWC will have to absorb costs for the newly diagnosed and those “repealed” out of Affordable Care Act plans. The need for care will increase, but funding, at best, will stagnate.

Justin Bell (FL-DOH-Broward) reported that FL-DOH now has gas cards available for eligible RWC clients. Interested clients should talk with their case managers about this.

Bryan Wilson of SunServe announced that SunServe will host a conference on aging and living with HIV (see below for details). In 2015 in Broward, 27 percent of new HIV diagnoses occurred among males over 50. Among males living with HIV, 54 percent were over 50. Scheduled speakers include Nelson Virgil, Mark King, Sean Black, and Bruce Richman.

On Feb. 6, some SFAN members met to resolve a problem with documenting adherence. ADAP, a payment and an adherence program, relies on payment data to document adherence. If ADAP cannot document adherence, ADAP may decertify the client. CVS, AIDS Healthcare Foundation, and the DOH dispensary have created systems to resolve this problem.

Representatives from Walgreens, Skyemed, Infinity, and Comcare, attended this meeting. As smaller pharmacies have more flexibility and fewer clients, they can develop ad hoc solutions. While Walgreens is committed to resolving this issue, it faces a much more complex task. The group agreed to meet again at the beginning of March to monitor progress.

Announcements

The HIV/AIDS seniors Conference “We know you’re still in the game” (www.SunServe.org/HIVSeniors) will occur March 31 from 8 a.m. to 4 p.m. at 4849 N. Dixie Highway.

Next SFAN Meeting: Thursday, March 2 at 6 p.m., at the Holy Cross Healthplex, 1000 NE 56^th Street, Ft. Lauderdale. Newcomers are encouraged to attend.

Follow Sean McShee on Twitter @SeanMcShee