The South Florida AIDS Network (SFAN) functions as the networking/advisory body for the Ryan White Care (RWC), Part B grant in Broward County. Its monthly meetings are open to the public.
This meeting focused on Ryan White Care (RWC) expenses and transitioning RWC clients to the Affordable Care Act (ACA).
Joshua Rodriguez, Florida Department of Health (FLDOH) Broward, reported on RWC expenses. The RWC residential substance abuse program had only spent 18 percent of its annual budget by the halfway point of its budget year. Rodriguez proposed moving $50,000 from residential substance abuse to those programs meeting their obligations: $30,000 to Medical Transportation (bus passes), $10,000 to Home Delivered Meals, and $10,000 to Home and Community Based Health.
Broward Addiction Recovery Center (BARC) runs the RWC residential substance abuse treatment program. This program consists of assessment, medically-supervised withdrawal, and residential treatment. As the number of clients served drives spending, this underspending indicated a failure to serve the contracted number of clients. Several people present questioned this underspending as they had had eligible clients refused admission to this program. David Runkle reported that BARC had refused to admit someone because they had co-occurring mental health issues. Another member reported that BARC had refused someone else because they did not have co-occurring mental health issues. No one from BARC attended this SFAN meeting (see related BARC’s Perspective).
Rodriguez discussed the continuing transition of RWC/ADAP clients to Affordable Care Act (ACA) plans. AIDS Drug Assistance Program (ADAP) will only pay premiums and copays for those plans approved for the county of residence. ADAP has approved four silver plans for Broward County (Molina Marketplace Plan, Compass HSA 3600, Compass 4000, and Blue Select Everyday Health 1443). As ACA plans vary by county, people living in other counties will have to contact their local ADAP.
Even if ADAP has approved the same plans as last year, those plans may cost more. Other factors could also change. When someone automatically re-enrolls, all data from last year carries over to the current year, including last year’s premiums. As a result, ADAP will pay last year’s premium to the insurance company, putting the client’s insurance in jeopardy.
When someone manually re-enrolls, however, they can enter this year’s data into the system. Other factors, besides the premium, may also change. This will ensure accurate and current information, and that ADAP will pay the correct amount. As re-enrollment can be difficult, people may want to obtain the help of ACA Navigators.
ADAP will transition about 950 clients with incomes ranging from 100 to 249 percent of the Federal Poverty Level (FPL) from RWC to ACA plans this year. About 350 clients with incomes between 250 and 400 percent of the FPL will also transition to ACA plans this year. RWC clients in the latter category require an additional subsidy to afford their premium.
CVS Pharmacy acts as the Pharmacy Benefits Manager for RWC. When a RWC client fills their prescriptions at CVS, the client pays nothing (no co-pays). RWC clients using drug stores other than CVS have to work out a co-pay arrangement with that drug store. As ADAP monitors adherence, clients have to notify their local ADAP when they have picked up their prescription.
Dec. 3, 2015 from 6-8 p.m. Poverello Center will host a Town Hall meeting, “Food is Medicine,” at The Sister Innocent Conference Center at Holy Cross Hospital, 4725 N. Federal Hwy., Fort Lauderdale. For more information, call 954-561-3663.
At the next meeting of SFAN, SFAN will elect its officers.
As Broward Addiction Recovery Center (BARC) had no representatives at the SFAN meeting of November 6, SFGN contacted BARC for their perspective.
Polly Cacurak of BARC could not comment on any of the admission issues brought up at the SFAN meeting without specific details about those events. She did offer two possible explanations for BARC’s low numbers. First, the client may not have disclosed their HIV status at admission or have only disclosed it after admission.
In the latter case, BARC staff may have failed to assign that client to the Ryan White Care (RWC) contract. Cacurak reported that FLDOH has set up trainings to remedy this situation. She also reported BARC staff would be attending those trainings. Cacurak offered another suggestion regarding those clients requiring medically-supervised withdrawal. The contract provides for assessment, medically-supervised withdrawal, and a residential program. The medically-supervised withdrawal ward has 34 beds with separate sections for men and women. If either gender-section has reached capacity, BARC can admit no more clients of that gender.
While Cacurak had no knowledge of the admission policy for transgender clients, Paul Faulk, Director of BARC, did. Transgender clients in residential treatment have their own rooms, but in medically-supervised withdrawal, all clients are on a gender-specific ward. Faulk stated that BARC held safety for all clients above all else. Admission of those transgender clients requiring medically-supervised withdrawal would be decided on a case-by-case basis, depending on the other patients in that gender specific ward.
Sometimes the other patients would be OK with a transgender admission and sometimes not be OK with it. Faulk stated that this situation did not occur often. He also emphasized that BARC was developing a new facility with individual rooms for medically-supervised withdrawal rather than wards, which would resolve this issue.
Next SFAN Meeting: Friday, Dec. 4, at 10 a.m., at the Holy Cross Healthplex, 1000 NE 56th Street, Ft. Lauderdale. Newcomers are encouraged to attend.