September Report from the South Florida AIDS Network (SFAN)

This SFAN meeting occurred during The United States Conference on AIDS (USCA) in Washington, DC. With many local HIV services providers at USCA, this meeting became somewhat skeletal.

Justin Bell, Florida Department of Health, Broward (FL-DOH-B) reported that the FL-DOH-B has added a position to increase retention in care, a key outcome of the HIV Continuum of Care and the National HIV-AIDS Strategy. This new staff position will have the responsibility to locate clients who have dropped out of care and re-link them to care.

Bell explained each item in the local RWC Part B Budget. Administration (10 percent of budget) funds supervision, management, and accountability. Clinical Quality Management (4.5 percent of budget) pays for monitoring clinical quality. Health Insurance Premium Cost Sharing (30.1 percent of budget) assists in the payment of health insurance premiums. Home and Community Based Health (0.5 percent of budget) provides home based services and devices. Home Delivered Meals (0.4 percent of budget) prepares and delivers meals to the homes of disabled and homebound clients. Medical Transportation (5.9 percent of budget) pays for bus passes for medical appointments. Referral for Health Care/Supportive Services (35.7 percent of budget) links clients to medical care and other services. Residential Substance Abuse Treatment (12.9 percent of total budget) pays for placement in a residential substance abuse facility. While about 33 percent of the fiscal year has already passed, only about 15 percent of the allocated funds have already been spent.

Bell reported that RWC Medicaid clients who need to obtain medical devices and a Medicaid Project AIDS Care (PAC) Waiver may now have a longer delay. Another authorization has been added to the process, increasing the time from application to authorization by one to three weeks.

Janet Vargas (Broward County Ryan White Care) reported on RWC Part A. The County has completed a data analysis of the Health Insurance Continuation Program (HICP) from January 1, 2015 through July 31, 2015. The analysts projected these costs for the rest of the calendar year. They estimated an average annual insurance cost of $3,312 per client, for the 269 clients enrolled in HICP. As these insurance payments will be less than full payments for medical care, these ACA insurance payments may result in a substantial cost transfer. Vargas reported a potential saving of up to one million dollars.

Leslie Washington (Community Feedback Forum) discussed plans for the next SFAN meeting. SFAN has several evening meetings over the course of the year to accommodate people whose schedules prevent their attendance at the monthly Friday morning meeting. Recent evening meetings failed to draw new people.

August Report Focuses on Ryan White Care and ADAP

Issues with the transition from Ryan White Care (RWC) to private health insurance and a report on the Updated National HIV/AIDS Strategy comprised most of the discussion at this meeting.

Cliff Sermon of Encompass Financial discussed his clients’ difficulties in resolving issues. The insurance company sends a RWC client a 30-day notice. This notice informs them that the company will cancel their insurance in 30 days unless certain issues are resolved. His clients find it difficult to find someone to help them resolve this issue. Atensia Earp (Care Resource) reported that some of her clients had reported similar problems.

Joey Wynn, Chair of SFAN, said that clients should keep all correspondence from ADAP, DOH, and their Insurance Companies. When the client receives a letter that they do not understand, the client should bring all this correspondence to the local ADAP office as soon as possible. Justin Bell (FL-DOH) agreed. Bell said that a staff person at the local ADAP office could contact the responsible person in Tallahassee and resolve things. Eserman replied that two of his clients did that, but their policies were still cancelled. Eserman said, “I want my clients to be happy. They are playing by the rules and still not getting the information that they need.”

Wynn said, “This is not a perfect system. It’s difficult and complicated. Private insurance always has drama.” Wynn also reported that Lorraine Wells of the ADAP office in Tallahassee would be visiting South Florida soon. He said that people should get their questions ready for her.

The Community Feed Back Committee reported that they would host a “Client Awareness Summit.” A five-person panel will discuss access to care from two perspectives: that of a person newly diagnosed, and that of someone who was once in care, has since dropped out, and wants to return to care.

Atensia Earp (Care Resource) reported that if clients have difficulty with copays, Care Resource and other Federally Qualifying Health Centers could lower them.

Joey Wynn reported on the updated National HIV/AIDS Strategy, which replaces the National HIV/AIDS Strategy of 2010. Its four goals include the following: to reduce new infections; to improve access to care and health outcomes; to reduce HIV-related health disparities between groups; and to achieve a more coordinated national response.

The strategy focuses on the right people, right places, and right practices. The phrase "right people" refers to the concentration of HIV infection in key groups: Gay bi men, Blacks, Latinos, Drug Injectors, Youth, People in the US South, and Transgender women. The disease concentrates geographically in major metropolitan areas and the US South. The phrase “right practices” refers to widespread HIV testing, linkage to care, full access to PrEP, broad support for people living with HIV, and universal viral suppression.

For brief summaries of the Updated National HIV/AIDS Strategy, visit https://aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update-5-things.pdf and https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update-what-you-need-to-know.pdf

For the complete Updated National HIV/AIDS Strategy, visit https://aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf

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.