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Quality Care, a perspective: Dreaming of the Perfect ADAP Program

Quality Care, a perspective: Dreaming of the Perfect ADAP Program. Joey Wynn Director of Public Policy, Broward House Co Chair – Florida HIV AIDS Advocacy Network April 2 nd , 2012 Washington D.C. Quality Care, a perspective: Dreaming of the Perfect ADAP Program. 3 background items:

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Quality Care, a perspective: Dreaming of the Perfect ADAP Program

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  1. Quality Care, a perspective:Dreaming of the Perfect ADAP Program Joey Wynn Director of Public Policy, Broward House Co Chair – Florida HIV AIDS Advocacy Network April 2nd, 2012 Washington D.C.

  2. Quality Care, a perspective:Dreaming of the Perfect ADAP Program 3 background items: * A cookie cutter approach will not work * High density areas operate very differently from rural areas * Funding levels will impact “Value added services”

  3. Snapshot of the U.S. HIV Epidemic: • More than one million Americans are now living with HIV/AIDS • Each year, there are approximately 50,000 people newly infected with HIV • One in five people with HIV do not know they are positive • About 50% of those diagnosed with HIV/AIDS are not in regular care

  4. AIDS Diagnoses by Region, per 100,000 Population, 2009 14.8 Northeast 6.6 Midwest 8.2West 13.9South U.S. Average = 11.2 Diagnoses/100,000 Note: Data do not include U.S. territories and possessions. Source: CDC, HIV Surveillance Report, Vol. 21, 2011.

  5. The role of the Community based Organization / AIDS Service Organization (CBO / ASO / NGO The average client access and referral process for Broward House: • If new to the agency, a home assessment by ARTAS, or case managers • Identify potential barriers: transportation, daycare, time off from work etc… • Initial blood work drawn & PPD, screenings completed • Set initial blood draws to have recent accurate lab values for upcoming doctor’s visit • Set Initial doctor’s visits (at least 2 weeks after lab draws) • Appointments complete, case managers assigned after visit • 1 on 1 counseling for treatment preparedness • Referrals to empowerment classes if needed • Follow up by peers or CMs or ARTAS if needed • Assistance for Co-Pay cards, PAPs, ins. premium support & deductibles etc.. • Next appointments set • Cycle starts over

  6. 15 Traits of an Excellent ADAP program: Treats consumers like their own family (Compassion) Easy as possible to enter & access ADAP services while collecting required data Ensures program is easy to understand in a way that is respectful (Health Literacy) Proactive & Adept at processing Medications; maintains & monitors profiles (MTM) Aware of ways to save money for both the program & their clients; staff offer tips & strategies to save time & effort Provides for access to disease management if needed (nurses) Obtains patient medical data (must resolve HIPPA barriers) program should be acquiring data for clients without asking them to run around to get it manually. Troubles shoots & resolves problems quickly - timely response when things go wrong, i.e. Medicare Part D, TrOOP, Insurance deductibles

  7. 15 Traits of an Excellent ADAP program: Works convenient hours & locations; offers mail order if asked (for stable clients) Measures & uses QI in a meaningful manner with documented annual outcomes Negotiates better discounts from Pharmaceutical companies. Improves rebate collections & state revenue matches Provides ongoing training for staff on Health literacy, cultural competency, & continuing education at all levels Provides all stakeholders meaningful data to assist in local & state level planning. ADAPs are more than dispensing vehicles, they are an adjunct to primary care & lab values: Community Viral Load will showcase this feature Looks at future trends to stay efficient: (Insurance coverage versus provisions of medications)

  8. 11 Traits of an Excellent Pharmacist: Treats clients like their own family member, COMPASSION! Understands the financial impact on a person’s life Asks if clients understand everything in a way that is respectful (Health Literacy levels) Proactive processing medications, & maintaining /monitors profiles Aware of ways to save money, time & effort; offers tips & strategies when asked Stays abreast of Industry hot topics & latest trends in dispensing Has excellent relationships w/ local healthcare providers & referrals Troubles shoots & resolves problems as quickly as possible (timely response when things go wrong) Works convenient hours & locations Understands my disease & my chronic condition Respects client confidentiality

  9. Take home messages: • ADAPS are a component of the Care team, not stand alone programs • All Care Act Stakeholders need aggregate level data to plan & adapt to client needs; data is essential for everyone! • ADAPs need to be visionary: in technology & procurement of services. • A national baseline assessment of service delivery needs to be disseminated, Also a template for cost benefit analysis for insurance premium purchasing versus Medication purchasing for high medium & low density states. • Barriers to care due to lack of data should not be acceptable • ADAPS need meaningful, demonstrable Quality Improvement (QI) programs, and be measured on their outcome measures to show success of improvement.

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