VA ADAP Update

1. VA ADAP Update 7/13/2012

2. Enrollment Criteria Now Includes • Effective 7/16/2012, all individuals on the waitlist with a CD4 count above 500 will enroll directly into ADAP. • We will be strategically enrolling clients on a first-on, first-off basis. Clients will be enrolled at the rate of 200 clients every 2 weeks, in the order they were placed on the wait list, completing enrollment within 6 weeks. • New clients with a CD4 count above 500 presenting to ADAP will be temporarily placed on the wait list and assisted with other medication resources, such as PAPs and Welvista.  These clients will be enrolled to ADAP in the order they were placed on the wait list, as part of the enrollment of wait list clients (they become part of the last 200 clients to be enrolled to ADAP). • We encourage ADAP stakeholders to refer clients to Welvista. This will ultimately streamline the enrollment process as the application will be completed. It may also be less administrative burden on ADAP stakeholders to find alternative medication resources.

3. Enrollment of WL clients with CD4s above 500 • 579clients meet this criteria • Clients who were recertified in February 2012 and already have an application with a signature on file will not need to complete a new application. A majority of the waitlist clients completed this process. Therefore, enrollment into ADAP will be expedited. • For clients that do not have a signature on file or a complete application, ADAP staff will assist the clients with the application process. The client will be given the option to complete an application over the phone or by mail. • The ADAP application may be found on the ADAP website. • VDH ADAP staff will contact each client using the most up to date telephone contact information to begin the application process. • Clients will need to obtain new prescriptions at the time of enrollment.

4. Confirmed Enrollment • The process will mirror enrollment for transitioned clients (i.e 351-500 in December). • Once enrolled, VDH will generate an approval letter that will include an effective date, LHD ADAP Coordinator name and phone number. • VDH will copy LHD ADAP Coordinator, Central Pharmacy and medical provider. The client will be mailed a copy of the letter (in English and Spanish and at 6th grade reading level).

5. New Clients with a CD4 above 500 will temporarily be placed on the wait list • We will enroll all clients that have been on the waitlist prior to enrolling new clients with CD4 counts above 500. New clients will be directly enrolled by September 10, 2012. We expect to have the wait list completely eliminated by September 30, 2012. • Please call VDH at 1-855-362-0658 • ADAP staff will walk you and the client through the application process and direct towards other medication access programs, whether it be a PAP or Welvista.

6. VA ADAP Success • As of7/12/2012VA ADAP has enrolled 736clients into ADAP since the criteria change in November 7, 2011! • These positive changes with ADAP have been made possible due to a variety of factors: • Our approach has been to clinically manage waitlist clients to support those with the highest clinical need and ensure we could sustain clients as we have enrolled them into ADAP

7. VA ADAP Success Cont. • We have taken a variety of actions to increase the capacity of ADAP. Examples include: • implementing and enforcing a 30-day dispensing policy • carefully assessing clients for any other medical access options (Medicaid/insurance) • removal of inactive clients from the program (no medications dispensed in 6 months or greater)

8. VA ADAP Success Cont. • Additionally, actions by several of our partners have made this possible: • These include additional funds appropriated by the Virginia General Assembly, lower medication cost negotiated with the pharmaceutical companies, contribution of funds by Part A partners and your support in redirecting all available funding to medication purchase.

9. Thank you • We want to express our sincere gratitude for making difficult decisions surrounding decreasing some services and working closely with clients to ensure they had access to medication assistance through pharmaceutical companies and Welvista.

10. Forms • The ADAP enrollment forms can be found on our website: • http://www.vdh.virginia.gov/ADAP

11. Enrollment Summary • Virginia ADAP is currently open to individuals meeting any of the following criteria: • Pregnant women • Children, ages 18 and below • Individuals being treated for an active opportunistic infection (OI) • Individuals with a CD4 count at or below 500, and currently waitlisted clients with CD4 counts above 500 • New clients with a CD4 count above 500 will be directly enrolled into ADAP by September 10, 2012

12. How to Contact Us • There are a variety of ways to contact us. • Please contact the Medication Eligibility Hotline toll-free at 1-855-362-0658 • We have in house Spanish speaking staff and the ability to use language services including services for deaf clients • Jennifer Flannagan, ADAP Operations Specialist, at 804-864-7360 • Also visit the web site at www.vdh.virginia.gov/ADAP

13. Press Release • A press release was issued on 7/13/2012 regarding enrollment expansion. Please contact us if you have questions or need assistance.