Planning Council Thursday, November 13, :00-6:00pm Old South Church; Guild Room. Summary of Attendance

Transcription

1 Planning Council Thursday, November 13, :00-6:00pm Old South Church; Guild Room Summary of Attendance Members Present Larry Day Cindy Estrada Andre Folkes Oscar Guevara-Perez Michael Goldrosen David Hawkesworth Leigh Kalbacker Kevin Koerner Heather Kough Kat Mackenzie Allan McClendon Sarah McPhee Erika Moreno Nicholas Paulo Whitney Reid Jonathan Reveil Carmen Rios Carla Rodriguez Darren Sack Tali Schiller Rahul Singh Jessica Stewart Lawrence Vinson III Arthur Ware Arthur Weeks Members Excused Barry Callis Durrell Fox Lauren Jones Alison Kirchgasser Kathy Lituri Members Absent Elizabeth Harrington LaKeysha Smith PCS Staff Lianne Hope Abiola Lawson BPHC Staff Eric Thai Guests Annette Rockwell Betsey John Craig Wells George Hastie Rebecca Hawrusik Welcome and Introductions Topic A: Welcome, Introductions Erika Moreno, Chair of the Planning Council, called the meeting to order, welcomed new and returning members, and asked everyone to introduce themselves for the record. Erika asked for a motion of silence. Erika reviewed the agenda for the meeting. Review and Approve Minutes Topic B: Review and Approve October 9, 2014 Summary of Meeting The Council members reviewed the minutes from the October 9, 2014 meeting. Motion to Approve: David Hawkesworth Second: Carmen Rios Results: Minutes were approved; (2) abstentions. 1

2 Committee Updates Topic C: Committee Update Erika asked the group to review the committee updates. She also highlighted the importance of attending committee and Council meetings and informing PCS staff of attendance issues as soon as possible. Consumer Committee - November 13 The Consumer Spotlight featured Andre Folkes The group discussed and prioritized educational topics and trainings for the year and also discussed policy topics of interest for the Policy Committee. Evaluation Committee November 6 meeting was cancelled due to low attendance. Executive Committee - October 23 Discussed results of the evaluation form voting and Adhoc Committee recommendations. Reviewed Council Meeting agendas and presentations. Planning Committee - October 6 Andre Folkes was elected as Vice Chair. The group reviewed the service categories and prioritization process; reviewed last year s Needs Assessment presentation and discussed this year s Unmet Need project. Policy Committee - October 16 Heather Kough was elected as Vice Chair. Reviewed last year s recommendations and this year s workplan. Resources and Allocations Committee Will meet February 9 for its first meeting of the Council term. Presentation: MA HIV Care Continuum Topic D: MA HIV Care Continuum Rebecca Hawrusik, from the HIV/AIDS Surveillance program at the Massachusetts Department of Public Health (MDPH) presented on the Massachusetts HIV Care Continuum. She provided a description of the care continuum, its purpose and significance, compared MA to National CDC data, explained the stages of HIV care for all PLWH and newly diagnosed (engagement, retention, viral suppression), and their methodology in collecting data. She added that data is limited because they could not account for people who may have moved or became deceased. She made the following conclusions: Discussion Points for all PLWH in 2012 in MA: A high proportion of those engaged and retained in care were virally suppressed. Engagement and retention in care is higher among females while rates of viral suppression among females are lower. Engagement and retention in care is similar among white (non-hispanic), black (non-hispanic) and Hispanic/Latino PLWHA. Rates of viral suppression are lower among black (non-hispanic) and Hispanic/Latino individuals. Engagement and retention in care is similar among risk groups. Rates of viral suppression are higher among MSM compared to other groups. 2

3 Discussion Points for Individuals Newly Diagnosed with HIV in 2012 in MA: Among those newly diagnosed with HIV infection in 2012, almost 75% were linked to care within 3 months of their diagnosis. Two-thirds of newly diagnosed individuals were virally suppressed within a year of diagnosis. Rates of care linkage and retention for females are higher than males, but rates of viral suppression are similar. Rates of care linkage and retention for newly diagnosed black (non-hispanic) are higher than for white (non-hispanic) individuals, but viral suppression is lower among black (non-hispanic) individuals. Rates of linkage, retention and viral suppression for heterosexual and presumed het groups are higher than for other risk groups. The group discussed the following: The first bar with 100% refer to people that we know are living with HIV 18,750. These are people that have been diagnosed and reported to us. Some other graphs and papers include those that are diagnosed and undiagnosed. If categories were to be compared by race would people of color experience the same rates? The rates are similar for retention and engagement in care, but people of color had slightly lower viral suppression rates The difference was not greater than 8%. In the future, will try to break it down further to see if there are any discrepancies between younger men of color, MSM, and IDU. Why would viral suppression rates be different? It could be adherence, type of medications. Hoping additional analysis will provide more information. The DPH has been awarded two different funding opportunities to address linkage to care, hopefully can use information to understand disparities. Who are the individuals that are not in the virally suppressed group (36%)? 10% are actually not virally suppressed but other 26% don t have a viral load for them in 2013 missing information. The 18,570 represents individuals who have been reported to the surveillance system since the beginning of reporting in Have individuals who could have reported once and never had any information from them after that. Think looking at second bar of those engaged in care would be more accurate to get viral suppression rates for PLWH in MA. Do you have information of individuals that are engaged and retained in care but decide not to be on treatment (CD4 count high, and viral load low but not necessarily suppressed)? Don t have treatment information; CDC recommends pulling ART information from other sources but don t have the capability at the moment. Some of those people may not be captured in MA Cascade. This information will be released through a webinar on World AIDS Day. Additional information on demographics will be included. A link and fact sheet will be sent out. It will also be recorded and posted on the MDPH website. Presentation: HDAP/ADAP in the EMA Topic E: Presentation: HDAP/ADAP in the EMA Annette Rockwell, HDAP & Federal Grants Coordinator, MDPH Office of HIV/AIDS gave an overview of the Massachusetts HIV Drug Assistance Program (HDAP). She discussed the history of the program, the program s managerial structure and funding sources, covered services, eligibility requirements, yearly expenditures, and demographics of enrollees. Take home Points: 3

4 Massachusetts has a very comprehensive and accessible drug assistance program due to open formulary covering all medications, as well as fairly high FPL Currently the state collects $7.5 million dollars in manufacturer rebates to support the program Unlike some states, there is state funding to support the program Program is financially stable at this point Discussion o What do co-pays cover? Currently only medications but looking at the possibility of covering copays for doctor visits. With so many different hospital clinics and doctors offices across the state, getting them to accept payment from a third party can be challenging. Looking to start a pilot at bigger sites. o Suggested to show comparison of MA HDAP program to other states. o How is FPL determined? Set by federal government. Formula decided years ago and does not take into account all factors people deal with in terms of cost of living. Used to be a dollar amount but because of COL in MA thought would be better to use an amount that goes up (a little) each year. o Is the HDAP program using MAGI (Modified Adjusted Gross Income)? MAGI is a formula used by a lot of affordable care act programs in existence to determine people s income. Some states have decided to change how they do it based on MAGI - for the time being looks like it will give similar eligibility to what we have now. It requires income tax returns but the HDAP program does not require that and there are issues with those that don t file taxes. o Why is it difficult to use insurance in different states for emergencies? For some insurances you can get covered for emergencies during a temporary visit to a different state, depends on insurance enrolled in. Each state has a Division of Insurance, which makes regulations different in each state. o What is the program doing regarding the high cost of the drugs for PLWH co-infected with HCV? Have a high number of people covered by insurance, thus able to include those drugs on their formulary. HDAP won t have to pay the full cost of the drug. o Would PreExposure Prophylaxis (PrEP) ever be covered? HDAP is set up for people who are already infected, however, Washington state is using state resources to cover PrEP. It may be something to consider in the future for HDAP. There is pressure on a national level for CDC to cover costs for PrEP since they have funding for people who are at risk. Members and guests added Gilead assistance program and a lot of insurers also help cover PrEP. New Hampshire ADAP Program (Sarah McPhee, NHDHHS) Sarah McPhee, Program Manager, NH CARE Program gave an overview of the NH AIDS Drug Assistance Program (ADAP). She discussed the eligibility criteria, the application process, ADAP s covered services, funding source, enrollee demographics, and the future of the program. Takeaways: NH ADAP is stable and has multiple resources. NH ADAP clients receive support for full pay medications, copays, insurance premiums and medical copays/deductibles. The transition to a reformed health insurance state is ongoing in NH. Discussion: o Is the expanded Medicaid program as comprehensive as the NH CARE program? The NH CARE program will cover certain services the expanded Medicaid program does not. In the expanded Medicaid you are put into a managed care program and you have to work with the network they have which is not as large as the Medicaid-fee-for-service network was previously. 4

5 o What is the situation in NH for covering PrEP? Not covered with federal dollars but heard some insurers carry it. o What are the rebates from the pharmaceutical company? Fluid, there is no cap, and it could be anywhere from $1-$4 million. o If enrolled in MA HDAP program and visited NH would client be able to obtain medication? If they had insurance, would contact insurer or if HDAP covers full cost of medication would contact them to figure out how to get it in the different state. o Update on pilot program with pre-existing condition insurance plan? Plan covers medical copays and deductible, program continues to work with providers to process. Agency Reports Topic H: Agency Reports Erika directed members to look in their handouts for written agency reports. Office of Medicaid Alison Kirchgasser This year s Open Enrollment period is from November 15, 2014 February 15, 2015 Individuals enrolled in the following programs WILL need to submit a new application during open enrollment: Qualified Health Plans (QHPs) (these are plans purchased through the Connector) Commonwealth Care (CommCare) Medical Security Program (MSP) Temporary MassHealth Coverage Temporary MassHealth Limited Current MassHealth members who are receiving benefits through the following MassHealth programs DO NOT need to submit a new application during the Open Enrollment period: MassHealth Standard CarePlus Family Assistance Limited Health Safety Net Children s Medical Security Plan CommonHealth New Hampshire Department of Health and Human Services (NHDHHS) Sarah McPhee NH DHHS is working on the Part B grant application, due carriers will be in the NH Health Exchange for 2015: Anthem, Harvard Pilgrim, Minuteman, Assurant and Maine Community Health Options. Full plan details will be available by Nov 15. NH DHHS will conduct cost benefit analysis to determine which plan(s) will be covered through the NH CARE Program. Procurement for outpatient/ambulatory medical care, dental care, mental health, substance abuse and home care services is in process - deadline of December 18. On Monday November 17 th, launching HIV Care Engagement Program, formerly named HIV Recapture Program, which aims to find people that have fallen out of care and reengage them back into care. Massachusetts Department of Public Health Barry Callis At the October 2014 MIPCC Meeting, members/guests received the MA HIV/AIDS Continuum presentation from Betsey John, Director of the HIV/AIDS Surveillance Program. Future 5

6 engagements with the MIPCC for this planning cycle will focus on the OHAs efforts to promote access to preventative services, ongoing linkage to care and responses to address population health disparities based on these data. The National Alliance of State and Territorial AIDS Directors (NASTAD) hosted a meeting with industry partners with Viral Hepatitis Program, OHA representatives, clinicians/providers and a consumer at Boston Healthcare for the Homeless Program (BHCHP). This meeting focused on the current surveillance system in MA and programmatic responses to support the needs of homeless patients seeking treatments for viral hepatitis C at BHCHP. The goal was to highlight successes and services needful to ensure success for persons seeking/on new HCV treatments. This engagement was timely given individuals were attending the American Association for Study of Liver Disease (AASLD) meeting taking place locally. OHA and BSAS continue to collaborate to sustain and manage increased demand for overdose education and naloxone distribution through pilot programs, prescription, and pharmacy access. Boston Public Health Commission Michael Goldrosen Acuity Scale Pilot BPHC and DPH co-sponsored a meeting of all MCM programs to review a pilot initiative on implementing an acuity scale tool to help triage case management clients in accordance with their level of need. Had great attendance Will be piloted and will be collecting feedback from providers. Sweeps Will be conducting sweeps process today and tomorrow Carryover Approved but still waiting for the $$ to arrive. HRSA TA HRSA has reengaged a TA consultant to work with us on next steps to come into compliance with mandate fan an annual comprehensive fiscal and programmatic site visit every year of every program. Will be receiving pilot tools for testing. Full implementation March Federal Budget Our FY 15 (March 1, 2015) comes from the federal fiscal year that began on October 1, No budget passed. Instead a Continuing Resolution (CR) until Dec 11. This keeps government open at last year s funding levels. Rumors are that congress may pass a full year extension through next September, or pass shorter term extensions. Impact of shorter term versions will likely be another delay at the start of the year where we receive partial funding to start the year. This makes it very difficult to plan and budget for the whole year and creates a lot of additional work. Topic K: Adjourn the meeting Motion: David Hawkesworth Second: Darren Sack Results: Meeting adjourned. Evaluation of Meeting & Adjourn 6