Advocates praise CA for dropping ADAP contractor
by Seth Hemmelgarn
HIV/AIDS advocates are praising California public health officials' decision to fire the company that briefly held a key contract in the state's AIDS Drug Assistance Program.
AJ Boggs had been awarded the contract to oversee ADAP eligibility enrollment beginning in July 2016, but ever since then, there have been problems with the system, and the state announced last week that it was terminating its contract with Boggs effective March 31.
Courtney Mulhern-Pearson, director of state and local policy at the San Francisco AIDS Foundation, told the nonprofit's Beta blog, "We are thankful that the State Office of AIDS has responded to our requests for change. The last seven months have been extremely disruptive for clients trying to obtain their medication through ADAP, and many of them have been denied coverage since the switch to AJ Boggs. We want to make sure that people living with HIV in our state are never without coverage or care for the medications they need."
Gay state Senator Scott Wiener (D-San Francisco), who'd been among people raising concerns about the ADAP issues, said the contract termination is "a positive step, and I'm happy that the department of public health is taking this very seriously and is making significant changes to fix the problem."
Wiener said he's "trying to figure out step by step how this happened, and how the department is ensuring the problem is being fixed now and that this won't happen again."
San Francisco District 8 Supervisor Jeff Sheehy, a gay man living with HIV who started on ADAP 20 years ago, said he found the problems with the system "very disturbing and frustrating. ... The way this has been botched is really unacceptable." Bruce MacDonald, 63, a gay San Leandro man who's living with AIDS, said that ADAP partially pays for surgery costs and other medical expenses he has.
MacDonald said before Boggs was brought on, it had usually taken about 60 days for a bill to be paid, but with Boggs, "it was taking more like 90 to 120 days."
He said it was "good" that the contract was being terminated.
Among other next steps, spokespeople for the California Department of Public Health said that the agency started conducting ADAP eligibility and enrollment services beginning March 6. The previous contract that Ramsell had held on its own was split into three contracts. Magellan Rx Management and Pool Administrators Inc., which along with Boggs were the new contractors, are staying.
The state had split up the contract in an effort to get better prices, spokespeople said.
However, Ramsell is suing the state over losing its contract and in court documents, the Oakland-based company alleges that its bid had been "$9 million lower than Boggs'."
In their response, state officials admitted that "Boggs' proposal resulted in a higher cost (by $9 million) over 3 years compared to Ramsell's." A spokeswoman for Ramsell didn't respond to an interview request for this story.
Messages sent to state officials just before Ramsell's contract expired June 30, 2016 expressed strong concerns about the state not being prepared for new contractors to take over.
In a June 14 letter to Dr. Gilberto F. Chavez, the state's epidemiologist and deputy director for infections diseases, the California HIV Alliance said, "We are concerned that the amount of time that has been allotted for system beta testing and enrollment worker training is not adequate ... A new system of this size, serving tens of thousands of Californians living with HIV, will require additional time to be beta tested with enrollment workers prior to a full scale transition."
Craig Pulsipher is state affairs specialist, government affairs at APLA Health (formerly known as AIDS Project Los Angeles), which is part of the HIV Alliance, along with the San Francisco AIDS Foundation and several other agencies.
Pulsipher said this week that in phone call with the health department after the letter was sent, advocates were told that "everything was going to be fine, and [the state] didn't need to do anything else to prepare."
Mulhern-Pearson told the Bay Area Reporter that issues had sometimes come up when Ramsell had the contract, "but we were always able to resolve them by calling Ramsell, basically. ... They'd been such a trusted community partner for so long." The company had had the contract for almost 20 years. By contrast, she said that with Boggs, "Whenever you got someone on the phone, it was pretty clear they were not familiar with this patient population," and "the tone wouldn't reflect the urgency."
In a phone interview with the B.A.R., Boggs CEO Clarke Anderson said he was "disappointed" the state terminated the contract.
Anderson, who declined to say how much money Boggs had been paid on its ADAP contract with California, said his company had "worked hard" to help people, and "We are disappointed that the department of public health has canceled our contract."
However, he said, "We aren't aware of any actions we've taken that have adversely impacted or somehow caused a person not to be able to receive their medications."