PRNewswire - September 29, 1999

"Not only will AB 1047 improve treatment and access to many new AIDS drugs for a very vulnerable group of Californians living with HIV and AIDS," said Assembly member Marco Firebaugh (D Cudahy), author of the bill, "but it also provides the state some measure of cost containment as well as some important consumer protections for the program and its participants."

"AB 1047 will strengthen the arsenal of life saving medications available to fight AIDS by placing many FDA-approved anti-viral AIDS drugs on the state's ADAP formulary much more quickly," said Michael Weinstein, President of AIDS Healthcare Foundation, the chief backer of the measure. "Prior to this bill, there was often a substantial delay between the time the FDA approved these drugs and the time they were actually added to the ADAP formulary. We thank Assembly Member Marco Firebaugh for authoring and carrying AB 1047 and Governor Davis for his signature, vision and leadership on this bill."

Presently, thousands of Californians who are HIV positive or who have AIDS but do not qualify for Medi-Cal depend on the ADAP program for access to these life-saving medications. While the Medi-Cal program-by-statute is required to (and does) add such drugs almost immediately upon FDA approval, AB 1047 levels the playing field for AIDS drug access for the increasing number of Californians not covered by Medi-Cal that are in need of assistance obtaining these effective AIDS medications.

Among the ADAP consumer protections AB 1047 provides are:

-- Filling of ADAP patient prescriptions within 24 hours of submission and shipping of mail order prescriptions within 48 hours;

-- Allowing the ADAP program to subcontract with any willing provider, including reporting on any denials of contracts with providers and the reason for denial;

-- Provision of information regarding program policies, procedures, enrollment procedures, eligibility guidelines and lists of drugs covered in appropriate literacy levels in English, Spanish, Mandarin/Cantonese, Tagalog, and in other languages as determined by the department; and

-- Development of a timely and accessible grievance procedure for clients and promotion of that procedure among clients.

"These consumer protections are a critical mechanism to monitor ADAP and how it delivers services," said Jessie Gruttadauria, AHF's Government Affairs Manager. "AB 1047 should save many lives by making FDA-approved AIDS drugs more readily available to ADAP clients. It makes perfect sense to balance the principal intent of this bill-expanded AIDS drug availability-with the addition of such strong consumer protections."

A variation of this bill had previously been filed as AB #889 (Martin Gallegos, D-Los Angeles) in 1998 where it died in committee before it could reach the desk of then Governor Pete Wilson.

AHF Urges Davis to Also Sign AB 217 (Scott Wildman, D-Los Angeles) to Improve Patient Access to Quality AIDS Care in Managed Care Plans

Another AIDS Healthcare Foundation-sponsored assembly bill-AB 217-authored and carried by Assembly Member Scott Wildman (D Los Angeles) and geared toward improving access to quality treatment and medical care for Californians living with HIV/AIDS also made it out of the legislature and awaits the Governor's consideration and signature.

"At present, the treatment of HIV/AIDS is not universally recognized as a medical specialty," said Michael Weinstein, AIDS Healthcare Foundation president. "So despite the fact that we now have the means to better manage HIV and AIDS clinically, some managed care plans may-and do-deny patients access to the very AIDS specialists who could help them manage their disease and remain well. AB 217 would increase patient access in managed care settings to physicians that specialize in the treatment of HIV AIDS."

AB 217 will also enhance Medi-Cal patients' access to quality care for HIV/AIDS. Specifically, the bill requires the department to establish risk-adjusted capitated rates for the treatment of HIV/AIDS patients by managed care plans and sets forth criteria for the development of those rates.

"Today, health plans that contract with Medi-Cal have insufficient incentive to develop special programs or enhance access to specialists to meet the needs of their patients living with HIV or AIDS." said Assembly Member Scott Wildman, author of the bill. "As a result, patients covered by these plans may receive a lower quality of care or medical treatment. AB 217 presents a cost-effective way to ensure patient access to quality AIDS care by negotiating with plans a risk-adjusted rate that accounts for the cost of caring for these patients."

Historically the most cost-effective way to ensure patient access to quality care has been to negotiate with plans to provide a structure that accounts for the costs of such care. There is precedent for the department negotiating these risk-adjusted rates for HIV/AIDS in Los Angeles County. The department negotiated these rates before because it realized that such rates are more cost-effective than having patients enrolled in fee-for-service plans. The same applies for the care of such patients statewide, and Assembly Member Wildman and AIDS Healthcare Foundation believe the most logical and compassionate action is to have the state offer plans across the state the opportunity to negotiate these rates. In order to prevent an increase in cost to the state, AB 217 also states that the capitation rate shall not exceed the fee-for-service equivalent.

"We believe AB 217 is a comprehensive means of addressing access to quality AIDS care," said Jessie Gruttadauria, AHF's Government Affairs Manager, "We urge the Governor to consider and sign this bill."

AIDS Healthcare Foundation (AHF), the nation's largest HIV/AIDS medical provider, serves over 3,600 Greater Los Angeles patients regardless of their ability to pay at 6 out-patient health care centers, one residential nursing care facility; the WomensCare Center; through Positive Healthcare (the first AIDS specific managed care program in the nation), through AHF's Research Division (offering clients the opportunity to participate in state-of-the-art clinical research trials), through AHF's Treatment=Life Division featuring the WEHO Lounge, the nation's first coffee house/HIV testing and information center, and through outreach and HIV testing offered at three of AHF's thirteen fund-raising Out of the Closet thrift stores located throughout Southern California.

For media inquiries, contact Jessie Gruttadauria, AHF's Government Affairs Manager, (323) 860-5203, or Ged Kenslea, AHF's Community Relations Director, (323) 860.5225.

SOURCE AIDS Healthcare Foundation

CONTACT: Jessie Gruttadauria, Government Affairs Manager, 323-860-5203 or Ged Kenslea, Community Relations Director, 323-860-5225, pager 213-209-8123, both of AIDS Healthcare Foundation/
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