Florida Phasing Out Project AIDS Care, Other Medicaid Waivers

Thousands of Floridians living with AIDS could be losing financial assistance they say is essential to living a normal life, and some AIDS groups are worried the state won’t carry through on its promises.

On a recent Tuesday morning, Brandi Geoit sits at a conference table at the West Coast Aids Foundation headquarters. Across from her in the small New Port Richey office with butter-yellow walls is Dwight Pollard, a 61-year-old man living with AIDS.

Geoit tells him a new Florida law means patients like him could lose some of the financial help they’re getting through Medicaid.

“We’re not sure if you would keep your Medicaid because you’re still pending for your social security. And you haven’t qualified for Medicare yet because you’re still not old enough,” Geoit said.

Pollard no longer works, and depends on a special Medicaid waiver to cover his health care costs. Medication alone can cost $15,000 a month.

His partner, Ed Glorius, was sitting next to Pollard as he heard the news.

“It just doesn’t make sense,” Glorius said. “It doesn’t make sense to put people’s lives in turmoil. We’re better off than most and I’m freaking out. I’m waking up first thing in the morning thinking about this every day.”

Pollard is one of about 8,000 Floridians with AIDS who get help paying for doctor visits, medications and various home health services through this Medicaid waiver fund, which is called Project AIDS Care. Last month, Gov. Rick Scott signed a bill formally eliminating this waiver for AIDS, along with waivers for cystic fibrosis, developmental disabilities and elder care.

Florida’s Agency for Health Care Administration said while the waiver is going away, AIDS patients in Florida will not see a loss or gap in services. The agency declined repeated requests for interviews, but issued a written statement, explaining transition into a Medicaid Managed Medical Assistance plan.

“We will continue to provide the same services through the same providers for these individuals. The PAC (Project AIDS Care) waiver is essentially a waiver that expanded Medicaid eligibility to those diagnosed with HIV/AIDS and allowed the recipients to access needed medical services (e.g., physician services) and drugs. Given the advances in pharmaceuticals available to treat HIV/AIDS, most PAC recipients in the waiver only need those medical services and case management. With this transition, their eligibility will be maintained and they will continue to have access to the medical services, drugs and case management under the MMA waiver through the health plans. They will see no reduction in services and will be able to continue to see the medical professional they always have.”

The agency said patients will go into the Medicaid Long Term Care program starting this month. Everyone will be transitioned into it by Jan. 1, 2018.

But Geoit estimates 90 percent of her clients will not meet the requirements for long term care, which normally applies to people needing round the clock nursing.

She said her clients will definitely lose certain services that Medicaid doesn’t cover. Massages for those with neuropathy? Gone. Pest control? Gone. And services that are currently covered – like delivered meals, adult diapers and wheelchair ramps – could be lost, too.

So, she’s asked the state to clarify how it’s now different.

“When we asked them, they said, ‘Don’t worry. Reassure your client that they’ll be taken care of.’ And when we asked them point-blank what happened, you know, we were under the impression that a single adult still does not qualify for Medicaid. Has this changed? And they ended the conference call,” Geoit said.

Her program – a non-profit – exists only to manage the Project Aids Care waiver money for 325 clients in seven counties including Pasco, Pinellas and Hillsborough. With the new law, Geoit said her foundation will shut its doors by the end of the year.

For Dwight Pollard and his partner, the State Agency for Health Care Administration’s lack of answers is a concern.

“You don’t need the stress of how you’re going to pay or how you’re going to do this,” Pollard said.

But that’s his reality. And Pollard said until the state agency can give clear answers, he’ll keep searching for other programs that can help pay for his life saving medications.

2018 United States Conference on AIDS

 

 

June 12th has been designated as Orlando United Day.  On this day, we remember the 49 angels who were killed at the Pulse nightclub in Orlando. This was a deliberate attack on the LGBT community that must never be forgotten.

To show our support for Orlando and the LGBT community, NMAC is pleased to announce that we will hold the 2018 United States Conference on AIDS in Orlando on September 6-9, 2018.  Please save the date.

The 2018 meeting will highlight the contributions made by the LGBT community to our efforts in ending the epidemic.  Our community has suffered so many losses and we must stand together.

The 49 beautiful portraits in this e-newsletter were created by 49 different artists across the country.  Each portrait portrays someone who was killed in the Pulse shootings.  They are all on exhibit at the Terrace Gallery at Orlando City Hall from May 1 – June 14, 2017.

Yours in the struggle,

Board & Staff of NMAC
Stronger Together!

AIDS United’s Statement on President Trump’s Budget for FY 2018

AIDS United is shocked by President Trump’s Fiscal Year 2018 budget request released today. It threatens to roll back the progress in the fight against the domestic HIV epidemic. Now more than ever we must maintain and strengthen our progress towards our national goals and priorities of reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities.

The deep proposed cuts to domestic HIV and STD prevention cannot be reconciled with the goal of preventing new HIV transmissions and the rising rates of STDs. The proposed $59 million cut to the Ryan White HIV/AIDS Program, coupled with a fundamental restructuring of the Medicaid program capping federal spending for the first time to the tune of a $610 million funding reduction over the next decade, diminishes every community’s ability to deliver quality health care to people living with HIV by eliminating AIDS Education and Training Centers and Special Programs of National Significance (SPNS).

“AIDS Education and Training Centers (AETCs) are essential to the HIV care continuum and the success of the national goals and priorities to end the epidemic,” said AIDS United President & CEO Jesse Milan, Jr. “AETCs assure that providers know and apply the best standards of care for people living with and at risk for HIV.”

Further, AIDS United is particularly concerned that the President’s budget eliminates SPNS and reduces funding for Minority AIDS Initiative (MAI) programs. SPNS and MAI programs address the HIV epidemic by developing targeted, innovative approaches to reach chronically underserved people.

“Investment in targeted approaches are effective and save money, at a time when 1 in 2 and 1 in 4 Black and Latino gay and bisexual men respectively are at substantial risk for HIV infection in their lifetime. How can we reduce funding to programs that address these disparities? The President’s budget isn’t just a set of numbers, it’s a disturbing statement of values. Every voter must send their own message to Congress to express that they value the health of our people,” said Milan.

AIDS United urges Congress to reject the draconian cuts proposed in the President’s budget request and support funding for Medicaid, HIV programs, and STD prevention. Congress cannot idly allow the return of reduced, sequester discretionary spending caps for fiscal year 2018. These restrictive caps must be raised so that non-defense discretionary programs, which include HIV programs, can be adequately funded in fiscal year 2018. A bipartisan budget agreement that provides relief from the sequester spending caps while preserving parity between defense and non-defense discretionary programs must be achieved for 2018.

“The president’s budget would turn back the clock for years and years on progress to end the HIV epidemic. We call on Congress to keep the country moving forward,” said Milan.

The facts are in – TrumpCare is dangerous and destructive

The Congressional Budget Office (CBO) has finally released their report on TrumpCare, the bill that passed out of the U.S. House of Representatives on May 4. Yeah. You read that right. The U.S. House passed TrumpCare before they knew what it cost or how it would affect health insurance.

And now we know why. The facts are clear. The American Health Care Act is dangerous and destructive.

The CBO tells us that the bill will strip 23 million people of their health insurance. We already knew that the bill completely guts protections for people with pre-existing conditions and makes devastating cuts to Medicaid. All while providing massive tax cuts to the wealthy and giant corporations.

But the fight is not over. The Senate now has to pass a bill, and it will then likely have to go to back to the House for a final vote.

WE CAN STILL STOP THIS.

Here are three things you can do NOW to make your voice heard:

Call Gov. Rauner at 312-814-2121 and demand that he publicly oppose the American Health Care Act, which will cost Illinois billions of dollars in Medicaid funding and thousands of jobs.
Call your member of Congress at 1-866-877-3303 and demand that they publicly oppose the American Health Care Act.
Forward this immediately to 10 friends and family members in Illinois, especially if they live outside of Chicago. You can also share these steps on social media using #ilsaveaca
We have asked a lot of you, but it is only because you are making a difference. Your Member of Congress is crucial in this fight and they need to hear from you again!

AIDS United Responds to Fiscal Year 2017 Omnibus Appropriations Bil

 

AIDS United acknowledges that the Fiscal Year 2017 omnibus appropriations bill, released last night, provides continuity of HIV funding for most domestic programs. This is an important development for maintaining our progress towards the national goals and priorities of reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities.

While most HIV programs will see level funding in the budget, AIDS United is concerned that a $4 million cut to Ryan White HIV/AIDS Program Part C clinical providers and a $5 million cut affecting the budget to fight sexually transmitted infections will diminish our response to HIV and health care, particularly given the increasing cases of sexually transmitted infections, such as syphilis, among men who have sex with men.

“Knowing that Congress plans to keep funding intact for most HIV efforts is reassuring, but we urge Congress to also ensure that Part C clinical providers and our response to sexually transmitted infections are fully funded,” said AIDS United President & CEO Jesse Milan, Jr.

AIDS United is particularly appreciative that Congress listened to the voices of people living with and affected by HIV in increasing funding for the Housing Opportunities for People With AIDS (HOPWA) program by $21 million. “Housing is fundamental to ensuring that people living with HIV live longer and healthier lives and we thank Congress for recognizing the importance of this program by securing its current stability,” said Milan.


About AIDS United: AIDS United’s mission is to end the AIDS epidemic in the U.S., through strategic grant-making, capacity building, formative research and policy. AIDS United works to ensure access to life-saving HIV/AIDS care and prevention services and to advance sound HIV/AIDS-related policy for U.S. populations and communities most impacted by the epidemic. To date, our strategic grant-making initiatives have directly funded more than $104 million to local communities, and have leveraged more than $117 million in additional investments for programs that include, but are not limited to HIV prevention, access to care, capacity building, harm reduction and advocacy. aidsunited.org

House and the Administration Begin to Show Their Hands

February 23, 2017

House Republicans Unveil a Health Care “Policy Menu”; Trump Department of Health and Human Services Proposes First Major Health Care Regulation

 

Although there is still no specific ACA repeal and replace proposal from the hill, both Congressional Republicans and the Trump Administration released documents last week articulating their approach to replacing the ACA and addressing concerns with the Marketplaces in the meantime. Congressional Republicans released a Health Care Policy Brief that is intended to serve as a menu of potential elements for a forthcoming ACA replacement bill. This Brief includes elements that have been found in previous ACA replacement proposals and that present concerns for access to care. Further, the Department of Health and Human Services (HHS) released a proposed rule entitled “Patient Protection and Affordable Care Act; Market Stabilization” (proposed rule), which is intended to help stabilize the Marketplaces until an ACA replacement is completed. Unfortunately, some of its changes may limit access to care for vulnerable individuals and make the Marketplaces less friendly to those living with chronic illnesses and disabilities. Advocates should be sure to understand both documents as well as send comments on the proposed rule to HHS by March 7, 2017.

Advocates Should:

1. Review the Health Care Policy Brief released by House Republicans last week to better understand which ideas are popular among Congressional Republicans and likely to make it into any ACA repeal and replace proposal.

2. Understand the proposed Market Stabilization regulation released by the Department of Health and Human Services and how it will impact access to care in the 2018 qualified health plans.

3. Submit comments on the proposed rule to HHS urging them to consider the impact the proposed regulations will have on access to care for vulnerable individuals.

House Republicans Unveil Health Care Policy Brief

On February 16, 2017, after a closed-door meeting, House Republicans unveiled a policy brief and resource document to explain major elements of their plan to repeal and replace key programs and protections of the ACA. House Leadership is terming this strategy “repeal plus.” The policy brief should not be considered an actual legislative proposal but rather a “menu” of replacement ideas such as tax credits for purchasing health care, health savings accounts, and high risk pools. Part of the intention of this document is to encourage Congressional Republicans, who have found it difficult to coalesce around a health care policy strategy, to find consensus on these issues. Unfortunately, many of the components of this “repeal plus” strategy would curb access to care for vulnerable individuals, including those living with chronic illnesses and disabilities.

 

When The HIV Community Speaks, Congress Better Learn to Listen

 

If the Republican majority in Congress, emboldened by its control of both chambers and the White House, thought it would be easy to roll back health reform and other progressive gains, they have begun to learn a lesson taught to Obama early on, that it is easier to articulate hope than it is to affect change. Over the first few weeks of Mr. Trump’s presidency, a massive and in many ways spontaneous resistance movement has formed all across the country, with millions of people taking to the streets to express their unwillingness to tolerate a White House and a Congress that pursues policies that are anti-woman, anti-immigrant, anti-Muslim, and would turn our social safety net to tatters.

One of the policies that has received some of the most vocal and passionate opposition has been the repeal and as-yet-unspecified replacement of the Affordable Care Act Repealing the ACA is a policy goal that served as the Republican Party’s white whale under the Obama administration, but one which their rhetoric and desire to implement have lagged in recent weeks. The lack of enthusiasm to promptly repeal the ACA is due to congressional Republican’s inability to design a replacement plan that doesn’t strip 18 million Americans of their health insurance in a year’s time and, perhaps more importantly, the fear of the collective outrage of millions of Americans should their health care be taken from them.

Over the past few weeks, numerous stories have been circling around both traditional and social media, showing Representatives going to extreme measures to avoid the wrath of a public that is rightfully incensed by plans to block grant Medicaid and tear apart the ACA with no concrete plans on how to sufficiently replace it. Whether it’s sneaking out of an event via a side exit or simply refusing to engage in town halls due to the anger of their constituents, members of Congress are clearly unnerved by the breadth and the intensity of the protests that have greeted them in their home districts. In fact, House Republicans were so shaken by the backlash against the prospect of ACA repeal that they convened a closed-door meeting this past Tuesday to discuss how to “protect themselves” from protesters.

It may not feel like it at times, but the power of collective resistance and protest is proving unparalleled in affecting change. If we are to save the ACA, or at least ensure that its most vital  benefits survive in a replacement plan, people living with HIV and those who advocate alongside them are going to have to engage in sustained, vocal opposition to any politician who tries to snatch our health care from us. This means suiting up and showing up to town halls and rallies, even when we don’t feel like going. It means calling your members of Congress at their offices and refusing to take no for an answer when you’re told a line is busy or a mailbox is full. The HIV community’s opposition to the destruction of the ACA must be unrelenting because the only way our elected officials will act in our best interest is if they are provided with no alternative.

Yes, changing the will of Congress may seem daunting, but each individual action on the road from where we are to where we aim to be is one step closer. One of the first steps you can take is to commit to meeting with your members of Congress and letting them know the repeal of the ACA is unacceptable. For the week beginning February 20, both the Senate and the House will be out of session and in their home districts and states. Many of them will be hosting town halls or have open hours for visiting and we must make sure that our presence is acutely felt. It is important to remember that they are beholden to us and that the amount of power they wield is indirectly proportional to degree to which we are politically engaged.

If you click here, you will find a substantial, but by no means comprehensive spreadsheet that lists the office hours and scheduled events for many members of Congress in their home districts and states in the near future. Use this list and any other resources you can find to plan an action during Presidents’ Day weekend and the days that follow. Make sure that, whether it’s in person or over the phone, your members of Congress are incapable of ignoring the needs of people living with HIV and all Americans living with chronic diseases.

Question them.
Tell your story.

Share your concerns and ensure that your voice is heard and that the provision of quality health care is nonnegotiable if they want to keep their job for long. And, if you want to continue with your HIV advocacy after the actions around Presidents’ Day, there’s no better way to do so than to register for AIDSWatch, the largest annual HIV/AIDS advocacy event in America. This year, AIDSWatch is more important than ever and we need your help more than ever if we’re going to make Congress recognize the possibility and importance of ending the AIDS epidemic and protecting the policies that allow people living with HIV to get access to quality, affordable care.

Posted By: AIDS United, Policy Department – Thursday, February 09, 2017

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