The ADAP Recertification Process; the Frustration Mounts! Important: Make Sure All Your Contact Info Is Up to Date!
By Kevin Maloney
February 25, 2012
This article originally appeared on the ADAP Advocacy Association Blog.
The U.S. Department of Health & Human Services' Health Resources & Services Administration (HRSA) -- which oversees HIV/AIDS support and services in the United States -- nearly a year ago put into place a rule that all 56 AIDS Drug Assistance Programs (ADAPs) must recertify its clients every six months. While very few states have complied from the beginning, it's not until most recently that letters have begun going out like rapid fire to ADAP enrollees in MANY states.
Horror stories are popping up all over as people living with HIV/AIDS (PLWHAs) are finding out the process to recertify is time consuming, frustrating and not very "user friendly." Individuals have talked about it taking hours at a time to complete the process. For those who fail to recertify on-time they are being dropped from the program. This recertification process is causing yet another barrier to access to care that should be a seamless process for PLWHA.
There is NO uniformity across ADAPs to this process. Individuals have been required to gather financial and health information, be denied for other programs first (Medicare/Medicaid) and provide the denial letters. Also no time frame exists as to when one must recertify. Is it 10 days, a month, or 6 weeks? Some states are sending out first notices, will there be a second and third notice? Will there be a follow-up phone call too? What if recertification notices arrive while a patient is in the hospital for a lengthy stay? What if someone hasn't updated their address and/or phone number in a long time and is incommunicado?
The frustration level over this process is really beginning to mount and will only become more frustrating to advocates, health professionals, case managers, and more importantly PLWHA as more recertification notices start going out.
Yes, ultimately the responsibility lies on the client to remember their recertification date, update their address, take time out of their busy schedules, gather documents, and be sure to cross the T's and dot the I's! Oh, and guess what? It's time to recertify again!
As mentioned above, if patients fail to recertify, then they will be dropped, which may mean now going onto a waitlist, and/or having a lapse in coverage with no access to medication. Those receiving ADAP should be sure that their contact information is up-to-date with their respective state health department, local health department and case managers.
Wouldn't it be better if this process occurred every one or two years instead? Had uniformity, and was more user-friendly? Weigh in below on what is happening with regard to recertification in your state, and with any comments or thoughts on this issue.
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Rising Up and Speaking Out About HIV and Hepatitis C
Random things about me: I am kind, caring, respectful and wanting to make a difference/impact in the World. I've been to Australia, New Zealand and 13 countries in Europe, and have traveled and lived all over the United States. I have a Bachelor's degree in Health Services Management and will be working towards my Master's In Public Health. I am an uncle of two of the MOST adorable girls in the World, and have one brother. I am a Momma's boy, and it is hard to see my mother's health in such a deteriorated state -- she has severe COPD (from 40 years of smoking). In March 2010 I was told that I have HIV and a month later, with follow-up labs, was then told I also acquired hepatitis C (not through IV drug use). I aspire to great things. Stay tuned.
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