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.