Florida: Change in Care Scares AIDS Patients

Last month, Florida's Agency for Health Care Administration (AHCA) announced it had terminated its AIDS care contracts with the nonprofit AIDS Healthcare Foundation (AHF) in favor of a small, for-profit company.

For eight years, AHF has contracted with the state, monitoring AIDS patients on Medicaid to ensure they receive proper treatment and cost-effective care. It serves around 7,700 patients statewide. California-based AHF has also advocated on behalf of patients and has been critical of how Florida handles AIDS patients on Medicaid.

AHCA said it will award the contracts to Specialty Disease Management Services (SDM), which is based in Jacksonville. SDM won the contract with its proposal to monitor patients for about $9 million over two years, more than $2 million less than AHF spent on those services last year. SDM founder and President Fred Goldstein said his company will use a combination of "telephonic" nurses and community-based nurses to meet the goal. While he declined to give a specific count, he said there will be more in-person nurses than phone nurses.

AHF sends more than 70 nurses out to monitor patients. Face-to-face contact is especially critical for patients who are low-income and lack regular phone service, said Gene Bundrock, AHF's director in Florida.

"The new vendor has a considerably reduced staff," said Bundrock. "I believe it will be about 16 field nurses for the entire state."

Goldstein said SDM, which has served several states' Medicaid patients since its start in 1997, will boost patient oversight with improved software to track patients' health status, related problems, and gaps in care. SDM previously was a subcontractor for AHF, so it already has experience with Florida's HIV/AIDS population, he added.

Concerned the decision may have been politically driven due to its sometimes aggressive advocacy, AHF has filed a formal protest of the contract award. A hearing by the state Division of Administrative Hearings is expected.

Back to other news for June 2007