TALLAHASSEE, Fla., June 12 /PRNewswire-USNewswire/ -- AIDS Healthcare Foundation (AHF), the operator of Positive Healthcare-Florida (PHC), the eight-year-old highly successful and cost-effective disease management program serving more than 8,000 Floridians living with HIV/AIDS under Florida's Medicaid (MediPass) system, is raising a red flag to alert Florida state officials including "People's Governor," Charlie Crist, as to numerous improprieties and misrepresentations in the recent application and awards process during Florida's are quest for proposals' (RFP) process to provide disease management services for Florida's MediPass' HIV/AIDS population. The RFP process resulted in Florida's Agency for Health Care Administration (AHCA) issuing a 'letter of intent' to award the disease management (DM) contract for MediPass' HIV/AIDS population to a private, for-profit vendor with little experience providing care for HIV/AIDS patients to operate the program. Several concerned AIDS and health care advocates say the decision was based on an application by the prevailing vendor that included misleading claims and material misrepresentations of the applicant's previous experience and qualifications in a attempt to hide the true nature of the vendor's likely ability to successfully manage such a complex, yet potentially cost- and life-saving disease management program.
"We are imploring Governor Crist and Florida state officials to immediately review and reevaluate the applications submitted to provide disease management services for Florida's Medicaid population living with HIV/AIDS," said Michael Weinstein, President of AIDS Healthcare Foundation. "After our own review of the submitted applications, we believe the prevailing applicant seriously misrepresented the scope and breadth of its prior HIV/AIDS disease management experience, and that they also made misleading statements in an attempt to obfuscate -- and perhaps overstate -- the true nature of the company's ability to manage a DM program for such a vulnerable and oftentimes hard to reach population. We challenge Governor Crist to truly be the 'People's Governor' for all the people of Florida, including people living with AIDS, and ask Florida officials to reconsider and reopen the RFP process."
One change proposed under the for-profit vendor's application is a whopping 77% cut in nursing staff, a move that would drastically threaten the continuity and quality of care for thousands of HIV/AIDS patients throughout Florida. This new proposal calls for only 16 field nurses statewide, down from the 70 nurses that AHF's Positive Healthcare currently mobilizes statewide (NOTE: PHC's proposal doubles the prevailing bidder's proposed nursing staffing rate). In addition, the for-profit vendor stated its intention to utilize another 7.5 nurses in a statewide call center -- an outreach method that the state of Florida itself has previously recognized as an ineffective outreach tactic to reach patients covered under the state's Medicaid disease management initiatives. (In 2004, Florida's AHCA cancelled Medicaid disease management contracts for four of five Medicaid DM vendors for failure to meet minimum enrollment levels in their respective programs. The failing programs all relied heavily on managing their DM programs telephonically, a nearly impossible challenge for programs targeting the state's vulnerable and oftentimes hard-to-reach Medicaid population. The only DM program retained by the state at the time was Positive Healthcare's HIV/AIDS program.)
"If the prevailing applicant truly had the HIV/AIDS disease management experience they alleged on their Florida application, they would know firsthand that relying on a nursing call center for fully one-third of its 23 person nursing staff is a recipe for disaster for the state and for HIV/AIDS patients covered under Florida's Medicaid program," added AHF's Weinstein. "I caution state officials against being penny-wise and pound-foolish by engaging a vendor whose program has all the hallmarks of previous -- and failed -- disease management programs administered and funded by the state. We ask the Governor to put AIDS patients first and stop these changes."
Other misrepresentations in the application include the fact that the prevailing bidder also has an interest in a company holding itself out as providing pharmacy services. In it RFP application, this vendor repeatedly stated that it had no ownership interests in any pharmacy provider. Under the RFP's guidelines, a DM contractor cannot directly also provide pharmacy services.
In addition, the prevailing bidder claims to have contacted other AIDS service organizations to better understand the services and resources available, and the needs of the targeted HIV/AIDS population. This vendor did not contact all the groups it claimed in its application, misrepresenting its actual ties and connections to the AIDS communities throughout Florida.
Since AHCA's 'letter of intent' to award its latest HIV/AIDS DM contract was first made public several weeks ago, AIDS Healthcare Foundation, the nation's oldest and largest non-profit HIV/AIDS healthcare, research, prevention and education provider, and its Positive Healthcare-Florida staff and patients have spoken out loudly, and regularly, against the looming changes. At passionate protests in Miami (June 7), Tampa (May 31) and Ft. Lauderdale (May 11) people spoke out against the proposed changes and awarding DM services for this vulnerable, often hard to reach population to a private, for-profit vendor who will have to create a replacement HIV/AIDS DM program from scratch. In addition, Over 3,000 letters appealing to the Governor to reverse these harmful changes have already been written by AIDS patients from across the state. One AIDS patient, F.J. Davis, who is upset over the potential changes and the prospect of losing Tricia Rodney, his Miami-based disease management nurse, told the Miami Herald, "This is like snatching your heart out."
HIV/AIDS patients, advocates and staff will now bring the issue to key decision makers in Tallahassee with a protest at the State Capitol Building Wednesday June 13th at 1:00 p.m. (exact location TBA). They hoped to persuade state officials, including Florida Governor Charlie Crist, to reconsider potential drastic service changes for Florida's HIV/AIDS population.
AHF has operated Positive Healthcare for more than eight years and in that time, met or exceeded all clinical performance measures and saved the state more than $20 million in healthcare costs. Positive Healthcare is the first of only two disease management organizations to receive full accreditation from the National Committee for Quality Assurance (NCQA), a national non-profit organization that measures and advocates for health care quality. In May 2003, Florida's Office of Program Policy Analysis and Government Accountability (OPPAGA) reviewed AHF/Positive Healthcare's disease management program for clinical performance and cost savings. While all of AHCA's other disease management programs had not met their cost-savings goals and health outcomes expectations, AHF/Positive Healthcare did. According to a May 2004 report, AHF/Positive Healthcare was projected to save the state a total of more than $20 million in healthcare costs over the five-year term of its contract. AHF/Positive Healthcare has been so successful that AHCA has consulted its staff to help turn around the state's other disease management programs.
"Florida's HIV/AIDS disease management program has been very successful at serving AIDS patients for the past eight years. Patients have reported extreme satisfaction with their care. Positive Healthcare has been able to significantly improve health outcomes while saving the state tens of millions of dollars," added Deborah Moffett, AHF/Positive Healthcare Registered Nurse (RN) Manager. "I am concerned that the disruptions in care and access to experienced HIV/AIDS specialists will place the most vulnerable individuals living with HIV/AIDS at risk. Compassionate, expert HIV patient care within a structured disease management program is not something that is learned or established overnight nor is it managed with a for-profit mindset. Florida's AIDS patients deserve better."
Florida is currently the third state with the highest number of HIV/AIDS cases in the U.S., behind New York and California. More than 4,000 HIV/AIDS cases are diagnosed in Florida every year, accounting for 10% of all new infections in the U.S., which is estimated at 40,000 new cases per year.
WHAT: AIDS Patients to Protest Governor Crist at the Capitol Building
HIV/AIDS patients, medical providers and concerned community
members to protest recent changes to Medicaid that will hurt
nearly 8,000 Florida AIDS patients and their families
WHEN: WEDNESDAY June 13, 2007
WHERE: 1:00 p.m.
The Capitol Building
(Exact Location TBA)
WHO: HIV/AIDS patients, Concerned Medical providers and Community
Members
B-ROLL: Protestors marching at the Capitol carrying signs and chanting
slogans, such as "Stop the Dying, Stop the Crying, Charlie, Help
Us Now!"
CONTACT: Lori Yeghiayan, AHF Associate Director of Communications
(323) 377-4312 cell (954) 522-3132 office
(323) 860-5227 alt. office
AIDS Healthcare Foundation
CONTACT: Lori Yeghiayan, Associate Director of Communications,
AHFPositive Healthcare, +1-323-860-5227, mobile, +1-323-377-4312, or Ged
Kenslea, Communications Director, AHFPositive Healthcare, +1-323-860-5225,
alt. office, +1-954-522-3132
