The AmericAn AcAdemy of HiV medicine HIV® S p ecIalist Ryan Patient Care, PraCtiCe ManageMent & Professional Development inforMation for HIV Care ProviDers Summer 2010 www.aahivm.org White Lives Saved, the Battle Continues 340B Pharmacies 3 Health Care Reform & HIV 4 National HIV/AIDS Strategy 8 Deborah Parham Hopson 11 By JaMes M. friedman, MHa, ExEcutivE dirEctor, aahivm LetteR fRom tHe DIR e c t OR Secretary Sebelius and President obama making a Commitment to the HIV Workforce n June, Health and Human Services panded routine testing, is a recipe for disaster. (HHS) Secretary Kathleen Sebelius and Additionally, the anticipated influx of patients Health Resources and Services Admin- resulting from the implementation of many of istration Administrator Mary Wakefield the health reform provisions in 2014 must be Iannounced a one-time investment of $250 mil- met with new and qualified providers. lion to strengthen the primary care workforce. HIV/AIDS workforce continues to be a This new money came from a $500 million high policy priority for the Academy. We have Prevention and Public Health Fund which was engaged Congress and advocated for the ex- a part of the new health reform law that passed pansion of the National Health Service Corps, this year (The Patient Protection and Afford- James Friedman and are pleased to see that the new health re- able Care Act). This investment is not to be confused with form law provides for growth in both funding and capacity the $1.3 billion authorized over five years for the National of the Corps in the future —a move that will certainly help Health Service Corps (also in the health reform bill), or the increase the number of HIV practitioners. The jumpstart nearly $300 million in the economic stimulus package for that Secretary Sebelius provided by putting $250 million di- the National Health Service Corps. rectly into the U.S. health workforce was an essential boost. Secretary Sebelius indicated that increasing the pri- On July 13, President Obama released the first ever U.S. mary care workforce was a personal priority and that this National Strategy on HIV/AIDS at a briefing and reception money was a “quick but critical investment” in developing at the White House. The release of the National Strategy primary care. Yet there were some congressional leaders included a 35-page Implementation Plan that identified who were critical of the move, including Congressman organizational responsibilities and timeframes for specific Henry Waxman and Senator Tom Harkin (both longtime actions. Director of the Office of National AIDS Policy, Jeff healthcare leaders on the Hill). While both indicated that Crowley, and his staff did an excellent job of balancing nu- they are supportive of increasing the primary care work- merous competing interests to provide a roadmap for HIV/ force, the $500 million in the Prevention and Public Health AIDS in the United States. Fund, they argued, was intended for other purposes. An adequate supply of well-trained HIV practitioners is I personally think Secretary Sebelius and her colleagues at the core of achieving virtually every aspect of the Nation- got it right. There is little more important to the cause of al Strategy. While the strategy discusses support for and an disease prevention than the primary care provider—the one increase of the HIV workforce, it does not set quantified who provides vaccinations, who counsels against smoking targets for expansion. The details of how an increase in the and drug abuse, who diagnoses serious illnesses, and who HIV workforce will be accomplished were left largely up to is more likely to routinely test for HIV. And the one who is HHS and HRSA to determine. more likely to become an HIV practitioner. Everyone can agree on the continued need to identify In the first edition of this magazine last year, we report- HIV infections, prevent transmissions, and to ensure all ed on an AAHIVM workforce survey that indicated nearly diagnosed HIV patients are properly linked to care. How- one-third of our current members plan to retire from the ever, without a continued investment in the HIV work- HIV field over the next decade. This trend, coupled with force, these patients may be hard-pressed to find a quality the increased patient load that is sure to come from ex- care provider. HIV www.aahivm.org HIV S p ecIalist Summer 2010 1 The AmericAn AcAdemy of HiV medicine Summer 2010 ® cONTENtS www.aahivm.org F e a t UR e S HIV S p ecIalist Patient Care, PraCtiCe ManageMent & Professional 4 Health Care Development inforMation for HIV Care ProviDers Reform & HIV VolUME 2 / nUmBER 2 • SUmmer 2010 In the 20th year of the c hair/Board of Directors Ryan White CARE Act, Donna ElainE SwEEt, MD, MaCP, aaHivs the nation embarks on historic e xecutive Director health care reform JamES FriEDman, MHa By HOLLY a. KILNESS, Ma, DIRECTOR OF Director of m a r k e t i n g PUBLIC POLICy, AAHIVM & c ommunications ambEr mcCraCkEn a s s i s t a n t p r o g r a m m a n a g e r rEbECCa GolDbErG e d i t o r robErt Gatty G-Net Strategic Communications 8 e: [email protected] the National p UB l I c a t I O N D e SI g N 11 Ryan White & a rt Direction HIV/AIDS Strategy bonotom StuDio, inC. A Significant Step Forward the Guiding force p: 703-276-0612 e: [email protected] By HOLLY a. KILNESS, Ma, DIRECTOR OF Ryan White Administrator PUBLIC POLICy, AAHIVM a d v e r t i s i n g Deborah Parham Hopson JanE DEES riCharDSon, President Values Partnerships Ad Marketing Group, Inc. p: 703-243-9046 ext. 102 with Providers e: [email protected] By BoB GATTY, eDITOR, HIV SPECIALIST p u b l i s h e r thE amEriCan AcaDEmy oF hiV mEDiCinE 14 1705 DeSales St., NW, Suite 700 Ryan White Washington, D.C. 20036 p: 202-659-0699 • f: 202-659-0976 the Inside Story e: [email protected] • w: www.aahivm.org How two Congressional e d i t o r i a l a d v i s o r y g r o u p staffers worked behind the scenes to help pass c h a i r the Ryan White JEFFrEy t. kirChnEr, Do, aaHivs, FAAFP Medical Director CARE Act 20 years ago Comprehensive Care Medicine for HIV By BoB GATTY, eDITOR, Lancaster General Hospital, Lancaster, PA HIV SPECIALIST JEFF bErry, editor Positively Aware Magazine, Chicago, IL JoSEph S. CErVia, MD, MBa, FACP, FAAP, aaHivs, fiDsa Clinical Professor of Medicine & Pediatrics Albert Einstein College of Medicine D e p a R t m e N t S Roslyn, NY 11576 anita kay kalouSEk, Do, aaHivs 18 BeSt pRACTICES Renaissance Medical Group Are We Now Back to West Hollywood, CA 1 LETTER FROm tHe DIRECTOR “Hit Hard, Hit Early” for tonia potEat, Pa-C, aaHivs Secretary Sebelius and President Chase Brexton Health Services Our HIV-Infected Patients? Baltimore, MD Obama Making a Commitment Can we afford to do this? to the HIV Workforce riCharD C. prokESCh, MD, FACP, fiDsa, aaHivs By JEFFREY t. KIRCHNER, Do, FAAFP, Infectious Diseases Associates, Riverdale, GA By JaMES FRIEDMAN, MHa, AAHIVS anD JOSEPH s. CERVIA, MD, k eXeCUTIVE DIRECTOR, AAHIVM MBa, FACP, FAAP, FIDSA, AAHIVS JEFFrEy t. SChoutEn, MD, aaHivs, C mages attorney at law to Director HIV/AIDS Network Coordination is / 3 at tHe FOReFRONt 21 ON tHe FRONTLINeS (HANC) Project, Fred Hutchinson Cancer 340B Pharmacies Needless Suffering, Research Center, Seattle, WA oto: AP I ph Sharon ValEnti, nP, aaHivs Help Patients and Providers Needless Death ainflash t By JoDy BORGMAN, MD, AAHIVS By RICHARD PROKESCH, MD, FACP, St. John Hospital and Medical Center ver ap C FIDSA, AAHIVS anD BONNIE Grosse Point Woods, MI Co PROKESCH, MD 2 Summer 2010 www.aahivm.org HIV S p ecIalist By JoDy BorgMan, MD, AAHIVS At tHe for e fron t 340B Pharmacies Help Patients and Providers he first time i heard about the con- Once getting the patient’s consent, I simply fax the list of cept of pharmacy care under the 340B program, I meds to CCN. All meds, not just HIV treatment, can be filled. was incredulous. Could my clinic really receive They take care of all the rest from contacting the patient di- revenue from processing our patients’ prescrip- rectly, to discussing a delivery day and time, to coordinating tions? There most certainly must be a catch: multiple forms with the patient’s insurance to arrange billing. When a refill to fill out, waiting endlessly on the phone to speak with a is needed, they fax a prescription to me. pharmacist, poor customer service for the patients. The patients enrolled report back a very high satisfac- But in an era where insurance company restrictions and tion rate with the program. The few patients that disen- hassles are the expectation not the exception, what a sur- rolled, did so mainly because they were not available for prise to learn that there are programs available that not only deliveries. What the patients appreciate the most is the per- make life easy for the patients, but for me as well—and pro- sonal service they receive. What I appreciate is having many vide financial rewards to our program. patients being cared for by one pharmacy. This reduces calls To fully understand the concept probably requires a law to multiple pharmacies and the time and effort to make sure degree, but basically Ryan White recipients have been granted patients have their meds.