Reasons for the changes

Ohio HIV Drug Assistance Program (OHDAP) Talking Points
Provided by Ohio Department of Health, HIV Care Services

KEY MESSAGES
We are in an unfortunate financial situation – largely due to the economy – where there are not enough resources to continue to provide the same level of care to the same number of clients as before.

This is not unique to Ohio. There is a national problem and we’re experiencing the same issues here in Ohio that many other states are facing. These are tough times in the HIV world and tough times mean tough decisions.

It is with heartfelt recognition of the seriousness of the situation that we have taken such a thoughtful, deliberate approach that has enabled us to identify the most medically-appropriate cost containment strategies that minimize the impact on our clients, yet allow us to sustain the program.

HOW WE GOT HERE
Ohio’s HIV Drug Assistance Program (OHDAP) has seen dramatic enrollment increases.  In less than four years, the number of clients in the program has more than doubled.
o    1,962 clients in December 2005
o    4,384 clients in December 2009
Now about 5,000 clients with 100 new clients per month since late last year

Due to the increasing enrollment, combined with increased costs of medications, increased client health insurance premium and medication co-pay costs, it is clear a new spending plan is in order. If we don’t take these actions, the program would be facing a $16.4 million deficit by the end of the fiscal year.

We have been examining options for months, researching the impact on clients and seeking out advice from numerous sources, including clients, case managers, advocates and the Ryan White Part B Advisory Board, which includes infectious disease physicians, nurses, social workers, pharmacists, advocates and consumers from around the state.

Several over-arching themes have provided guidance for ODH during deliberations about this program redesign: 
o    Make data-driven decisions that limit the impact on our clients, especially our most vulnerable clients;
o    Focus on HIV drugs and core medical services for HIV-specific conditions;
o    Reduce expenditures that represent the most savings with the least impact on clients; and
o    Access other avenues for care (Medicaid/Medicare, existing manufacturer drug assistance programs, etc.) to help clients.